Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
Hong Kong Med J. 2013 Oct;19(5):434-46. doi: 10.12809/hkmj134063.
The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals.
Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched.
"Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review.
The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis.
Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation.
By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.
本综述的目的是确定影响医院认证计划实施的因素，并评估认证过程对公立医院质量改进的影响。
系统检索了两个电子数据库，即 Medline（OvidSP）和 PubMed。
使用“公立医院”、“医院认证”和“质量改进”作为检索词。最初确定了 348 条引文。经过批判性评价和研究选择，共有 26 篇文章纳入综述。
使用 SWOT（优势、劣势、机会、威胁）分析提取和分析数据。
确定了以下优势：员工参与度和沟通的提高、多学科团队建设、组织文化的积极变化以及领导力和员工对持续质量改进的意识增强。劣势包括组织对变革的抵制、员工工作量增加、对持续质量改进缺乏认识、对持续质量改进的员工培训和支持不足、缺乏适用于当地使用的认证标准以及缺乏绩效结果衡量标准。机会包括确定改进领域、增强患者安全性、额外资金、公众认可和市场优势。威胁包括机会主义行为、资金削减、参与缺乏激励以及强制性参与的监管方法。
通过将研究结果与认证的运营问题联系起来，本综述讨论了成功实施的影响以及认证如何推动质量改进。这些发现对于各种利益相关者（政府、公众、患者和医疗保健提供者）在开展认证工作时具有重要意义。
