Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, Sydney 2052, Australia.
BMC Health Serv Res. 2013 Oct 24;13:437. doi: 10.1186/1472-6963-13-437.
Accreditation programs are complex, system-wide quality and safety interventions. Despite their international popularity, evidence of their effectiveness is weak and contradictory. This may be due to variable implementation in different contexts. However, there is limited research that informs implementation strategies. We aimed to advance knowledge in this area by identifying factors that enable effective implementation of accreditation programs across different healthcare settings.
We conducted 39 focus groups and eight interviews between 2011 and 2012, involving 258 diverse healthcare stakeholders from every Australian State and Territory. Interviews were semi-structured and focused on the aims, implementation and consequences of three prominent accreditation programs in the aged, primary and acute care sectors. Data were thematically analysed to distil and categorise facilitators of effective implementation.
Four factors were identified as critical enablers of effective implementation: the accreditation program is collaborative, valid and uses relevant standards; accreditation is favourably received by health professionals; healthcare organisations are capable of embracing accreditation; and accreditation is appropriately aligned with other regulatory initiatives and supported by relevant incentives.
Strategic implementation of accreditation programs should target the four factors emerging from this study, which may increase the likelihood of accreditation being implemented successfully.
认证计划是复杂的、全系统的质量和安全干预措施。尽管它们在国际上很受欢迎，但它们的有效性证据是薄弱和相互矛盾的。这可能是由于在不同的环境中实施的情况不同。然而，关于实施策略的研究有限。我们旨在通过确定在不同医疗保健环境中实现认证计划有效性的因素来推动这一领域的知识发展。
我们在 2011 年至 2012 年间进行了 39 次焦点小组和 8 次访谈，涉及来自澳大利亚每个州和地区的 258 名不同的医疗保健利益相关者。访谈采用半结构化方式，重点关注老年、初级和急性护理领域三个知名认证计划的目的、实施和后果。对数据进行主题分析，以提炼和分类有效的实施促进因素。
确定了四个关键因素作为有效实施的促进因素：认证计划具有协作性、有效性并使用相关标准；认证受到卫生专业人员的欢迎；医疗保健组织能够接受认证；认证与其他监管举措适当保持一致，并得到相关激励的支持。
认证计划的战略实施应针对本研究中出现的四个因素，这可能会增加认证成功实施的可能性。
