Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Health Policy. 2017 Jul;121(7):816-822. doi: 10.1016/j.healthpol.2017.05.006. Epub 2017 May 19.
To examine general practice accreditation stakeholders' perspectives and experiences to identify program strengths and areas for improvements.
DESIGN, SETTING AND PARTICIPANTS: Individual (n=2) and group (n=9) interviews were conducted between September 2011-March 2012 with 52 stakeholders involved in accreditation in Australian general practices. Interviews were recorded, transcribed and thematically analysed. Member checking activities in April 2016 assessed the credibility and currency of the findings in light of current reforms.
Overall, participants endorsed the accreditation program but identified several areas of concern. Noted strengths of the program included: program ownership, peer review and collaborative learning; access to Practice Incentives Program payments; and, improvements in safety and quality. Noted limitations in these and other aspects of the program offer potential for improvement: evidence for the impact of accreditation; resource demands; clearer outcome measures; and, specific experiences of accreditation.
The effectiveness of accreditation as a strategy to improve safety and quality was shaped by the attitudes and experience of stakeholders. Strengths and weaknesses in the accreditation program influence, and are influenced by, stakeholder engagement and disengagement. After several accreditation cycles, the sector has the opportunity to reflect on, review and improve the process. This will be important if the continued or extended engagement of practices is to be realised to assure the continuation and effectiveness of the accreditation program.
调查普通科医学实践认证利益相关者的观点和经验，以确定计划的优势和改进领域。
设计、地点和参与者：2011 年 9 月至 2012 年 3 月，对 52 名参与澳大利亚普通科医学实践认证的利益相关者进行了个人（n=2）和小组（n=9）访谈。访谈进行了录音、转录和主题分析。2016 年 4 月的成员检查活动根据当前的改革评估了调查结果的可信度和时效性。
总体而言，参与者认可认证计划，但也确定了一些关注领域。该计划的显著优势包括：计划所有权、同行审查和协作学习；获得实践激励计划付款；以及安全性和质量的提高。该计划在这些方面和其他方面的局限性为改进提供了潜力：认证的影响证据；资源需求；更明确的结果衡量标准；以及具体的认证经验。
认证作为提高安全性和质量的策略的有效性受到利益相关者的态度和经验的影响。认证计划的优势和劣势影响着利益相关者的参与和脱离，反之亦然。经过几个认证周期，该行业有机会反思、审查和改进这一过程。如果要继续或扩大实践的参与，以确保认证计划的连续性和有效性，这将是重要的。
