Offering the latest news in health care quality and safety, the ISQua blog also features guest posts from the best and brightest in the industry.

By ISQua Wednesday. Aug 7, 2019

Three challenges for external evaluation: ensuring relevance and preparing for the 30’s Featured

ISQua were delighted to host Professor René Amalberti, who presented a great live webinar on Three challenges for external evaluation: Ensuring relevance and preparing for the 30’s. This session was a joint production of the Innovation and System Change Working Group and the Accreditation Council of ISQua.


Webinar title
Three challenges for external evaluation: Ensuring relevance and preparing for the 30’s


The recent and fast-growing occurrence of tremendous social changes impacting health and care (massive ageing, growing regional disparities, lack of medical resources, digital revolution) coupled with many tremendous technical changes that already exist, or will exist soon, (e.g. day surgery, personalized medicine, big data, artificial intelligence) question accreditation and certification programs (collectively, external evaluation).

The webinar explained why the present model of external evaluation needs to change. 

Three directions for improvements were debated:

First, making evaluation more context-dependent, region-specific, with flexible standards and varying levels of achievement depending on the context—that is, flexing to the resources, services and complexity of the organization or services being assessed. 

Second, making a pivotal change and adopting the patient’s journey as the focus and pathway for assessment purposes. We suggest that such a refocus would require two components. First, focus accreditation on transitions and the person’s health journey. Second, incorporate end users’ input and judgement in the assessment and caring process since the patients, their families and carers will be those who are most familiar with the journey and most able to judge it (including PROMS and PREMS). 

Third, adapting external evaluation to the digital era and the exponential growth of complex biomarkers in healthcare. External assessment programs will need to consider how conditions are effectively monitored and treated at a distance, providing quality health and social care and with consistent access to digital tools for all citizens in all places.

Learning objectives


  • To understand why the present system of external evaluation will become ill-adapted to the new context of healthcare.
  • To learn about the challenges to change external evaluation/ accreditation at the horizon of 2030.
  • To discuss specific issues such as contextual approaches of external evaluation, impact of the digital revolution, and the evaluation of initiatives to increase patients participation, PREMS and PROMS.

René Amalberti, MD, PhD, Professor of Medicine, Director of FONCSI.
René Amalberti has spent his life working on systemic risk management in various industries and services (Healthcare, Aviation, Nuclear, Chemical industry, Fishing industry, Land transportation). He was a member of the board of ISQua from 2014 to 2017, and took the lead of ISQua's Innovation and System Change Working Group in 2015, for which he is still the president (ISCWG). He has published over 150 international papers, chapters, and authored 6 books which have been translated into many languages (last books: Navigating safety, Springer, 2013, and Safer healthcare (co-authored with Charles VIncent, strategies for the real world, Springer 2016).

Watch the full recording below and share your feedback in the Comments box at the end of the page:



If you're interested in more virtual events like this and more opportunities to share with and learn from peers across the globe, have a look at ISQua education programmes HERE.

Opinion paper
This opinion paper, Three challenges for external evaluation: Ensuring relevance and preparing for the 2030’s, co-authored by the members of the ISQua External Evaluation Association Accreditation Council, and the Innovation and Systems Change Working group of ISQua, is a first attempt to define the extent of the challenge, and tentatively show what type of (r)evolution is required to address evaluation in the 2030's.

Download the paper now



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