Ten additional perspectives about health services accreditation

We congratulate the Deeble Institute and the authors, Mr Ryan Swiers and Dr Rebecca Haddock, on the recent publication of the evidence brief (#18) titled “Assessing the value of accreditation to health systems and organisations”.  As a group of professionals committed to the contribution of accreditation to quality improvement in healthcare, this brief is one of value and raises some key issues.

We congratulate the Deeble Institute and the authors, Mr Ryan Swiers and Dr Rebecca Haddock, on the recent publication of the evidence brief (#18) titled “Assessing the value of accreditation to health systems and organisations”.  As a group of professionals committed to the contribution of accreditation to quality improvement in healthcare, this brief is one of value and raises some key issues.

We at the ISQua External Evaluation Association (IEEA) wish to present some additional perspectives about health services accreditation to complement the evidence brief.

      1. Accreditation as a quality systematic evaluation is based on the core principles of Juran, i.e. quality planning, control, measurement and improvement. The impact, therefore, needs to be assessed within this framework.
      2. We take a systems approach to external evaluation in keeping with the latest theories of how to improve complex adaptive systems.
      3. Today we are accrediting more than facilities. We accredit healthcare organisations – many without walls across different systems such as home care and community-based programmes.  We are moving beyond the facility focus in order to reflect the continuum of care delivery.
      4. While the brief notes that ‘the core function of healthcare accreditation remains assurance that a level of compliance to minimum standards is achieved’, the majority of our accreditation organisations develop standards which enable quality improvement with the goal of ‘raising the bar’, not basic safety standards. The basic safety standards primarily rest within the domain of regulatory bodies (and/or perhaps licensing). This quality improvement approach is fundamental.
      5. There is a reference to the viewpoint of the workforce on accreditation, however, it is essential to note that current accreditation standards include a focus on elements such as focusing on and enabling a healthy workplace for all who work within that organisation, that the leadership is strong, that there is provider involvement in decision-making.
      6. While there is a current focus on the impact of accreditation on outcomes, the impact of accreditation on structures and processes should also be recognised as these are inter-related. For example, there is a well-known link between hand washing compliance and infection rates. 
      7. The brief acknowledges that ‘accreditation cannot simply be judged as a stand-alone entity’. We strongly support this statement as it fits in with the Juran construct.  Accreditation is a quality improvement tool of quality control management and improvement that requires planning by the leadership of the organisation. This complements other quality improvement strategies and methodologies that organisations adopt, such as LEAN and clinical pathways.  These should be part of an overall quality improvement programme of an organisation in which the strengths of each is recognised.
      8. Accreditation fundamentally focuses on standards that nurture a culture which enables the provision of quality and safe healthcare, one in which caring for the staff and those providing care, directly and indirectly, is equally important to the provision of quality healthcare to the recipients and their families.
      9. Finally, accreditation is a knowledge transfer and knowledge translation tool. It enables consistent communication using a common language through the standards across organisations and between professionals.  If standards reflect current evidence, they contribute to the knowledge of those providing the care and those in leadership positions. (We encourage the organisation leaders to utilise the standards in an ongoing way to assess and improve the care, and not only every 3 – 4 years, whatever the cycle of accreditation.)
      10. We agree that the evidence base needs to be developed further and we encourage organisations to publish their data and to facilitate learning from what is an essential part of quality improvement implementation.

IEEA is an organisation committed to the value of external evaluation. It is essential that accreditation programmes continue to evolve and respond to the healthcare needs and environment, to be sensitive to changes in evidence and positively contribute to a healthier and safer healthcare system.

Wendy Nicklin, President of the IEEA and Steve Clark, IEEA Accreditation Council Chair

Assessing the Value of Accreditation to Health Systems and Organisations

Recent Blog Articles

Quarter One: ISQua’s Global Impact

Adverse Events Outside Direct Care

Nominations for 2026 PROMS

ISQua EEA call for tenders

Celebrating ISQua’s Women Leaders on International Women’s Day

Stay in Touch

We bring you the latest research, expert opinions, and industry updates in healthcare safety and quality – so you’re always in the know.

Follow us on social media

Nourhan Kawtharani

Nourhan, a quality and safety coordinator with eight years of experience in ambulatory healthcare in Lebanon, aims to deepen her understanding of the systemic and holistic approach to healthcare through this fellowship.

She aims to identify gaps and develop tailored interventions that address specific contexts rather than applying general solutions. Engaging with diverse professionals and perspectives during this educational journey will expand the application of these concepts across different cultural settings.

Nourhan emphasizes the importance of promoting a culture of continuous learning and improvement within healthcare institutions, considering it a vital leadership responsibility to integrate quality and safety initiatives into the organizational culture.

Nourhan's commitment to patient safety and quality management includes sourcing practical resources and transforming insights into actionable knowledge to drive continued progress in healthcare practices and outcomes.

This will close in 0 seconds

Elom Otchi

Elom is passionate about improving quality of care and patient safety outcomes.

In view of this, he has had the opportunity to work in various capacities with various organisations including AfIHQSA, WHO, UNICEF and others undertaking research, supporting the development of national quality policies and strategies, facilitating the establishment of quality governance systems across all the levels of the health sector and building capacity of national and sub-national quality leads/teams to institutionalize the practice of quality and patient safety across the continent.

He has also worked extensively across all levels of care in the health sector of Ghana, including leading the Quality & Patient Safety program in its largest teaching hospital.

I would like to use this Fellowship as a learning platform and an opportunity to acquire the requisite knowledge, skills and competencies to complement ongoing efforts by like-minded individuals and organizations to continuously advance improve the quality and patient safety in Ghana and the continent.

This will close in 0 seconds

Stephen Taiye Balogun

Stephen is a Senior Programme Officer at the Institute of Human Virology in Nigeria as well as Country Representative for Health Information for All (HIFA).

Stephen plans to use this opportunity to maximise his impact by championing the cause of patient safety and quality in Nigeria and across Africa.

Stephen says "Quality and safety is a major wheel through which universal healthcare coverage can be achieved. The goal is to be a bridge in the gap between the International Quality Improvement and Patient Safety community and my country to ensure rapid spread, adoption, implementation and practice."

We are looking forward to working with both Stephen and our 2020 winner Rhoda Kalondu over the next year.

This will close in 0 seconds

Dr Rhoda Kalondu

Rhoda is the Head of the Patient Safety Unit at Kenyatta Hospital in Nairobi and wants to use this Fellowship to learn how to establish a culture of safety and develop systems for assessment and analysis at her institution, and more widely. As well as this, Rhoda intends to develop and execute an intervention to improve patient safety in Kenyatta National Hospital.

It is one thing to institute measures and processes for improvement, but quite another to change the culture of an environment. Rhoda's ambition to lead others in this change inspired the panel.

This will close in 0 seconds

Dr Subhrojyoti Bhowmick

I am an MBBS graduate from Calcutta University with a Gold Medal in Gynecology & Obstetrics.

I have completed M.D in Pharmacology from IPGME& R, Kolkata and have over 12 years of experience in the field of Clinical Research, Pharmacovigilance and Medication management in Hospitals.

I have completed certification in Clinical Research Administration & Project Management from Stanford University, USA and in Patient Safety from Johns Hopkins University, USA.

I am an Assessor for National Accreditation Board for Hospitals & Health care providers (NABH), India assessing hospitals for medication safety and clinical quality standards and NABH Assessor for Ethics Committee Accreditation program in India as well.

I serve as the Chairperson, Institutional Ethics Committee of Health Point Hospital, Kolkata and am associated with 2 other Hospital ethics committees as a member.

I finished my Fellowship in Healthcare Quality from the International Society of Quality in Healthcare (ISQua) from Ireland in 2017.

I have published several research articles and have also authored a chapter on “Regulations governing Clinical Trial” in the book “Fundamentals of Clinical Trial & Research”.

I am a peer reviewer for prestigious international journals like the British Journal of Clinical Pharmacology, CNS Drugs and Drug Safety case reports.

I am the recipient of the UK Seth Oration Award for Best Clinical Pharmacology paper by the Indian Pharmacological Society in 2009 and the “Most promising Healthcare professional in Patient Safety in India” award by the Asian African Chamber of Commerce and Industry in October 2018.

Recently in April 2019, I received the Young Quality Achiever award by Consortium of Accredited Healthcare Organizations (CAHO), India for 2019 for my work in the field of medication safety and clinical research.

I have a keen interest in teaching and am visiting adjunct faculty of Pharmacology at KMC, Mangalore, India and for Healthcare technology at MAKAUT, Kolkata, India.

I was associated with Stanford University School of Medicine, in the USA as a Senior Clinical Research Associate from 2015 to 2017 and have certification in Biostatistics, Evidence-based Medicine and Medical Writing from Stanford University.

Currently, I am working as the Clinical Director of Academics, Medical Quality and Clinical Research at Peerless Hospital and B K Roy Research Centre, Kolkata.

I am very happy and thrilled to receive the prestigious ISQua Lucian Leape Patient safety Fellowship Award for 2019 and I look forward to honing my skills further in the field of healthcare quality and patient safety through my experiences during this fellowship.

I sincerely believe that successful completion of this fellowship will help me evolve as a more confident Patient safety leader in India who in turn can provide significant inputs on policy changes through NABH for the Indian healthcare system.

This will close in 0 seconds