AI Article Synopsis
- Since 2009, Flanders' hospital quality policy relies on a triad of accreditation, public reporting (PR), and inspection, with current discussions on its effectiveness.
- A narrative review from 2009 to 2020 examined the effects of these strategies on various patient outcomes, finding mostly low-level evidence and mixed results.
- Overall, while some studies showed positive impacts from accreditation on process adherence, the individual effects of all three strategies on patient outcomes were generally found to be limited, suggesting a need for further research on their combined impact.
Article Abstract
Background: Since 2009, hospital quality policy in Flanders, Belgium, is built around a quality-of-care triad, which encompasses accreditation, public reporting (PR) and inspection. Policy makers are currently reflecting on the added value of this triad.
Methods: We performed a narrative review of the literature published between 2009 and 2020 to examine the evidence base of the impact accreditation, PR and inspection, both individually and combined, has on patient processes and outcomes. The following patient outcomes were examined: mortality, length of stay, readmissions, patient satisfaction, adverse outcomes, failure to rescue, adherence to process measures and risk aversion. The impact of accreditation, PR and inspection on these outcomes was evaluated as either positive, neutral (i.e. no impact observed or mixed results reported) or negative.
Objectives: To assess the current evidence base on the impact of accreditation, PR and inspection on patient processes and outcomes.
Results: We identified 69 studies, of which 40 were on accreditation, 24 on PR, three on inspection and two on accreditation and PR concomitantly. Identified studies reported primarily low-level evidence (level IV, n = 53) and were heterogeneous in terms of implemented programmes and patient populations (often narrow in PR research). Overall, a neutral categorization was determined in 30 articles for accreditation, 23 for PR and four for inspection. Ten of these recounted mixed results. For accreditation, a high number (n = 12) of positive research on adherence to process measures was discovered.
Conclusion: The individual impact of accreditation, PR and inspection, the core of Flemish hospital quality, was found to be limited on patient outcomes. Future studies should investigate the combined effect of multiple quality improvement strategies.
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| http://dx.doi.org/10.1093/intqhc/mzab085 | DOI Listing |
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