Systematic survey of accreditation models for designing a national model

Abstract

Background and Aim: People, patients, governments and third party payers seek in-depth accurate assessment of health care quality world wide. To meet this aim, countries have different approaches to improving quality and standards, which licensure, certification and accreditation are some of these systems developed for this purpose. Because of maximum and challenging standards, accreditation is distinguished as the most powerful method. The aim of this study was to perform a systematic review of advantages and disadvantages of accreditation models to select and use as the reference model to develop a national accreditation model. Materials and Methods: In this study, a systematic review was conducted in SID, Ovid Medline and PubMed databases using key words of accreditation, hospital, medical practice, clinic, accreditation models and health care in both English and Persian languages. Considering defined inclusion and exclusion criteria, 2379 articles were identified. After that, based on the advantages and disadvantages of accreditation models, titles, abstracts and content of selected articles were studied step by step and finally 83 articles were selected and analyzed. Then the findings were extracted and summarized in the summary tables. Finally, based on 25 selected items the best accreditation models in the world were compared with one another in order to develop a national model. Results: The accreditation models which were of much debate were JCAHO from USA and CCHSA from Canada, and the accreditation models of UK, Australia and France were in the next places. The results of this study were compatible with those of previous studies. According to the comparative items the accreditation models of JCAHO and CCHSA had the most advantages and the least disadvantages respectively. Conclusion: Based on the defined items, the JCAHO accreditation model and then CCHSA model are the models which can be best applied and other important accreditation models such as ACHS of Australia, ANAES of France, QHNZ of New Zealand and UK accreditation models are almost as the same level as JCAHO and CCHSA models. Therefore it seems that the Joint Commission accreditation model (JCAHO) is the best model which can be used as a benchmark to design a national accreditation model.