JMIR Publications

ABSTRACT

Background:

Accreditation is the process by which hospitals and health services are independently reviewed against established safety and quality standards, and it has been a feature of global health systems for over a century. However, evidence that accreditation directly improves patient safety and quality outcomes remains inconclusive. Inefficiencies and a culture of ‘gaming’ have also been observed, raising questions about the overall effectiveness of accreditation. Consequently, exploration of other formats of accreditation assessment, such as short notice accreditation, have arisen. From 1 July 2023, the Australian Commission on Safety and Quality mandated Australian public and private hospitals to engage in short-notice accreditation.

Objective:

This study seeks to explore the impact of short notice accreditation on hospitals, both in terms of safety and quality indicators and in shaping organisational safety and quality culture.

Methods:

A mixed-methods design will be used to investigate these impacts. Quantitative safety and quality indicators will be drawn from a regional health service prior to and following its first short-notice accreditation cycle. From the same site, staff will be invited to complete the Patient Safety Culture Survey and participate in semi-structured interviews. Employing Schein’s [1] Culture Framework as an organisational culture model, the study will examine observable outcomes (artefacts, behaviours, and indicators) alongside staff perceptions and experience (norms and values) to inform understanding of underlying assumptions and beliefs about short notice accreditation assessment processes. Quantitative data will be analysed through cross-tabulation, trend analysis and other statistical techniques, while qualitative data will be synthesised to provide a comprehensive understanding.

Results:

This protocol outlines the planned evaluation of short-notice accreditation and its influence on patient safety and quality culture within a regional health service. Data collection is underway, with pre-intervention surveys being completed and recruitment open for post-intervention interviews. The study is expected to generate new knowledge on how this accreditation assessment process affects patient safety and quality culture of a regional and rural hospitals.

Conclusions:

The findings will inform health policy on the suitability and long-term viability of short notice accreditation as an approach to ensuring safe, high-quality healthcare. Clinical Trial: NA