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      The impact of hospital accreditation in selected Middle East countries: a scoping review

      research-article
      Salma Khan , Taraneh Yousefinezhadi , Reece Hinchcliff
      Journal of Health Organization and Management
      Emerald Publishing
      Hospital accreditation, Quality improvement, Patient safety, Jordan, Iran, Saudi Arabia

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          Abstract

          Purpose

          There is conflicting evidence concerning the impact of hospital accreditation programmes, including across the Middle East Region, where such programmes have been most recently implemented in Iran, Jordan and Saudi Arabia. This paper maps available evidence regarding the impact of hospital accreditation in these three countries and draws attention to knowledge gaps for consideration.

          Design/methodology/approach

          This scoping review was conducted in 2020, using the Arksey and O'Malley framework. Five research databases were searched, along with five government and accreditation agency websites. Searches were complemented by citation chaining. English and Arabic publications evaluating hospital accreditation in the selected countries were included. Commentaries and articles not based on primary data collection and reviews of existing registry data were excluded. There were no exclusions based on study design or methods. A descriptive numerical summary and thematic analysis were used to synthesise the literature.

          Findings

          studies were included. The majority ( n = 35) were published since 2014 and conducted in Saudi Arabia ( n = 16). Four themes emerged: organisational impacts, patient safety, quality of care, and patient satisfaction and experience. The literature generally highlights positive impacts of accreditation, but most studies were based solely on health professionals' subjective perceptions. “Organisational impacts” had the largest, and strongest body of supporting evidence, while “patient safety” had the least and most variable evidence.

          Originality/value

          Opportunities to strengthen the design and evaluation of hospital accreditation programmes in the selected countries are highlighted. Additional experimental, mixed-method research is recommended to strengthen the evidence base and inform practical enhancements to hospital accreditation programmes in the region.

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          Most cited references76

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          Scoping studies: towards a methodological framework

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            Health sector accreditation research: a systematic review.

            The purpose of this study was to identify and analyze research into accreditation and accreditation processes. A multi-method, systematic review of the accreditation literature was conducted from March to May 2007. The search identified articles researching accreditation. Discussion or commentary pieces were excluded. From the initial identification of over 3000 abstracts, 66 studies that met the search criteria by empirically examining accreditation were selected. DATA EXTRACTION AND RESULTS OF DATA SYNTHESIS: The 66 studies were retrieved and analyzed. The results, examining the impact or effectiveness of accreditation, were classified into 10 categories: professions' attitudes to accreditation, promote change, organizational impact, financial impact, quality measures, program assessment, consumer views or patient satisfaction, public disclosure, professional development and surveyor issues. The analysis reveals a complex picture. In two categories consistent findings were recorded: promote change and professional development. Inconsistent findings were identified in five categories: professions' attitudes to accreditation, organizational impact, financial impact, quality measures and program assessment. The remaining three categories-consumer views or patient satisfaction, public disclosure and surveyor issues-did not have sufficient studies to draw any conclusion. The search identified a number of national health care accreditation organizations engaged in research activities. The health care accreditation industry appears to be purposefully moving towards constructing the evidence to ground our understanding of accreditation.
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              Narrative synthesis of health service accreditation literature.

              To systematically identify and synthesise health service accreditation literature. A systematic identification and narrative synthesis of health service accreditation literature published prior to 2012 were conducted. The search identified 122 empirical studies that examined either the processes or impacts of accreditation programmes. Study components were recorded, including: dates of publication; research settings; levels of study evidence and quality using established rating frameworks; and key results. A content analysis was conducted to determine the frequency of key themes and subthemes examined in the literature and identify knowledge-gaps requiring research attention. The majority of studies (n=67) were published since 2006, occurred in the USA (n=60) and focused on acute care (n=79). Two thematic categories, that is, 'organisational impacts' and 'relationship to quality measures', were addressed 60 or more times in the literature. 'Financial impacts', 'consumer or patient satisfaction' and 'survey and surveyor issues' were each examined fewer than 15 times. The literature is limited in terms of the level of evidence and quality of studies, but highlights potential relationships among accreditation programmes, high quality organisational processes and safe clinical care. Due to the limitations of the literature, it is not prudent to make strong claims about the effectiveness of health service accreditation. Nonetheless, several critical issues and knowledge-gaps were identified that may help stimulate and inform discussion among healthcare stakeholders. Ongoing effort is required to build upon the accreditation evidence-base by using high quality experimental study designs to examine the processes, effectiveness and financial value of accreditation programmes and their critical components in different healthcare domains.
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                Author and article information

                Contributors
                Journal
                JHOM
                10.1108/JHOM
                Journal of Health Organization and Management
                JHOM
                Emerald Publishing
                1477-7266
                17 August 2021
                24 February 2022
                : 36
                : 1
                : 51-68
                Affiliations
                [1]School of Business, University of Jeddah , Jeddah, Saudi Arabia
                [2] Shahid Beheshti University of Medical Sciences , Tehran, Islamic Republic of Iran
                [3]Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology , Brisbane, Australia
                Author notes
                Salma Khan can be contacted at: ShKhan@uj.edu.sa
                Article
                670996 JHOM-04-2021-0159.pdf JHOM-04-2021-0159
                10.1108/JHOM-04-2021-0159
                c82d36b8-d6e4-46d9-84e6-7ce280c7d9eb
                © Emerald Publishing Limited
                History
                : 29 April 2021
                : 16 July 2021
                : 16 July 2021
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 78, Pages: 18, Words: 12114
                Categories
                research-article, Literature review
                cat-HSC, Health & social care
                , Healthcare management
                Custom metadata
                Yes
                Yes
                Journal
                included

                Health & Social care
                Patient safety,Jordan,Iran,Saudi Arabia,Hospital accreditation,Quality improvement

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