Using clinical indicators to facilitate quality improvement via the accreditation process: An adaptive study into the control relationship

Sheu-Wen Chuang, Peter P. Howley, Stephen Hancock

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective. The aim of the study was to determine accreditation surveyors' and hospitals' use and perceived usefulness of clinical indicator reports and the potential to establish the control relationship between the accreditation and reporting systems. The control relationship refers to instructional directives, arising from appropriately designed methods and efforts towards using clinical indicators, which provide a directed moderating, balancing and best outcome for the connected systems. Design. Web-based questionnaire survey. Setting. Australian Council on Healthcare Standards' (ACHS) accreditation and clinical indicator programmes. Results. Seventy-three of 306 surveyors responded. Half used the reports always/most of the time. Five key messages were revealed: (i) report use was related to availability before on-site investigation; (ii) report use was associated with the use of non-ACHS reports; (iii) a clinical indicator set's perceived usefulness was associated with its reporting volume across hospitals; (iv) simpler measures and visual summaries in reports were rated the most useful; (v) reports were deemed to be suitable for the quality and safety objectives of the key groups of interested parties (hospitals' senior executive and management officers, clinicians, quality managers and surveyors). Conclusions. Implementing the control relationship between the reporting and accreditation systems is a promising expectation. Redesigning processes to ensure reports are available in pre-survey packages and refined education of surveyors and hospitals on how to better utilize the reports will support the relationship. Additional studies on the systems' theory-based model of the accreditation and reporting system are warranted to establish the control relationship, building integrated systemwide relationships with sustainable and improved outcomes.

Original languageEnglish
Pages (from-to)277-283
Number of pages7
JournalInternational Journal for Quality in Health Care
Volume25
Issue number3
DOIs
Publication statusPublished - Jul 2013

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Accreditation
Quality Improvement
Delivery of Health Care
Safety
Education
Surveys and Questionnaires

Keywords

  • Accreditation
  • Clinical indicators
  • Control relationship
  • Feedback
  • Quality measurement and reporting
  • Systems theory

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

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abstract = "Objective. The aim of the study was to determine accreditation surveyors' and hospitals' use and perceived usefulness of clinical indicator reports and the potential to establish the control relationship between the accreditation and reporting systems. The control relationship refers to instructional directives, arising from appropriately designed methods and efforts towards using clinical indicators, which provide a directed moderating, balancing and best outcome for the connected systems. Design. Web-based questionnaire survey. Setting. Australian Council on Healthcare Standards' (ACHS) accreditation and clinical indicator programmes. Results. Seventy-three of 306 surveyors responded. Half used the reports always/most of the time. Five key messages were revealed: (i) report use was related to availability before on-site investigation; (ii) report use was associated with the use of non-ACHS reports; (iii) a clinical indicator set's perceived usefulness was associated with its reporting volume across hospitals; (iv) simpler measures and visual summaries in reports were rated the most useful; (v) reports were deemed to be suitable for the quality and safety objectives of the key groups of interested parties (hospitals' senior executive and management officers, clinicians, quality managers and surveyors). Conclusions. Implementing the control relationship between the reporting and accreditation systems is a promising expectation. Redesigning processes to ensure reports are available in pre-survey packages and refined education of surveyors and hospitals on how to better utilize the reports will support the relationship. Additional studies on the systems' theory-based model of the accreditation and reporting system are warranted to establish the control relationship, building integrated systemwide relationships with sustainable and improved outcomes.",
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