Quality programmes, accreditation and certification in Switzerland.
OBJECTIVE
To report on current quality initiatives in health care in the context of accreditation and certification in Switzerland.


METHODS
A review from the Swiss Accreditation Service, the Swiss Medical Association and the University of Zurich.


METHODS
In Switzerland, health care providers and health insurers are obliged by law to sign contracts on quality of care. The law texts and related ordinances do not state explicitly the content and format of quality contracts between providers and costs payers. Finding adequate practical solutions is the responsibility of the partners involved. Six different possibilities of quality initiatives are studied and discussed in this report. These include initiatives to create independent certification or inspection bodies for health care organizations accredited by the national accreditation body.


RESULTS
So far, there is only one established standardized system with clear requirements. This accreditation and certification model is an adaptation of the International Standards Organization but so far it has not been used often in the public domain. Each of the other five approaches are more frequently applied but none of them lead to full external peer review certification including medical outcome yet.


CONCLUSIONS
A lot of harmonization work still has to be done and clear branch specific requirements need to be agreed upon. Practicability and validity of external peer review schemes may also need further evaluation and improvement to reach the goals of health care systems in the future.
Schilling
J
J
Institute of Social and Preventive Medicine, University of Zurich, Switzerland. juli@ifspm.unizh.ch
Cranovsky
R
R
Straub
R
R
D000068:Accreditation; D002568:Certification; D006268:Health Facilities / Q000592:standards*; D006801:Humans; D009313:National Health Programs / Q000592:standards*; D011785:Quality Assurance, Health Care; D013557:Switzerland