title: Health service accreditation as a predictor of clinical and organisational performance: a blinded, random, stratified study.
abstract: BACKGROUND
  Despite the widespread use of accreditation in many countries, and prevailing beliefs that accreditation is associated with variables contributing to clinical care and organisational outcomes, little systematic research has been conducted to examine its validity as a predictor of healthcare performance.
  
  
  OBJECTIVE
  To determine whether accreditation performance is associated with self-reported clinical performance and independent ratings of four aspects of organisational performance.
  
  
  METHODS
  Independent blinded assessment of these variables in a random, stratified sample of health service organisations.
  
  
  METHODS
  Acute care: large, medium and small health-service organisations in Australia. Study participants Nineteen health service organisations employing 16 448 staff treating 321 289 inpatients and 1 971 087 non-inpatient services annually, representing approximately 5% of the Australian acute care health system.
  
  
  METHODS
  Correlations of accreditation performance with organisational culture, organisational climate, consumer involvement, leadership and clinical performance. Results Accreditation performance was significantly positively correlated with organisational culture (rho=0.618, p=0.005) and leadership (rho=0.616, p=0.005). There was a trend between accreditation and clinical performance (rho=0.450, p=0.080). Accreditation was unrelated to organisational climate (rho=0.378, p=0.110) and consumer involvement (rho=0.215, p=0.377).
  
  
  CONCLUSIONS
  Accreditation results predict leadership behaviours and cultural characteristics of healthcare organisations but not organisational climate or consumer participation, and a positive trend between accreditation and clinical performance is noted.
authors.affiliation: University of New South Wales, Level 1 AGSM Building, Randwick, Sydney, NSW 2052, Australia. j.braithwaite@unsw.edu.au
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
authors.forename: David
authors.initials: D
authors.lastname: Greenfield
authors.forename: Johanna
authors.initials: J
authors.lastname: Westbrook
authors.forename: Marjorie
authors.initials: M
authors.lastname: Pawsey
authors.forename: Mary
authors.initials: M
authors.lastname: Westbrook
authors.forename: Robert
authors.initials: R
authors.lastname: Gibberd
authors.forename: Justine
authors.initials: J
authors.lastname: Naylor
authors.forename: Sally
authors.initials: S
authors.lastname: Nathan
authors.forename: Maureen
authors.initials: M
authors.lastname: Robinson
authors.forename: Bill
authors.initials: B
authors.lastname: Runciman
authors.forename: Margaret
authors.initials: M
authors.lastname: Jackson
authors.forename: Joanne
authors.initials: J
authors.lastname: Travaglia
authors.forename: Brian
authors.initials: B
authors.lastname: Johnston
authors.forename: Desmond
authors.initials: D
authors.lastname: Yen
authors.forename: Heather
authors.initials: H
authors.lastname: McDonald
authors.forename: Lena
authors.initials: L
authors.lastname: Low
authors.forename: Sally
authors.initials: S
authors.lastname: Redman
authors.forename: Betty
authors.initials: B
authors.lastname: Johnson
authors.forename: Angus
authors.initials: A
authors.lastname: Corbett
authors.forename: Darlene
authors.initials: D
authors.lastname: Hennessy
authors.forename: John
authors.initials: J
authors.lastname: Clark
authors.forename: Judie
authors.initials: J
authors.lastname: Lancaster
mesh_terms: D000068:Accreditation; D001315:Australia; D003256:Community Participation; D006296:Health Services / Q000592:standards*; D006801:Humans; D007857:Leadership; D015279:Organizational Culture; D017063:Outcome Assessment, Health Care / Q000379:methods; D011785:Quality Assurance, Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care