Health service accreditation as a predictor of clinical and organisational performance: a blinded, random, stratified study.
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.
Braithwaite
Jeffrey
J
University of New South Wales, Level 1 AGSM Building, Randwick, Sydney, NSW 2052, Australia. j.braithwaite@unsw.edu.au
Greenfield
David
D
Westbrook
Johanna
J
Pawsey
Marjorie
M
Westbrook
Mary
M
Gibberd
Robert
R
Naylor
Justine
J
Nathan
Sally
S
Robinson
Maureen
M
Runciman
Bill
B
Jackson
Margaret
M
Travaglia
Joanne
J
Johnston
Brian
B
Yen
Desmond
D
McDonald
Heather
H
Low
Lena
L
Redman
Sally
S
Johnson
Betty
B
Corbett
Angus
A
Hennessy
Darlene
D
Clark
John
J
Lancaster
Judie
J
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