title: Towards hospital standardization in Europe.
abstract: OBJECTIVE
  There is no simple tool to assess compliance with common national and European directives, guidance and professional advice on the management of healthcare institutions. Despite evidence of unacceptable variations in the protection of patient and staff safety little attention has been given to harmonizing the way services are organized and managed.
  
  
  METHODS
  Existing systems which define organizational standards, or assess compliance with them, are not in a position to extend this activity into or across national borders in Europe. Certification, accreditation and licensing programmes are too variable to provide a common basis for consistent assessment. Consensual standards would inevitably be minimal if they were to achieve acceptance by all or a majority of member state governments; they would not be standards for excellence or help the majority of organizations to improve performance.
  This paper proposes the development of a framework and measurement tool, initially for hospitals, which could be used for self-assessment or peer review to demonstrate compliance with European legislation, guidance and public expectations without infringing national responsibilities. A common code of management practice could be developed through a process similar to that adopted for clinical practice guidelines by the European commission-funded project on appraisal of guidelines research and evaluation.
  
  
  CONCLUSIONS
  In practice, the legal relationships between member states and intergovernmental organizations inhibit the harmonization of management practice across-borders. Faster progress to higher levels of performance would be achieved by voluntary, non-regulatory cooperation of enthusiasts to define, measure and improve the quality of healthcare in European hospitals.
authors.affiliation: European Society for Quality in Healthcare, Limerick, Ireland. cdshaw@btinternet.com
authors.forename: Charles
authors.initials: C
authors.lastname: Shaw
authors.forename: Charles
authors.initials: C
authors.lastname: Bruneau
authors.forename: Basia
authors.initials: B
authors.lastname: Kutryba
authors.forename: Guido
authors.initials: G
authors.lastname: de Jongh
authors.forename: Rosa
authors.initials: R
authors.lastname: Suñol
mesh_terms: D000068:Accreditation / Q000458:organization & administration / Q000592:standards; D002568:Certification / Q000458:organization & administration / Q000592:standards; D005060:Europe; D005062:European Union / Q000458:organization & administration; D006284:Health Plan Implementation / Q000379:methods; D006761:Hospitals / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000458:organization & administration / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards; D014944:World Health Organization / Q000458:organization & administration