title: The impact of national accreditation reform on survey reliability: a 2-year investigation of survey coordinators' perspectives.
abstract: OBJECTIVE
  Accrediting health care organizations against standards is a recognized safety and quality intervention. The credibility of an accreditation programme relies on surveying reliability. We investigated accreditation survey coordinators' perceptions of reliability issues and their continued relevancy, during a period of national accreditation reform.
  
  
  METHODS
  In 2013 and 2014, questionnaire surveys were developed using survey coordinators' feedback of their experiences and concerns regarding the accreditation process. Each year, a purpose-designed questionnaire survey was administered during the accrediting agency survey coordinator training days.
  
  
  RESULTS
  Participants reported that survey reliability was informed by five categories of issues: the management of the accreditation process, including standards and health care organizational issues; surveyor workforce management; survey coordinator role; survey team; and individual surveyors. A new accreditation system and programme did not alter the factors reported to shape survey reliability. However, across the reform period, there was a noted change within each category of the specific issues that were of concern. Furthermore, consensus between coordinators that existed in 2013 appears to have diminished in 2014. Across all categories, in 2014 there was greater diversity of opinion than in 2013.
  
  
  CONCLUSIONS
  The known challenges to the reliability of an accreditation programme retained their potency and relevancy during a period of reform. The diversity of opinion identified across the coordinator workforce could potentially place the credibility and reliability of the new scheme at risk. The study highlights that reliability of an accreditation scheme is an ongoing achievement, not a one-off attainment.
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia. david.greenfield@mq.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Greenfield
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Hogden
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, New South Wales.
authors.forename: Reece
authors.initials: R
authors.lastname: Hinchcliff
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Virginia
authors.initials: V
authors.lastname: Mumford
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Pawsey
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Debono
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Johanna I
authors.initials: JI
authors.lastname: Westbrook
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
mesh_terms: D000068:Accreditation; D006302:Health Services Research; D015397:Program Evaluation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: health care; health policy; health services research