title: Levers for change: an investigation of how accreditation programmes can promote consumer engagement in healthcare.
abstract: OBJECTIVE
  To examine how consumer engagement (CE) can be promoted through Australian accreditation programmes.
  
  
  METHODS
  A nation-wide qualitative study completed in 2012.
  
  
  METHODS
  All eight Australian States and Territories.
  
  
  METHODS
  Two-hundred and fifty-eight healthcare stakeholders from the acute, primary and aged care sectors.
  
  
  METHODS
  Forty-seven individual and group interviews were undertaken. Questions elicited views on the dimensions and utility of CE promotion by accreditation programmes.
  
  
  METHODS
  Healthcare stakeholders' views on the dimensions and utility of CE promotion by accreditation programmes.
  
  
  RESULTS
  Four mechanisms of CE promotion were identified. Two involved requirements for health service organizations to meet CE-related standards related to consumer experience and satisfaction surveys, and consumer participation in organizational governance processes. Two mechanisms for promoting CE through accreditation processes were also identified, concerning consumer participation in the development and revision of standards, and the implementation of accreditation surveys. Accreditation programmes were viewed as important drivers of CE, yet concerns were raised regarding the organizational investments needed to meet programmes' requirements.
  
  
  CONCLUSIONS
  Accreditation programmes use diverse mechanisms as levers for change to promote CE in healthcare. These mechanisms and their inter-relationships require careful consideration by accreditation agencies and health policymakers to maximize their potential benefits, while maintaining stakeholder engagement in programmes.
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia.|Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia.
authors.forename: Reece
authors.initials: R
authors.lastname: Hinchcliff
authors.affiliation: Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Greenfield
authors.affiliation: Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Hogden
authors.affiliation: Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.
authors.forename: Pooria
authors.initials: P
authors.lastname: Sarrami-Foroushani
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Travaglia
authors.affiliation: Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
mesh_terms: D000068:Accreditation; D001315:Australia; D003256:Community Participation; D003695:Delivery of Health Care / Q000592:standards*; D018166:Health Care Reform; D007407:Interviews as Topic; D036301:Qualitative Research
keywords: certification/accreditation of hospitals; consumer engagement; external quality assessment; health system reform; measurement of quality; qualitative methods; quality improvement