Accreditation and culture usually go hand-in-hand in health organisations

Friday, May 10, 2019

A positive attitude to accreditation usually signifies good leadership and a positive culture in health organisations—and vice versa, says the Australian Healthcare and Hospitals Association (AHHA).

The Association has released a Deeble Institute for Health Policy Research Evidence Brief, Assessing the value of accreditation to health systems and organisations.

Lead author Ryan Swiers said that although healthcare quality and safety accreditation processes are embedded in health systems in more than 70 countries around the world, the actual benefits have not received much research attention, and are not well understood.

‘This does not mean, however, that accreditation or the available research are of no value’, Mr Swiers said.

‘Because accreditation is usually a “point in time” audit process, a successful accreditation result cannot guarantee the complete safety of a health facility. But the available studies do indicate a positive association between accreditation success and a good safety culture, high quality care, high patient satisfaction and good outcomes.

‘Some studies also demonstrate a positive association between accreditation and quality indicators such as infection control and adherence to guidelines and protocols.

‘However, some organisations view accreditation as a costly, time-consuming bureaucratic burden that adds little value in terms of patient care.

‘In such situations accreditation tends to be seen as a separate “event”, with the organisation focusing on short-term compliance rather than long-term continuous improvement— everything reverts to “normal” once the accreditation visit has finished.’

‘In addition, some commentators suggest that accreditation has “failed” in Australia, pointing to variations in complication rates across Australian hospitals, and safety failures resulting in patient deaths at hospitals in Queensland, New South Wales and Victoria’, Mr Swiers said.

‘Overall, however, we found that accreditation processes can be used to develop and support a culture of safety and quality among health workers—although more work is needed on how to determine its value and how to measure it.

‘Also, accreditation tends to be more valued when staff are aware of its purpose and are involved in the accreditation process. If staff are not directly involved, they are more likely to see accreditation as a bureaucratic burden’, Mr Swiers said.

‘In terms of “Where do we go from here?” with accreditation, a 2018 review by the Australian Commission on Safety and Quality in Health Care has resulted in revisions to the assessment process, the assessment team, use of data, regulatory oversight, communication of assessment outcomes, and resources and support for health services.

‘The changes will be phased in from January 2019, and it will be interesting to see a formal evaluation of the results a little further down the track.’


The Assessing the value of accreditation to health systems and organisations evidence brief is available here (Authors: Mr Ryan Swiers and Dr Rebecca Haddock). The brief was produced with funding support from the Australian Council on Healthcare Standards (ACHS). 

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, and community and primary healthcare services. The Deeble Institute for Health Policy Research is based at AHHA.

Media enquiries:  

Mr Ryan Swiers, Specialty Registrar—Public Health

National Health Service (UK) (author)

0452 412 131