Read and discuss the following three articles: 1. ACAs Performance Based Healthc

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ACAs Performance Based Healthcare Standards-

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road to accrediation -

Accreditation is usually a voluntary program, sponsored by a non-governmental organization (NGO), in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standard

Accreditation is a quality assurance process designed to ensure an educational program meets a national standard. It serves to support and encourage program responsiveness to the ra­pidly changing environmental field by ensuring that policies, procedures and structures are in place to continually improve in response to student needs, evolving knowledge and industry developments.

The accreditation review process is objective and impartial, and the standards have been developed by Canadian academics.

JCAHO Accreditation and Quality of Care for Acute Myocardial Infarction-

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is an independent, not-for-profit organization that is the nation’s leading accreditor of hospitals. Obtaining JCAHO accreditation is important for hospitals, as the Medicare Act of 1965 decreed that accredited hospitals were deemed to have satisfied federal health and safety requirements necessary to participate in Medicare. Hospitals also have considerable incentive to become accredited for marketing purposes, often using JCAHO accreditation as a “third-party endorsement of quality.” As a result, approximately 80 percent of the 6,000 U.S. hospitals have sought JCAHO accreditation.

JCAHO accreditation- A hospital seeking to obtain JCAHO accreditation is visited every three years by a survey team that observes hospital operations, conducts interviews, and reviews medical documentation for compliance with a set of standards in forty-five performance areas.9 JCAHO surveyors assign a score in each performance area and determine an “accreditation level” based on a hospital’s overall score and whether JCAHO cited specific areas for improvement (for example, type I recommendations, which indicate the need to resolve unsatisfactory compliance). JCAHO accreditation levels during our study period were (in descending order of compliance) accreditation with commendation, accreditation without (type I) recommendations (hereafter referred to as “accreditation”), accreditation with (type I) recommendations, conditional accreditation, and not accredited. We obtained data from JCAHO on hospital accreditation level and summary scores for hospitals surveyed between 1994 and 1998. Hospitals that had neither a summary score nor an accreditation level reported were considered to be not surveyed.

quality of care for acute myocardial infarction-

On examining the association between JCAHO accreditation of hospitals, those hospitals’ quality of care, and survival among Medicare patients hospitalized for acute myocardial infarction. Hospitals not surveyed by JCAHO had, on average, lower quality (less likely to use aspirin, beta-blockers, and reperfusion therapy) and higher thirty-day mortality rates than did surveyed hospitals. However, there was considerable variation within accreditation categories in quality of care and mortality among surveyed hospitals, which indicates that JCAHO accreditation levels have limited usefulness in distinguishing individual performance among accredited hospitals. These findings support current efforts to incorporate quality of care in accreditation decisions.

A higher JCAHO accreditation level did not necessarily guarantee higher-quality care or better outcomes in the management of AMI.

Does accreditation impact quality?

There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.

Are there less errors in hospitals that are accredited?

High-quality care causes fewer errors and less harm than low-quality care. Quality improvement (QI) aims to shift the entire quality curve to the right and increase the height of the right-hand tail (more truly excellent care). Patient safety improvement is quality improvement focused on lowering or truncating the lower tail of the quality distribution. Both kinds of improvement are needed, and both improve safety for patients, but their focus is different.

Accreditation benefits all stake holders. Patients are the biggest beneficiary. Accreditation results in high quality of care and patient safety. The patients get services by credential medical staff. Rights of patients are respected and protected. Patient satisfaction is regularly evaluated.

The staff in a accredited health care organisation are satisfied lot as it provides for continuous learning, good working environment, leadership and above all ownership of clinical processes.

Accreditation to a health care organisation stimulates continuous improvement. It enables the organisation in demonstrating commitment to quality care. It raises community confidence in the services provided by the health care organisation. It also provides opportunity to healthcare unit to benchmark with the best.

What is the value of accreditation?

"A public recognition of the achievement of accreditation standards by a healthcare organisation, demonstrated through an independent external peer assessment of that organisation's level of performance in relation to the standards".

Accreditation benefits all stake holders. Patients are the biggest beneficiary. Accreditation results in high quality of care and patient safety. The patients get services by credential medical staff. Rights of patients are respected and protected. Patient satisfaction is regularly evaluated.

The staff in a accredited health care organisation are satisfied lot as it provides for continuous learning, good working environment, leadership and above all ownership of clinical processes.

Accreditation to a health care organisation stimulates continuous improvement. It enables the organisation in demonstrating commitment to quality care. It raises community confidence in the services provided by the health care organisation. It also provides opportunity to healthcare unit to benchmark with the best.

accreditation provides an objective system of empanelment by insurance and other third parties. Accreditation provides access to reliable and certified information on facilities, infrastructure and level of care.

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