ISQUA17-1718LOTS TO LEARN: ACCREDITATION LESSONS FROM OTHER INDUSTRIES

Abstract

Objectives: Regulation of the health-care industry is considered to be an important tool to improve quality of care, however, the literature evaluating the effectiveness of accreditation internationally is mixed. The study explores and assessed the effects of regulation & accreditation in non-healthcare industries, with an aim to provide learnings relevant to healthcare. Accreditation provides significant opportunities to drive improvement in patient care. However, the accreditation process is costly and time consuming and has a large opportunity cost for patients if the accreditation system are not maximised to drive improvement in care and reduce harm. We present five key learnings from other industries, which we believe could transform accreditation with the aim of maximising improvements in patient care. Methods: The review of literature was conducted using the Oxford CASP criteria, based on a research protocol agreed by the authors. A diverse range of data bases were sourced using key search terms and specified selection criteria. The study categorised findings into models of Regulation and Accreditation/ Regulating and Models in Practice from Banking and Finance, Education, Manufacturing, Nuclear Power and Aviation. Results: The review demonstrates that the system of Accreditation in healthcare is less mature than what is seen in other industries. There are 5 key learnings from this review of other industries: - Assessing safety requires not just assurance, but also assessment of quality improvement and culture. - A diverse toolbox available to regulators to assess assurance, improvement and culture. - Regulation and accreditation must identify and address key risks and gaps in operational performance. - Lessons for healthcare from the both high risk and low risk industries. - Models of regulation have not been trialled properly by implementation, such that assessment of successes or failures has not been as scientific as they could have been. Conclusion: The large proportion of resources dedicated to accreditation of hospitals presents a considerable opportunity cost for patients and healthcare systems, unless the accreditation system is maximised to drive improvement in patient care. We reviewed the practice for regulation and accreditation in other industries to see if there are learnings applicable to health care. No single model is perfect under every condition or context. Moreover, there are important differences between health care and other industries, in the realms of culture, professional autonomy and customer focus and empowerment. The study provides important lessons from the more mature regulatory systems in other industries and present an opportunity to drive better care for patients.