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Cited by 239Healthcare Quality and ManagementPatient Satisfaction in HealthcareHealthcare Regulation

The impact of hospital accreditation on the quality of healthcare: a systematic literature review

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Hussein, Mohammed, Pavlova, Milena, Ghalwash, Mostafa, Groot, Wim·2021·BMC Health Services Research
DOI 10.1186/s12913-021-07097-6PMC PMC8493726
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Abstract

Background: Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation. Methods: We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes. Results: We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures. Conclusion: There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains. PROSPERO registration number CRD42020167863.

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  • Hospital accreditation programs usually lead to improved patient safety, clinical performance, and operational efficiency, driven by stronger safety cultures, standardized procedures, and better compliance with care guidelines.

    “Studies have found that hospital accreditation programs usually lead to improved patient safety, clinical performance, and operational efficiency, driven by stronger safety cultures, standardized procedures, and better compliance with care guidelines [347,348].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [347]

    The Results (The impact themes; page not supplied) report generally positive findings for safety culture, process-related performance, guideline adherence, and efficiency. The Conclusion says accreditation stimulates performance improvement and patient safety, but explicitly calls the evidence on causality inconclusive. The review does not establish that stronger safety cultures, standardized procedures, and guideline compliance drive those improvements, as the claim asserts. (LLM, conf=0.85)

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Authors
Hussein, M., Pavlova, M., Ghalwash, M., & Groot, W.
Affiliations
Maastricht University Medical Centre (NL)
Corresponding author
Hussein, Mohammed
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2021-10-06
Volume
21
Issue
1
Pages
1057-1057
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-021-07097-6
PMC
PMC8493726
OpenAlex
W3202395426
Cited by
239
References
130
Citations by year
2026: 65 · 2025: 59 · 2024: 54 · 2023: 35 · 2022: 25 · 2021: 1
FWCI
5.10
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (acceptedVersion, cc-by)
  • Research Publications (Maastricht University) (acceptedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
  • Health Sciences › Health Professions › Health Information Management › Healthcare Regulation
Keywords
hospital accreditation, quality of care, patient safety, safety culture, hospital performance, length of hospital stay, hospital readmission, patient satisfaction, nosocomial infections, mortality, occupational stress, healthcare workers
MeSH terms
Accreditation, Health Personnel, Hospitals, Humans, Patient Satisfaction, Outcome Assessment, Health Care

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