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Impact of Accreditation on the Quality of Healthcare Services: a Systematic Review of the Literature
Open accessAbstract
BACKGROUND AND OBJECTIVE: Accreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standards. The aim of this study was to evaluate the impact of accreditation programs on the quality of healthcare services METHODS: We did a systematic review of the literature to evaluate the impact of accreditation programs on the quality of healthcare services. Several databases were systematically searched, including Medline, Embase, Healthstar, and Cinhal. RESULTS: Twenty-six studies evaluating the impact of accreditation were identified. The majority of the studies showed general accreditation for acute myocardial infarction (AMI), trauma, ambulatory surgical care, infection control and pain management; and subspecialty accreditation programs to significantly improve the process of care provided by healthcare services by improving the structure and organization of healthcare facilities. Several studies showed that general accreditation programs significantly improve clinical outcomes and the quality of care of these clinical conditions and showed a significant positive impact of subspecialty accreditation programs in improving clinical outcomes in different subspecialties, including sleep medicine, chest pain management and trauma management. CONCLUSIONS: 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.
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“Accreditation is typically a voluntary program sponsored by a non-governmental agency using external peer reviews to assess whether healthcare organizations adhere to pre-established standards [346].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [346]
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“Facilities intended to deliver more specialized services have not been impacted by accreditation, which contradicts the finding of Shaw(4), who found accreditation had benefitted larger hospitals in improving the quality of care.”
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“In Alkhenizan and Shaw’s study on accreditation and quality, the authors evaluate acute myocardial infarctions, trauma, ambulatory surgical care, and infection control and pain management and find that accreditations considerably elevate the process of care by improving the structure and organization of health care fa…”
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“The authors pointed out that accreditation could be a tool to enhance the quality of care [6].”
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Frimpong, J. A., Kipyegon, Z., Kong, Y., & Wang, S. (2026) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-026-10009-3 · Cited by 2
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Bischof, E., Wilczok, D., Kirkland, J. L., Wilaksono, B., Huang, C. Y., Suwannaphong, S., Sanphasitvong, W., Čamdžić, D., Hernández, C., Madea, Y., et al. (2025) · JMIR Medical Education · doi:10.2196/83779 · Cited by 2
“Literature shows that physician accreditation in medical subdomains is correlated with better patient outcomes [19], while national board certification opportunities accompanied by CME education are associated with practice growth, career satisfaction, and better employment opportunities [20].”
Kartikawati, D., Rusyidi, B., Apsari, N. C., & Sulastri, S. (2025) · The social science · doi:10.3390/socsci14050307 · Cited by 2
“Existing studies have primarily focused on healthcare settings, where accreditation has been shown to improve service quality and patient outcomes (Zendrato 2022; Alkhenizan and Shaw 2011; Lazzeri et al. 2022).”
Scanlan, R., Flenady, T., & Judd, J. (2024) · Journal of Advanced Nursing · doi:10.1111/jan.16169 · Cited by 2
Nazareth, J., Kamath, R., Lakshmi, R., & Somu, G. (2023) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2023.10590 · Cited by 2
Exploring the Maturity of Quality Management in Saudi Healthcare: A Mixed Methods Approach
Alrashed, A. M. (2022) · Journal of Health Management · doi:10.1177/09720634221109064 · Cited by 2
“Yet, the review emphasised the proper use of accreditation programmes as a service improvement tool (Alkhenizan & Shaw, 2011).”
BackgroundBezos, C., Salazar, R., & Caballero, M. (2021) · Patient Experience Journal · doi:10.35680/2372-0247.1432 · Cited by 2
Competency-Based Methods in Adult Cardiac Sonography and its Application to Credentialing
Dunstatter, D. (2021) · Journal of Diagnostic Medical Sonography · doi:10.1177/87564793211002502 · Cited by 2
“Cognitive assessments included the following: (1) recognizing vital clinical information and historical facts that may impact the diagnostic examination; (2) the student reviews data from current and previous examinations to summarize findings; (3) the student adjusts instrument controls; (4) the student demonstrates…”
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“Another systematic review article by Alkhenizan and Shaw (2011) pointed out that the accreditation programs significantly improve the process of care and the quality of the clinical outcomes of a wide spectrum of clinical specialties.”
BackgroundShah, J. N., Murray, K. M., Lucas, F. L., Fairfield, K. M., & Cohen, M. C. (2020) · Journal of Nuclear Cardiology · doi:10.1007/s12350-020-02230-0 · Cited by 4
da Silva, M. D., Lunardi, M., Serpa-Ganz, A.-C., & Zonatto, V. C. D. S. (2020) · Estudios Gerenciales · doi:10.18046/j.estger.2020.155.3562 · Cited by 2
“…is a management tool used by health organizations to improve the quality of their internal processes and patient care (Jaafaripooyan et al., 2011; Alkhenizan & Shaw, 2011; Rooney & Van Ostenberg, 1999), it is assumed that accreditation is a management control tool that, when implemented,…”
BackgroundMethodAnalyzing Hospital Choices of Colon Cancer Patients in Four States in Appalachia
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Optimizing the treatment of pain and anxiety in pediatric emergencies: the role of accreditation
Brody, A., & Sethuraman, U. (2019) · Israel Journal of Health Policy Research · doi:10.1186/s13584-019-0305-9 · Cited by 2
Ghith, N., Merlo, J., & Frølich, A. (2019) · BMJ Open Quality · doi:10.1136/bmjoq-2018-000449 · Cited by 2
“Several studies reported that accreditation along with audit and feedback have the potential to influence and improve the delivery of clinical activities 30 48 49 such as measurement of albuminuria.”
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Framework for establishing records control in hospitals as an ISO 9001 requirement.
Al-Qatawneh, L. (2017) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa-02-2016-0022 · Cited by 2
Accreditation of Healthcare Facilities: A Friend or Foe?
Zaman, M., & Fatima, N. (2015) · Journal of the College of Physicians and Surgeons--Pakistan : JCPSP · doi:10.2015/jcpsp.711712 · Cited by 2
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Moldovan, F., & Blaga, P. (2022) · The 15th International Conference Interdisciplinarity in Engineering · doi:10.1007/978-3-030-93817-8_32 · Cited by 2
Quality Management Systems Including Accreditation Standards
Papassavas, A. C., Chatzistamatiou, T. K., Michalopoulos, Ε., Serafetinidi, M., Gkioka, V., Markogianni, E., & Stavropoulos‐Giokas, C. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-407785-0.00017-7 · Cited by 5
Perception of the healthcare accreditation system in Colombia
Herrera, A. L. F., Osorio, A. D. F., Torre, A. D. L., Muñoz, M. C., Ordóñez-Hernández, C., & Gonzalez, C. (2021) · Colombia Médica · doi:10.25100/cm.v52i3.4894 · Cited by 1
Pripkó, J. (2026) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa-03-2026-0069 · Cited by 1
“Empirical studies have shown that accreditation systems can contribute to improvements in organisational performance, patient safety practices and the development of quality management infrastructures within healthcare organisations (Alkhenizan and Shaw, 2011).”
Jayanthi, T., & Jain, T. (2026) · Indian Journal of Community Health · doi:10.47203/ijch.2026.v38i01.019 · Cited by 1
Müller, O., Gross-fengels, W., Zorger, N., Hinrichs, A., Cotta, L., & Steinbauer, M. (2026) · Gefässchirurgie · doi:10.1007/s00772-026-01307-3 · Cited by 1
Challenges of accreditation in hospitals and their operational solutions.
Afshari, M., Bahador, R. C., & Alirezaei, S. (2026) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa-04-2025-0047 · Cited by 1
Metadata
- Authors
- Alkhenizan, A., & Shaw, C.
- Affiliations
- King Faisal Specialist Hospital & Research Centre (SA)
- European Society for Quality in Healthcare, Limerick, Ireland
- Corresponding author
- Alkhenizan, Abdullah
- Venue
- Annals of Saudi Medicine
- Published
- 2011-07
- Volume
- 31
- Issue
- 4
- Pages
- 407-416
- ISSN
- 0256-4947 (ISSN-L)
- 0975-4466
- PMC
- PMC3156520
- OpenAlex
- W2128099173
- Cited by
- 425
- References
- 34
- Citations by year
- 2026: 31 · 2025: 24 · 2024: 26 · 2023: 32 · 2022: 25 · 2021: 49 · 2020: 44 · 2019: 25 · 2018: 22 · 2017: 24 · 2016: 20 · 2015: 21 · 2014: 73 · 2013: 3 · 2012: 4
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Annals of Saudi Medicine (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- American College of Surgeons
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- healthcare accreditation, quality of healthcare services, clinical outcomes, process of care, acute myocardial infarction, trauma care, outpatient surgery, infection control, pain management, sleep medicine, chest pain management
- MeSH terms
- Accreditation, Delivery of Health Care, Humans, Peer Review, Quality of Health Care, Outcome Assessment, Health Care
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