Hospital accreditation provides for a gatekeeper for hospitals that want to participate in the Medicare program. It gives a body a non-exclusive license to control the flow of federal funds into hospitals through its control of the accreditation process (Scholsberg, 1999). Hospital accreditation has strengths and weaknesses. They may be found in the areas of accountability, performance review, data-gathering, reporting, stakeholder participation, information and reform. These strengths and weaknesses will be discussed in the following paragraphs.
The first strength of hospital accreditation is its ability to provide increased public access to information on the performance of hospitals (Trowbridge; O’Leary). Accreditation bodies employ data-gathering and reporting techniques to inform consumers of relevant data about hospitals accredited under their name. This information may help consumers make adequate choices as regards hospitals. It is difficult to gather information when one is merely a consumer and one has to rely only on advertisements, reputation and experiences of other people, which may often be subjective and unreliable.
Ordinary consumers do not have to power to assess all hospitals nor compel the latter to give them information as regards their services that can help assess if the hospital is good or not. Moreover, such endeavor will be very difficult and time-consuming for consumers to perform. An accreditation body will make the job easier for them. Second, there is also a strengthening of federal mechanisms for providing performance feedback to State agencies. Accreditation ensures that hospitals will comply with minimum requirements for practice.
First, there will be an initial evaluation as to whether a hospital shall be given accreditation. After these, there are performance reviews that will determine whether such accreditation, after it has been given, should be withdrawn or not (See O’Leary, Jovanovic, 2005, p. 156). This will ensure that hospitals will continue to comply with relevant laws and guidelines even after they are given accreditation. Hospital accreditation will also increase the accountability of the hospitals both to the public and to the state.
The third strength involves an increase in stakeholder participation (O’Leary). Many stakeholders such as other professional organizations, labor and consumers have an interest in hospital oversight. Hospital accreditation may allow them to participate in the negotiation of any policy change or rulemaking to achieve greater accountability and a more meaningful oversight. These stakeholders can also help in providing information and overlooking the actions of accrediting agencies and hospitals.
Lastly, hospital accreditation gives consumers another remedy or avenue for dissatisfaction and malpractice of hospitals (O’Leary). There are many complaints as regards bad performance and malpractices of hospitals that are not given attention to because there is no avenue for the complaint but the hospital administration itself, which may just ignore these complaints. There may be recourse to courts but such is time-consuming and requires financial resources that not everyone can afford.
A body tasked with accreditation and monitoring hospital performance gives unsatisfied consumers this avenue. It must be noted that this remedy is an effective one because the body has a power to withdraw accreditation, thus there is a motivation for hospitals to avoid dissatisfaction and complaints. On the contrary, hospital accreditation also has weaknesses. One of these weaknesses is the difficulty in ensuring accountability of the accrediting body. There is often little or no accountability in its accreditation of hospitals and control and grant of the federal funds (Scholsberg, 1999).
The ideal situation is for an accreditation body to provide an independent appraisal of hospital records. However, there is often a conflict of interest because the body has a relationship to both the consumers and hospitals. While it has a duty to serve and ensure the safety of the public on the one hand, it should be noted that, on the other hand, hospitals and other health care facilities pay large fees for accreditation services. This relationship has to be disclosed fully to consumers if accrediting bodies will to be accountable to them.
Next, especially in its initial stages, accrediting agencies may have weak form of reporting and data gathering (Scholsberg, 1999). Hospitals and other health care facilities are numerous. It is difficult to gather data from all of them other than those internal reports that are sourced from the hospital management. However, to ensure reliability of data, an accrediting office will have to employ its own means and techniques of data-gathering that are not within the control of hospitals they are monitoring and which are designed for the purpose of informing the public what they need to know.
After this, the data gathered will have to be translated to something that consumers will understand. However, these will require lots of time and resources, including financial and human resources. Unfortunately, these resources are limited and have to be allocated wisely. Aside from these, accrediting agencies also have other tasks aside from data-gathering and reporting. Included in these tasks are processing of papers and applications for accreditation and renewal of accreditations and acting on complaints.
For this reason, it is often to be observed that accrediting agencies provide data that are general or aggregate data. Hospital-specific data may not often be provided due to the constraints discussed above. These are the strengths and weakness of hospital accreditation. All in all, it may be observed that, ideally, there is more strength. The weaknesses often arise only from the difficulty in implementation. However, these weaknesses are not incapable of being addressed. The first step has been made in recognizing them and tracing their roots.They may easily be transformed into the organization’s strengths if they are properly anticipated and addressed.
References
Jovanovic, B. (2005). Hospital Accreditation as Method for Assessing Quality in Healthcare. Arch Oncol, 13(3-4), 156-157. O’Leary, D. M. D. Clinical Laboratory Quality: Oversight Weaknesses Undermine Federal Standards: Hearing Before the Committee on Government Reform Subcommittee on Criminal Justice, Drug Policy and Human Resources. Retrieved Dec. 18, 2007, from http://www. jointcommission.
org/NewsRoom/OnCapitolHill/testimony_6_27_06. htm. Scholsberg, C. (1999). Letter to June Gibbs Brown, Inspector General of the Department of Health and Human Services-Re: Comments Draft Inspection Reports on External Review of Hospital Quality. Trowbridge, R. M. D. , Wachter, R. M. M. D. Chapter 55. Legislation, Accreditation, and Market-Driven and Other Approaches to Improving Patient Safety. University of California, San Francisco School of Medicine. Retrieved Dec. 18, 2007, from http://www. ahrq. gov/clinic/ptsafety/chap55. htm.