Are accreditation surveys reliable?

Int J Health Care Qual Assur. 2009;22(2):105-16. doi: 10.1108/09526860910944601.


Purpose: The purpose of this article is to test whether healthcare accreditation survey processes are reliable.

Design/methodology/approach: The study uses multiple methods to document stakeholder experiences and views on accreditation survey reliability. There were 29 research activities, comprising 25 focus groups, three interviews and a survey questionnaire. In total, 193 stakeholders participated; 134 in face-to-face activities and 56 via questionnaire. All were voluntary participants. Using open-ended questioning, stakeholders were asked to reflect upon accreditation survey reliability.

Findings: Stakeholders perceived healthcare accreditation surveys to be a reliable activity. They identified six interrelated factors that simultaneously promoted and challenged reliability: the accreditation program, including organisational documentation and surveyor accreditation reports; members' relationship to the accrediting agency and survey team; accreditation agency personnel; surveyor workforce renewal; surveyor workforce management; and survey team conduct including coordinator role. The six factors realised shared expectations and conduct by accreditation stakeholders; that is, they enabled accreditation stakeholder self-governance.

Practical implications: Knowledge gained can be used to improve accreditation program reliability, credibility and ongoing self-governance.

Originality/value: The paper is a unique examination of healthcare accreditation surveys the reliability. The findings have potential application to reliability in other healthcare areas.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accreditation / organization & administration*
  • Accreditation / standards
  • Australia
  • Focus Groups
  • Health Care Surveys / standards*
  • Health Services / standards*
  • Humans
  • Medical Audit / organization & administration
  • Program Evaluation
  • Quality Assurance, Health Care / organization & administration*
  • Quality Assurance, Health Care / standards
  • Reproducibility of Results