Development and application of an indicator assessment tool for measuring health services accreditation programs

TL;DR

This paper introduces a new tool to assess and compare health service accreditation indicators, focusing on infection control measures like hand hygiene and SAB rates.

Contribution

The paper presents a validated indicator assessment tool for evaluating health accreditation programs using specific infection control metrics.

Findings

Hand hygiene compliance rates are identified as a suitable process indicator for accreditation assessment.

Hospital acquired Staphylococcus aureus infection (SAB) rates are proposed as an outcome indicator linked to accreditation performance.

The tool requires further testing in other health domains to confirm its robustness.

Abstract

Hospital accreditation programs are internationally widespread and consume increasingly scarce health resources. However, we lack tools to consistently identify suitable indicators to assess and monitor accreditation outcomes. We describe the development and validation of such a tool.

Using Australian accreditation standards as our reference point we: reviewed the research evidence for potential indicators; looked for links with existing external indicators; and assessed relevant state and federal policies. We allocated provisional scores, on a five point Likert scale, to the five accountability criteria in the tool: research; accuracy; proximity; no adverse effects; and specificity. An expert panel validated the use of the purpose designed indicator assessment tool. The panel identified hand hygiene compliance rates as a suitable process indicator, and hospital acquired Staphylococcus aureus infection (SAB) rates as an outcome indicator, with the hypothesis that improved hand hygiene compliance rates and lower SAB rates would correlate with accreditation performance.

This new tool can be used to identify, analyse, and compare accreditation indicators. Using infection control indicators such as hand hygiene compliance and SAB rates to measure accreditation effectiveness has merit, and their efficacy can be determined by comparing accreditation scores with indicator outcomes. To verify the tool as a robust instrument, testing is needed in other health service domains, both in Australia and internationally. This tool provides health policy makers with an important means for assessing the accreditation programs which form a critical part of the national patient safety and quality framework.