Stakeholder perspectives on implementing accreditation programs: a qualitative study of enabling factors

TLDR

Accreditation programs are complex, system‑wide quality and safety interventions whose evidence of effectiveness is weak, contradictory, and varies across contexts, underscoring a lack of research on implementation strategies. The study sought to identify factors that enable effective implementation of accreditation programs across diverse healthcare settings. We conducted 39 focus groups and eight semi‑structured interviews with 258 stakeholders across Australia, thematically analysing the data to distil and categorise facilitators of effective implementation. Four critical enablers emerged—collaborative, valid, standards‑relevant programs that are favourably received by health professionals, organisational capacity to embrace accreditation, and alignment with other regulatory initiatives and incentives—which should guide strategic implementation.

Abstract

Accreditation programs are complex, system-wide quality and safety interventions. Despite their international popularity, evidence of their effectiveness is weak and contradictory. This may be due to variable implementation in different contexts. However, there is limited research that informs implementation strategies. We aimed to advance knowledge in this area by identifying factors that enable effective implementation of accreditation programs across different healthcare settings. We conducted 39 focus groups and eight interviews between 2011 and 2012, involving 258 diverse healthcare stakeholders from every Australian State and Territory. Interviews were semi-structured and focused on the aims, implementation and consequences of three prominent accreditation programs in the aged, primary and acute care sectors. Data were thematically analysed to distil and categorise facilitators of effective implementation. Four factors were identified as critical enablers of effective implementation: the accreditation program is collaborative, valid and uses relevant standards; accreditation is favourably received by health professionals; healthcare organisations are capable of embracing accreditation; and accreditation is appropriately aligned with other regulatory initiatives and supported by relevant incentives. Strategic implementation of accreditation programs should target the four factors emerging from this study, which may increase the likelihood of accreditation being implemented successfully.