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Table 2 Hospital accreditation and audit

From: Increasing the options for reducing adverse events: Results from a modified Delphi technique

Proposals Effect [1 = v.high 6 = negative] mean (std dev) Implement (months) Impact (months) Total (years)
2.1 Accreditation should be compulsory for all public and private hospitals and day surgery facilities. 2.16 (.83) 9 26 2.9
2.2 There should be a review of the criteria for achieving accreditation. Criteria should be expanded to include more stringent procedures relating to safety.a 2.17 (.99) 18 30 4.0
2.3 Accreditation should be more focused on measurable outcomes which should be standardised to allow benchmarking against other hospitals. 2.65 (1.06) 12 41 4.4
2.4 Hospitals should undertake regular anonymous surveys of medical and nursing staff to get feedback on the safety and quality climate in the hospital.b 2.22 (.94) 6 11 1.4
2.5 There should be no forewarning of the date on which the accreditation review occurs. Accreditation should include follow-up reviews on random dates. All hospitals should be subject to random audit of facilities and procedures. 2.89 (1.66) 9 12 1.8
2.6 The audit procedures used in the Quality in Australian Health Care Studyc should be introduced as a permanent feature of the public and private hospital systems, with mandatory auditing of identified high-risk hospitals, and random auditing of the remainder. 2.33 (.97) 12 24 3.0
2.7 The criteria for accreditation should be subject to evaluation against known standards for the achievement of safety and quality. Where possible, the results of random control trials should be the basis for the inclusion or rejection of criteria and standards. 2.33 (.84) 26 42 4.8
  1. a The Australian Health Ministers have recently endorsed the release of a Discussion Paper on National Safety and Quality Accreditation Standards as the basis for consultation with stakeholders [33].
  2. b We note that some hospitals already do this – e.g. the Royal Children's Hospital in Victoria.
  3. c Wilson, R. M., W. B. Runciman, R. W. Gibberd, B. T. Harrison, L. Newby and J. D. Hamilton (1995). 'The Quality in Australian Health Care Study.' Medical Journal of Australia 163(9): 458–471.