Short-notice (48 hours) ACCREDITATION trial in Australia: stakeholder perception of assessment thoroughness, resource requirements and workforce engagement

Hailie Uren; Branislav Vidakovic; Michael Daly; Kellie Sosnowski; Vladimir Matus

doi:10.1136/bmjoq-2019-000713

Short-notice (48 hours) ACCREDITATION trial in Australia: stakeholder perception of assessment thoroughness, resource requirements and workforce engagement

BMJ Open Qual. 2019 Sep 11;8(3):e000713. doi: 10.1136/bmjoq-2019-000713. eCollection 2019.

Authors

Hailie Uren¹, Branislav Vidakovic¹, Michael Daly^{2

3}, Kellie Sosnowski⁴, Vladimir Matus¹

Affiliations

¹ Logan Hospital Clinical Governance Unit, Metro South Hospital and Health Service, Meadowbrook, Queensland, Australia.
² Clinical Governance Unit, Metro South Hospital and Health Service, Woolloongabba, Queensland, Australia.
³ School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
⁴ Logan Hospital Intensive Care Unit, Metro South Health Service District, Meadowbrook, Queensland, Australia.

Abstract

Background: External, independent accreditation assessments of healthcare organisations are necessary to ensure the nationally legislated minimum standards of quality and safety (QS) are met. The predetermined scheduling of the assessments continues to be criticised due to the high level of organisational emphasis on preparing for accreditation.

Objectives: To determine the stakeholder perception of assessment thoroughness, staff resource requirements and workforce engagement changes if only 48 hours' notice is given to an organisation prior to an accreditation assessment, compared with the standard-notice accreditation process.

Methods: Logan and Beaudesert Hospitals in Brisbane, Australia, trialled the 'Short-Notice Survey Accreditation Assessment Process' (SNAAP) between August 2017 and December 2018. The organisation was given just 48 hours' notice prior to an accreditation assessment. Staff perception of the standard-notice accreditation process and short-notice process was assessed using a 5-point Likert scale repeated measures questionnaire (pretrial, 6 and 12 months after SNAAP launch).

Results: There was a statistically significant stakeholder opinion that SNAAP more effectively identified the true strengths and achievements of the organisation's QS compared with 'standard-notice' survey (p=0.033). There was a significantly lower overall perceived proportion of staff resources required for SNAAP preparation in contrast to 'standard-notice' process (Baseline Av=21.38% vs Follow-up 1 and 2 Av=9.75%-6.25%, p=0.021). The questionnaire results reflected that SNAAP increased staff engagement in QS activities (Av=3.75 and 3.69, 95% CI=3.45-4.05 and 3.45-3.94).

Conclusions: With sufficient cultural and operational preparation to move to SNAAP, hospitals can potentially use SNAAP as a truer validation of QS standards, require less staffing resources to prepare for accreditation assessments and improve staff engagement in QS assurance and improvement.

Keywords: accreditation; health quality improvement; patient safety; quality improvement; safety culture.