Søren Bie Bogh1,2, Anne Mette Falstie-Jensen3, Erik Hollnagel1,2, René Holst1, Jeffrey Braithwaite1,4, Søren Paaske Johnsen3. 1. Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, Odense C DK-5000, Denmark. 2. Centre for Quality, Region of Southern Denmark, P.V. Tuxenvej 5, Middelfart DK-5500, Denmark. 3. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N DK-8200, Denmark. 4. Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109, Australia.
Abstract
OBJECTIVE: To assess changes over time in quality of hospital care in relation to the first accreditation cycle in Denmark. DESIGN, SETTING AND PARTICIPANTS: We performed a multi-level, longitudinal, stepped-wedge, nationwide study of process performance measures to evaluate the impact of a mandatory accreditation programme in all Danish public hospitals. Patient-level data (n = 1 624 518 processes of care) on stroke, heart failure, ulcer, diabetes, breast cancer and lung cancer care were obtained from national clinical quality registries. INTERVENTION: The Danish Healthcare Quality Programme was introduced in 2009, aiming to create a framework for continuous quality improvement. MAIN OUTCOME: Changes in week-by-week trends of hospital care during the study period of 269 weeks prior to, during and post-accreditation. RESULTS: The quality of hospital care improved over time throughout the study period. The overall positive change in trend odds ratio (OR) = 1.002 per week; 95% confidence interval (CI: 0.997-1.006) observed when comparing the period during accreditation with the period prior to accreditation was not significant. However, when restricting the analyses to processes of care where the performance did not meet target values for satisfactory quality prior to accreditation, we found a significant positive change in trend (OR = 1.006 per week; 95% CI: 1.001-1.011). When comparing the post-accreditation period with the period during accreditation, we found a significantly reduced trend (OR = 0.994 per week; 95% CI: 0.988-0.999), indicating the improvement in quality of care continued but at a lower rate than during accreditation. CONCLUSION: These findings support the hypothesis that hospital accreditation leads to improvements in patient care.
OBJECTIVE: To assess changes over time in quality of hospital care in relation to the first accreditation cycle in Denmark. DESIGN, SETTING AND PARTICIPANTS: We performed a multi-level, longitudinal, stepped-wedge, nationwide study of process performance measures to evaluate the impact of a mandatory accreditation programme in all Danish public hospitals. Patient-level data (n = 1 624 518 processes of care) on stroke, heart failure, ulcer, diabetes, breast cancer and lung cancer care were obtained from national clinical quality registries. INTERVENTION: The Danish Healthcare Quality Programme was introduced in 2009, aiming to create a framework for continuous quality improvement. MAIN OUTCOME: Changes in week-by-week trends of hospital care during the study period of 269 weeks prior to, during and post-accreditation. RESULTS: The quality of hospital care improved over time throughout the study period. The overall positive change in trend odds ratio (OR) = 1.002 per week; 95% confidence interval (CI: 0.997-1.006) observed when comparing the period during accreditation with the period prior to accreditation was not significant. However, when restricting the analyses to processes of care where the performance did not meet target values for satisfactory quality prior to accreditation, we found a significant positive change in trend (OR = 1.006 per week; 95% CI: 1.001-1.011). When comparing the post-accreditation period with the period during accreditation, we found a significantly reduced trend (OR = 0.994 per week; 95% CI: 0.988-0.999), indicating the improvement in quality of care continued but at a lower rate than during accreditation. CONCLUSION: These findings support the hypothesis that hospital accreditation leads to improvements in patient care.
Authors: Laura Müller; Reida El Oakley; Mohammed Saad; Ali H Mokdad; Giamal A Etolhi; Antoine Flahault Journal: J Glob Health Date: 2021-05-08 Impact factor: 4.413
Authors: Viktor Dombrádi; Barnabás Margitai; Csaba Dózsa; Orsolya Karola Bárdos-Csenteri; János Sándor; Tibor Gáll; Sándor Gődény Journal: BMJ Open Date: 2018-02-01 Impact factor: 2.692
Authors: Peter Van Bogaert; Danny Van Heusden; Stijn Slootmans; Ingrid Roosen; Paul Van Aken; Guy H Hans; Erik Franck Journal: BMC Health Serv Res Date: 2018-10-03 Impact factor: 2.655