Recent developments in accreditation.

Within the past five years, accreditation has been adopted in a number of countries. Accreditation, originally perceived as a vehicle to enable organisational development, is found to be increasingly of interest to wider publics including governments in regulating and promoting quality. The newer systems are based upon the experience of the mature accreditation systems of the Joint Commission in the USA, the Canadian Council on Health Facilities Accreditation and the Australian Council on Health Care Standards. The mature accreditation systems have demonstrated their responsiveness to the changing needs of the health care systems in which they operate. In the past decade, these accreditation systems have responded to the decline in the role of the hospital in health care delivery; the demands of governments and the public for greater information about quality of health care. They have also responded to pressure for greater knowledge of clinical effectiveness by introducing indicators of clinical performance and are looking to outcome measures.