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Introduction: Accreditation programmes for healthcare systems have been implemented in more than 70 countries to stimulate high-quality organisational performance. Several Danish healthcare institutions are covered by the Danish Healthcare Quality Programme (DDKM) and all Danish public hospitals have been accredited according to the DDKM since 2010. The dates of each survey are currently being announced 8-10 months beforehand. Announcing surveys has been criticised for creating an "arranged reality". It has therefore been suggested that a national intervention be conducted to evaluate the effect of unannounced hospital surveys. Methods and analysis: All public somatic and psychiatric hospitals in Denmark (n=30) were invited to participate in the trial. Twenty-three hospitals (77%) (3 university hospitals, 5 psychiatric hospitals, and 15 general hospitals) agreed to participate and to be randomised to one of the trial clusters. Eleven hospitals will receive announced surveys (control group) and 12 hospitals will receive unannounced surveys (intervention group).We hypothesise that hospitals receiving unannounced surveys will be rated as less successful than hospitals receiving announced surveys, defined as meeting less compliance with accreditation standards and performance indicators. Nine experienced surveyors employed and educated by The Danish Institute for Quality and Accreditation in Health Care (IKAS) will be responsible for conducting the surveys according to an abbreviated version of the current Danish periodic survey. The outcome is compliance with indicators reflecting organisational performance. Compliance will be analysed using logistic or linear regression analysis with random effects, contingency tables, and Pearson's chi-squared test or Fishers exact test, whichever is most appropriate. Ethics and Dissemination: This trial is pending ethics approval from Research Ethichs Comite for North Denmark Region. The findings from this randomised controlled trial will be disseminated through peer-reviewed journals, national and international conferences and will be utilised as health care political decision making for the future national accreditation programme. In addition, the results will facilitate to validate the effect of unannounced hospital surveys; given the issues of currently meeting an "arranged reality" during hospital surveys, this seems extremely desirable.