Accreditation Clinical Trial
Official title:
Unannounced or Announced Periodic Hospital Surveys: A Study Protocol for a Nationwide Cluster-randomised, Controlled Trial
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.
Status | Active, not recruiting |
Enrollment | 23 |
Est. completion date | November 2015 |
Est. primary completion date | November 2015 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: public hospitals: - psychiatric hospitals - university hospitals - general hospitals Exclusion Criteria: - private hospitals NOTE: "accept of healthy volunteers": we assess accreditation indicators at hospital level. human subjects (hospital staff and patients) are interviewed in relation to hospital accreditation indicators performed by hospital surveyors. |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Caregiver), Primary Purpose: Health Services Research
Country | Name | City | State |
---|---|---|---|
Denmark | Danish Center for Healthcare Improvements | Aalborg |
Lead Sponsor | Collaborator |
---|---|
Danish Center for Healthcare Improvement | Institute for Quality and Accreditation in Healthcare |
Denmark,
Greenfield D, Moldovan M, Westbrook M, Jones D, Low L, Johnston B, Clark S, Banks M, Pawsey M, Hinchcliff R, Westbrook J, Braithwaite J. An empirical test of short notice surveys in two accreditation programmes. Int J Qual Health Care. 2012 Feb;24(1):65-71. doi: 10.1093/intqhc/mzr074. Epub 2011 Dec 2. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | hospital accreditation standards/indicators | The surveyors will classify each assessed performance indicator (n=113) in predetermined phrases that covers the organisational performance. Each phrase is assigned a level of performance (1-4), to enable a convertion of data into categorical ordinal variables. The predetermined phrases are determined as; "consistent implementation"=1, "consistent implementation with single deviations"=2, "weak implementation"=3, and "missing implementation"=4. All findings will be accumulated on each performance indicator. | 25 weeks | No |