Hospital accreditation has been defined as “A self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve”. Critically, accreditation is not just about standard-setting: there are analytical, counseling and self-improvement dimensions to the process. There are parallel issues around evidence-based medicine, quality assurance and medical ethics (see below), and the reduction of medical error is a key role of the accreditation process. Hospital accreditation is therefore one component in the maintenance of patient safety. However, there is limited and contested evidence supporting the effectiveness of accreditation programs.
Broadly speaking, there exist two types of hospital accreditation:
- Hospital and healthcare accreditation which takes place within national borders
- International healthcare accreditation.
Hospitals and healthcare services are vital components of any well-ordered and humane society, and will indisputably be the recipients of societal resources. That hospitals should be places of safety, not only for patients but also for the staff and for the general public, is of the greatest importance. Quality of hospitals and healthcare services is also of great interest to many other bodies, including governments, NGOs targeting healthcare and social welfare, professional organisations representing doctors, patient organisations, shareholders of companies providing healthcare services, etc. However, accreditation schemes are not the same thing as government-controlled initiatives set up to assess healthcare providers with only governmental objectives in mind - ideally, the functioning and finance of hospital accreditation schemes should be independent of governmental control.
How quality is maintained and improved in hospitals and healthcare services is the subject of much debate. Hospital surveying and accreditation is one recognised means by which this can be achieved.
It is not just an issue of hospital quality. There are financial factors as well. For example, in the USA, up until recently the Joint Commission exercised a de facto veto over whether or not US hospitals and other health providers were able to participate, and therefore earn from, the Medicare and Medicaid programs. This situation has changed in recent years.
Accreditation schemes recognised as providers of national healthcare accreditation services include:
- Malaysian Society for Quality in Health, or MSQH - based in Malaysia
- QHA Trent Accreditation - based in the UK-Europe 
- Australian Council for Healthcare Standards International, or ACHSI - based in Australia 
- Accreditation Canada, formerly known as Canadian Council on Health Services Accreditation, or CCHSA - based in Canada 
- Healthcare Facilities Accreditation Program (HFAP) -based in the USA 
- Joint Commission (JC) - based in the USA 
- Community Health Accreditation Program (CHAP) - based in the USA 
- Accreditation Commission for Health Care Inc. (ACHC) - based in the USA 
- The Compliance Team: "Exemplary Provider Programs" - based in the USA 
- Healthcare Quality Association on Accreditation (HQAA) - based in the USA 
- DNV Healthcare Inc. DNVHC - based in Norway and the USA  
- Thailand Hospital HA - based in Bangkok, Thailand 
- Taiwan Joint Commission on Hospital Accreditation (財團法人醫院評鑑暨醫療品質策進會) - based in Taipei, Taiwan 
- La Haute Autorité de Santé, French National Authority for Health, based in Paris, France 
- Co.N.A.S., National Commission for Accreditation of Hospitals based in Bucharest, Romania 
- American Accreditation Council (AAC) based in USA, http://www.americanaccreditation.com
The different accreditation schemes vary in quality, size, intent and the skill of their marketing. They also vary considerably in terms of the cost incurred by hospitals and healthcare institutions. They have varying degrees of commitment to assessing medical ethical standards and clinical standards.
They all have web sites.
Some accreditation schemes also undertake international healthcare accreditation work outside of their base country. One of the large number of accreditation schemes in the USA, the Joint Commission (TJC) currently being the best known, has created Joint Commission International, or JCI. In recent years, DNV have been challenging TJC in the USA.
The former Trent Accreditation Scheme (TAS) from the UK was the first to accredit a hospital in Asia, in Hong Kong in 2000 , and QHA Trent Accreditation from the UK have continue to work in the same field. Since TAS started the process, others, such as JCI, have entered the market.
DNV Healthcare is a Norwegian-US health care accrediting organisation providing a quality management system constructed in accordance with ISO 9001 and approved by the U.S. Centers for Medicare and Medicaid Services (CMS).
- International healthcare accreditation
- Health insurance
- Evidence-based medicine
- List of healthcare accreditation organisations in the USA
- Patient safety
- Medical ethics
- United Kingdom Accreditation Forum
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