Promoting research into healthcare
evaluation: advancing an ISQua initiative
In 2005, the Research Working Group of the ISQua
Accreditation Council began discussing how to stimulate,
promote and share accreditation/external evaluation research
and information. What research in this area currently exists?
What are the research gaps? What mechanisms might be
developed to facilitate the sharing of this research?
Healthcare accreditation started in 1918. However, since the
1980s there has been a marked increase in expansion globally,
with accreditation organizations now existing in over 70
countries and using a great amount of resources and effort.
Questions are being raised about the value of accreditation and
whether it makes a verifiable improvement in healthcare deliv-
ery and healthcare outcomes [1, 2]. Those directly involved in
the accreditation projects strongly believe in its contribution to
improving health service and care quality. Others have differing
opinions based on their perceptions . Research in the area of
accreditation/external evaluation is, for that reason, essential to
address those issues. Accreditation/external evaluation must be
relevant and measurably contribute to healthcare improvement.
Given the escalating uptake of accreditation and the resultant
increasing amount of accreditation-related research and data
being generated , it is increasingly important to enable effec-
tive sharing of research ideas and findings. It is important to
learn from each other, to share the evidence and, at the same
time, to identify the gaps and areas within which more research
One of the first steps undertaken by the ISQua Research
Working Group was the creation of a preliminary inventory
of the existing accreditation/external evaluation research
being undertaken within the ISQua member organizations.
We discovered that a significant number of projects were
kept as ‘grey literature’. For that reason, it was decided to
create a database that would allow trends and gaps in
the research to be identified while simultaneously helping
researchers avoid redundant projects. Following this step, it
was agreed to develop a research website within which
accreditation/external evaluation research would be posted
including both official and ‘grey literature projects’.
Though we do not have a unique conceptualization for
accreditation performance , research on accreditation
focuses on primarily three areas: the impact of accreditation
on the quality and safety of healthcare delivery, the efficiency
of accreditation tools and systems for providing feedback
organizations as well as all key stakeholders and the impact
on the capacity development of systems.
includes topics such as organizational and managerial
changes due to accreditation, professional involvement and
satisfaction with the process, changes in organizational
culture, changes in key processes that are evidence based
related to outcomes, changes in outcomes and costs and
impact of patients’ and other stakeholders involvement in the
process. All of these are hot topics that have been insuffi-
ciently explored in research projects in past years. One
reason for this is that accreditation has been implemented in
some countries for many decades and consequently it is dif-
ficult to identify ‘control groups’ to compare. In countries
starting the process, driving forces of accreditation generally
do not consider the need for research in this field.
The new ISQuA Accreditation/external evaluation research
website, hosted by Accreditation Canada, formerly the
Canadian Council on Health Services Accreditation, www.
isquaresearch.com, enables identification of projects and key
researchers and supports open dissemination of the data and
research to the accreditation community, the public and other
stakeholders. Projects are easily searchable based on multiple
criteria, and can be browsed for your convenience. Projects
may be in the early stage of initiation, ongoing or completed.
Each completed project listed includes the project abstract and
the results. Contact information for all projects is included.
Readers of the website will note trends in accreditation
research topics that can be recognized such as mandatory
versus voluntary accreditation, or impact of performance
measures within the accreditation process . At the same
time, opportunities for international comparative research
emerge. Data reported in the website is obtained from
researchers and accreditation organizations as well as from
literature review. For that reason is important to involve all
interested groups involved in this effort.
Your partnership to ensure completeness of the website
content is essential. The website is populated by submissions
authors. ‘Consequently, in order to populate the website we
strongly encourage, invite and welcome new submissions for
inclusion’. Criteria have been identified that are applied to
screen research projects and related reports. Following
acceptance for posting and meeting these criteria, the
International Journal for Quality in Health Care vol. 21 no. 1
# The Author 2008. Published by Oxford University Press in association with the International Society for Quality in Health Care;
all rights reserved27
International Journal for Quality in Health Care 2009; Volume 21, Number 1: pp. 27–28
Advance Access Publication: 2 October 2008
by guest on January 13, 2016