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Accreditation across borders: the introduction of Joint Commission accreditation in Spain.

BACKGROUND: Introducing accreditation as conducted by the Joint Commission on Accreditation of Healthcare Organizations (Oakbrook Terrace, III) into Spain has raised many issues regarding the internationalization of accreditation. CHARACTERISTICS OF ACCREDITATION: In recent years more and more countries have considered accreditation a useful tool for the improvement of health care quality. In spite of the differences in the health care systems of the countries where accreditation has been introduced, many of the original characteristics of accreditation as seen in the United States largely remain: peer review evaluation, support of professional associations, voluntary participation, and a national approach. These similarities reflect the fact that the majority of the programs are based on models created by the Joint Commission. THE EXPERIENCE OF THE AVEDIS DONABEDIAN FOUNDATION: In 1994 the Avedis Donabedian Foundation (FAD), a nonprofit organization founded in Barcelona in 1988, broadened its scope to include accreditation. Having rejected the idea of creating de novo its own standards and accreditation program, FAD worked out an agreement with the Joint Commission whereby FAD would become a Spanish accrediting body to accredit Spanish hospitals but would collaborate with Joint Commission International to adopt the Joint Commission's accreditation standards and processes. DISCUSSION: The development of accreditation continues. As of spring 1998, seven hospitals and two ambulatory care centers are preparing for accreditation. FAD's experience with adapting the Joint Commission model of accreditation should be instructive to other countries considering health care accreditation.

Accreditation↗

Voluntary accreditation of cellular therapies: Foundation for the Accreditation of Cellular Therapy (FACT).

Voluntary accreditation of cells, tissues, and cellular and tissue-based products intended for human transplantation is an important mechanism for improving quality in cellular therapy. The Foundation for the Accreditation of Cellular Therapy (FACT) has developed and implemented programs of voluntary inspection and accreditation for hematopoietic cellular therapy, and for cord blood banking. These programs are based on the standards of the clinical and laboratory professionals of the American Society of Blood and Marrow Transplantation (ASBMT), the International Society for Cellular Therapy (ISCT), and NETCORD. FACT has collaborated with European colleagues in the development of the Joint Accreditation Committee in Europe (jACIE). FACT has published standards documents, a guidance manual, accreditation checklists, and inspection documents; and has trained as inspectors over 300 professionals active in the field. All inspectors have a minimum of 5 years' experience in the area they inspect. Since the incorporation of FACT in 1996, 215 hematopoietic progenitor cell facilities have applied for FACT accreditation. Of these facilities, 113 are fully accredited; the others are in the process of document submission or inspection. Significant opportunities and challenges exist for FACT in the future, including keeping standards and guidance materials current and relevant, recruiting and retaining expert inspectors, and establishing collaborations to develop standards and accreditation systems for new cellular products. The continuing dialogue with the Food and Drug Administration (FDA) is also important to ensure that they are aware of the accomplishments of voluntary accreditation, and keep FACT membership alerted to FDA intentions for the future. Other potential avenues of communication and cooperation with FDA and other regulatory agencies are being investigated and evaluated.

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[The integrated approach between Health Organisation accreditation and professional excellence accreditation].

Later than in other industrialized areas, Health Organisation accreditation has become popular in our country during the last few years as a result of legislation requiring accreditation for healthcare providers of the National Health Service. Out of the two accreditation models, for regulation and public accountability (institutional) and professional, voluntary self-developed (for excellence), Institutional accreditation process has been slowly growing with the adoption of generic structural and organisational standards, which have been set up and managed directly by government. The recently undertaken second model is a peer review assessment activity that originates from a comparison with explicit standards during reciprocal visits carried out by professional organisations. The basis for the assessment is primarily clinical and patient oriented. The healthcare quality of Institutional accreditation is guaranteed mainly through the achievement of predetermined standards for risk management and organisation. On the other hand, the excellence accreditation, whose aim is to implement the continuous improvement of quality, depends on the context and the changes that result from new knowledge and scientific progress. The model operates according to values, which can change in the long run. It measures the effort to improve performances while special care is required to define standards through peer consensus. Once the prescribed model of accreditation is adopted, as is the case for Health Organisation accreditation, it is essential to have flexible patient-oriented tools ensuring that new knowledge and scientific progress complete the assessment and audit.

Accreditation↗

Is clinical pathology accreditation worth it? A survey of CPA-accredited laboratories.

Following two pilot studies, Clinical Pathology Accreditation (CPA) accreditation was introduced to UK pathology laboratories in 1992. Since then, significant numbers of laboratories have undergone accreditation but many have never applied. We carried out a postal survey of 145 accredited laboratories in the UK to independently determine the opinions of laboratory managers/clinicians about CPA and whether accreditation had produced any significant benefits to pathology services. Ninety-three replies were received (64 per cent) a good response to an unsolicited questionnaire. Most laboratories felt accreditation by CPA had resulted in better laboratory performance with more documentation and better health and safety and training procedures. CPA accreditation was believed to provide useful information by approximately 50 per cent of laboratories but was also felt by a significant proportion of laboratories to be over-bureaucratic, inefficient and expensive (46 of 93 respondents). Many complaints were voiced about the excessive paperwork that CPA generated and there was also a significant body of opinion that felt that CPA assessed areas were the domain of other regulatory bodies such as the CPSM, IBMS and HSE.

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[Genuine medical accreditation systems in the USA according to standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)--reflections on the transferability of the procedures to Germany].

In a number of anglophone countries in parallel to the industrial trend accreditation systems have been developed for health care organizations and specially for hospitals. These systems were introduced and instituted as a part of the health care system in the countries. Central elements and central procedures of these genuine-medical accreditation systems for hospitals in the United States, in Australia, Canada, France and in Great Britain are mostly identical. They focus primarily on the patient and his way from access to post discharge in a hospital. Core of the systems is a catalogue with standards, which in a systematic and comprehensive way gives ideas of good professional performance in hospitals. The catalogues can be used internally to develop and improve quality and quality management in a hospital. Primarily, however, the accreditation systems are designed to provide most objective measures for external evaluation of quality and quality management.

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Royal College of Pathologists' United Kingdom pilot study of laboratory accreditation. The College Accreditation Steering Committee.

The Royal College of Pathologists recently commissioned a pilot study to assess the feasibility, desirability, and cost of establishing a national scheme for laboratory accreditation in the United Kingdom. Using a format similar to that designed by the College of American Pathologists, eight inspectors visited 24 laboratories comprising the major disciplines of two district hospitals, two teaching hospitals, a specialised (paediatric) hospital and a private hospital. Nine were considered accreditable without reservation, but 15 had deficiencies identified of differing importance which needed to be corrected before accreditation could be awarded. Problems identified were variable, but none related to technical performance and many did not require extra resources to correct. The exercise was conducted without organisational difficulty at an approximate direct cost of 300 pounds per laboratory. The study shows that the format used could form the basis of a cost effective nationwide strategy. The type of problems identified suggest that such a strategy is more likely to succeed if it is organised from within the pathology professions.

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Requirements for accreditation by the College of American Pathologists Laboratory Accreditation Program.

The College of American Pathologists Laboratory Accreditation Program expects a participant laboratory or laboratory section to be able to demonstrate that it is in compliance with the Standards for Laboratory Accreditation. The program expects laboratories to demonstrate that they are continually taking steps to identify and correct deficient areas and improve performance, in compliance with the Clinical Laboratory Improvement Amendments of 1988 regulatory requirements, particularly those pertaining to proficiency testing performance, and participating as inspectors in the accreditation process.

Accreditation↗

Joint Commission on Accreditation of Healthcare Organizations: standards and accreditation for durable medical equipment providers.

The accreditation survey for home medical equipment suppliers, as performed by the Joint Commission on Accreditation of Healthcare Organizations, emphasizes the process of care delivery, which includes equipment management and patient/caregiver instruction. Companies preparing for a survey are advised to perform a self-assessment to determine areas in need of review and improvement.

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Accreditation requirements for ORYX: the next evolution in accreditation.

This year, the Joint Commission of Accreditation of Healthcare Organizations approved new requirements for participation in the accreditation process for hospitals and long-term care facilities. This article offers an ORYX overview--plus information on choosing a performance measurement system.

Accreditation↗

Home care accreditation through Joint Commission on Accreditation of Healthcare Organizations.

As home care has become an increasingly viable alternative to inpatient care, the need for industrywide standards has become a major concern for consumers and payors of health care. The Joint Commission on Accreditation of Healthcare Organizations has developed standards which measure the quality of care and services provided by a home care organization. This article outlines the basic standards that a home infusion therapy service must meet in order to earn accreditation.

Accreditation↗

On accreditation of healthcare organizations. Determining eligibility for Accreditation of Home Pharmaceutical Services.

Many misperceptions exist in the health care community about the Joint Commission's accreditation of home pharmaceutical services, primarily related to when pharmacy services are considered home care and which patients or services are eligible for survey. This article concentrates on eligibility for survey and accreditation of just one of the six eligible home care services-home pharmaceutical services. The concept of home care and pharmaceutical services is difficult for most people to understand. Unlike other home care services, pharmacy services cannot be provided directly in the patient's home. Pharmacy laws prohibit pharmacists from compounding and dispensing directly in the patient's home. The pharmacists must do these activities in a licensed pharmacy. Also, most patients who receive medications from pharmacies take their own medications in their homes. So the differences between home care pharmacy and ambulatory or retail pharmacy are much less clear-cut than the delivery of more traditional home care services such as nursing or home health aide services.

Eligibility Determination↗

Using accreditation of prior learning and accreditation of prior experiential learning for entry on to the BSc in Medical Illustration.

The Accreditation of Prior Learning (APL) and Accreditation of Prior Experiential Learning (APEL) scheme described in this paper has been prepared following discussions between the Institute of Medical Illustrators (IMI) and Glasgow Caledonian University (GCU), departments of Learning and Educational Development and Biological Sciences. The scheme gives specific academic credit under the Scottish Credit Accumulation and Transfer (SCOTCAT) scheme for learning gained from experience, allowing access onto the Bachelor of Science Degree (BSc) in Medical Illustration to potential students who do not have the required Higher National Diploma (HND) or equivalent entry qualification. The need, rationale and structure of the scheme are described.

Accreditation↗