ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2014
The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 142 citations in OpenAlex.
- The impact of hospital accreditation on the quality of healthcare: a systematic literature review.BMC health services research · 2021Pooled it
- Mediators of change in healthcare organisations subject to external assessment: a systematic review with narrative synthesis.BMJ open · 2020Pooled it
- A systematic review of hospital accreditation: the challenges of measuring complex intervention effects.BMC health services research · 2015Pooled it
- Effects of external inspections on sepsis detection and treatment: a stepped-wedge study with cluster-level randomisation.BMJ open · 2020Trial
- Healthcare facility accreditation status and associated factors in Somalia: evidence from the 2022-2023 harmonized health facility assessment.BMC health services research · 2026Article
- Hospital Accreditation Governance in Afghanistan: Challenges and Solutions.Journal of healthcare leadership · 2026Article
- Review
- Effect of Accreditation on Patient Safety Culture: Insights from a Brazilian Multicenter Cross-Sectional Study.Global journal on quality and safety in healthcare · 2025Article
- Association between hospital accreditation and healthcare providers' perceptions of patient safety culture: a longitudinal study in a healthcare network in Brazil.Israel journal of health policy research · 2025Article
- The Impact of ISO Certification Procedures on Patient Safety Culture in Public Hospital Departments.Healthcare (Basel, Switzerland) · 2025Article
- The elicitation of patient preferences for hip replacement surgery: a discrete choice experiment.BMC health services research · 2025Article
- International models of accreditation and certification for hospitals with a focus on nursing: a scoping review.BMC health services research · 2024Article
- The influence of hospital accreditation on nurses' perceptions of patient safety culture.Human resources for health · 2024Article
- Implementation of a quality management system in a liver transplant programme.BMJ open quality · 2023Article
- The association between first-time accreditation and the delivery of recommended care: a before and after study in the Faroe Islands.BMC health services research · 2021Article
- Impact of the Introduction of Accreditation Standards on the Satisfaction of Patients in Cardiology Departments.Healthcare (Basel, Switzerland) · 2021Article
- Comparison of Major Clinical Outcomes between Accredited and Nonaccredited Hospitals for Inpatient Care of Acute Myocardial Infarction.International journal of environmental research and public health · 2021Article
- Contribution of Healthcare Professionals in Issues that Relate to Quality Management.Materia socio-medica · 2021Article
- Effects of National Hospital Accreditation in Acute Coronary Syndrome on In-Hospital Mortality and Clinical Outcomes.Acta Cardiologica Sinica · 2020Article
- Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison.Medicina (Kaunas, Lithuania) · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 14 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals.
designA mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. SETTING AND
participantsSeventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey.
main outcome measureFour composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways.
resultsAccreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke).
conclusionsAccreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.