Can we simplify the hospital accreditation process? Predicting accreditation decisions from a reduced dataset of focus priority standards and quality indicators: results of predictive modelling

Details

Serval ID
serval:BIB_E7F4FCF75EAE
Type
Article: article from journal or magazin.
Collection
Publications
Title
Can we simplify the hospital accreditation process? Predicting accreditation decisions from a reduced dataset of focus priority standards and quality indicators: results of predictive modelling
Journal
BMJ Open
Author(s)
Guérin Sophie, Le Pogam Marie-Annick, Robillard Benjamin, Le Vaillant Marc, Lucet Bruno, Gardel Christine, Grenier Catherine, Loirat Philippe
ISSN
2044-6055
2044-6055
Publication state
Published
Issued date
08/2013
Peer-reviewed
Oui
Volume
3
Number
8
Pages
e003289
Language
english
Abstract
Objectives: Accreditation in France relies on a mandatory 4-year cycle of self-assessment and a peer review of 82 standards, among which 14 focus priority standards (FPS). Hospitals are also required to measure yearly quality indicators (QIs-5 in 2010). On advice given by the accreditation committee of HAS (Haute Autorité en Santé), based on surveyors proposals and relying mostly on compliance to standards, accreditation decisions are taken by the board of HAS. Accreditation is still perceived by hospitals as a burdensome process and a simplification would be welcomed. The hypothesis was that a more limited number of criteria might give sufficient amount of information on hospitals overall quality level, appraised today by accreditation decisions.
Design: The accuracy of predictions of accreditation decisions given by a model, Partial Least Square-2 Discriminant Analysis (PLS2-DA), using only the results of FPS and QIs was measured. Accreditation decisions (full accreditation (A), recommendations or reservation (B), remit decision or non-accreditation (C)), results of FPS and QIs were considered qualitative variables. Stability was assessed by leave one out cross validation (LOOCV).
Setting and participants: All French 489 acute care organisations (ACO) accredited between June 2010 and January 2012 were considered, 304 of them having a rehabilitation care sector (RCS).
Results: Accuracy of prediction of accreditation decisions was good (89% of ACOs and 91% of ACO-RCS well classified). Stability of results appeared satisfactory when using LOOCV (87% of ACOs and 89% of ACO-RCS well classified). Identification of worse hospitals was correct (90% of ACOs and 97% of ACO-RCS predicted C were actually C).
Conclusions: Using PLS2-DA with a limited number of criteria (QIs and FPS) provides an accurate prediction of accreditation decisions, especially for underperforming hospitals. This could support accreditation committees which give advices on accreditation decisions, and allow fast-track handling of 'safe' reports.
Keywords
Hospital accreditation, Quality indicators, HAS, Haute Autorité en Santé, Acute care, Predictive modeling, Health services research, Quality of care
Pubmed
Web of science
Publisher's website
Open Access
Yes
Create date
03/11/2023 16:12
Last modification date
07/11/2023 8:11
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