American Speech-Language-Hearing Association

Quality Improvement: Accreditation

What is accreditation?

In today's consumer-oriented world, service providers often seek credentialing or special recognition by another agency or body of persons who give a "seal of approval" for services and goods provided to customers. This "seal of approval" in education and health care takes the form of accreditation.

How do accrediting bodies influence QI?

Accrediting bodies review ongoing quality improvement activities and programs. Accrediting bodies no longer accept paperwork compliance alone to satisfy the requirements of the accreditation process. While the documentation of ongoing QI activities is still a part of the accreditation process, today's accrediting bodies want to see QI activities that address actual client care (including the quality and appropriateness of care, the accuracy of diagnostics, the efficacy of treatment, the appropriateness of referrals, and the outcomes of services provided). Accrediting bodies want to review how the audiologist has addressed these areas, not only after the client was discharged, but also when actual care is being provided.

Accrediting bodies like Joint Commission (formerly referred to as the Joint Commission on Accreditation of Healthcare Organizations) have fostered the evolution of QI activities (referred to by Joint Commission as "performance improvement"). Joint Commission has moved from the patient care audit to more contemporary QI methods. While previous Joint Commission audits heavily emphasized data collection and were done retrospectively, new methods allow for retrospective, concurrent, and prospective review and emphasize outcomes. The outcome-oriented approach focuses on the actual performance of practitioners and clients, rather than on paper compliance and theoretical practice.

The shift in accreditation emphasis-from whether a facility can provide high quality care to whether it actually does-has become the major focus in recent years and will continue to be emphasized until quality care is firmly incorporated into the accreditation process.

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