Quality in Hospital Based Services

Original Editor - Angeliki Chorti Top Contributors - Angeliki Chorti

Introduction[edit | edit source]


Quality in healthcare has been a key and much debated concept in the last few decades. [1] [2] Due to its multifaceted and complex nature, various approaches for improvement and reinforcement have been developed globally.

In hospital care, indicators and checklists may be used as tools of quality improvement, e.g. to decrease morbidity and mortality, [3] [4] or to qualify for a recognised quality approval instrument.

Quality instruments and subsequent accreditation procedures have been traditionally used to evaluate and benefit the quality of health care. Indeed, in their systematic review, Hussein et al. [5] have found that compliance with accreditation standards may enhance performance and improve patient safety in the hospital setting.

Examples of International Accreditation Organisations for Hospital Services[edit | edit source]

The Joint Commission International (JCI)[edit | edit source]

The Joint Commission International (JCI) is a non-profit organisation that identifies, assesses and promotes best healthcare practices in quality and safety of patients worldwide. [6]Their accreditation processes may also include educational programmes, publications, but also certifications on clinical programmes or specialty centres. [7] On their Quality Check Website, hospital performance measure results can be found and quality reports can been created to learn about National Patient Safety Goal compliance and National Quality Improvement Goals performance for hospitals on key quality indicators. [8]

Qmentum[edit | edit source]

Qmentum is another organisation whose accreditation and certification programmes facilitate hospital facilities in assessing their processes and developing and implementing effective strategies to meet standards and regulatory requirements in daily practice. [9] The Qmentum standards include the Required Organizational Practices (ROPs), which aim to enhance patient safety and minimize risk. [10]

Health Standards Organization (HSO)[edit | edit source]

Health Standards Organization is a Canadian non-profit organisation that develops and asssesses standards and tools for health and social care. [11] HSO builds on the experience of Accreditation Canada, the Canadian accreditation body for health and social care.

Relevance to Physiotherapy[edit | edit source]

Hospital-based physiotherapy is part of the multidisciplinary team addressing various patient groups, ages, conditions and health statuses during hospitalisation. Physiotherapists may provide their services in acute settings, at the rehabilitation stage, or other complex hospital settings requiring long-term support. [12]

Quality of hospital-based physiotherapy has been referred to as the degree of resemblance between criteria of desirable and the actual care. [13]A prerequisite for high-quality physiotherapy services in a hospital setting is to successfully combine expectations and perceptions of patients with key stakeholders. [14] To date, very scarce information exists regarding quality improvement frameworks for hospital-based physiotherapy, and existing accreditation instruments to measure quality mainly rely on hospital policy and procedures without taking into account specifics of the profession. [14]

A Dutch Delphi study provided a set of 56 quality indicators that were condensed into 7 composite indicators to assess the quality of a hospital-based physiotherapy departments. [15] The seven composite indicators representing a quality theme were based on definitions of the European Foundation for Quality Management. [15]These were the following:

  1. Culture of continuous learning, improvement and open dialogue
  2. Promotion of staff expertise that is consistent with the demand for care
  3. Using a planning and control cycle to work on achieving its goals in the short, medium and long term, with a policy plan that fits within the frameworks of organisational policy
  4. Forming an integral part of the overall patient and hospital process
  5. Implementing a patient-oriented policy
  6. Systematically ensuring that the physiotherapeutic interventions undertaken by employees are of the highest possible quality and
  7. Collecting feedback on performance from stakeholders and staff and taking action that is based on this feedback.

Resources[edit | edit source]

Jont Commission International


HSO, Health Standards Organization

References[edit | edit source]

  1. Institute of Medicine Committee on Quality of Health Care in America. In: Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US), 2000.Available from: https://nap.nationalacademies.org/catalog/9728/to-err-is-human-building-a-safer-health-system [accessed 14/7/2023]
  2. Altman DE, Clancy C, Blendon RJ. Improving patient safety--five years after the IOM report. N Engl J Med. 2004;351(20):2041–3.
  3. Wright J, Dugdale B, Hammond I, Jarman B, Neary M, Newton D, Patterson C, Russon L, Stanley P, Stephens R, Warren E. Learning from death: a hospital mortality reduction programme. J R Soc Med 2006;99:303–8.
  4. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, Herbosa T, Joseph S, Kibatala PL, Lapitan MC, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009 Jan 29;360(5):491-9.
  5. Hussein M, Pavlova M, Ghalwash M, Groot W. The impact of hospital accreditation on the quality of healthcare: a systematic literature review. BMC Health Services Research 2021; 21:1057.
  6. Joint Commission International. Available from: https://www.jointcommission.org/who-we-are/joint-commission-international/ [accessed 16/7/2023]
  7. Joint Commission International. What we offer. Available from: https://www.jointcommissioninternational.org/what-we-offer/ [accessed 16/7/2023]
  8. Joint Commission International. Quality Check. Available from: https://www.jointcommission.org/who-we-are/facts-about-the-joint-commission/quality-check-and-quality-reports/ [accessed 16/7/2023]
  9. Qmentum Consulting. Available from: https://qmentum.com/ [accessed 16/7/2023]
  10. Miyata M, Munroe J. Tracking Required Organizational Practices Related to Processes Involving Medications. Can J Hosp Pharm. 2011 May-Jun; 64(3): 212–15.
  11. About - HSO Health Standards Organization. Available from: https://healthstandards.org/about/ [accessed 22/7/2023]
  12. Ministry of Health. Physical Therapy in Hospitals. (updated 15/2/2023). Available from: https://www.gov.il/en/departments/general/physiotherapy-hospitals [accessed 12/7/2023]
  13. Donabedian A. The definition of quality and approaches to its assessment: Vol 1. explorations in quality assessment and monitoring. Ann Arber, MI: Health Administration Press, 1980.
  14. 14.0 14.1 Steenbruggen R, Maas M, Hoogeboom T, Brand P, van der Wees P. A framework to improve quality of hospital-based physiotherapy: a design-based research study. BMC Health Services Research. 2023; 23; 34.
  15. 15.0 15.1 Steenbruggen R, van Oorsouw R, Maas M, Hoogeboom T, Brand P, van der Wees P. Development of quality indicators for departments of hospital-based physiotherapy: a modified Delphi study. BMJ Open Quality 2020; 9(2):e000812.