Accreditation: A Global Regulatory Mechanism to Promote Quality and Safety (Term Paper Sample)

Accreditation: A Global Regulatory Mechanism to Promote Quality and Safety Name: Institution: Accreditation: A Global Regulatory Mechanism to Promote Quality and Safety Definitions Accreditation Accreditation is the process through which healthcare organizations are reviewed as to determine their ability to standards and other criteria that have been set up by professional accrediting agencies. Once an institution has been accredited, then it is perceived to be reputable and credible in providing its services with regard to the highest quality standards in the industry (Shortell & Ferlie, 2001, p.285). Such compliance is reviewed regularly to maintain the quality of services, especially in the healthcare industry and experts are involved in these processes to make sure that the standards created are of high quality. Licensure Licensure involves an involuntary process through which a government body is mandated to regulate the profession. This means that for any healthcare practitioner to be permitted to undertake a particular occupation, then he/she has to apply for licensure whereby his/her competency is checked to make sure that public health, welfare and safety is always protected in the industry. Differences between Accreditation and Licensure Accreditation is broadly referred to as the process through which institutions voluntarily agree to be evaluated and be publicly recognized for having met a particular set of qualifications or standards involve periodic evaluations of the institutions. In this case, the process of accreditation is usually carried out by an association or agency of professionals. On the other hand, licensure involves individual practitioners who are legally bound by a government agency that checks their competency in a particular field before being allowed to practice (Shortell & Ferlie, 2001, p.291). History of Accreditation in the United States In the early 20th century, accreditation was developed to regulate the increased number of institutions in the United States. This was due to the fact that there were no standards in place to distinguish institutions and the quality of services they offered. These efforts were mainly put in areas of health care and education since they were the pillars of the nation at the time. With the number of people in communities increasing, it was important to develop standards that would guide these institutions to ensure that quality was maintained. In the 1800’s, the first accrediting agencies were formed as regional blocs after which they began to steadily evolve. In healthcare, quality is the most important aspect since it determines whether a person lives or dies. According to the Institute of Medicine (IOM), quality was defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Therefore, quality in healthcare has been an evolving process that was complex and difficult to describe but achieved through movements and innovation (Bozic & Marjoua, 2012, p.266). In 1965, Congress passed the Medicare legislation that ensured that disabled and aging people over the age of 65 years received medical insurance. Afterwards, Congress also saw the need to review and assess the legislation hence set a list of rules and conditions to guide the implementation of the new legislation. These new sets of conditions included several elements that were necessary for any hospital to participate in the program. Therefore, conditions for hospital operations were set up and they included the credentials of staff members, 24-hour nursing services as well as review of utilization. This led to the formation of Utilization Review Committees that were established in 1972 with their main aim being to identify the hospitals and practitioners that provided quality clinical services as described in the new legislation. However, these committees were ineffective since there was no formal criterion that was in use to evaluate decision making and quality provided in the different healthcare institutions. Congress later decided to introduce the Experimental Medical Care Review Organizations that were responsible for reviewing healthcare delivery, especially in in-patient settings and also assessing how appropriate the delivered care was with regard to quality. These organizations became successful because they developed models that could be implemented that went hand in hand with the findings of the quality review processes that they undertook. Their success led to the development of Medicare’s Professional Standards Review Organizations (PSRO’s) that enabled the creation of non-profit run organizations that had the task of assessing the application, necessity and quality of the services provided in the healthcare industry (Bozic & Marjoua, 2012, p.270). Their goal therefore, became to affirm that the medical practitioners as well as health care institutions met obligations under the Medicare program of quality health care. However, PSRO’s did not fully meet government expectations and were critiqued over their prioritization of costs over quality due to rising health care costs. This led to the replacement of PSRO’s with utilization and quality control Peer Review Organizations (PRO’s). The findings of the newly formed PRO’s helped Congress to see the need of investing in research and the Agency for Healthcare Research and Quality (AHRQ) was formed. The focus for this program was to establish the clinical effectiveness, practice guidelines in the industry as well as treatment outcomes. In 1990, the National Committee for Quality Assurance (NCQA) was formed to improve the quality of health care. Since it is a non-profit organization, it performed its tasks of accrediting individual medical practitioners, medical groups and also medical plans being used in the United States. Challenges of Accreditation Current Challenges Accreditation is a challenge in the United States currently because it has become difficult to review the high number of health institutions that have come up over the years. This is because most of these institutions are underusing, overusing and misusing resources for profit instead of providing quality health care. This means that most health care institutions are charging a lot of money to patients to access their facilities hence causing a problem in the entire system. With more focus being put on the profit side, the quality tends to slump hence accreditation becomes an issue at...