Ontology highlight
ABSTRACT: Objective
To evaluate the effectiveness of unannounced versus announced surveys in detecting non-compliance with accreditation standards in public hospitals.Design
A nationwide cluster-randomized controlled trial.Setting and participants
All public hospitals in Denmark were invited. Twenty-three hospitals (77%) (3 university hospitals, 5 psychiatric hospitals and 15 general hospitals) agreed to participate.Intervention
Twelve hospitals were randomized to receive unannounced surveys (intervention group) and eleven hospitals to receive announced surveys (control group). We hypothesized that the hospitals receiving the unannounced surveys would reveal a higher degree of non-compliance with accreditation standards than the hospitals receiving announced surveys. Nine surveyors trained and employed by the Danish Institute for Quality and Accreditation in Healthcare (IKAS) were randomized into teams and conducted all surveys.Main outcome measure
The outcome was the surveyors' assessment of the hospitals' level of compliance with 113 performance indicators-an abbreviated set of the Danish Healthcare Quality Programme (DDKM) version 2, covering organizational standards, patient pathway standards and patient safety standards. Compliance with performance indicators was analyzed using binomial regression analysis with bootstrapped robust standard errors.Results
In all, 16 202 measurements were acceptable for data analysis. The risk of observing non-compliance with performance indicators for the intervention group compared with the control group was statistically insignificant (risk difference (RD) = -0.6 percentage points [-2.51-1.31], P = 0.54). A converged analysis of the six patient safety critical standards, requiring 100% compliance to gain accreditation status revealed no statistically significant difference (RD = -0.78 percentage points [-4.01-2.44], P = 0.99).Conclusions
Unannounced hospital surveys were not more effective than announced surveys in detecting quality problems in Danish hospitals.Trial registration number
ClinicalTrials.gov NCT02348567, https://clinicaltrials.gov/ct2/show/NCT02348567?term=NCT02348567.
SUBMITTER: Ehlers LH
PROVIDER: S-EPMC5890868 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
Ehlers Lars Holger LH Simonsen Katherina Beltoft KB Jensen Morten Berg MB Rasmussen Gitte Sand GS Olesen Anne Vingaard AV
International journal for quality in health care : journal of the International Society for Quality in Health Care 20170601 3
<h4>Objective</h4>To evaluate the effectiveness of unannounced versus announced surveys in detecting non-compliance with accreditation standards in public hospitals.<h4>Design</h4>A nationwide cluster-randomized controlled trial.<h4>Setting and participants</h4>All public hospitals in Denmark were invited. Twenty-three hospitals (77%) (3 university hospitals, 5 psychiatric hospitals and 15 general hospitals) agreed to participate.<h4>Intervention</h4>Twelve hospitals were randomized to receive u ...[more]