- B H Ente: Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois 60181, USA.
BACKGROUND: Throughout the world, in developed and developing countries alike, governments, payers, employers, and consumers desire means of holding providers accountable for the quality of care purchased and delivered. To explore the relevance and value of accreditation systems for meeting these various needs, the Joint Commission on Accreditation of Healthcare Organizations (Oakbrook Terrace, III) cosponsored a "World Symposium on Improving Health Care Through Accreditation," in Barcelona, Spain, July 8-10, 1999. To sharpen the issues involved in improving health care worldwide, the program was organized around debates focusing on four provocative propositions. Each pair of keynote debaters was followed by a reactor panel, audience discussion, and balloting.
PROPOSITIONS: 1. No single set of quality standards is appropriate for universal use in health care organizations; 2. Health care financing mechanisms provide the primary incentives and disincentives to deliver high-quality health care; 3. Effective health system reform must be legislated and encompass reliance on the private sector; and 4. An accreditation system that includes professional credentialing and evidence-based practice will improve health care outcomes.
SUMMARY: There was much agreement that emphasis on accountability has stimulated dramatic growth in internal (organizational) quality management programs, external (cross-organizational) benchmarking with comparative data, and accreditation or certification.