A Comparative Study Of Assessment Method And Accreditation Standards Of Grade Accreditation Of Medical Institutions In Different Periods

Objective：This paper compared with the old and new national top-level policy documentsof grade accreditation of medical institutions, which included method of assessment andaccreditation standards. It combined with existing typical cases in the assessment activitiesand analyzed the design reasons of the new grade accreditation of medical institutions, as wellas evaluated the influence of accreditation policy which impacted on practice and effects. Andthen it investigated defects and problems of accreditation policy and proposed to policyapproaches and measures which can further improve accreditation policy, in order to providea reference for standard to the grade accreditation policy of medical institutions in ourcountry.Methods: The research mainly involves the methods of literature review and literaturesurvey and comparative study. According to compare to the content of the assessment methodand accreditation standards in different periods and combined with the typical case in thenews, this paper analyzed and discussed the content of review policy using reduction toabsurdity of historical events.Results: The paper showed the main comparative content by listing tables.1. It showed the main comparative content of the assessment method in different periodson the basis of the index of the purposes, the hospital classification, the range, the principle,the policy, the grade, the organization, the implementent, the using of results, the supervision,the standard and additional instructions of accreditation. The result showed that there was nodifference in the purpose of review in all of comparative contents, but all others hadsignificant change. The rate of change was91.67%, and the contents of principle and policyof accreditation and supervision were additional contents.2. The paper showed that the never formulated index account of the total number ofindicators is80%in the method in1989, and this proportion respectively was50%,5%and10%in the method in1995,2011and2012. The content of the longest time limit was thereview cycle that was also named the term of validity of the certificate, and it was four years.The content of the shortest time limit was the time limit of application and acceptance andfinishing the report and hearing of witnesses of objection and the retrial overhaul, and it was five days.3. It showed the main comparative content of the accreditation standards in differentperiods on the basis of the index of the scope, the principle, the contents, the method, theresult, the safety of the patients, the safety and quality of medical care, the nursing, thecontinuous improvementand and social evaluation and hospital management. There are greatchanges which on the basis of the index of the scope, the principle, the contents, the method,the result, the safety of the patients, the safety and quality of medical care, nursing andcontinuous improvementand, social evaluation and hospital management in accreditationstandard in2011than1989. The accreditation standard in2011covered the hospital running,medical quality, patient safety, the quality of disease, severe medical quality, rationaladministration and the hospital infection control. The accreditation standard in2011whichused the hospital information management system and the information of medical recordstored monitored and used215statistical evaluation index. It was more comprehensive,detailed and in-depth than the accreditation standard in1989which only used50single factorstatistical index, and it was more objectively showed the level of hospital operation andmanagement.Conclusion: Compared with other policies, the new round of review policy hadsignificant improvement in the multi-level and on a number of indicators whether in themethod of assessment nor in the accreditation standards. It was the consistently purpose thatwe should do better in work of hospital hierarchical management. It was the clearlyassessment principles and guidelines that conducive to opportunely complete to the job ofgrade assessment. The changing of the accreditation organization highlighted the industrialhospital management which the administrative departments of public health want to reach.The new method of assessment had the more clear, scientific and advanced provision whichused for reviewing. The added special section which was known as regulatory could ensurethe implementation of the principles of assessment. The time limit for the job of review hadshall be defined, which was a tremendous progress in the health administrative department ofthe public power self restriction. A clearly four-year review cycle was propitious to scientificmanagement and sustainable development of hospital. It is not less than6months before theapplication for self-evaluation that the new method of assessment formulated is a concrete manifestation of review principles in the review process. The new accreditation standard inthe design was in accordance with the basic standards, the core standard and optional standard,it was helical and progressive. It adopted the cycle theory of PDCA in the concept. And it wasinsisted on continuous improvement of the quality. The standard and index system designedhad more reasonable and scientific. It was more consistent with the current internationalhospital in the use of standards and evaluation methods.It was couldn’t avoid that there was some serious failures in the designed top policywhich were debatable and needed improving. The method of assessment should recover to therequirements that the level of the hospital was according to regional health programming. Thespecific definition of hospital classification should not be deleted. The method of assessmentshould cover all medical institutions. The name of the assessment method should change tothe method of hierarchical management and grade assessment of medical institutions. Theevaluation principle should hold on the idea that is increasing to the proportion of socialparticipation firmly and expand in further. We should respect the will of medical institutions ifthey didn’t want to review. The use of the review results should be clearly defined. Evaluationcriteria could be unified but one could not have everything. The time limits of the new methodof assessment made strictly and clearly requirement for the job and efficiency of operations ofpublic health administration and the organization of assessment. Too harsh time limits mightnot be able to make the assessment more pragmatic and efficient. It is the time limits of theindividual articles should be consummate in the future that could serve up the quality of themethod of assessment. The contents of accreditation standards were too complicated, and theywere difficult to master. Some of the contents of accreditation standards were out of touchwith the reality of hospital management. On the whole, a new round of accreditation standardwas too complicated and was difficult to master. The feasibility and the operation of part ofthe standard was still to be improved.