Objectives: The purposes of this study were to explore the use of quality indicators in hospitals, and to recommend hospital quality indicator sets complimenting the hospital accreditation program. Methods: The study included extensive literature reviews of international experiences with indicators, interviews with seven surveyors and key members of the board of Hospital Accreditation (HA)-Thailand and 18 quality coordinators from 12 hospitals, and a panel review by participants from member hospitals. The proposed indicator set was tested in 35 public and private hospitals in the pilot hospital accreditation program. Results: The hospitals in the accreditation program have applied a variety of different quality indicators. All agreed that the purposes of the indicators are mainly to facilitate organization learning and quality improvement, rather than for accreditation decisions. Nine dimensions of quality could be drawn, including safety, effectiveness, efficiency, appropriateness, accessibility, accountability, competency, continuity and commitment. Some 22 quality indicators were initially recommended for field testing, encompassing clinical, service and management areas of quality. There were a number of conceptual and practical problems in implementing the indicators, particularly regarding definitions of the indicators and different capability levels of hospital information systems among the hospitals. Conclusions: Establishment of the quality indicator system should consider validity, reliability, responsiveness, applicability, practicality and feasibility. At the beginning, the aim is for internal use rather than external use as public information to avoid misunderstanding and misuse.
Learning Objectives: At the conclusion of the presentation, the participants will be able to: 1. identify important dimensions of hospital quality 2. describe important steps to construct hospital quality indicators to facilitate the hospital accreditation program in the setting of a developing country 3. recognise problems related to implementation of hospital quality indicators
Keywords: Indicators, Quality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Hospital Accreditation (HA)-Thailand
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.