Regulatory, Legal, Ethical, Accreditation Issues in Research

Regulatory, Legal, Ethical, Accreditation Issues in Research

Regulatory, Legal, Ethical, Accreditation Issues in Research

Question description

As highlighted in Chapter 9 of your course text, three research methods are available (descriptive, analytic, and evaluative). Discuss these methods and give one example of how each would be used when conducting research using homeless individuals as subjects. Analyze regulatory, accreditation, ethical, and legal issues and challenges related to each research method.

Your initial contribution should be 250 to 300 words in length.

Your research and claims must be supported by your course text and at least one other scholarly source. Use proper APA formatting for in-text citations and references

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One way to improve quality and safety in healthcare organizations (HCOs) is through accreditation. Accreditation is a rigorous external evaluation process that comprises self-assessment against a given set of standards, an on-site survey followed by a report with or without recommendations, and the award or refusal of accreditation status. This study evaluates how the accreditation process helps introduce organizational changes that enhance the quality and safety of care.

Methods
We used an embedded multiple case study design to explore organizational characteristics and identify changes linked to the accreditation process. We employed a theoretical framework to analyze various elements and for each case, we interviewed top managers, conducted focus groups with staff directly involved in the accreditation process, and analyzed self-assessment reports, accreditation reports and other case-related documents.

Results
The context in which accreditation took place, including the organizational context, influenced the type of change dynamics that

occurred in HCOs. Furthermore, while accreditation itself was not necessarily the element that initiated change, the accreditation process was a highly effective tool for (i) accelerating integration and stimulating a spirit of cooperation in newly merged HCOs; (ii) helping to introduce continuous quality improvement programs to newly accredited or not-yet-accredited organizations; (iii) creating new leadership for quality improvement initiatives; (iv) increasing social capital by giving staff the opportunity to develop relationships; and (v) fostering links between HCOs and other stakeholders. The study also found that HCOs’ motivation to introduce accreditation-related changes dwindled over time.

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Conclusions
We conclude that the accreditation process is an effective leitmotiv for the introduction of change but is nonetheless subject to a learning cycle and a learning curve. Institutions invest greatly to conform to the first accreditation visit and reap the greatest benefits in the next three accreditation cycles (3 to 10 years after initial accreditation). After 10 years, however, institutions begin to find accreditation less challenging. To maximize the benefits of the accreditation process, HCOs and accrediting bodies must seek ways to take full advantage of each stage of the accreditation process over time.

Peer Review reports
Introduction
Today’s healthcare organizations (HCOs) struggle with paradoxes of all kinds. They must reconcile multiple goals, such as teaching students and caring for patients, with different modi operandi (managerial, professional, technocratic, and others) [1, 2]. They must give doctors the freedom to exercise their clinical judgment while promoting the standardization of practices [3]. They must act autonomously, yet in coordination with community players, and they must both meet expectations and innovate. In addition, they are under increasing pressure to improve performance, as a number of recent publications have reported serious shortcomings in the quality and safety of services and care [4–8].

One of the ways in which countries around the world have sought to improve performance is through accreditation [9–12]. A literature review of the impacts of accreditation on HCOs suggests that more research is necessary to determine whether accreditation truly improves healthcare services delivery and health outcomes [13]. This is certainly the case in Canada, where even though accreditation through the United States’ Joint Commission of Healthcare Organizations dates from the beginning of the twentieth century, little is known about the real impacts of the accreditation process on Canadian HCOs [14–19]. Still, recent government-commissioned reports that recommend making accreditation obligatory for all HCOs demonstrate the prevalence of Canadians’ assumption that accreditation is a guarantee of a high level of quality and safety of care [6, 7].

Given this background, our study aimed to clarify the impacts of accreditation in Canada by asking the following question: what kind of organizational changes does the accreditation process introduce within HCOs?

To answer this question, we analyzed changes that occurred during a recent accreditation cycle in five Canadian HCOs. The lack of result indicators during the period of study prevented us from assessing the impact of accreditation on patient outcomes. Rather, we identified the principal organizational changes that occurred during the accreditation cycle