Implementing a national accreditation programme in Kuwaiti hospitals : understanding the impact, facilitators and barriers using a multiple methods approach

• Main Author: Alhaleel, Azari Sulaiman
• Published: University of Glasgow 2018
• Subjects: RA Public aspects of medicine
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.754350

Background and aim: Accreditation is a process of evaluating an organisation. It comprises a self-assessment against a set of standards and an external evaluation followed by a report. The trend towards implementing healthcare accreditation has reached the Middle East, since the World Health Organisation reported, in 2003, a lack of accreditation programmes in this region. Many countries in the Middle East, including Kuwait, have been developing and implementing accreditation programmes since then. The aim of this research was to explore implementation of the accreditation programme in Kuwait general hospitals from the multiple perspectives of the healthcare professionals involved. Methods: The research employed a multiple methods approach with three inter-linked studies. The first study was a systematic review of the international literature that explored the implementation of accreditation programmes. Data analysis was guided by Normalisation Process Theory (NPT). The second study was a documentary analysis of the accreditation reports of six general Governmental hospitals. The third study involved interviews with twenty-five participants, from two general hospitals, who represented different professional backgrounds and were all self-assessment team members. The accreditation implementation process was explored in depth, focusing on the impact of the programme and the factors that influenced the process. Both the documentary analysis and the interviews were analysed by thematic analysis. The findings of the three studies were then synthesised, using Normalisation Process Theory. Results: The findings from the three studies identified four broad areas representing the process of accreditation implementation: understanding the accreditation process; engagement with the accreditation process; the work of accreditation; and monitoring the impact of accreditation. Within these themes, key factors were found to influence the successful implementation of the programme. These were: understanding the process; individuals’ engagement; communication and teamwork; leadership support; resources; infrastructure; adaptation of Standards; and education and training. The evidence for the impact of accreditation programmes on healthcare services in the systematic review was inconclusive. However, accreditation was perceived, in the interviews, to have a positive organisational impact. On the individual level, the findings identified the process of implementing accreditation to impact positively on the personal development; improve working relationships; and the morale of the teams. Conclusion: This thesis has contributed to the evidence for the implementation of accreditation in the hospital setting and its impact, from the perspective of accreditation self-assessment team members. Furthermore, it provides valuable insights for policy makers within the Kuwaiti healthcare context in future planning and monitoring of the National Accreditation Programme.