The Impact of Accreditation on Quality of Care: Perception of Nurses in Saudi Arabia
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Accreditation is recognized worldwide as a tool to improve health care quality. In developing countries, the interest in attaining international accreditation is growing despite the considerable resources the accreditation process consumes and the lack of information about its impact on quality of care. The purpose of this study was to assess the impact of Joint Commission International (JCI) accreditation on health care quality and to explore the contributing factors that affect quality of care as perceived by nurses. The theoretical foundation for this study was based on total quality management theory and Donabedian's model. The research questions for the study examined the impact of JCI accreditation on quality of care and the relationship between quality improvement activities and quality of care. A cross-sectional quantitative design was employed in which a self-administered questionnaire was used to collect data. Participants from one accredited and another nonaccredited hospital in a developing country in the Middle East formed the purposive nonprobability sample that included 353 nurses. The results of a Wilcoxon Rank Sum Test and a correlation analysis indicated that JCI accreditation has a significant impact on quality of care ratings by nurses. Also, multiple regression analysis showed that leadership commitment is the best predictor of quality of care as perceived by nurses. This study may foster social change by encouraging hospital administrators and policy makers, particularly in developing countries, to implement quality improvement programs that will eventually improve the health care system in their countries.
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