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Value of Accreditation and Certification Literature Database

This database is the product of a two-year effort to identify and review thousands of peer-reviewed research articles and other publications that address the value of accreditation, certification and the impact of other Joint Commission initiatives. The initial collection of articles included in the database was identified through a scoping literature review conducted in 2016. During that initial review, a total of 11,004 titles and abstracts were screened, 588 full-text sources were reviewed and 171 sources were summarized and included in this database. While the 2016 review identified 171 articles, new publications are regularly added to the database. New articles are typically identified through an annual literature search, although they may also be added intermittently, as they are identified and reviewed by the research team.
The scoping review process was conducted by three reviewers who screened all titles and abstracts and made independent recommendations for inclusion and exclusion. Upon completion of the title and abstract screening, the independent review and consensus process was repeated for the second stage review of full text of articles which passed the initial screen.

The review was designed to identify literature that addressed any of the following research questions:
  1. Do accredited / certified organizations have a greater rate of improvement or more sustained improvement than the non-accredited / certified organizations? (RQ1)
  2. Do Joint Commission-accredited / certified organizations perform better (have better structures, processes and outcomes) than non-accredited / certified organizations? (RQ2)
  3. What is the impact of Joint Commission accreditation and certification processes, specific standards, performance measures and or other products or initiatives on accredited and certified organizations? (RQ3)

Articles that were focused on exclusively non-Joint Commission accreditation and certification (domestic or international), and articles that were published in non-peer reviewed publications were excluded from the study.

The summary of each publication included in the database represents the research team's consensus opinion of:
  • The Purpose of the publication (as it pertains to accreditation, certification or the impact of Joint Commission initiatives),
  • Study Design and Methods (if applicable),
  • Findings (primarily focused on findings that are most directly related to research questions related to accreditation, certification or the impact of Joint Commission activities).
  • The research team also made an effort to categorically characterize the results/conclusions of each publication with respect to the Impact of accreditation or certification. Each publication was categorized as either positive (the publication reports benefits associated with accreditation or certification), negative (accreditation or certification was associated with unfavorable performance), neutral (accreditation or certification were unrelated to, or had no influence, on performance), mixed (the publication reports some mix of positive/neutral/negative results), or UTD (unable to determine or not applicable -- which generally indicated that the article focused on some aspect of accreditation or certification but was not designed to assess impact or value). Publications with the UTD/NA impact assessment are not included in this database.
There are currently 189 published articles on this site which include an Impact determination summarizing their results (i.e., "Positive", "Neutral", "Mixed", "Negative").* We encourage visitors to the site to review article summaries and use links (when available) to read the original articles. At this time, the results from the published literature overwhelmingly support the value of accreditation:
  • Positive = 152 (80.4%)
  • Neutral = 23 (12.2%)
  • Mixed = 9 (4.8%)
  • Negative = 5 (2.6%)

* Please note that an additional 15 articles on the site do not have an Impact determination, but they are listed as “Unable to Determine or Not Applicable” (i.e., “UTD”). These published articles describe some aspect of Joint Commission influence or impact, but they were not research studies that provided a statistical assessment of impact.

The articles described in this database were identified through a scoping literature review performed by researchers at The Joint Commission in 2016, and through annual follow-up reviews. While the research team took reasonable efforts to ensure that the review was comprehensive, The Joint Commission makes no claim about the completeness of the review, nor does it imply that the articles listed in this database are the only studies addressing accreditation or certification. The summaries of each article are focused on aspects of each study that are related to accreditation, certification or the impact of Joint Commission initiatives, and they are not intended to completely describe all aspects of each study. The categorization of the results/conclusions represent the consensus opinion of the research team. As such, they constitute a good faith effort to interpret a study's findings with respect to specific research questions that are related to accreditation, certification or other Joint Commission activities. The Joint Commission does not endorse any particular article, and users are encouraged to review the original articles referenced in this database and to draw their own conclusions about each article. The description of articles provided in this database is made available as a resource only. The Joint Commission makes no representations, and accepts no responsibility or liability, with regard to the use of information provided in this database.

["30-day mortality", "accrediation", "accreditation", "accreditation decisions", "acute ischemic stroke (AIS)", "acute medical conditions", "acute myocardial infarction", "acute stroke", "Acute Stroke Ready Certification", "addiction treatment outcomes", "adolescent opioid use", "adverse event reporting", "adverse events", "ambulatory", "ambulatory care", "ambulatory surgery centers", "ambulatory surgery procedures", "aneurysm", "antibacterial prescriptions", "antibacterial stewardship", "antibiotic stewardship program", "asthma care", "best practices", "bioterrorism", "cancer", "cardiac arrest", "cardiac care", "cardiac care facilities", "cardiovascular disease", "cataract surgery", "Cerebral Venous Sinus Thrombosis (CVST)", "cerebrovascular accident", "certifed stroke center", "certification", "Chi-square distributions", "children", "chronic kidney disease", "clinical dietitian", "clinical outcomes", "clostridioides difficile infection (CDI)", "Colombia", "community health centers", "community preparedness", "compliance", "Comprehensive Stroke Center", "comprehensive stroke center", "continuous quality improvement", "cost", "critical access hospitals", "cultural competence", "delivery of health care", "diagnostic stewardship", "disaster response", "disclosure practices", "disease specific", "disease specific care certification", "disease-specific certification", "disparities", "door-to-balloon (DTB) time", "dose levels", "education", "education department", "electronic handoff", "emergency care", "emergency care measures", "emergency department", "emergency departments", "emergency medicine", "emergency preparedness", "emergency response", "emergency room", "endoscopy", "endovascular-reperfusion therapy", "expenditures", "falls", "federally qualified health center", "financial performance", "focus groups", "geriatric patients", "HAC reduction program", "health care", "health consumer", "health disparities", "health markets", "health outcomes", "health policy", "health professionals", "health service needs and demands", "healthcare", "healthcare organizations", "healthcare quality", "healthcare quality dimensions", "healthcare quality indicators", "healthcare worker vaccinations", "heart failure", "heart failure core measure", "heart failure core measures", "heart-assist devices", "hip and joint replacement", "hip fractures", "home care", "home health", "Home Health Compare", "hospice", "hospital", "hospital accreditation", "hospital mortality", "hospital penalties", "hospital performance", "hospital readmission", "hospital system", "hospitals", "hospitals certification", "Imaging", "in-hospital adverse events", "incentives", "infection prevention practices", "infection rates", "influenza vaccination", "information technology", "inpatient", "inpatient neurological services", "inpatient psychiatric unit", "international accreditation", "International Patient Safety Goals (IPSG)", "International Patient Safety Goals (IPSGs)", "interprofessional care", "invasive procedures", "ischemic stroke", "isolation", "Joint Commission International", "Joint Commission International (JCI)", "life cycle model; accreditation", "long term care", "managed care", "market quality achievements", "marketing mix", "medical emergency team", "medical error reporting", "medical errors", "medical prescribing errors", "medical safety", "medical tourism", "medication administration", "medication errors", "medication management", "medication prescriptions", "medication safety", "mental health service", "mental health services", "meperidine", "methadone", "methadone maintenance", "methadone treatment", "military clinic", "morphine", "mortality", "mortality rate", "myocardial infarction", "narcotics", "National Patient Safety Goal", "national patient safety goals", "national quality measures", "neonatal morbidity", "nonmethadone outpatient treatment", "nursing", "nursing audit", "nursing home", "nursing homes", "nursing records", "nutrition services", "obstetrics", "occupational safety", "operating room", "opiate", "opioid", "opioid disorders", "opioids", "oral anticoagulation therapy", "organization of health care", "organizational correlates", "organizational performance", "outcomes", "outpatient", "outpatient centers", "outpatient substance abuse programs", "outpatients", "pain assessment", "pain control", "pain initiative", "pain management", "pain treatment", "palliative care units", "patient mortality", "patient outcomes", "patient safety", "patient satisfaction", "pediatrics", "perception of accreditation", "performance", "performance improvement", "performance measurement", "performance measures", "performancemeasurement", "peri-operative protocol", "perinatal quality measure", "pharmacists", "pharmacotherapy", "pharmacy", "pneumonia", "prescribing", "primary care", "primary stroke center", "primary stroke centers", "psychiatric hospitals", "public hospitals", "public reporting", "quality", "quality assessment", "quality assurance", "Quality improvement", "quality improvement", "quality improvements", "quality indicators", "quality indicators maternal mobidity", "quality measurement", "quality measurement system", "quality measures", "quality of care", "quality of prescribing", "quality ratings", "racial differences", "rapid response team", "readmission", "readmission rates", "reducing errors", "regulation", "restraint", "rural", "rural hospital", "rural hospitals", "safety", "safety culture", "seclusion", "sedation", "skilled nursing facility", "small hospitals", "smoking ban standard", "smoking bans", "smoking cessation", "smoking policies", "smoking restrictions", "staffing", "star ratings", "stroke", "stroke care", "stroke centers", "stroke certification", "substance abuse", "substance abuse treatment", "substance abuse treatment centers", "substance dependence", "suicide screening", "surgery time", "surgical marking", "surgical outcomes", "surgical procedures", "surgical site marking", "surveys", "surveys and questionnaires", "systems of care", "systems-theory", "telemedicine", "terrorism preparedness", "The Joint Commission", "thrombolysis", "timeout", "tobacco control standards", "tPA", "training", "transfer patterns", "treatment center", "treatment outcomes", "United States", "universal protocol", "vaccinations", "value", "value based purchasing", "Venous Thromboembolism", "ventilation", "ventricular assist device", "Veteran Affairs", "wrong site surgery", "wrong-site surgery"]

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