Towards an Enhanced Framework for Improvement in Quality Healthcare: A thematic analysis of outstanding achievement outcomes in hospital and health service accreditation

Increased scrutiny of healthcare in advanced economies has created an emphasis on the need to understand factors influencing quality and efficiency within the sector. In response to this situation, the Australian Council on Healthcare Standards' (ACHS) Evaluation and Quality Improvement Program (EQuIP) was established to foster quality and efficiency improvements through the identification and publicising of outstanding achievements in healthcare accreditation standards. A recent, major investigation has independently demonstrated that these outstanding achievements contribute to healthcare outcomes. Through conducting a qualitative content analysis of ACHS' EQuIP case studies presenting outstanding achievement, this research identified common factors that act as managerial and organisational drivers for achieving excellence. Four major relevant and overarching themes emerged leadership, communication and culture; management, organisation and human resources; information and knowledge management; and outcomes - along with various sub-themes. This deeper level of analysis provides additional criteria and understanding for indicating outstanding achievement thereby providing stronger insight to EQuIP evaluation criteria and previous research. The findings demonstrate both the value of using an exploratory methodology and the inherent flexibility of EQuIP. Insights from this approach provide recognition of unanticipated and valuable healthcare innovations, offer initial guidance for healthcare organisations aiming to enhance their performance, and form the basis for future research and publications on outstanding achievement in healthcare.