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- 19 June 2013
See also Hospital library standards & their value | Human resources | Medical education in Canada | Problem-based learning
Accreditation refers to the official evaluation of programs and services in health organizations, hospitals and academic programs. The goal of accreditation is to determine whether or not your hospital or educational program meets the standards that have been explicitly articulated by the accreditation body. Formal accreditation is granted to an organization on completion of a thorough review of its services and operations. For full certification, the accrediting body establishes standards of excellence which must be met at least satisfactorily (although substantially meeting requirements is often the goal). The accreditation process often requires the compilation of dossiers that provide an overview of the governance of services and programs and are compiled to demonstrate to surveyors that all required benchmarks have been substantially met. In Canada, hospitals and health care organizations obtain formal accreditation through an organization called Accreditation Canada. Typically, the entire accreditation process is repeated in hospitals and medical schools approximately once every three to five years but occasionally is performed more often. Part of the process is receiving approval but the extensive review is also used to identify key areas to be addressed later during strategic planning.
In the United States, hospital accreditation is carried out by the organization called the Joint Commission
Health librarians & accreditation
Why should health librarians be concerned about accreditation? In Canada, hospital accreditation is undertaken by Accreditation Canada. In the United States, health care accreditation is undertaken by the Joint Commission. Both processes are considered to be rigorous, and potentially very valuable to the long-term stability of health library services in health care.
In both health care accreditation processes, qualified library professionals are required to vouch for the provision of sound reference and information services within their health organizations. This includes making available library and information professional expertise and instruction in locating and using good health information. Many medical libraries are located in close proximity to medical schools (often in the same building) and may seek accreditation on that basis. In Canada, medical school programs are sanctioned through organizations such as the Committee on Accreditation of Canadian Medical Schools (CACMS).
In the age of information, providing access to bricks-and-mortar libraries is receding somewhat in importance. It seems likely that more digital access to information will destabilize the long-term viability of physical libraries. For example, several years ago, in support of open access to the biomedical literature, the NLM created a freely-accessible, digital library of articles called PubMed Central and supplemented it through various PubMedCentral repositories. Consequently, more and more of the medical literature is available online and requires a lot less library space. Free repositories of information have sprung up around the world but do not preclude the importance (or necessity) of having onsite libraries in hospitals and health organizations.
Some medical residencies, for example, require access to onsite libraries or at least convenient access to digital information. Where inequities of access to health information exist, the NLM works with the National Network of Libraries of Medicine to provide regional and state support for health professionals who seek biomedical information. American consumers also have access to consumer health information at the NLM through MedlinePlus. Other English-speaking countries such as Australia, Canada and the United Kingdom have well-developed medical libraries and regional supports though nothing quite like the NLM system. In Canada, the national medical library is probably CISTI though its mandate is broader than medicine alone; the CVHL project is intended to address some of the information inequities that we have in Canada.
Accreditation Canada is a not-for-profit, independent organization accredited by the International Society for Quality in Health Care (ISQua). It provides national and international health care organizations with an external peer review process to assess and improve the services provided to patients and clients based on standards of excellence. Accreditation Canada's programs and guidance have helped organizations promote quality health care for more than 50 years. see Knowledge exchange at Accreditation Canada
Accreditation of programs
Can hospitals and/or medical schools do with e-access alone? It depends.
According to the LCME, policy ER-11:
- "...medical school must have access to a well-maintained library and information facilities, sufficient in size, breadth of holdings, and information technology to support its education and other missions. There should be physical or electronic access to leading biomedical, clinical and other relevant periodicals, the current numbers of which should be readily available. The library and other learning resource centers must be equipped to allow students to access information electronically, as well as to use self-instructional materials.
According to the LCME, policy ER-12:
- "...the library and information services staff must be responsive to the needs of the faculty, residents and students of the medical school. A professional staff should supervise the library and information services, and provide training in information management skills. The library and information services staff should be familiar with current regional and national information resources and data systems, and with contemporary information technology. [Revised annotation approved by the LCME in October 2007 and effective immediately] Both school officials and library/information services staff should facilitate access of faculty, residents, and medical students to information resources, addressing their needs for information during extended hours and at dispersed sites...."
To accredit: Give authority or sanction to (someone or something) when recognized standards have been met (Simpson and Weiner 2011).
- " ...in Canada, responsibility for accreditation of postgraduate medical education programs lies with the Royal College of Physicians and Surgeons of Canada. Responsibility for accreditation of family medicine programs belongs to the College of Family Physicians of Canada. There are several key stakeholders involved in the Canadian postgraduate medical education and significant collaboration between organizations. Stakeholders include the 17 faculties of medicine in Canada who are charged with delivery of educational content, a variety of health-care delivery sites including hospitals and clinics, and the national resident organizations. Through assessment and evaluation, Canada has established an international reputation for leadership in medical education.
- accreditation formally assesses each program against national standards set out by the Royal College and specialty committees. Accreditation is granted to those residency programs under the direction of a Canadian university medical school. The School must have affiliated teaching hospitals and education sites, including community-based offices and practices, all of whom share a commitment to education and quality of patient care. There must be arrangements between the university and all sites participating in postgraduate medical education to provide a good environment, including working conditions and faculty–learner interactions
CHLA/ABSC (Canada) recommendations for inclusion in Accreditation Canada’s Effective Organizational Standards:
- Add librarian or library staff to the list of interdisciplinary team members in the standards
- Revise 15.1 in Measuring Quality and Achieving Outcomes to read: The team has access to electronic & print databases, books or journals to provide evidence-based guidelines for [the clinical area] through the service of the professional library staff...
- Refer to the 2006 Standards for Libraries and Information Services in Canadian Healthcare Facilities in guideline section 15.5 and adopt the following language:
- The organization provides its staff and service providers with 24x7 access to library and information services for research-based evidence and best practice. Information services include print and electronic resources, training and document delivery and are managed by a professional librarian.
- Chatterley T, Storie D, Chambers T, Buckingham J, Shiri A, Dorgan M. Health information support provided by professional associations in Canada. Health Info Libr J. 2012 June
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