International comparison of nine accreditation programmes for ambulatory care facilities

Aim In order to generate ideas for the improvement of German accreditation programmes, we aimed at exploring similarities and differences of nine international approaches to the accreditation of ambulatory primary and specialist care facilities. Subjects and methods Nine accreditation programmes from Germany, Switzerland, the Netherlands, Great Britain, the USA, and Australia were included. Selective literature review, systematic analysis of the documents identified, and descriptive comparison of findings regarding key information on accreditation standard development, contents, and methods of accreditation; inclusion of patient surveys; and special features were performed. Results All practice accreditation programmes include a consensus process to develop mainly quality managementbased criteria for practices' structures and processes. Several accreditation programmes require structured patient surveys. All accreditation processes include a selfassessment, a review and verification of documented evidence, and a peer-based on-site visit. Some accreditation programmes show unique features, such as a high degree of external consultation and support, or a link of accreditation to pay-for-performance programmes. Conclusion Comparison of international accreditation programmes of ambulatory primary and specialist care facilities reveals considerable similarities in regard to the development of accreditation criteria, the criteria themselves, and the process of accreditation. German practice accreditation programmes may benefit from including a structured patient survey, a higher degree of consultative support, and financial incentives. © Springer-Verlag 2011.