The Development of the Questionnaire on Health Care Professionals' Attitudes on Accreditation of Health Care Institutions

Introduction: Accreditation is a procedure for evaluating the quality of work of a health care institution. It is based on the application of the optimal level of established work standards on health care institutions in a particular area of health care (branch of medicine). As health care professionals are the main carriers during the accreditation process of healthcare institutions, it is very important to evaluate the structure and gain insight into the most important components of their positions regarding accreditation, prior to starting this process. Methods: The study was conducted in two secondary and tertiary level hospitals, one of which is accredited and the other is not. It was designed as an observational study and included a survey of two groups of respondents. The experimental group consisted of employees of a hospital where the process of accreditation had been conducted, while the control group consisted of employees of a hospital where the process of accreditation had not been conducted yet. The survey used an original questionnaire that consists of 23 questions as a tool for measuring the health care professionals' attitudes on accreditation. The data reduction and structural validity evaluation of the aforementioned instrument was performed by principal component analysis, while its relativity was evaluated using the Cronbach's Alpha coefficient. Results: The Questionnaire on Health Care Professionals' Attitudes on Accreditation with the resulting 10 questions has high structural validity (Kaiser-Meyer-Olkin measure of adequacy = 0.909). The total Cronbach's Alpha was 0.916. By analysing the main components of the extracted ten questions, three factors (components) were identified: (1) the Attitude on the Positive Long-Term Impacts of Accreditation on the Planning, Implementation and Changes of the Overall Concept of Health Care, (2) the Attitude on Increasing Professional Affirmation and Improving Work Morale, and (3) the Attitude on Improving Communication and Safety at Work. Health care professionals employed in a hospital that had completed the accreditation had significantly more positive attitudes about the process in all of the aforementioned components compared to employees of a hospital that had not completed the accreditation process. Conclusions: The Questionnaire on Health Care Professionals' Attitudes on Accreditation has high content and structural validity. By applying it prior to the hospital's accreditation process, potential positive resources within the institution could be assessed, resulting from the positive attitudes of healthcare professionals about accreditation. Also, with this instrument, potential barriers to the successful implementation of accreditation could be assessed, resulting from the predominantly negative attitudes of health professionals about the accreditation process.