Accreditation as an Engine for Improvement: Joint Learning for Quality Improvement


All too often, quality is something that is seen as “somebody else’s responsibility.” But when everyone is responsible, nobody takes charge.

The Opportunity

A high-quality health system is defined by its fidelity to cost-effective, evidence-based care; its capacity to continuously learn from and prevent errors; and its commitment to the respect and dignity of the patients and families it serves. Policymakers, payers, providers, patients and the public each have a role to play in achieving these goals; through collaboration, they can achieve an effective quality strategy that, combined with expansions in health care access, will achieve improvements in health outcomes.

Our Work

The JLN Quality Technical Initiative developed a quality framework for payers to present the strategies available to insurers to influence the quality of care within three domains: ensuring a basic standard of quality, motivating providers and professionals to improve, and activating patient and public demand for quality. By being sensitive to the local context, building cohesion among key stakeholders and selecting context-appropriate ideas for improvement, insurers can influence the quality through four possible mechanisms: selective contracting; provider payment systems; benefit package design and investments in systems, patients and providers.

In addition, JLN participants decided to more deeply investigate accreditation and empanelment as levers for improving quality. This led to the identification of accreditation and empanelment as an entry point for many countries. JLN participants continue to leverage the Joint Learning Fund to explore a variety of issues related to accreditation and empanelment including:

  • How can accreditation simultaneously drive improvement among mid- and top-level performers, while also getting to basic levels of quality in remote areas?
  • How should accreditation be financed? How can its costs be kept under control?
  • Can national health insurance schemes create incentives for accreditation? What are the implications of linking accreditation with payment?
  • What should be the institutional structure? Where should accreditation “live” within the system?

As the JLN moves forward, countries continue to virtually explore the best institutional arrangements for quality that can support improved systems.

Technical Facilitators

Amanda Folsom

Results for Development Institute

Sinit Mehtsun

Results for Development Institute

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