A decade of commitment to hospital quality of care: overview of and perceptions on multicomponent quality improvement policies involving accreditation, public reporting, inspection and pay-for-performance

Abstract Background Quality improvement (QI) initiatives such as accreditation, public reporting, inspection and pay-for-performance are increasingly being implemented globally. In Flanders, Belgium, a government policy for acute-care hospitals incorporates aforementioned initiatives. Currently, questions raised on the sustainability of present policy. Objective First, to summarise various have adopted under encouragement between 2008 2019. Second, study perspectives healthcare stakeholders current Methods this multi-method study, we collected data QI initiative implementation from governmental institutional sources through an online survey among hospital quality managers. We compiled overview all Flemish ( n = 62) 2019 53 after mergers). Stakeholder were assessed via second available employees focus group with experts was consulted. Variation professions assessed. Results been implemented, especially 2016 onwards, majority (87%) having obtained first accreditation label publicly reporting performance indicators, receiving regular inspections entered initiative. On topic external international overall attitudes within predominantly neutral (36.2%), while 34.5% expressed positive 29.3% negative views towards accreditation. examining specific professional groups in-depth, learned 58% doctors regarded negatively, judged be largest contributors according respondents. Conclusions Hospitals demonstrated increased efforts into QI, since 2016, perceptions currently heterogeneous. To assure care remains top-priority hospitals, recommend revision multicomponent where adoption is streamlined co-created bottom-up.