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Charles D. Shaw

Hospital accreditation began almost 100 years ago as an assessment scheme for surgical training in the USA. It developed as a broader, professionally driven institutional assessment and improvement system and is now established in more than 50 countries. Since the turn of the century several international programmes have become available across national borders. Most accreditation programmes assess compliance with published standards across an entire hospital, but some offer certification of specific services. ISO certification commonly uses standard 9004 to assess quality management systems (not specific to healthcare), or 15189 which is specific to medical laboratories. DNV accreditation is based on ISO 9004 adapted to the healthcare setting. Several countries have regulatory systems for compliance with mandatory national standards which are comparable to voluntary accreditation programmes. The value to medical tourism of accreditation and similar external assessment systems lies in reliable independent verification of a hospital’s compliance with validated organisational standards. The criteria, procedures and level of detail in published findings vary between programmes, but are more consistent within programmes which are themselves accredited by the International Society for Quality in Healthcare, ISQua.