Proposition of a substantive theory for the hospital accreditation process: the “commitment to care” model

This study presents a substantive theory that aims to explain the factors that interact and influence the elements involved in the implantation, maintenance, and evolution of hospital accreditation. The study was carried out between 2015 and 2017, through the case of the Transamazonica Regional Publ...

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Bibliographic Details
Authors: Berto, Andreia Maria, Erdmann, Rolf Hermann, Uhlmann, Vivian Osmari
Format: article
Status:Published version
Publication Date:2021
Country:Brasil
Institution:Fundação Getulio Vargas (FGV)
Repository:Cadernos EBAPE.BR
Language:Portuguese
English
OAI Identifier:oai:ojs.periodicos.fgv.br:article/84530
Online Access:https://periodicos.fgv.br/cadernosebape/article/view/84530
Access Level:Open access
Keyword:Hospital Accreditation
Substantive theory
Public hospital
Acreditación hospitalaria
Teoría sustantiva
Hospital público
Acreditação hospitalar
Teoria substantiva
Description
Summary:This study presents a substantive theory that aims to explain the factors that interact and influence the elements involved in the implantation, maintenance, and evolution of hospital accreditation. The study was carried out between 2015 and 2017, through the case of the Transamazonica Regional Public Hospital (HRPT), located in Altamira (state of Pará), in the northern region of Brazil. Interviews, documentary analysis, and participant observation were conducted longitudinally over a period of 24 months, a period that comprised the maintenance of level 2 of hospital accreditation in HRPT, and the evolution at level 3 and its maintenance at this level. Under a constructivist and qualitative bias, data collection was divided into five rounds, according to the guidelines of Charmaz grounded theory, and involved 56 participants. The proposed model, called “Commitment to Care,” was an integrative and systemic alternative to understanding how hospital accreditation occurs in the organization studied. Its structure consists of three central categories: “The way we work,” “Accreditation as an instrument of action,” and ‘Love to the cause’; a category of support: ‘Development of health professionals’; and two outcome categories: “Excellence in Outcomes” and “Patient-Centered Care.” These findings were in dialogue with complex thinking and the study of institutions.