The certification of hospitals for quality of care

In place for more than 20 years in France, certification is a compulsory independent assessment procedure for the quality and safety of care in public and private hospitals. It is conducted every 4 years by professionals (peers) appointed by the HAS (surveyors).

In 2020, the certification procedure was radically overhauled to more effectively address current quality and safety of care challenges. The new process for the certification of hospitals for quality of care has been simplified, is more closely anchored in the practices of caregivers and focuses on patient care outcomes.

  The information document  

What ambitions?

The development of the new certification procedure was underpinned by three ambitions:

• Medicalise and more effectively take into account patient care outcomes. The aim is to move away from an assessment culture primarily based on methods (or processes) towards a culture that focuses more on patient outcomes.
• Simplify the various aspects of the certification process in order to align quality and safety assessment and improvement work as closely as possible with the practices of healthcare professionals and their teams.
• Adapt to changes in the healthcare system promoting the local integration of hopitals and the construction of care pathways.

What challenges?

4 major challenges of certification:

• Development of patient engagement
• Development of a culture of relevance and outcome assessment
• Development of teamwork, a driving force for improving practices
• Adaptation to changes in the healthcare system

What type of standard?

• A standard structured into 15 shared objectives divided into three chapters : the patient, healthcare teams, the hospital ;
• A standard including criteria with 3 requirement levels : standard, imperative and advanced;
• A modular standard that can be adapted based on the hopitals activities;
• A standard co-constructed with healthcare professionals, authorities and user representatives.

What type of process?

Certification for quality of care is a process that is:

• Jointly constructed to make it meaningful for both caregivers and patients
• Continuous
• Simplified and care-centric
• Focused above all on outcomes, recognising teams for their organisational autonomy
• Modular, adapting to the facility’s particular profile (types of patients cared for, activities, care methods, etc.)

Who is certified?

All French hospitals, both public and private

By whom?  

By surveyors, who are professionals practising in the hospital, appointed and trained by the HAS. To find out more about their role and become a surveyor.

How?  

During a healthcare facility survey, surveyors assess the level of quality of care. They base their assessment on the certification standard containing 15 objectives broken down into criteria.

Each criterion is assessed using assessment methods close to the reality on the ground, conducted by several surveyors.  

What results?

The results obtained for each criterion enable calculation of an overall score. This is obtained from the average results for criteria, objectives and chapters. The HAS bases its certification decision on this overall score.

The overall score is 50% or more		The overall score is less than 50%
High Quality of care. Facility certified with distinction	Quality of care confirmed. Facility certified	Quality of care to be improved. Facility certified subject to conditions	Quality of care insufficient. Facility not certified

What benefits?

For the patient
Being informed about the quality of care in the facility and benefiting from improved care.

For healthcare teams
Seeing their commitment to continuous improvement of quality and safety of care recognised

For the hospital
Promoting the quality and safety of care to all stakeholders: patients, caregivers, institutions.

Reference documents

• The certification manual  composed of:
  • The standard
  • Descriptive data sheets for the criteria
  • Practical guides for the implementation phases
• The information document 

The regulatory framework:

The obligation of French hospitals to undertake an accreditation process is governed by a regulatory framework. The certification procedure, introduced from 1996, is required for all hospitals in application of articles L. 6113-3 et seq. of the French Public Health Code. The certification procedure is developed and implemented by the HAS (Art. L. 161-37 of the French Social Security Code and R. 161-74 of the French Social Security Code).

Accreditation for foreign health institutions

HAS offers foreign health instituions the opportunity to deploy its expertise in the assessment of the quality and safety of care within healthcare institutions through its accreditation system.