Quality programmes, accreditation and certification in Switzerland

Purpose. To report on current quality initiatives in health care in the con text of accreditation and certification in Switzerland. Source of information. A review from the Swiss Accreditation Service, the S wiss Medical Association and the University of Zurich. Setting. In Switzerland, health care providers and health insurers are obli ged by law to sign contracts on quality of care. The law texts and related ordinances do not state explicitly the content and format of quality contra cts between providers and costs payers. Finding adequate practical solution s is the responsibility of the partners involved. Six different possibiliti es of quality initiatives are studied and discussed in this report. These i nclude initiatives to create independent certification or inspection bodies for health care organizations accredited by the national accreditation bod y. Findings. So far, there is only one established standardized system with cl ear requirements. This accreditation and certification model is an adaptati on of the International Standards Organization but so far it has not been u sed often in the public domain. Each of the other five approaches are more frequently applied but none of them lead to full external peer review certi fication including medical outcome yet. Conclusions. A lot of harmonization work still has to be done and clear bra nch specific requirements need to be agreed upon. Practicability and validi ty of external peer review schemes may also need further evaluation and imp rovement to reach the gods of health care systems in the future.