Table 2 Key individual, program, organisational and system-level factors and themes perceived to enable implementation of accreditation programs

The program is collaborative, valid and uses relevant standards

Accreditation agency use of a collaborative ethos increases healthcare organisations’ engagement in programs

The face validity of programs is largely determined by the level of inter-survey and inter-surveyor reliability

The clarity and focus of standards affects the perceived relevance of programs and how efficiently they can be implemented

Accreditation is favourably received by health professionals

Health professionals’ views of the benefits and costs of accreditation affects their engagement in programs

Regular accreditation agency feedback to healthcare organisations using effective communication and framing strategies can affect professionals’ views of the value of programs

Healthcare organisations are capable of embracing accreditation

Leadership styles that champion quality and safety facilitate healthcare organisations’ uptake of CQI via accreditation

Programs have limited capacity to drive improvements in healthcare organisations lacking cultures that support staff-wide efforts to integrate CQI into everyday practices

Accreditation is appropriately aligned with other regulatory initiatives and supported by relevant incentives

Accreditation programs are more likely to be implemented effectively when they are streamlined with other regulatory initiatives to engender a holistic approach to health system quality and safety

Healthcare organisations’ participation in accreditation programs is encouraged by significant financial incentives that are provided by governments and insurance agencies