Sustaining public healthcare organizations: accreditation, legitimacy and personnel assessment

Processes of accreditation, as means for achieving organizational legitimacy, can affect human resource management and personnel assessment practices in healthcare organizations. Sine 1990s public management reforms are leading healthcare organizations to behave as institutions client and outcome-oriented. Organizations tend to achieve greater legitimacy and better performance conforming to the expectations of the key stakeholders in their environment by enhancing credibility of their actions and pursuing active or passive support. Healthcare organizations tend to improve their survival chances being successful in obtaining legitimacy from normative sources as the Joint Commission of the Accreditation of Healthcare Organizations (JCAHO). Accreditation is a periodic external evaluation of a healthcare organization, by recognized experts, which furnishes evidence of the quality of care, treatments and services delivered to the individuals served by the firm. Processe of personnel assessment are considered directly related to the safety and the quality of the care, because its appropriateness should increase job satisfaction and commitment of employees, and guarantee their competences, indirectly reducing clinical errors and gaining in organizational effectiveness and efficiency. Processes of accreditation should help practices of personnel assessment to be specifically designed and implement for a specific context and focused on personnel development and psychological safety rather than on control. This study is based on archival data, namely the content of the accredtation standards for healthcare organizations in relation to personnel assessment. In this paper we analyze the requirements of two widely used accreditation standards as the Joint Commission International (JCI) and the Internationa Society for Quality in health Care (ISQua) relate to performance assessment practices in health care.