Development and application of an indicator assessment tool for measuring health services accreditation programs

Table 2 Indicator assessment tool—score allocation examples

Indicator assessment criteria	Scoring system for indicator assessment tool
Indicator assessment criteria	Low score	High score
Research	Low level of evidence. For example, results of individual case studies	High level of evidence. For example systematic reviews, or adoption by regional or national health bodies
Accuracy	The indicator only measures a small part of the standards, or is not sufficiently or independently verified	The indicator measures whether the accreditation intervention has been implemented or the service provided in accordance with the standard
Proximity	Multiple steps or processes between the indicator measurement and accreditation standard make it difficult to link the indicator with the effects of accreditation	Close temporal or process links exist between accreditation surveys and the indicator measurement
No adverse effects	Measurement or publication of results gives incentives for gaming or misallocation of resources	Indicator measurement or publication does not give rise to unintended adverse effects or consequences
Specificity	Multiple and recent policy initiatives covering the same topic as the accreditation standard under discussion	Accreditation is the main policy implementation tool