Healthcare Facilities: Certification & Evaluation

Certification and Evaluation in Social and Medico-Social Establishments

Certification of Healthcare Facilities

• Certification is a mandatory external evaluation of a healthcare facility's quality and safety of care.
• The Haute Autorité de Santé (HAS) (High Authority of Health) conducts the certification.

Bodies Responsible for Certification

• Haute Autorité de Santé (HAS) is an independent public authority.
  • HAS aims to regulate the quality of the healthcare system.
  • HAS evaluates the medical and economic aspects of health products, services, and technologies for reimbursement purposes.
  • HAS defines best practice recommendations.
  • HAS is responsible for certifying healthcare facilities and the quality of medical practitioners in certain disciplines on a voluntary basis.
• Agence Nationale chargée de l'évaluation et de la qualité des établissements et services sociaux et médico sociaux (ANESM) or National Agency for the Evaluation of the Quality of Social and Medico-Social Institutions and Services
  • ANESM was created in 2007.
  • ANESM’s primary mission is to develop a culture of kindness in social and medical establishments and services.
• Fédération de l'Hospitalisation Privée (FHP) or the French Federation of Private Hospitals
  • FHP informs, advises, and assists its members in economic, legal, and social matters.
  • FHP represents private clinics and hospitals to supervisory bodies (ministry) and employee unions.
  • FHP develops actions to promote the quality of care and their role to the public.
  • FHP plays an important role in the French healthcare system.

Steps in the Certification Procedure

• Certification is an external evaluation of public and private healthcare facilities.
  • Experts mandated by the HAS carry out certification.
  • The procedure focuses on the level of care provided to patients and the facility's approach to improving the quality and safety of care.
  • Healthcare facilities enter the certification process every four years.
• Steps include:
  • Preparing for the procedure and providing information to the HAS.
  • Professionals conduct a self-assessment (auto-évaluation) to evaluate their organization and practices based on the certification manual.
  • Certification visits aim to identify points of conformity and discrepancies compared to the certification manual.
    • Experts conduct visits and are healthcare professionals trained by the HAS for their mission.
    • During visits, they use methods like audits or patient pathway analysis to evaluate the maturity of quality approach, risk management, and actual patient care.
• Following these steps, a certification report is prepared to help decision-makers identify the strengths in quality management and areas of non-compliance.
• The HAS then makes a certification decision, which can be:
  • Complete certification
  • Certification with recommendations
  • Certification with reservations
• The report is sent to:
• The healthcare facility
• Regional health agency (ARS)
• Published on the HAS website

Evaluation in Établissement d'Hébergement pour Personnes Âgées Dépendantes (EHPAD) (Nursing Homes)

• The 2002 law introduced the requirement for institutions and services to evaluate their activities and the quality of services they provide.
  • Evaluation is done by an external organization.
  • The evaluation leads to the implementation of corrective actions.
  • Evaluation concerns all social and medico-social establishments.
• Two types of evaluations:
  • External evaluation is carried out by an external organization listed by ANESM, takes place every 7 years, and is required for the renewal of the authorization to operate.
  • Internal evaluation is a self-assessment that takes place every 5 years, and its results are sent to the tariff authorities.