2020 DNVGL Hospital Accreditation Survey

Overview

The 2020 DNVGL Hospital Accreditation Survey marked the ninth cycle of the organizations ISObased accreditation program for acute care facilities. DNVGL combines the rigor of the International Organization for Standardization (ISO9001) qualitymanagement system with the clinical safety standards of the Joint Commission International (JCI). The 2020 survey was conducted across 1,200 hospitals in 43 countries, representing a broad crosssection of public, private, and academic institutions.

Key objectives of the survey were to:

• Assess compliance with DNVGLs Hospital Accreditation Standards (HAS) and associated ISO9001 clauses.
• Identify opportunities for continuous improvement in patient safety, quality of care, and organizational resilience.
• Provide benchmarking data that hospitals can use to compare performance with peers.
• Validate the effectiveness of COVID19 response measures that many facilities had adopted during the first months of the pandemic.

Methodology

DNVGL follows a threephase approach for each accreditation cycle:

1. PreSurvey SelfAssessment: Hospitals complete an online questionnaire covering all 38 DNVGL standards, submit documentation, and upload evidence of compliance.
2. OnSite Survey: Trained surveyors conduct a 3 to 5day visit, reviewing policies, interviewing staff, and observing clinical processes. In 2020, 30% of visits were performed virtually due to travel restrictions.
3. PostSurvey Review: Surveyors submit a final report with findings, correctiveaction recommendations, and an accreditation decision (full, provisional, or denied).

Surveyors evaluate each standard on a scale of:

• Compliant Full evidence of meeting the requirement.
• Partially Compliant Minor gaps that can be closed within 90 days.
• NonCompliant Significant deficiencies requiring corrective action before reaccreditation.

Data collection tools included:

Key Findings

Overall Compliance

Out of the 1,200 surveyed hospitals:

• 84% achieved full compliance across all standards.
• 12% were granted provisional accreditation (minor gaps addressed within 90 days).
• 4% received a noncompliant designation and were required to undergo a resurvey within six months.

Top Performing Areas

• Leadership Commitment: 93% demonstrated robust governance structures and clear qualitymanagement policies.
• Risk Management: Integration of ISO31000 principles resulted in a 15% reduction in reported adverse events compared with 2018 data.
• PatientCentred Care: High scores in communication, discharge planning, and patient education.

Areas Needing Improvement

• Data Analytics: Only 58% had realtime dashboards for key performance indicators.
• Supply Chain Resilience: 31% reported shortages in critical PPE and medication during early pandemic peaks.
• Staff WellBeing Programs: 42% lacked documented mentalhealth support for frontline workers.

COVID19 Specific Observations

The pandemic forced rapid changes. DNVGL noted that hospitals that had preexisting infectioncontrol committees adapted more quickly. Key COVID19 findings included:

• 96% implemented a triage algorithm consistent with WHO guidance.
• 78% documented a formal surgecapacity plan.
• Only 65% performed regular fittesting of N95 respirators, highlighting a gap in occupational safety.

Implications for Healthcare Providers

The 2020 survey outcomes have several practical implications:

1. Strategic Planning: Institutions should embed dataanalytics capability into their qualitymanagement systems to meet the growing demand for evidencebased decision making.
2. Supply Chain Management: Building diversified supplier relationships and maintaining a minimum 30day buffer stock for essential items will enhance resilience.
3. Workforce Support: Formalizing mentalhealth programs and offering flexible scheduling can reduce burnout and improve compliance with safety standards.
4. Continuous Improvement: Hospitals with provisional or noncompliant status must develop correctiveaction plans within 90 days and schedule followup audits.
5. Accreditation Value: Maintaining DNVGL accreditation continues to provide a credible signal to insurers, regulators, and patients that a facility adheres to internationally recognized quality standards.

Resources

For further reading and tools, visit the following:

• DNVGL Hospital Accreditation Portal
• ISO9001:2015 Quality Management Systems
• WHO Guidance on Infection Prevention and Control for COVID19
• Joint Commission International Standards