The cost of accreditation: one hospital's experience.

OBJECTIVE The 1989 survey conducted by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) at the UCLA Neuropsychiatric Hospital was the hospital's first using standards outlined in the 1989 edition of JCAHO's Accreditation Manual for Hospitals. The authors' goal was to calculate the cost of preparing for and undergoing the 1989 survey. METHODS Costs associated with planning for the survey and conducting a mock survey and the actual survey were based on records of staff time spent on those activities, fees for consultant services, and fees for the actual survey. Costs associated with follow-up of the mock survey, preparation for the actual survey, and additional staff time spent in record keeping and treatment planning to meet accreditation standards were based on staff estimates of time spent in these activities. RESULTS Documented and estimated costs for the survey process totaled $326,784, which represented about 1 percent of the hospital's operating budget for 1989. CONCLUSIONS Although the hospital had a successful survey outcome and received accreditation with few contingencies, the authors question whether quality of care was improved by the survey process and whether the high cost of the survey constitutes an appropriate use of resources.