Levers for change: an investigation of how accreditation programmes can promote consumer engagement in healthcare.

<bold>Objective: </bold>To examine how consumer engagement (CE) can be promoted through Australian accreditation programmes.<bold>Design: </bold>A nation-wide qualitative study completed in 2012.<bold>Setting: </bold>All eight Australian States and Territories.<bold>Participants: </bold>Two-hundred and fifty-eight healthcare stakeholders from the acute, primary and aged care sectors.<bold>Intervention: </bold>Forty-seven individual and group interviews were undertaken. Questions elicited views on the dimensions and utility of CE promotion by accreditation programmes.<bold>Main Outcome Measure: </bold>Healthcare stakeholders' views on the dimensions and utility of CE promotion by accreditation programmes.<bold>Results: </bold>Four mechanisms of CE promotion were identified. Two involved requirements for health service organizations to meet CE-related standards related to consumer experience and satisfaction surveys, and consumer participation in organizational governance processes. Two mechanisms for promoting CE through accreditation processes were also identified, concerning consumer participation in the development and revision of standards, and the implementation of accreditation surveys. Accreditation programmes were viewed as important drivers of CE, yet concerns were raised regarding the organizational investments needed to meet programmes' requirements.<bold>Conclusions: </bold>Accreditation programmes use diverse mechanisms as levers for change to promote CE in healthcare. These mechanisms and their inter-relationships require careful consideration by accreditation agencies and health policymakers to maximize their potential benefits, while maintaining stakeholder engagement in programmes. [ABSTRACT FROM AUTHOR]