Definitions of health and social care standards used internationally: A narrative review. (20th September 2022)

• Record Type: Journal Article
• Authors: Kelly, Yvonne; O'Rourke, Niamh; Flynn, Rachel; Hegarty, Josephine; O'Connor, Laura
• Is Part Of: International journal of health planning and management. Volume 38:Number 1(2023)
• Page Start: 40
• Page End: 52
• Publication Date: 2022-09-20
• Subjects: definition -- health care -- inspection -- legislation -- quality improvement -- social care -- standards; Health planning -- Periodicals; Health services administration -- Periodicals; Santé publique -- Planification -- Périodiques; Santé, Services de -- Administration -- Périodiques; 362.1068
• DOI: 10.1002/hpm.3573
• Languages: English
• ISSNs: 0749-6753

Abstract

Abstract: Setting standards is a quality improvement mechanism and an important means for shaping the provision of health and social care services. Standards comprise statements describing a process or outcome of care. Setting standards is a global practice. It would be useful to have an understanding of the underpinning definitions of standards used internationally. Therefore, the aim of this review was to examine definitions of health and social care standards used internationally and identify similarities and differences. A targeted grey literature search of standard‐setting bodies' websites and related health legislation was conducted to retrieve explicit definitions of standards. Of 15 standard‐setting bodies that were searched, 12 definitions of standards were narratively synthesised. Terms that appeared in two or more of the definitions were extracted. Counts and percentages were calculated for these terms to determine magnitude of use. The commonalities among definitions included 'quality' ( n = 6, 50%), 'statements' ( n = 5, 42%), 'performance' ( n = 5, 42%), and 'measureable' ( n = 4, 33%). The less commonly used terms were 'processes' ( n = 3, 25%), 'set' ( n = 3, 25%), 'evidence based' ( n = 2, 17%), 'outcome' ( n = 2, 17%), 'safe' ( n = 2, 17%), and 'guidance' ( n = 2, 17%). Explicit definitions of standards were not retrieved from health legislation documents. Standard‐setting bodies develop standards in the context of the health systems in which they are implemented; some are aspirational levels of quality, while others are minimum levels of quality. Researchers, standards developers and policy makers should be cognisant of this when comparing standards between countries. Key points: In analysing 12 standards definitions, we found considerable variation. Some were aspirational levels of quality, others were minimum quality levels. Common terms were 'quality', 'statements', 'performance', and 'measureable'. Comparing standards between countries should be conducted with caution.