Results may include recommendations for continuous improvement of safety and quality in the practice. The accreditation process assumes that the structure and operation of practices significantly influence outcomes for patients19 (and costs, quality and value20), but recent efforts have been made to adopt outcomes measures for example in the United States.20Practice accreditation typically combines weak social control, through a process of external review, with elements of self regulation through internal assessment and self directed but professionally supported performance improvements.21 In the former context, accreditation is part of a network of activities for quality control with which it is related but should not be confused (box 2). Complementary approaches to the development and external assessment of practice quality are external peer review of professional performance, the Excellence model, and the International Organization for Standardization model (table 1).12 As with accreditation, they involve assessments against standards.
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