Audits and Accreditation.  If you wince at these words, read this.

Terry Pratchett had a certain way that he wanted us to imagine auditors: dead-eyed, celestial soul eaters created by god-like bureaucrats.  Pratchett and Hollywood have captured the zeitgeist surrounding what many in industry would consider the innovation-destroying, big-brothering of the accreditation process.  Perhaps you agree.

But I think they go alright.  And unlike superman, these real heroines/heros stand a lot closer between you and death and ruin than you may like to think.   In the healthcare or education industries, where we can all so easily work in isolation, or cut corners, accreditation points us towards a common set of standards and outcomes.  Essentially, for the accreditation period at least, personal agendas are trumped by nationally recognised-best practice and legislation.

A strategic problem I see with accreditation (in healthcare anyway) is that it does not occur often enough, and comes with too much warning.  This might make me sound like a misdemeanour ninja – (lurking in the shadows, waiting to pounce on the first person to step a toe out of line) I swear I am not that person – but I get an overwhelming sense of disappointment when practice improves during accreditation and then quickly goes back to the status quo afterwards.  This article, published in the Harvard Business Review found that during hospital accreditation periods patient mortality rates dropped by 6% and then climbed back to pre-accreditation rates within 3 days of accreditation!  If staff do perform better when they know that they are being watched, then why aren’t we watching them more regularly than every 3-5 years?

Let’s not downplay the steep, stressful learning curve accreditation sends all managers on. I feel like I have been pushed beyond the edges of my intelligence each time I have been involved in the process. Also at times I have questioned the relevance of a particular accreditation standard or guideline to my subspecialty.  But overwhelmingly, accreditation seemed like a help rather than a hindrance.  And, in terms of building knowledge of and competence in your profession, there is no better teacher.

Getting back to the auditor trope used in literature and Hollywood.  Though funny, I don’t think it’s fair.  Never once have I felt that an auditor has been set on destroying me.  Mostly I have just felt that they have empathy and will work with me to ensure we are protecting the public and offering a great service.

So as I head into another accreditation process, I reflect on how much more I have learned about teaching at the post-graduate level.  Sure I’ll be nervous, but I understand that this is for the good of nursing education and patient safety and it will give me the tools I need to create an awesome course.