{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:30:39Z","timestamp":1754155839015,"version":"3.41.2"},"reference-count":24,"publisher":"Emerald","issue":"2","license":[{"start":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T00:00:00Z","timestamp":1486339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJQRM"],"published-print":{"date-parts":[[2017,2,6]]},"abstract":"<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title>\n<jats:p>The purpose of this paper is to apply quality management tools and practices in the design of an integrated accreditation model for Local Health Trusts, in order to contribute to the sustainability of the Portuguese Primary HealthCare Service. Following the guidelines of the Portuguese Health Quality Strategy, the proposed model is an adaptation of the model from Agencia para la Calidad Sanitaria de Andaluzia.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title>\n<jats:p>The development of the integrated accreditation model was based on a literature review, complemented with observation and analysis of the usual working methods in a Local Health Trust (Western Oporto Health Trust).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Findings<\/jats:title>\n<jats:p>Local Health Trusts include not only clinical management units but also non-clinical administrative units. Therefore, the National Model for Accreditation of HealthCare Institutions is not easily or directly applicable to them. To overcome this problem, the model proposed in this study incorporates ISO 9001 principles, widely accepted regarding organizational management. The success of the application of this model is highly dependent on the ability of public Primary HealthCare organizations to deal with potential problems such as resistance to change, lack of leadership and inadequate people management and involvement.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title>\n<jats:p>The integrated accreditation model proposed in this research is expected to promote the cohesion of Local Health Trust units, encouraging integrated quality management practices and continuous improvement strategies, leading Local Health Trusts, Primary Care and HealthCare in a global perspective toward sustainability.<\/jats:p>\n<\/jats:sec>","DOI":"10.1108\/ijqrm-05-2015-0066","type":"journal-article","created":{"date-parts":[[2017,1,23]],"date-time":"2017-01-23T03:55:58Z","timestamp":1485143758000},"page":"251-264","source":"Crossref","is-referenced-by-count":5,"title":["Portuguese primary healthcare \u2013 sustainability through quality management"],"prefix":"10.1108","volume":"34","author":[{"given":"S\u00f3nia Duarte","family":"Silva","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3207-4819","authenticated-orcid":false,"given":"Ana","family":"Fonseca","sequence":"additional","affiliation":[]}],"member":"140","reference":[{"key":"key2020120905255808800_ref001","doi-asserted-by":"crossref","unstructured":"Almuedo-Paz, A., N\u00fa\u00f1ez-Garc\u00eda, D., Reyes-Alc\u00e1zar, V. and Torres-Olivera, A. (2012), \u201cThe ACSA accreditation model: self-assessment as a quality improvement tool\u201d, in Savsar, M. (Ed.), Quality Assurance and Management, ISBN: 978-953-51-0378-3, InTech, Rijeka, pp. 289-314.","DOI":"10.5772\/33863"},{"volume-title":"The Quality of Care and Services (A Qualidade dos cuidados e dos servi\u00e7os)","year":"2010","key":"key2020120905255808800_ref002"},{"key":"key2020120905255808800_ref003","unstructured":"Centro de Estudos e Investiga\u00e7\u00e3o em Sa\u00fade da Universidade de Coimbra (CEISUC) (2009), \u201cMonitoriza\u00e7\u00e3o da Satisfa\u00e7\u00e3o dos utilizadores das USF \u2013 Sondagem \u00e0s 1\u00aa 146 USF\u201d, available at: www.portaldasaude.pt\/portal\/conteudos\/a+saude+em+portugal\/publicacoes\/estudos\/satisfacao+usf.htm (accessed February 2014)."},{"issue":"S3","key":"key2020120905255808800_ref004","first-page":"S47","article-title":"Key elements of high-quality practice organisation in primary health care: a systematic review","volume":"201","year":"2014","journal-title":"Medical Journal of Australia"},{"volume-title":"Quality, Cost, and Clinical Decisions","year":"1983","key":"key2020120905255808800_ref005"},{"issue":"4","key":"key2020120905255808800_ref006","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1468-0009.2005.00397.x","article-title":"Evaluating the quality of medical care","volume":"83","year":"2005","journal-title":"The Milbank Quarterly"},{"issue":"83","key":"key2020120905255808800_ref007","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-86","article-title":"The impact of accreditation in primary healthcare centers: successes, challenges and policy implications as perceived by healthcare providers and directors in Lebanon","volume":"14","year":"2014","journal-title":"BioMed Central Health Services Research"},{"issue":"3","key":"key2020120905255808800_ref008","first-page":"S56","article-title":"Surveyor\u2019s perceptions of the impact of accreditation on patient safety in general practice","volume":"201","year":"2014","journal-title":"Medical Journal of Australia"},{"key":"key2020120905255808800_ref009","unstructured":"Institute of Medicine (2001), \u201cCrossing the quality chasm: a new health system for the 21st century\u201d, available at: www.nap.edu\/openbook.php?isbn=0309072808 (accessed February 2014)."},{"volume-title":"ISO 9001 \u2013 Quality Management Systems \u2013 Management Standards","year":"2008","author":"ISO","key":"key2020120905255808800_ref010"},{"issue":"S1","key":"key2020120905255808800_ref011","first-page":"18","article-title":"Understanding the conditions for improvement: research to discover which context influences affect improvement success","volume":"20","year":"2011","journal-title":"Quality and Safety"},{"issue":"3","key":"key2020120905255808800_ref012","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1590\/S0102-311X2013000300002","article-title":"Contemporary quality improvement","volume":"29","year":"2013","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"6","key":"key2020120905255808800_ref015","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1590\/S1413-81232011000600022","article-title":"Primary healthcare reform in Portugal on two fronts: autonomous family healthcare units and management of health clusters (Reforma da Aten\u00e7\u00e3o Prim\u00e1ria em Portugal em duplo movimento: unidades assistenciais aut\u00f3nomas de sa\u00fade familiar e gest\u00e3o em agrupamentos de centros de sa\u00fade)","volume":"16","year":"2011","journal-title":"Ci\u00eancia e Sa\u00fade Coletiva"},{"key":"key2020120905255808800_ref016","first-page":"43","article-title":"Quality of primary healthcare (Qualidade de cuidados de sa\u00fade prim\u00e1rios)","volume":"2","year":"2001","journal-title":"Revista Portuguesa de Sa\u00fade P\u00fablica"},{"key":"key2020120905255808800_ref013","unstructured":"Portuguese Health Ministry (Minist\u00e9rio da Sa\u00fade) (2009), \u201cDespacho no 14223\/2009 \u2013 national strategy for quality in health (Estrat\u00e9gia Nacional para a Qualidade na Sa\u00fade)\u201d, available at: www.sg.min-saude.pt\/NR\/rdonlyres\/A110CE46-A607-4BD1-AB82-BE86B31314C3\/17393\/Desp142232009QualidSaude1.pdf (accessed July 2015)."},{"key":"key2020120905255808800_ref014","unstructured":"Portuguese Health Ministry (Minist\u00e9rio da Sa\u00fade) (PHM) (2011), \u201cAccreditation manual for health care facilities: clinical management (Manual de Acredita\u00e7\u00e3o de Unidades de Sa\u00fade: Gest\u00e3o Cl\u00ednica)\u201d, available at: www.dgs.pt\/ms\/8\/default.aspx?id=5521 (accessed June 2013)."},{"edition":"2nd ed.","volume-title":"The Healthcare Quality Book: Vision, Strategy and Tools","year":"2008","key":"key2020120905255808800_ref017"},{"key":"key2020120905255808800_ref018","unstructured":"Rooney, A. and Ostenberg, P. (1999), \u201cSeries of improvements on the methodology of quality assurance, licensing, accreditation, and certification: approach to quality health services (S\u00e9rie de aperfei\u00e7oamento sobre a metodologia de garantia de qualidade: licenciamento, acredita\u00e7\u00e3o e certifica\u00e7\u00e3o: abordagem \u00e0 qualidade de servi\u00e7os de sa\u00fade)\u201d, available at: www.hciproject.org\/sites\/default\/files\/Licenciamento_Acredita%C3%A7%C3%A3o_Certifica%C3%A7%C3%A3o_2000.pdf (accessed October 2013)."},{"volume-title":"Quality of Care: A Process for Making Strategic Choices in Health Systems","year":"2006","author":"WHO","key":"key2020120905255808800_ref019"},{"key":"key2020120905255808800_ref020","unstructured":"WHO (2010), \u201cWHO evaluation of the national health plan of Portugal (2004-2010)\u201d, available at: http:\/\/pns.dgs.pt\/files\/2011\/01\/avaext.pdf (accessed November 2013)."},{"key":"key2020120905255808800_ref021","first-page":"6","article-title":"Quality in healthcare: a conceptual perspective (Qualidade em Sa\u00fade: uma perspectiva conceptual)","year":"2000","journal-title":"Qualidade em Sa\u00fade"},{"key":"key2020120905255808800_ref022","first-page":"93","article-title":"Defining and measuring the quality of health care (Definir e medir a qualidade de cuidados de sa\u00fade)","volume":"33","year":"1991","journal-title":"Revista Cr\u00edtica de Ci\u00eancias Sociais"},{"key":"key2020120905255808800_ref023","unstructured":"Guimar\u00e3es, M. d. 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