The last decade has seen an unprecedented rise in the development and implementation of quality and safety improvement initiatives in health care, both in France and abroad, as awareness of medical errors and variation in clinical practice and quality has grown. This has resulted in the introduction of improvement programmes nationwide, including hospital accreditation, professional practice appraisal, and accreditation of doctors in high-risk specialties.
However, given the significant public and professional investment in these health care quality and safety improvement initiatives, evaluation of these programs is essential. HAS is currently assessing the impact of quality improvement systems to determine their effectiveness, the factors driving practice and organizational change, and where they should go next. This appears to be a necessary and crucial step to (re)design strategies that will engage the professionals, disseminate quality and safety culture and impact positively on the quality of care. 

These efforts have included :

• Studies to assess the impact of accreditation of hospitals ;
• A scheme for global monitoring of the quality of services in hospitals, by introducing national indicators for certain key sectors ;
• Leadership and support for a movement led by health professionals to assess the clinical impact of improvement programmes. One manifestation of this movement is a joint publication by HAS and the British Medical Journal (BMJ) summarising the contributions of many French teams.

In 2011, HAS is stepping up these actions by publishing a number of reports on the impact of improvement initiatives in hospitals, including :