The need for ASF’s standards was established through environmental scanning of leading international accreditation frameworks, direct feedback from Georgian pilot facilities and international partnership data, and the knowledge of ASF’s founding technical team.

Relationships with other standards are identified: ASF’s methodology is explicitly built on internationally recognised certification architecture and stepwise accreditation models, adapted for small transitional-country hospitals; overlap with national Ministry of Health requirements is mapped per country.

There is a planned process for development/revision: standards are drafted by ASF’s Accreditation & Evaluation branch, reviewed by the Technical Support & Development branch, and revised on a defined cycle.

Standards are based on current research and internationally recognised guidance: WHO Global Patient Safety priorities, leading international accreditation methodologies, and legal/regulatory requirements of each country of operation.

Government, professional and patient interests have input into standards development through national partners (e.g. PHIG in Georgia), the ASF Patient Council system, and consultation with partner clinics during pilot phases.

Scope is explicit: general hospitals and equivalent ambulatory/diagnostic/cardiology/laboratory facilities in transitional and limited-resource health systems.

Purpose is explicit: to set an acceptable, continuously improving performance level; to facilitate quality improvement as a standing function; to support ASF’s binary public accreditation award; and to support insurer/payer recognition.

Standards are organised under a clear framework: six principle categories, each with numbered, indexed criteria; a defined numbering system allows any criterion to be located quickly.

Wording is kept clear and unambiguous: each standard states a single measurable requirement, avoids vague qualifiers, and avoids undefined acronyms.

Standards are tested and evaluated by providers and surveyors prior to approval, in line with RUMBA (Relevant, Understandable, Measurable, Beneficial, Achievable): the Georgian pilot programme and international partnership data serve as the test bed.

New and revised standards are approved by ASF’s governing body before implementation, with a documented approval record.

ASF defines the conditions under which national partner organisations may apply the standards independently, including a written partnership agreement and feedback obligations.

Information and training on new/revised standards are provided to facilities and surveyors through ASF Academy and structured onboarding at the start of membership.

A published implementation plan sets timeframes and transitional arrangements whenever standards are revised, distributed via the annual service calendar/roadmap.

Feedback from surveyed facilities and surveyors is collected after every survey and mock survey, analysed, and used to revise standards.

ASF’s standards development process is published and publicly available on the ASF website.

ASF uses a transparent rating system for each standard/criterion, scored on a defined scale applied consistently across every survey.

Guidelines are provided to surveyors and to facilities to ensure consistent self-assessment and survey scoring, including weighting where safety risk is identified.

A defined methodology determines overall achievement: baseline-and-improvement doctrine combined with survey scores produces the binary accredited/not-accredited outcome, validated by continuous monitoring via ASF’s three-tier alert system.

Facility and surveyor satisfaction with the rating system is evaluated after each survey cycle and used to improve the measurement system.

Standards require member facilities to define mission, values, code of behaviour, and strategic objectives within a documented plan, reviewed at quarterly working sessions.

Standards require an organisational plan identifying expected services and tracking progress, consistent with ASF’s remote-by-design data model.

Standards define facility responsibilities for governance, clinical governance, organisational management, financial stewardship and quality performance, each with a named accountable role.

Standards are consistent with the legal and health-policy requirements of each country of operation; ASF maps national regulatory requirements before enrolling facilities.

Standards require facilities to plan staffing levels and skill mix using a documented planning process appropriate to services provided.

Standards require staff, independent practitioners and volunteers to have current orientation, training, education and demonstrated skills — tracked individually through ASF’s Training Passport.

Standards require credentialing of all practitioners permitted to practise, with defined scope of practice and a systematic validity-check process.

Standards require regular, documented performance and competency evaluation of staff, shared with the individual concerned.

Standards require arrangements for ongoing education, benchmarked against European CME standards and supported by ASF’s discounted training package for members.

Standards require staff to follow current evidence-based protocols and guidelines.

Standards require facilities to involve patients, families, staff and the wider community in planning service provision, via the independent Patient Council model.

Standards require coordination of departments and services with each other and with relevant external services, including verified suppliers under ASF Verified.

Standards require a risk management framework covering both reactive and proactive measures, including staff training and a defined list of strategic, operational, financial and hazard risks.

The risk framework is supported by a policy, procedure, and a live risk register reviewed at monthly touchpoints.

Standards require risk assessments safeguarding patients from unintended consequences of care: medication management, falls, infection control, nutrition, equipment risk.

Standards require a process for reporting, investigating and acting on safety incidents, adverse events and near misses, implemented as ASF’s no-blame outsourced incident-reporting service.

Standards require protection of staff health and safety, including protective equipment, workload monitoring and protection from occupational hazards.

Standards require training on safe equipment operation and restrict specialised equipment use to trained, competent staff.

Standards require compliance with safety laws and regulations, adequate facilities/equipment/supplies, and a planned maintenance schedule, extended by ASF Verified supplier-chain checks.

Standards align with WHO Global Patient Safety priority areas (patient identification, medication safety, safe surgery, hand hygiene, etc.).

Standards require a planned infection prevention and control programme including hand hygiene, sterilisation, and monitoring of infection rates.

Standards require patient records to be current, complete, accurate and secure, supporting continuity of care and ASF’s near-zero-paper, AI-readable monitoring model.

Standards identify patient rights — privacy, dignity, confidentiality, safety, informed consent, right to refuse treatment — and require facilities to inform patients of these rights.

Standards require a system to receive, investigate and resolve patient complaints in a timely way, implemented through ASF’s complaint-intake and ombudsman service.

Standards require a process to receive and resolve ethical dilemmas in a timely way.

Standards require staff to involve patients in their own care: respecting preferences, informing on treatment options, and obtaining informed consent.

Standards require recognition of patients’ cultural context and spiritual preferences.

Standards require facilities to publish information on how patients access care, including access for people with disabilities and special needs.

Standards require patient assessments to involve relevant disciplines, be performed by qualified individuals, and be documented per policy.

Standards require individual treatment/care plans based on assessed needs, involving the patient and family where appropriate, with stated goals.

Standards require treatment plans to be followed, progress monitored, and plans revised on reassessment.

Standards require planned discharge, referral or transfer of care, including preparation for end-of-life care where relevant.

Standards require facilities to publish information on services provided, kept current and accurate, reflected in ASF’s open, clickable public register.

Standards require a formalised, facility-wide quality improvement plan with allocated responsibilities, subject to evaluation.

Standards require measurement of quality performance processes and outcomes, implemented via ASF’s continuous indicator-monitoring system with a three-tier alert framework validated by annual on-site survey.

Standards require collected performance data to be used to evaluate and guide quality improvement, accessible on a timely basis to those responsible.

Standards require key policies, procedures and plans to be documented, authorised, kept current on a review schedule, and implemented.