Accréditation Sans Frontières
International Accreditation of Healthcare Facilities
Accréditation Sans Frontières
International Accreditation of Healthcare Facilities
You do not need to be accredited. You do not even need to be an ASF member. You need only to want to hear the truth — from a body the patient trusts because it is not the hospital.
Every hospital has a feedback form. Patients fill it in carefully — because the hospital that treated them will read it, and they may need that hospital again. So the form says “everything was fine.” The real story goes to Facebook. Management learns about the problem from a viral post two days later.
The hospital’s own form goes into a black hole. The anger goes public. Neither outcome helps the next patient.
The fix is structural, not technical. Patients speak honestly when the listener is not the hospital. That listener is ASF.
International research (Reader, Gillespie & Roberts, BMJ Quality & Safety) shows that a structured, independent complaint system is the single most reliable early-warning signal for patient safety problems.
Vanderbilt University data: a small minority of doctors generate the majority of patient complaints — and those complaints predict malpractice risk (Hickson et al., JAMA). An unanswered complaint is a lost lesson. A neutral intermediary protects patient and hospital alike.
We place a QR code in your wards, reception and discharge papers. A patient scans it and submits — complaint, praise, question, idea. Anonymity is allowed. The message goes directly to ASF. It never passes through the hospital.
ASF acknowledges in writing within two working days and responds substantively within five. We take neither the hospital’s side nor the patient’s. We mediate — including feedback that first appeared on social media — and we close every case in writing.
The hospital receives a monthly Patient Voice report: themes, severity coding, praise passed to the team by name, and the issues that need fixing — analysed with an internationally validated complaint taxonomy, comparable month to month.
ASF holds no stake in any outcome. We have no disciplinary role over the facility. We are not the hospital’s agent and we are not the patient’s advocate — we are the neutral facilitator between them. These four principles are drawn from international ombuds practice (International Ombuds Association Standards of Practice) and are the governance spine of this service. A breach of any one of them destroys the trust the service depends on.
We recruit, train and convene a council of real patients — never controlled by the hospital. The council meets quarterly, reviews the Patient Voice reports, proposes improvements, and publishes what changed. Hospital representation sits at the table. Hospital management does not control the agenda.
This is the model we operate in Georgia today, documented publicly at pacienti.ge. Every session minuted. Every outcome published.
Patient Voice is available as a standalone service — you do not need to be an ASF member or pursuing accreditation. Pricing is indexed to facility size and published on request.
For ASF member facilities, Patient Voice is included in the membership fee. The patient council is convened from the first month of membership.
The method is deliberately simple. One council. One meeting a month, sixty to ninety minutes. ASF is the secretariat — not the chair, not a member, not the hospital’s agent and not the patient’s advocate. The council belongs to the patients; the hospital sits at the table; ASF makes it run. What makes it unusual is the order of operations: the meeting is built on a report of everything patients said in the previous month, and the report goes to the hospital first — so that by the time the council meets, every concern has a verified account and, where possible, an answer.
| Who | How many | What they do | What they never do |
|---|---|---|---|
| Patients and families | 3–6 (max 7) | Members of the council. Review the month’s report, ask, propose, decide what to raise. Chair from among themselves. | Represent the hospital |
| Hospital representatives | 1–2 | Sit at the table. Explain what was found and what was done. Take actions away. | Chair, vote, control the agenda, or see who complained when anonymity was asked |
| ASF secretariat | 1 | Collects every piece of feedback, writes the report, checks it with the hospital, convenes, records, tracks actions, runs the education session, closes the loop with each patient. | Take sides. Discipline anyone. Decide outcomes. Hold a stake in any result |
| Step | When | What happens | Output |
|---|---|---|---|
| 1 · Collect | All month | Every piece of feedback, from every source, lands with ASF: QR code, hotline, online form, email, paper forms, WhatsApp, social-media posts and tags. Praise as well as complaints. Each gets a case number. | One register, one place |
| 2 · Report | Month end | ASF writes the monthly Patient Voice report: every case, themed and severity-coded with a validated taxonomy; praise by name; what was asked, what is open. | Draft report |
| 3 · Verify with the hospital | Days 1–5 | The draft goes to the hospital’s liaison first. This is the conflict-of-interest safeguard in reverse: patients sometimes report inaccurately or without context, and the hospital must have the chance to clarify, correct and say what it has already done. Nothing is softened; facts are checked. | Verified report with the hospital’s responses |
| 4 · Council meeting, part one | Days 7–10 · 40–60 min | The verified report is presented to the council. Positives and negatives. What has been done. What will be done, by whom, by when — and where an answer can already be given to the patient. | Action log with owners and dates |
| 5 · Close the loop | Within 5 working days of the meeting | Every patient who raised a concern hears back, in writing, with what was found and what changed. This is the step that matters most. | Written answer to each patient |
| 6 · Council meeting, part two | Same meeting · 30 min | Patient education: one session, one topic, chosen from what the month’s feedback shows patients most need to know — rights, consent, medication, discharge, how to ask questions. | Education record |
| 7 · Publish | After the meeting | The council record, minus anything identifying, goes on the public archive. Actions carried to next month’s report until closed. | Public record |
The hospital recruits, openly and continuously. The invitation goes out through every channel the hospital already uses — its website, its social media, and a notice at the entrance or in the patient corner — and it stays up, because members come and go: a patient joins after a stay, serves, moves on. The council is small by design. Three members is the minimum for a small clinic; six is the working maximum, occasionally seven. Beyond that, honest discussion becomes management.
| Rule | How it works |
|---|---|
| Recruitment | Announced by the hospital on its website, social media and at the entrance/patient corner; open to any current or former patient or family member; rolling — new members join as others leave |
| Size | Minimum 3 (small clinic) · working maximum 6 · never more than 7 |
| Chair | A patient, elected by the members. Rotates — no one chairs for more than one year |
| Hospital seat | One or two: usually the head of quality and the head of reception or administration — the people who have the first contact with patients and the authority to fix what they hear |
| Secretariat | ASF: one person, precise and persistent. Keeps the register, writes the report, chases the actions, makes the sessions worth attending, and follows up with members who miss a meeting |
| Channel between meetings | A WhatsApp group of members, hospital seat and secretariat — for reminders, sharing the report and materials, and questions between meetings. Not for individual cases |
| Term | No fixed term for members; chair rotates yearly; a member who misses three consecutive meetings is asked whether they wish to continue |
Trust needs paper. Three signed documents, all short, all plain-language:
The agreements protect three things at once: the patients (their privacy and their freedom to speak), the hospital (against damage from what is said in a confidential forum), and the council itself (because a body that leaks is a body no one speaks to). They are drafted under French law with a local-law annex where the council operates outside France.
| Hospital-run Patient and Family Advisory Councils (North America) | Statutory consumer bodies (UK Healthwatch, Australian consumer committees) | ASF Patient Voice council | |
|---|---|---|---|
| Who runs it | The hospital’s patient-experience office | An external body, at system or regional level | An independent secretariat, at facility level |
| What the agenda is built on | Topics the hospital brings | Surveys, visits, system issues | Every piece of feedback from the last month, verified with the hospital first |
| Loop closure to the individual | Rarely structured | Not the body’s role | Every case, in writing, within 5 working days |
| Education | Occasional | Campaigns | Every meeting, topic chosen from the month’s feedback |
| Time required | Quarterly, 2–3 hours | Varies | Monthly, 60–90 minutes |
| Public record | Internal minutes | Published reports | Published council record (pacienti.ge in Georgia) |
Eight documents, every one with worked examples, every one also as an editable Word file. Together they are the whole method: a facility, an NGO or a national body can read them on a Monday and hold its first council within a month. Free to reuse with attribution and a note of what was changed.
Patient Voice is built on what the strongest health systems already do — and then removes the one weakness they share. In the United Kingdom every NHS trust runs a Patient Advice and Liaison Service, complaints are handled to national Complaint Standards set by the Parliamentary and Health Service Ombudsman, a statutory consumer champion (Healthwatch) sits in every area, and an independent ombudsman is the final tier. In Australia, the Australian Charter of Healthcare Rights gives every patient seven rights — access, safety, respect, partnership, information, privacy and the right to give feedback — and the National Safety and Quality Health Service Standards make partnering with consumers a condition of keeping accreditation, with state Health Complaints Commissioners as independent statutory bodies. Ontario has had an independent Patient Ombudsman since 2016.
| Element | United Kingdom (NHS) | Australia | ASF Patient Voice |
|---|---|---|---|
| First point of contact | PALS inside every trust — helpful, but part of the hospital | Hospital complaints unit, then a state commissioner | Outside the hospital from the first message — QR, hotline, online form, all reaching ASF, never the hospital’s desk |
| Acknowledgement | Within 3 working days (Complaint Standards) | Varies by state; typically 5 working days | 2 working days, in writing |
| Quick resolution | Around 10 working days where possible | — | Substantive response within 5 working days; complex cases with a written plan and dates |
| Full resolution target | Straightforward: 95% within 3 months; complex: 80% within 6 months | Commissioner timelines vary | Straightforward: 90% within 20 working days; complex: within 3 months, with monthly updates |
| Patient rights | NHS Constitution | Charter of Healthcare Rights — seven rights, embedded in accreditation | ASF Patient Charter — the same seven rights, displayed in every Patient Voice facility and assessed in the ASF standards |
| Consumer partnership | Patient participation groups; Healthwatch | Consumer advisory committees required for accreditation | Independent Patient Council convened by ASF, not appointed by the hospital, meeting monthly with a secretariat |
| Independence of the ombudsman | Final tier only, after local resolution | Statutory commissioner, after local process | Neutral from day one — ASF holds no stake, has no disciplinary role, and mediates rather than adjudicates |
| Learning | Trusts report complaint learning annually | Open disclosure and improvement required | Monthly Patient Voice report with a validated complaint taxonomy, quarterly council review, annual public summary |
| Anonymity | Limited | Limited | Allowed, with plain notice when it cannot be fully preserved |
Aligned with the Australian Charter of Healthcare Rights as a reference, and assessed in the ASF standards.
Timelines are commitments, measured and published in the annual summary.
| Step | What happens | When |
|---|---|---|
| 1 | Case reference issued to the patient | Immediately (form, hotline, WhatsApp) or same day (email) |
| 2 | Written acknowledgement, track assigned (concern about care · praise · question · idea) | Within 2 working days |
| 3 | ASF contacts the facility’s named liaison with the substance — never the patient’s identity if anonymity was requested | Within 3 working days |
| 4 | Substantive written response to the patient; for complex cases, a written plan with dates | Within 5 working days |
| 5 | Mediation where needed — both sides heard before any conclusion | Within 20 working days for straightforward cases |
| 6 | Case closed in writing to patient and facility; learning recorded in the taxonomy | At resolution; complex cases within 3 months with monthly updates |
| 7 | Immediate patient danger | Escalated the same day under the Sentinel Event Policy — no queue |
Patient Voice is a service in its own right, and it is also how the ASF standards are met. Every ASF organizational standard carries patient-experience criteria — reception and information, complaints and feedback, aftercare — and each standard’s Governance chapter asks for a functioning consumer-partnership mechanism. A facility running Patient Voice has that evidence produced for it every month, independently. It is also the Patient Voice Package in ASF Local Advisory Services, priced openly at €120 per month, and services 5–6 of full ASF membership.
Since January 2024 the Patient and Family Council model has run in hospitals in Tbilisi, Kutaisi and Batumi through the ASF/PHIG alliance, with the first Batumi council bringing five facilities of one group to a single table. Council meetings, education sessions and initiatives are documented publicly — the working record, not a brochure — on pacienti.ge. Three of the complaint-handling and communication courses that support it are accredited CME activities delivered in Georgia since 2024. The model was tested in a health system with no tradition of independent patient voice at all; that it works there is the strongest evidence it will work in yours.
Patient Voice is not a concept. The Patient and Family Council model was launched in Georgia in January 2024 through the ASF/PHIG alliance, at a time when patient involvement in hospital decisions was minimal. Councils meet monthly — three to six patients and family members, one or two hospital representatives, one secretariat representative — and the secretariat runs the logistics, keeps the records, tracks every action item, and conducts independent patient-satisfaction surveys with a monthly analytical report. It has run in hospitals across Tbilisi, Kutaisi and Batumi, with measurable improvements in patient satisfaction; the first council meeting in Batumi brought together five healthcare facilities of one group. Council proceedings, education sessions and initiatives are documented publicly on pacienti.ge.
Developed with the Public Health Institute of Georgia and David Tvildiani Medical University because hospitals asked. Free to print, use and translate; keep the ASF mark.
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