Background: In Japan, hospital infection control (IC) programs are frequently under-resourced, whereas their improvement is considered a pressing issue. Hospital accreditation may have a positive impact on IC program performance. The Japan Council for Quality Health Care (JCQHC) is a hospital accreditation organization that now prescribes broad elements of IC as part of its accreditation standards. Methods: We sent questionnaire surveys to all teaching hospitals in Japan to characterize the current situation of hospital IC activities and identify the impact of accreditation on IC infrastructure and performance. The self-administered questionnaire that we used was developed based on the JCQHC accreditation standards. Surveys were sent to all institutions in 2004 and again in 2005. Results: Of the 638 hospitals surveyed, 335 (52%) answered in both years. Most IC practitioners in Japanese teaching hospitals were working part time and spent limited hours performing IC duties. Surveillance was poorly implemented in Japan, and IC activities without evidence of effectiveness were widely performed. Surveillance was implemented more frequently in hospitals with adequate IC staffing. Improvement in IC infrastructure and performance between the surveys was larger in the newly accredited hospitals than the others. Conclusions: Hospital accreditation had a significant impact on hospitals' IC infrastructure and performance.
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