Accreditation is the means by which a centre can demonstrate that it is performing a required level of practice in accordance with agreed standards of excellence. Essentially it allows a centre to certify that it operates an effective quality management system.

A quality management system is a mechanism to ensure that procedures are being carried out inline with agreed standards with full participation by all staff members. In a cell transplant programme, this ensures that the clinical, collection and laboratory units are all working together to archive excellent communication, effective communication, effective common work practices and increased guarantees for patients. It is a means of rapidly identifying errors or accidents and resolving them so that the possibility of repetition is minimized. It assists in training and clearly identified the roles and the responsibilities of all the staff.

Once the required level of quality has been achieved, the remaining challenge is to maintain this standard of practice. With a working quality management system in place and adequate resources, the fundamental elements necessary to sustain the programme are continued staff commitment and vigilance.

Having said of all this, there is still a basic question: will implementing quality management make a difference to my patients? In answer to this, evidence is emerging of a relationship between quality in transplantation and improved patient outcome. The analysis that was presented during the annual meeting of EBMT in Vienna, Austria in March 2009 shed some light on this aspect: using the EBMT registry, and the information regarding more than 100.000 HSCT performed between 1999 and 2007 at 421 different HSCT programs, the authors conducted a retrospective analysis to study whether the introduction within a HSCT program of a quality management system in order to obtain the JACIE accreditation would produce results in terms of clinical outcome. Confounding factors – including EBMT risk factor for individual patients, centre size, per-capita income in different countries – were included in the analysis, in order to eliminate potential biases. Improvement of overall survival peaks at 14% for patients with chronic leukemias who received an allogenic HSCT. Although mostly evidenced for recipients of allogenic transplantation, improvement in overall and disease-free survival was also apparent for recipients of high-dose chemotherapy supported with autologous HSCT.

The Journal of Clinical Oncology has published the Gratwohl et al Introduction of a Quality Management System and Outcome After Hematopoietic Stem-Cell Transplantation. JCO Apr 11, 2011:JCO.2010.30.4121;