Table 2.

Potential use of reverse innovation in accreditation systems

Innovation	Countries where used	Applicability
Focus on entire system, not just best facilities.	Thailand, Malaysia, India, Kenya, Ghana	Any setting with variable quality
Indicator use very focused, requirements of accrediting body, insurer and government fully harmonized	Malaysia, India	Could benefit state innovation projects in US
Accreditation used as a “brand” for ambulatory facilities; linked to community education	KMET in Kenya	Any setting where improvement in the ambulatory setting is desirable
“Graded” accreditation used to ensure that facilities which do not fully pass are supported in improving.	India; reported from other countries such as Brazil	Any country where not all facilities are accredited
Surveys used to identify facility need; resources such as loans provided where appropriate	Kenya, Ghana (Pharmaccess)	Any country where capital resources are constrained
Surveys used as teaching opportunity	Thailand, Malaysia	All accreditation settings