A More General Consideration About Accreditation Standards: From VET to Health Systems

Abstract

The research introduced in this chapter also focuses on the application of compliance with Decree 231 as a compulsory requirement of an accreditation system. What changes is the sector analysed, Health Care. By analysing this sector, we can expand our reflections on the intertwined relationship between ethics and compliance, by outlining the pros and cons of the current applications made by the Italian government. In this sector too, critical aspects are confirmed, and compliance appears to be incomplete and unable to drive corporate behaviour towards ethics. Here too, the new institutionalism theory finds a perfect fit: both VET and health-care providers simply incorporate norms, in our case the organisational model under Decree 231, in order to gain legitimacy, resources and stability, while at the same time trying to avoid any real change in their functioning and organisation. In so doing, they enter into a sort of “institutional inertia”, which risks sterilising the effort made by the legislator.

To break this vicious circle, we suggest using the “lens of organisational theories” once again and to break down the institutional inertia that arises as a result of coercive, normative and mimetic isomorphism through the contingency theory approach, with the aim of moving from an approach oriented merely towards formality and rhetoric to an approach oriented towards making concrete changes in organisational behaviour and efficacy. In so doing, the innovative standard in the accreditation system which was presented in the previous chapters can become an important pillar for creating new “rules of the game”, which focus on transparency, ethics and the accountability of all the stakeholders engaged in accreditation systems.