HAS 2025 Certification: Ensuring Excellence in Healthcare Facilities

The Essential HAS Certification for Quality and Safety of Care

Certification by the French National Authority for Health (HAS) is a cornerstone for healthcare facilities in France, whether public or private. Established in 1996 under the name of accreditation, it has become a mandatory procedure whose main objective is to ensure the continuous improvement of the quality and safety of care provided to patients. More than just regulatory compliance, this certification guarantees the quality of care and patient safety, aspects considered crucial.

The HAS certification process is independent of the facility and its governing bodies, and it is conducted by professionals appointed by the HAS, known as expert assessors. Its mission is to assess the quality and safety of care provided, based on objectives collectively defined at the national level by healthcare professionals and patients. Certification is neither an inspection nor a ranking of institutions, but a comprehensive framework for external analysis and evaluation, serving as a lever to mobilize teams and patient representatives in a continuous improvement process. It emphasizes the patient’s perspective, the evaluation of care outcomes (health, reception, information, coordination), and encourages team autonomy in organizing their practices to achieve the set objectives. HAS certification is also internationally recognized, as HAS itself is accredited by the International Society for Quality in Health Care (ISQua) for the rigor and quality of its system. This process is constantly evolving, with annual updates to adapt to the realities of the healthcare system. In 2025, the certification of healthcare facilities enters its sixth cycle, with new developments aimed at strengthening requirements on key issues, adapting to public health priorities, and making patients true partners.

The Foundations and Continuity of HAS Certification

The sixth cycle of HAS certification, applicable to visits beginning in September 2025, builds on the previous cycle while making adjustments. The French National Authority for Health (HAS) has chosen to retain the fundamental structure of its framework. Thus, the organization into chapters, objectives, criteria, and evaluation elements remains unchanged. This approach, which builds on the achievements of previous cycles, aims to facilitate the adoption of the process by professionals.

Similarly, the Calista platform, an essential collaborative tool for communication between the HAS and healthcare facilities, remains in use. This platform allows healthcare facilities to validate their data, grant access rights to professionals, access their personalized repository, news, shared documents, internal assessment reports, their visit schedule, and their certification reports. The five main assessment methods, which are widely used, are also retained, although they may be subject to minor adjustments. These methods are patient tracing, pathway tracing, targeted tracing, system audit, and observation. Patient tracing enables a collective retrospective analysis of a patient’s journey, integrating the perspectives of the patient and their family and cross-referencing them with the analysis of care provided by professionals. This method assesses, in particular, organizational structures, interfaces between sectors, and interprofessional coordination. The pathway tracer evaluates the continuity and coordination of care, teamwork, and the culture of quality and safety throughout a patient’s journey. The evaluator retraces the patient’s physical path and meets with the teams and patients involved. The targeted tracer aims to assess the actual implementation of a process in the field to ensure its control and its ability to achieve objectives. It involves meetings with teams, review of documents, and observations. Eight categories of targeted tracers are planned to assess specific processes such as medication management, transfusion, adverse event management, infection prevention, and other critical areas. The system audit assesses the institutional governance strategy and the participation of professionals and user representatives in its implementation. It verifies the facility’s ability to achieve its objectives and those set for it, through meetings with governance bodies, user representatives, and teams at their work sites. The observation allows for visual or oral assessment of compliance with best practices in the field, complementing the tracer methods, and is based on an observation grid. Finally, the four decision levels following the certification visit (certified facility with distinction, certified, certified with conditions, not certified) and their publication on the Qualiscope website remain unchanged. The facility’s overall score is the average of the results from the three chapters of the framework. Certification is valid for four years, unless a decision is made to deny certification or to grant certification with conditions, which entails a new procedure within a timeframe defined by the HAS (French National Authority for Health). Key changes in the HAS V2025 framework: Although the 6th cycle of HAS certification emphasizes continuity, it incorporates significant changes, particularly in the structure and types of criteria. The three chapters of the framework—the patient, the care teams, and the facility—are retained, but their objectives have been rebalanced. The new framework now includes 12 objectives (four per chapter), each broken down into criteria with four to six evaluation elements. This rebalancing aims to simplify the calculation of averages.

The 12 objectives of the V2025 framework are as follows:

1. Respect for patient rights
2. Patient Information
3. Patient involvement in their care plan
4. Involvement of patients and their representatives in the life of the institution
5. Coordination of teams for patient care
6. Control of risks associated with practices
7. Safety in high-risk areas (emergency care, surgery and interventional procedures, radiation therapy, maternity care, critical care, emergency medical services, mental health, and psychiatry)
8. A culture of relevance and results
9. Comprehensive management through quality and safety of care
10. Management of professional resources and skills
11. Geographical positioning
12. Adapting to eco-friendly care and digital innovations

A notable change concerns the number of mandatory criteria, which increases from 17 to 21 between the 2024 and 2025 versions. These mandatory criteria are fundamental requirements, and a negative assessment of any one of them can prevent the facility from obtaining certification or affect its rating. Among these new mandatory criteria are requirements such as respect for patient privacy and dignity, pain management, compassionate care, informed patient consent, patient satisfaction and experience, best practices for prescribing and administering medications, prevention of medication errors, standard hygiene precautions, appropriateness of antibiotic prescriptions, reporting of adverse events, management of exceptional health situations, control of life-threatening emergencies, and criteria specific to psychiatry (physical examination, isolation/restraint of patients hospitalized without consent) and perinatal care (newborn care, prevention of major obstetric risks). The 2025 framework also introduces five advanced criteria, the results of which are not factored into the certification score. These criteria represent desirable, but not yet mandatory, requirements and are considered potential future standard criteria. These include aspects such as governance support for the use of Patient-Reported Outcome Measures (PROMs), promotion of patient self-administration of medication (PAAM), accreditation of physicians and medical teams, and the use of innovative, non-medical technological tools, including those based on artificial intelligence. These adjustments aim to make the framework more relevant and adapted to the current challenges of the healthcare system, while encouraging innovation and continuous improvement of practices. src="https://cdn.prod.website-files.com/61f1c5bbc327ec3679e7457c/68500f4410dfe89580b7746f_haute_qualite_des_soins.jpg" loading="lazy">

Reinforced Priorities and New Quality Indicators

The 6th HAS certification cycle highlights several key areas for improvement, reflecting public health priorities and changes in the medical landscape.

1. Digitalization and Cybersecurity: The2025 framework significantly strengthens the criteria related to digital technology, a trend that was already underway in the previous version. It introduces requirements regarding the use of digital medical devices (DMDs), particularly those incorporating artificial intelligence.

2. Postpartum Care and Obstetric Risks: Francefaces a concerning infant mortality rate. To address this, the 2025 framework sets higher standards for risk management related to the care of pregnant women and newborns.

• Mandatory criterion 2.3-10 requires teams to implement measures to prevent major obstetric risks, ensuring the rapid detection of potential complications, strict protocols, and emergency drills.
• Mandatory criterion 2.3-11 aims to ensure the safety of newborn care, particularly through immediate identification, infection prevention, and assessment of vital signs at birth. The birth and parenting plan is also emphasized.

3. Ecology and Eco-Responsible Care: Anew feature of the framework is the inclusion of criteria related to ecology, encouraging facilities to reduce their environmental impact.

• Criterion 3.4-02 commits the facility to environmentally responsible practices by promoting a culture of sustainable development and assessing the environmental impact of its operations.
• Criterion 3.4-03 requires the facility to take action to support the ecological transition by reducing its energy consumption, improving waste management (separation at the source), and promoting sustainable mobility.

4. Patient Experience and Its Role: The 2025 framework places greater emphasis on patient experience, positioning it as a full partner in the healthcare system.

• Criterion 1.4-01 encourages patients to express their satisfaction and share their experiences, particularly through national surveys such as e-Satis or internal mechanisms.
• Imperative Criterion 1.4-02 stipulates that patient satisfaction and experience must be taken into account when establishing guidelines for quality and safety improvement policies.
• Advanced Criterion 1.4-03 encourages healthcare organizations to support the use of questionnaires that focus on patient-reported outcome measures (PROMs), recognizing their role in quality improvement and patient-professional communication.
• Patient partners and associations are also involved in the development of care pathways (criterion 1.4-04). The involvement of user representatives in the institution’s operations is valued (criteria 1.4-05 and 1.4-06).

5. Appropriate Use of Antibiotics: Giventhe continued failure to adequately manage risks associated with medication use, the objectives and evaluation criteria have been revised.

• Mandatory criterion 2.4-02 ("The appropriateness of antibiotic prescriptions is justified and reassessed") has been strengthened, emphasizing the importance of justifying prescriptions, regularly reassessing them, monitoring antibiotic use, and participating in networks to combat antimicrobial resistance. Criterion 2.3-05 on good antibiotic prophylaxis practices has become a standard requirement.

6. Psychiatry and Emergency Care: Certificationis aligned with public health priorities, particularly in psychiatry and emergency care.

• In psychiatry, the evaluation criteria have been revised to drive significant improvements in practice. The objectives focus on suicide prevention (criterion 2.1-11), the development of care programs that promote social inclusion (criterion 1.3-09), adherence to best practices for seclusion and restraint (mandatory criterion 2.3-14), and the improvement of somatic care (mandatory criterion 2.1-12). Access to mental health care is also organized and monitored (criterion 2.1-10). For emergencies, the framework emphasizes the management of unscheduled patients, the systematization of direct hospitalization pathways, and the organization of intra-pathway meetings with local stakeholders (criterion 3.3-04). Preventing unnecessary transfers of elderly people is a mandatory criterion (criterion 3.3-05). The management of life-threatening emergencies (mandatory criterion 2.2-12) is also strengthened.

These changes underscore the HAS's commitment to adapting certification to the contemporary challenges of the healthcare system, emphasizing safety, appropriate care, and a more integrated and patient-centered approach.

Assessment methods at the heart of the 2025 framework

Assessment methods are crucial for evaluating the quality and safety of care in healthcare facilities. The HAS 2025 framework retains the five main methods: patient tracer, pathway tracer, targeted tracer, system audit, and observation. However, the application and scope of these methods can be adapted to meet new requirements. The Tracer Patient: This method allows for the evaluation of the quality and safety of a patient’s care throughout their journey by gathering their experience and that of their loved ones. The evaluator (exclusively a visiting physician expert for external evaluations) interviews the patient, then the care team responsible for their care. The chosen patient profile should be close to their discharge date to maximize the breadth of experience gathered. For example, mandatory criterion 1.3-01 regarding respecting the patient’s privacy and dignity is partly assessed by the tracer patient, who gathers the patient’s perspective on their reception and care conditions. The tracer patient also allows for the assessment of whether the patient was able to express their free and informed consent (mandatory criterion 1.3-01).

The Tracer PathwayThetracer pathway is used to assess the continuity and coordination of patient care, teamwork, and the quality and safety culture. The evaluator meets with the teams involved and retraces the patient's physical journey, supplementing their assessment with meetings with the teams involved in this journey. This method is relevant for criteria such as team coordination (criterion 2.1-03), compassionate care (mandatory criterion 1.1-06), or the safety of newborn care (mandatory criterion 2.3-11).

The Target TracerThismethod involves evaluating the actual implementation of a process in the field to ensure it is under control and capable of achieving its objectives. The evaluation begins on-site and can be traced back to the process organization in the event of malfunctions. It involves meetings with teams, document review, and observations. Key processes are evaluated using targeted tracers, such as the medication circuit (mandatory criterion 2.2-05 on medication administration, mandatory criterion 2.2-06 on medication error prevention), the prevention of healthcare-associated infections (mandatory criterion 2.2-08 on standard hygiene precautions), the management of adverse events (mandatory criterion 3.1-04), or intervention areas (mandatory criterion 2.3-06 on the control of risks related to equipment and professional practices). The System Audit evaluates a process to ensure its control and its ability to achieve objectives, from the process itself to its verification on the ground. It includes document reviews and meetings with management, governance bodies, user representatives, and teams. This method is fundamental for evaluating criteria related to the overall quality and safety of care management (criterion 3.1-01 on quality/safety policy), professional resource management (criterion 3.2-06 on professional health policy), territorial positioning (criterion 3.3-01 on care pathway coordination), and adaptation to digital innovations (criterion 3.4-05 on the management of digital health data). Observation: Observations are conducted continuously during each tracer visit. They allow for a visual assessment of adherence to best practices in the field, such as the cleanliness of the premises, respect for patient privacy, and the use of personal protective equipment. For example, criterion 3.4-01 concerning the maintenance of premises and equipment is assessed through observation and system audits. These methods, combined, allow expert visitors to obtain a comprehensive and robust view of the level of quality and safety of care within the facility. Internal facility assessments can also use these same methods, with the support of tools like Calista to generate customized assessment grids. Effectively preparing for the transition to HAS 2025 Certification: Preparing for HAS 2025 certification is a crucial step for healthcare facilities, with significant implications for their reputation and the quality of care. To successfully transition from the V2024 to the V2025 framework, a structured approach and the involvement of all teams are essential. Key steps for optimal preparation: The first step involves a thorough analysis of the new requirements of the HAS 2025 framework and a comprehensive understanding of the five assessment methods by all professionals. It is imperative to familiarize oneself with the changes introduced in the framework, released on January 2, 2025, and applicable from September 1, 2025, in order to define their impact on professionals and the institution. Secondly, it is strongly recommended to conduct a self-assessment of the institution or each department. This self-assessment allows for measuring the institution’s level of compliance with the criteria of the applicable framework and identifying areas for improvement. It can be carried out by internal evaluators using the same methods as expert visitors, with tools like Calista to generate evaluation grids. The goal is no longer to submit this self-assessment to the HAS (French National Authority for Health), but to use it as an internal tool to define an action plan. Pitfalls to avoid: Certain recurring difficulties can compromise the preparation and success of the certification process. It is crucial to anticipate and avoid them. Among the most common obstacles are:

• Lack of internal communication: Transparent and regular communication with all stakeholders is essential from the start of the preparation phase.
• Failure to follow up on corrective actions: Rigorous follow-up on corrective actions identified during the self-assessment is essential to ensure that nonconformities are corrected before the official visit.
• Failure to meet deadlines: Precise planning and strict adherence to deadlines are essential for effective preparation.

To overcome these obstacles, it is advisable to:

• Involve all stakeholders, including staff, from the very beginning of the process.
• Establish a steering committee, representing all departments of the institution, with the authority to make decisions to effectively oversee preparations.

Tools and Resources to Mobilize: Severaltools and resources are available to help institutions comply with the new requirements.

• Training: This is essential to help teams understand the new requirements and know how to implement them. Organizations such as AGEVAL Formations provide expert support to help teams navigate every step of the process.
• External support: Specialized consultants can provide expertise and an outside perspective to optimize the institution's internal processes.
• Practical guides: Developed by experts, these guides provide detailed information on the steps to follow.
• HAS resources: The French National Authority for Health (HAS) provides valuable official documentation, including the Healthcare Facility Certification Framework for Quality of Care (2025 version), the Methodological Guide for Certification, informational documents on the 6th cycle, and educational fact sheets detailing evaluation methods (system audit, observation, patient tracer).

Preparation should be viewed as a proactive approach to continuous improvement, rather than a mere obligation, by mobilizing all available resources to ensure a successful transition to HAS 2025 certification.

The role of team involvement and governance

The success of HAS 2025 certification fundamentally depends on the involvement and mobilization of all teams within the healthcare facility. This involvement is a determining factor, as the quality of care and patient safety are the result of each professional's daily practices. Staff Engagement Strategies: Staff engagement strategies must be implemented from the very beginning of the certification preparation process. It is essential to raise awareness among teams about the importance of certification, not only as a regulatory obligation, but above all as an opportunity to improve their work and patient care. Teams must be actively involved in the various stages of the process, from analyzing the new requirements to implementing improvement actions. Improving internal communication is essential to keeping teams informed and motivated. Regular meetings, effective communication tools, and constructive feedback help create an environment of transparency where everyone feels involved and heard. Promoting the quality approach is another key to success. Recognizing the efforts made by the teams and highlighting the improvements achieved through their work helps maintain their commitment and strengthen their sense of belonging to a culture of quality and safety in care.

The Role of GovernanceTheinstitution's governance (management, medical staff committee—CME, nursing management) plays a leading role in driving this process. It must implement a clear, personalized, and participatory policy for improving the quality and safety of care, involving management, healthcare professionals, and patient representatives. This policy must be based on an analysis of available indicators (particularly the Quality and Safety of Care Indicators—IQSS and patient experience) and the risks specific to the institution.

Governance must promote a positive safety culture in which human error is analyzed to learn from it, rather than being condemned. It must support team initiatives, such as reporting adverse events related to patient care (AERCs) and sharing lessons learned. The accreditation of physicians and medical teams is a measure encouraged by the HAS to foster this safety culture and maintain competencies.

Moreover, governance is responsible for managing professional resources and skills. It must ensure the adequacy between available human resources and the quality/safety of care, particularly during periods of strain. This includes verifying the credentials and skills of professionals, implementing continuing education, and evaluating competencies. The hospital must also have a health policy for its professionals (prevention of occupational risks, psychological support, vaccination) and a quality of work life (QWL) policy.

By fostering teamwork and creating a supportive environment, governance and management enable professionals to fully commit to the quality process, which is essential for successful certification and, more importantly, for continuous improvement in patient care.

HAS Certification: A Lever for Continuous Improvement

HAS 2025 certification is not an end in itself, but a fundamental step in a continuous improvement approach to the quality and safety of care within healthcare facilities. The ultimate goal is to permanently anchor the culture of quality and risk management in daily practices.

Process monitoring and optimizationTo guarantee this continuous improvement, effective monitoring of the preparation for and the certification visit is essential. This monitoring ensures that good practices are maintained beyond the evaluation period and that the corrective actions implemented are sustainable. The HAS itself is evaluated on its certification process, which attests to the rigor of its continuous improvement approach.

Optimizing internal processes must be a constant priority. This implies a regular evaluation of practices and organizations, based on audits, Professional Practice Evaluations (PPE), and feedback (REX). The quality approach (policy, objectives, measurement tools) must be integrated at all levels of the hospital. Morbidity and Mortality Reviews (MMR) and Feedback Committees (CREX) are key tools for collectively analyzing adverse events and implementing improvement actions.

Anticipating future developmentsIt's crucial to keep abreast of new requirements, as HAS standards generally evolve every year. This ongoing adaptation of the facility's practices is the key to maintaining a high level of quality and anticipating future challenges. Adapting to changes in the healthcare system, including medical, economic and social changes and health crises, is one of the ambitions of certification.

The certification promotes the evaluation of the results of the quality and safety of care approach, encouraging hospitals to improve their performance while preserving their achievements. It emphasizes the relevance of care, multi-professional teamwork, and the promotion of the territorial integration of healthcare facilities in the construction of fluid and coordinated care pathways.

Hospitals are encouraged to develop a culture of evaluation, relying on quality and safety of care indicators (QSCIs) to measure the impact of their practices and identify areas for improvement. The use of data from PROMs and PREMs (Patient Reported Outcome Measures and Patient Reported Experience Measures) to measure care outcomes and patient experience is also a lever for continuous improvement.

In summary, HAS certification is a dynamic process that encourages hospitals to not rest on their laurels, but to constantly commit to a process of excellence for the benefit of patients and their own teams.

Towards a safe and sustainable future of care

HAS 2025 certification marks a new stage in France's commitment to excellence in healthcare. By combining continuity and innovations, the framework adapts to the complex realities of the healthcare system, placing quality, safety, and patient experience at the heart of its concerns.

The introduced changes, whether it is the strengthening of mandatory criteria, the appearance of advanced criteria, or the new requirements in terms of digitization, cybersecurity, environmental health, perinatal care, antibiotic resistance, and mental health, demonstrate a desire for holistic and proactive improvement. They encourage hospitals to reflect more deeply on their practices, their organization, and their overall impact.

The success of this certification depends on rigorous preparation, involving a thorough self-assessment, the use of available resources and tools, and, above all, the mobilization and commitment of all teams. The hospital's governance plays a leading role, instilling a culture of quality and safety, supporting its professionals, and fostering internal and territorial collaboration.

More than a one-time validation, HAS certification is a powerful driver of continuous improvement, pushing hospitals to constantly evolve to offer increasingly relevant, safe, and patient-centered care. It is a path that contributes not only to the individual excellence of each structure but also to the overall performance of the French healthcare system, for a more sustainable and resilient future of care.

Sources

https://www.has-sante.fr/jcms/p_3219705/fr/la-certification-des-etablissements-de-sante-pour-la-qualite-des-soins

https://www.has-sante.fr/jcms/p_3579049/fr/certification-des-etablissements-de-sante-un-6e-cycle-s-ouvre-en-2025

https://www.has-sante.fr/upload/docs/application/pdf/2025-01/referentiel_certification_es_qualite_des_soins_version_2025.pdf

https://www.preventioninfection.fr/actualites/certification-has-ce-qui-change-en-2025-et-synthese-du-cpias-nouvelle-aquitaine/

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