<![CDATA[Background: Clinical accreditation is an effort to improve the quality of healthcare services, but its implementation in primary healthcare facilities still faces various challenges, particularly in ensuring quality sustainability. This study aims to evaluate the implementation of clinical accreditation standards and analyze their impact on service quality based on the 5M management approach. Subjects and Methods: This study used a qualitative evaluative approach, encompassing four levels: input, process, output, and outcome evaluation. Data were collected through in-depth inter-views with key informants, field observations, and document studies at four clinics in Surakarta, Central Java, Indonesia. The study was conducted from September to December 2025. Data validity was triangulated by creating a descriptive analysis. Results: Accreditation implementation has improved aspects of service structure and processes, including organizational governance, availability of SOPs, increased human resource understanding, and arrangement of service facilities and documentation. However, implementation is still dominated by administrative fulfillment and has not been fully integrated into a sustainable quality management system. Impacts on outcomes, such as patient satisfaction and quality culture, are beginning to be seen, but are not yet supported by data-based quality indicators and systematic evaluation. Key supporting factors include leadership commitment, availability of basic resources, and regulatory support, while inhibiting factors include limited human resources, workload, a suboptimal monitoring system, and the perception of accreditation as an administrative burden. Conclusion: Implementation of accreditation acts as an initial step in improving service quality, but is not enough to guarantee sustainability without strengthening the monitoring system, indicator-based evaluation, and internalization of a quality culture]]>
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