Aidin Aryankhesal; Niusha Shahidi Sadeghi; Sorur Mazhari; Rafat Bagherzadeh; Hadi Kalantari
Volume 25, Issue 1 , 2023
Abstract
Background: Studies have often examined the challenges presented to the implementation of accreditation. Nonetheless, after developing and implementing four generations of accreditation over 25 years, multiple questions have been left unanswered regarding the number of resolved challenges, the emergence ...
Read More
Background: Studies have often examined the challenges presented to the implementation of accreditation. Nonetheless, after developing and implementing four generations of accreditation over 25 years, multiple questions have been left unanswered regarding the number of resolved challenges, the emergence of new challenges and problems, as well as the mitigation of these problems by policymakers and managers for the next generations.
Objectives: Therefore, the present study aims to explain the development progress of the last two generations of the National Hospital Accreditation Program (NHAP) with the previous versions in Iran.
Methods: As a qualitative research, Semi?structured interviews were conducted in 2020. Through purposive sampling, 20 hospital managers at different levels with experience in all four generations participated. Thematic analysis was used to analyze.
Results: The themes included designing the measurement criteria, the supervisor's performance (university and ministry), the hospital's performance, the measurement process, as well as announcing the results and outcomes. Moreover, the status of the development of the national accreditation with previous versions was explained in categories, including improvable points, improved problems, and cases of deterioration.?
Conclusion: The revision process of the NHAP in Iran is indicative of an upward trend, and almost proper modifications have been made. Significant changes have been made since the third generation. Changes in performance-oriented and highlighted patient safety have been very helpful. Changing the assessment of universities affiliated to Ministerial, which is trying to become partly external evaluation. In addition, some positive changes have been achieved in the fourth generation, including a significant reduction in criteria, more professional evaluators, elimination of document uploads, and the definition of outpatient criteria. The improvable points were as follows: defining some measurement criteria, limitations of physicians' criteria, evaluating input instead of output, lack of medical guidelines, failure to pay attention to hospital-type criteria, lack of continuous monitoring of universities, and lack of motivation mechanisms for new criteria.
Niusha Shahidi Sadeghi; Mohammadreza Maleki; Hasan Abolghasem Gorji; Soudabeh Vatankhah; Bahram Mohaghegh; Mahnaz Raouf; Leila Abdollahi; Fatemeh Samie; Hasan Askari
Volume 24, Issue 7 , 2022
Abstract
Background: Hospitals, similar to other organizations, are complex social systems influenced by elements, such as staff, resources, and structures, that work to achieve specific goals. In terms of goals and missions, hospitals are divided into teaching and non-teaching categories. There are many differences ...
Read More
Background: Hospitals, similar to other organizations, are complex social systems influenced by elements, such as staff, resources, and structures, that work to achieve specific goals. In terms of goals and missions, hospitals are divided into teaching and non-teaching categories. There are many differences in the nature and needs of these two types of hospitals that must be considered for proper operation by policymakers and managers.
Objectives: The present study compared issues between non-teaching and teaching hospitals in Iran.
Methods: A qualitative study was conducted using semi-structured interviews according to an interview guide with 40 Iranian hospital managers and policymakers selected through purposive sampling in 2021. Data were analyzed through thematic analysis with an inductive approach using the MAXQDA software (version 10).
Results: According to the results, the main categories of differences between non-teaching and teaching hospitals in Iran were as follows: legal and social responsibility, cost-effectiveness and efficiency, supply of resources, empowerment of human capital, goals and missions, external and internal communications, revenue-cost management, organizational structure, customer satisfaction, organizational behavior, clinical and support departments, hospital processes, type and level of services, manpower, performance evaluation, and the organization of the teaching mission.
Conclusion: Practical findings of this study include understanding the complexity and instability of command unity in teaching hospitals, understanding the differences in organizational hierarchy, developing a mechanism to cover costs for clients, increasing the legal and social responsibility of the management team, prioritizing organizational goals, coordinating policy demands with providing resources, funding the teaching mission, organizing multiple supervisory organizations, establishing transparent communication between hospitals and colleges, understanding the complexity of processes, considering the change of individual and group communication, changing the performance appraisal system, and paying for performance. It is suggested that policymakers consider these issues in providing the resources and facilities needed for hospitals based on their function.
