Iranian Journal of Public Health 2017. 46(10):1347-1358.

An Analysis of Hospital Accreditation Policy in Iran
Taraneh YOUSEFINEZHADI, Ali Mohammad MOSADEGHRAD, Mohammad ARAB, Mozhdeh RAMEZANI, Ali AKBARI SARI

Abstract


Abstract

Background: Public policymaking is complex and lacks research evidences, particularly in the Eastern Mediterranean Region (EMR). This policy analysis aims to generate insights about the process of hospital accreditation policy making in Iran, to identify factors influencing policymaking and to evaluate utilization of evidence in policy making process.

Methods: The study examined the policymaking process using Walt and Gilson framework. A qualitative research design was employed. Thirty key informant interviews with policymakers and stakeholders were conducted. In addition hundred and five related documents were reviewed. Data was analyzed using framework analysis.

Results: The accreditation program was a decision made at Ministry of Health and Medical Education in Iran. Many healthcare stakeholders were involved and evidence from leading countries was used to guide policy development. Poor hospital managers’ commitment, lack of physicians’ involvement and inadequate resources were the main barriers in policy implementation. Furthermore, there were too many accreditations standards and criteria, surveyors were not well-trained, had little motivation for their work and there was low consistency among them.

Conclusion: This study highlighted the complex nature of policymaking cycle and highlighted various factors influencing policy development, implementation and evaluation. An effective accreditation program requires a robust well- governed accreditation body, various stakeholders’ involvement, sufficient resources and sustainable funds, enough human resources, hospital managers’ commitment, and technical assistance to hospitals.

 


Keywords


Hospital, Accreditation, Policy analysis, Iran

Full Text:

PDF

References


Mosadeghrad AM (2003). Principles of Healthcare Management, Dibagran Tehran, Iran. [In Persian]

Mosadeghrad AM (2015). Essentials of healthcare organization and management, Tehran: Dibagran Tehran, Iran [in Persian]

Mosadeghrad AM, Akbari-sari A, Yousefinezhadi T (2017). Evaluation of hospital accreditation standards. RJMS, 23 (153): 43-54. [in Persian]

Mosadeghrad AM, Akbari-sari A, Yousefinezhadi T (2017). Evaluation of hospital accreditation method in Iran. Tehran Univ Med J, 75 (4): 288-298. [in Persian]

Mosadeghrad AM (2016). Comments on “Iran Hospital Accreditation System”. Iran J Public Health, 45 (6): 837-893.

World Health Organization (2003). Quality and Accreditation in Health Care Services: A Global Review. Geneva, Switzerland.

Alkhenizan A, Shaw C (2011). Impact of accreditation on the quality of healthcare services: A systematic review of the literature. Ann Saudi Med, 3(14): 407–416.

Greenfield D, Braithwaite J. Health sector accreditation research: A systematic review. Int J Qual Health Care, 20(3): 172-183.

Peter TF, Rotz PD, Blair DH, Khine AA, Freeman RR, Murtagh MM (2010). Impact of laboratory accreditation on patient care and the health system. Am J Clin Pathol, 134(4): 550-555.

Baskind R, Kordowicz M, ChaplinR (2010). How does an accreditation programme drive improvement on acute inpatient mental health wards? An exploration of members’ views. J Ment Health, 19(5): 405-411.

Mate KS, Rooney AL, Supachutikul A, Gyani G (2014). Accreditation as a path to achieving universal quality health coverage. Globalization and Health, 10(1):68.

Touati N, Pomey MP (2009). Accreditation at a crossroads: Are we on the right track? Health Policy, 90(2-3): 156-165.

Pomey M P, Lemieux-Charles L, Champagne F, Angus D, Shabah A, Contandriopoulos AP (2010). Does accreditation stimulate change? A study of the impact of the accreditation process on Canadian health care organizations. Implement Sci, 5(1):31.

Shaw CD (2003). Evaluating accreditation. Int J Qual Health Care, 15: 455–456.

El-Jardali F, Jamal D, Dimassi H, Ammar W, Tchaghchaghian V (2008). The impact of hospital accreditation on quality of care: Perception of Lebanese nurses. Int J Qual Health Care, 20(5): 363-371.

Braithwaite J, Westbrook J, Johnston B, Clark S, Brandon M, Banks M, et al (2011). Strengthening organizational performance through accreditation research -a framework for twelve interrelated studies: the ACCREDIT project study protocol. BMC Res Notes 4(1):390.

Greenfield D, Pawsey M, Braithwaite J (2011). What motivates professionals to engage in the accreditation of healthcare organizations? Int J Qual Health Care, 23(1): 8-14.

Ladha-Waljee N, McAteer S, Nickerson V, Khalfan A (2014). Using the accreditation journey to achieve global impact: UHN’s experience at the Kuwait Cancer Control Center. Healthc Q, 17(2): 33-37.

Davis MV, Reed J, Devlin LM, Michalak CL, Stevens R, Baker E (2007). The NC accreditation learning collaborative: Partners enhancing local health department accreditation. J Public Health Manag Pract, 13(4): 422-426.

Griffith JR, Knutzen SR, Alexander JA (2002). Structural versus outcomes measures in hospitals: A comparison of Joint Commission and Medicare outcomes scores in hospitals. Qual Manag Health Care, 10(2): 29-38.

Chen J, Rathore SS, Radford M J, Krumholz HM (2003). JCAHO accreditation and quality of care for acute myocardial infarction. Health Aff (Millwood), 22(2): 243-254.

Al Tehewy M, Salem B, Habil I, El Okda S (2009). Evaluation of accreditation program in non-governmental organizations’ health units in Egypt: Short-term outcomes. Int J Qual Health Care, 21(3): 183-189.

Menachemi N, Chukmaitov A, Brown S, Saunders C, Brook R (2008). Quality of care in accredited and nonaccredited ambulatory surgical centers. Jt Comm J Qual Patient Saf, 34(9): 546-551.

Flodgren G, Pomey MP, Taber SA, Eccles MP (2011). Effectiveness of external inspection of compliance with standards in improving healthcare organization behavior, healthcare professional behavior or patient outcomes. Cochrane Database Syst Rev, (11): CD008992.

Thornlow DK, Merwin E (2009). Managing to improve quality: The relationship between accreditation standards, safety practices, and patient outcomes. Health Care Manage Rev, 34(3): 262-272.

El-Jardali F, Ammar W, Hemadeh R, Jamal D, Jaafar M (2013). Improving primary healthcare through accreditation: baseline assessment of readiness and challenges in Lebanese context. Int J Health Plann Manage, 28(4): e256-279.

Aiken LH, Buchan J, Ball J, Rafferty AM (2008). Transformative impact of Magnet designation: England case study. J Clin Nurs, 17(24): 3330-3337.

Lin BY, Hsu CP, Chao MC, Luh SP, Hung SW, Breen GM (2008). Physician and nurse job climates in hospital-based emergency departments in Taiwan: management and implications. J Med Syst, 32(4): 269-281.

Auras S, Geraedts M (2010). Patient experience data in practice accreditation – An international comparison. Int J Qual Health Care, 22(2): 132-139.

Gale NK, Heath G, Cameron E, Rashid S, Redwood S(2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol, 13(1):117.

Nakamura RT. The textbook policy process and implementation research. Review of Policy Research, 7(1):142-54.

Hanney SR, Gonzalez-Block MA, Buxton MJ, Kogan M (2003). The utilization of health research in policy-making: concepts, examples and methods of assessment. Health Res Policy Syst, 1(1):2.

Buse K, Dickinson C, Gilson L, Murray SF (2009). How can the analysis of power and process in policy-making improve health outcomes? World Hosp Health Serv, 45(1): 4-8.

El-Jardali F, Jamal D, Ataya N et al (2011). Health Policy and Systems Research in Twelve Eastern Mediterranean Countries: a stocktaking of production and gaps (2000-2008). Health Res Policy Syst, 9: 39.

Walt G, Shiffman J, Schneider H, Murray SF, Brugha R, Gilson L (2008). ‘Doing’ health policy analysis: methodological and conceptual reflections and challenges. Health Policy Plan, 23(5): 308-317.

Cheung KK, Mirzaei M, Leeder S (2010). Health policy analysis: a tool to evaluate in policy documents the alignment between policy statements and intended outcomes. Aust Health Rev, 34(4): 405-413.

Walt G, Gilson L (1994). Reforming the health sector in developing countries: the central role of policy analysis. Health Policy Plan, 9(4): 353-370.

Kingdon JW (1984). Agendas, alternatives and public policies. Boston: Little, Brown.

Smits H, Supachutikul A, Mate KS (2014). Hospital accreditation: lessons from low- and middle-income countries. Global Health, 10:65.

Yousefinezhadi T. An analysis of hospital accreditation policy in Iran [PhD thesis].School of Public Health, Tehran University of Medical Sciences, Iran; 2016.

World health organization (2004). Expert group meeting on hospital accreditation, Cairo: world health organization, regional office for the eastern Mediterranean.

Jafari, GH, Khalifegari S, Danaii KH et al (2010). Hospital accreditation standards in Iran. Tehran: Seda publication,Iran Iran [in Persian]

Mosadeghrad AM (2014). Factors influencing health care service quality. Int J Health Policy Manag, 3(2):77-89.

Mosadeghrad AM (2014). Factors affecting medical service quality. Iran J Publ Health, 43(2):210-20.

Mosadeghrad AM, Ferlie E, Rosenberg D (2011). A study of relationship between job stress, quality of working life and turnover intention among hospital employees. Health Serv Manage Res, 24(4):170-81.

Mosadeghrad AM (2014). Occupational stress and its consequences: Implications for health policy and management. Leadersh Health Serv J, 27(3):224-39.

Mosadeghrad AM (2013). Occupational stress and turnover intention: Implications for nursing management. Int J Health Policy Manag, 1(2):169-76.

Mosadeghrad AM, Ferdosi M, Afshar H, Hosseini-Nejhad SM (2013). The impact of top management turnover on quality management implementation. Med Arch, 67(2):134-40.

Mosadeghrad AM (2014). Essentials of total quality management: a meta-analysis. Int J Health Care Qual Assur, 27(6):544-58.

Mosadeghrad AM (2014). Why TQM does not work in Iranian healthcare organisations. Int J Health Care Qual Assur, 27(4):320-35.

Bukonda N, Tavrow P, Abdallah H, Hoffner K, Tembo J(2002). Implementing a national hospital accreditation program: the Zambian experience. Int J Qual Health Care, 1:7-16.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.