Top

BMC Health Services Research

Published in:

Open Access 01-12-2021 | Research

The challenges of physicians’ participation in hospital accreditation programs: a qualitative study in Iran

Authors: Hosein Ebrahimipour, Elahe Hooshmand, Mehdi Varmaghani, Javad Javan-Noughabi, Seyyed Morteza Mojtabaeian

Published in: BMC Health Services Research | Issue 1/2021

Abstract

Background

Due to the increasing pressure on hospitals to enhance the quality of services, the participation of physicians in accreditation programs has become more important than ever. The present study was conducted to describe challenges of physicians’ participation in hospital accreditation programs in Iran using a qualitative approach.

Methods

We conducted interviews with 11 managers, 9 physicians and 8 experts in the field of hospital accreditation. Interviewees were selected through purposive snowball sampling. In-depth unstructured and semi-structured interviews were conducted for data collection. The data obtained were analyzed in ATLAS.ti using the conceptual framework method.

Results

The results of this study extracted 3 main themes including: cultural, organizational and behavioral factors. Also, this study found 12 sub-themes and 57 items. Sub-themes in the cultural domain were motivation, patient demand, mutual trust and evaluation system. The organizational domain consisted of seven sub-themes, including high workload, understanding the role of quality management unit, unrealistic accreditation, nature of accreditation, empowerment of physicians in the field of quality, effective communication, resource constraint. Sub-themes in the behavioral dimension were ambiguity in the role and uncertainty about how to participate in accreditation program.

Conclusion

Physicians’ participation in accreditation programs can be increased through culture building and proper training about accreditation activities in the medical community.

Mosadeghrad AM. Patient choice of a hospital: implications for health policy and management. Int J Health Care Qual Assur. 2014;27(2):152–64. https://doi.org/10.1108/IJHCQA-11-2012-0119.CrossRefPubMed

Giuffrida I, Treece T. Keeping AI under observation: anticipated impacts on Physicians' standard of care. Tul J Tech Intell Prop. 2020;22:111.

Sugita JA, Garrett MD. Elder abuse and oral health care providers: an intervention to increase knowledge and self-perceived likelihood to report. J Elder Abuse Negl. 2012;24(1):50–64. https://doi.org/10.1080/08946566.2011.608051.CrossRefPubMed

Mosadeghrad AM. Hospital accreditation: the good, the bad, and the ugly. Int J Healthc Manage. 2020:1–5. https://doi.org/10.1080/20479700.2020.1762052.

Mosadeghrad AM, Akbari-sari A, Yousefinezhadi T. Evaluation of hospital accreditation standards. Razi J Med Sci. 2017;23(153):43–54.

Tabrizi JS, Gharibi F, Wilson AJ. Advantages and disadvantages of health care accreditation models. Health Prom Perspect. 2011;1(1):1–31. https://doi.org/10.5681/hpp.2011.001.CrossRef

Yousefinezhadi T, Mosadeghrad AM, Mohammad A, Ramezani M, Sari AA. An analysis of hospital accreditation policy in Iran. Iran J Public Health. 2017;46(10):1347–58.PubMedPubMedCentral

Marcum JA. Professing clinical medicine in an evolving health care network. Theoret Med Bioethics. 2019;40(3):197–215. https://doi.org/10.1007/s11017-019-09492-x.CrossRef

Saadati M, Yarifard K, Azami-Agdash S, Tabrizi JS. Challenges and potential drivers of accreditation in the Iranian hospitals. Int J Hospital Res. 2015;4(1):37–42.

10.

Mathur B, Gupta S, Meena ML, Dangayach G. Healthcare supply chain management: literature review and some issues. J Adv Manage Res. 2018;15(3):265–87. https://doi.org/10.1108/JAMR-09-2017-0090.CrossRef

11.

Gharibi F, Tabrizi JS. Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study. Health Prom Perspect. 2018;8(2):155–62. https://doi.org/10.15171/hpp.2018.20.CrossRef

12.

Ferdosi M, Ziyari FB, Ollahi MN, Salmani AR, Niknam N. Implementing clinical governance in Isfahan hospitals: barriers and solutions, 2014. J Educ Health Prom. 2016;5(1):20. https://doi.org/10.4103/2277-9531.184554.CrossRef

13.

Mainz J, Kristensen S, Bartels P. Quality improvement and accountability in the Danish health care system. Int J Qual Health Care. 2015;27(6):523–7. https://doi.org/10.1093/intqhc/mzv080.CrossRefPubMed

14.

Durrheim K. Quantative analysis, M. Terre Blanche & K. Durrheim. Research in practice, applied methods for social sciences. 1999.

15.

Henning E. Finding your way in qualitative research: van Schaik; 2004.

16.

Lincoln YS, Guba S. EG (1985). Naturalistic inquiry. Handbook of Qualitative Research Thousand Oaks, Sage. 1954.

17.

Baker R, Bała M, Czabanowska K, Dubas K, Eriksson T, Godycki-Ćwirko M, et al. Guidebook on implementation of quality improvement in general practice. 2010.

18.

Coyle Y, Mercer S, Murphy-Cullen C, Schneider G, Hynan L. Effectiveness of a graduate medical education program for improving medical event reporting attitude and behavior. BMJ Qual Safety. 2005;14(5):383–8. https://doi.org/10.1136/qshc.2005.013979.CrossRef

19.

Hudelson P, Cléopas A, Kolly V, Chopard P, Perneger T. What is quality and how is it achieved? Practitioners’ views versus quality models. BMJ Qual Safety. 2008;17(1):31–6. https://doi.org/10.1136/qshc.2006.021311.CrossRef

20.

Salehi Z, Payravi H. Challenges in the implementation accreditation process in the hospitals: a narrative review. Iran J Nurs. 2017;30(106):23–34. https://doi.org/10.29252/ijn.30.106.23.CrossRef

21.

Choa G, Arfeen Z, Chan SCC, Rashid MA. Understanding impacts of accreditation on medical teachers and students: a systematic review and meta-ethnography. Med Teach. 2021:1–8. https://doi.org/10.1080/0142159X.2021.1965976.

22.

Drephal M. Accreditation and Performance. Afghanistan and the Coloniality of Diplomacy: Springer; 2019. p. 173–232.

23.

Gleeson H, Calderon A, Swami V, Deighton J, Wolpert M, Edbrooke-Childs J. Systematic review of approaches to using patient experience data for quality improvement in healthcare settings. BMJ Open. 2016;6(8):e011907. https://doi.org/10.1136/bmjopen-2016-011907.CrossRefPubMedPubMedCentral

24.

Kamau PN. Health worker perceptions towards safe-care accreditation and quality of care: a case of the Ruaraka Uhai Neema Hospital. Nairobi: Strathmore University; 2020.

25.

Zarkali A, Acquaah F, Donaghy F. Trainees leading quality improvement. London: Faculty of Medical Leadership Management; 2016.

26.

Patow CA, Karpovich K, Riesenberg LA, Jaeger J, Rosenfeld JC, Wittenbreer M, et al. Residents' engagement in quality improvement: a systematic review of the literature. Acad Med. 2009;84(12):1757–64. https://doi.org/10.1097/ACM.0b013e3181bf53ab.CrossRefPubMed

27.

Boyle A, Keep J. Clinical audit does not work, is quality improvement any better? Br J Hosp Med. 2018;79(9):508–10. https://doi.org/10.12968/hmed.2018.79.9.508.CrossRef

28.

Andersen MK, Pedersen LB, Waldorff FB. Retirement, job satisfaction and attitudes towards mandatory accreditation: a Danish survey study in general practice. BMJ Open. 2018;8(8):e020419. https://doi.org/10.1136/bmjopen-2017-020419.CrossRef

29.

Ehlers LH, Jensen MB, Simonsen KB, Rasmussen GS, Braithwaite J. Attitudes towards accreditation among hospital employees in Denmark: a cross-sectional survey. Int J Qual Health Care. 2017;29(5):693–8. https://doi.org/10.1093/intqhc/mzx090.CrossRefPubMed

30.

Bethune RM. The leaders of quality improvement are the ones who are doing the improvement work. J R Soc Med. 2013;106(6).

31.

Hooper P, Kocman D, Carr S, Tarrant C. Junior doctors’ views on reporting concerns about patient safety: a qualitative study. Postgrad Med J. 2015;91(1075):251–6. https://doi.org/10.1136/postgradmedj-2014-133045.CrossRefPubMed

32.

Solberg LI, Elward KS, Phillips WR, Gill JM, Swanson G, Main DS, et al. How can primary care cross the quality chasm? Ann Fam Med. 2009;7(2):164–9. https://doi.org/10.1370/afm.951.CrossRefPubMedPubMedCentral

33.

Hoffimann E, Campelo D, Hooper P, Barros H, Ribeiro AI. Development of a smartphone app to evaluate the quality of public open space for physical activity. An instrument for health researchers and urban planners. Landsc Urban Plan. 2018;177:191–5. https://doi.org/10.1016/j.landurbplan.2018.05.005.CrossRef

Title: The challenges of physicians’ participation in hospital accreditation programs: a qualitative study in Iran
Authors: Hosein Ebrahimipour
Elahe Hooshmand
Mehdi Varmaghani
Javad Javan-Noughabi
Seyyed Morteza Mojtabaeian
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-021-07182-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The challenges of physicians’ participation in hospital accreditation programs: a qualitative study in Iran

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Factors influencing client recall of contraceptive counseling at community-based distribution events in Kinshasa, Democratic Republic of the Congo

From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales

Use of primary and hospital care health services by chronic patients according to risk level by adjusted morbidity groups

Using Theoretical Domains Framework (TDF) to understand implementation of a pragmatic clinical trial in Public Dental Service in Norway

Continuous quality improvement as a tool to implement evidence-informed problem solving: experiences from the district and health facility level in Uganda

‘We always find things to learn from.’ Lessons from the implementation of the global maternal sepsis study on research capacity: a qualitative study