The Existing Barriers and Infrastructures to Implement Accreditation from the Perspective of Hospital's Managers in East Azerbaijan Hospitals: A Mixed Method Study

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The aim of this study was to assess the infrastructures and barriers of effective accreditation in East Azerbaijan hospitals.

In this triangulation (qualitative-quantitative) study, all the managers of 43 hospitals in East Azerbaijan were selected. The authors developed an 8-item questionnaire for quantitative section of the study which its validity was improved by experts’ comments and its reliability was assessed by half-structure methods (9. =α). In addition, two open-ended questions were used in qualitative section of the study. Quantitative data were analyzed using descriptive statistics, t-test, and ANOVA test using SPSS version 20 statistical software packages. Qualitative content analysis was used to analyze the responses to the two open-ended questions.

Seventy-six percent of the managers agreed to implementation of accreditation in hospitals and believed that accreditation could improve the health services and increase the patient and staff satisfaction. Fifty percent of the participants had lack of required knowledge about the accreditation and they declared that the hospitals managed by them were not prepared to implement accreditation with respect to resources, manager’s commitment, staff skills and knowledge. In Tabriz hospitals, resources and infrastructures were mentioned to exist in a significantly higher proportion than other cities (P < 0.01). Important barriers were explored to include the lack of the following: manpower, participation of clinicians, resources, appropriate documentation and information systems.

Considering the barriers and lack of infrastructures in the hospitals of East Azerbaijan to achieve an effective accreditation, it is essential to eliminate the existing barriers and provide appropriate infrastructures.