accreditation

Physical restraint (PR) is one of the most common methods nurses use to reduce patient movement, especially in intensive care units (ICUs); however, PR is considered one of the undesirable methods due to its related clinical and ethical issues. This study investigates Jordanian nurses’ knowledge, attitudes, and practices regarding using PR, its alternatives in different ICUs, and its associated factors. 

This was a descriptive-cross-sectional study, conducted in the ICUs of four different hospitals in Jordan from October 2023 to March 2024. A convenience sample of 240 ICU nurses was recruited to fill out a self-administered PR questionnaire. The data were analyzed using an independent sample t-test, analysis of variance, and the Pearson correlation coefficient using the SPSS software, version 25. All conducted tests were two-tailed and considered significant when the P<0.05. 

The results revealed moderate knowledge (11.1±2.46), positive attitude (27.04±3.35) and good practice (37.19±3.33) regarding the use of PR. Receiving training on the use of PR had a direct significant relationship with the use of alternative methods before PR in the patients (P<0.001) and the total practice score (P=0.049). The presence of PR as part of the new hire orientation program and the number of times of using PR had a significant association with the use of alternatives before PR for the patients (P<0.0001 and P=0.043, respectively). In terms of total knowledge (P=0.01), use of alternatives (P=0.025) and practice (P<0.001) regarding the use of PRs, accredited hospitals were at a higher level, but the difference in nurses’ attitudes was not significant (P=0.839). There was a significant difference in terms of total alternatives (P=0.016), attitude (P<0.001), and practice (P=0.02) depending on the type of ICU. There were other significant relationships between the main variables among which the relationship between total knowledge and total practice (r=0.434, P<0.01), and total use of alternatives and total practice (r=0.43, P<0.01) were more powerful.

The current study indicates variations in nurses’ knowledge levels, attitudes, and practices across different ICUs and hospital types. These findings emphasize the importance of in-service education as a golden role in improving nurses’ knowledge levels and practices toward PR. The journey to accreditation in the management of hospitals by nursing managers and policymakers has a positive impact on improving nursing knowledge and skills regarding PR application and enhancing patient safety and care outcomes.

Accreditation is a systematic evaluation process of health services that evaluates health organizations based on approved standards to determine their quality. A qualitative study exploring the experiences of trauma center nursing managers regarding the accreditation program can help in better evaluation. The purpose of this study was to explain the experiences of trauma center nursing managers concerning the hospital accreditation process.

This research applied the content analysis method to explain the experiences of trauma center nursing managers in hospital accreditation. We used Lincoln and Guba's approach for data analysis. Sampling was done purposefully from November 2021 to January 2022 by voluntary nursing administrators. Finally, sixteen interviews were held with 14 participants.

After analyzing the interviews, 398 main codes, 5 main categories, and 13 sub-categories were extracted as a hospital accreditation process. The five main categories included a low balance of cooperation in the treatment team, accreditation standards issues, immaturity of treatment systems, management issues in accreditation, and bias in the evaluation.

The results show that trauma centers need to make significant changes in the use of accreditation as a quality certificate tool. It seems necessary to plan for management processes, evaluation, standards, and structure and infrastructure issues.

Human rights, which are very important for the health system and hospital accreditation requirements, include the issue of patient rights in hospitals. Artificial Intelligence (AI) is one of the advanced technologies in this industry, which aims to improve the standard of medical services for patients. This study was conducted with the aim of improving the enhancing patient's rights criteria in hospital accreditation standard by using AI (case study: selected hospitals in Zahedan county), which examines the factors affecting patient rights and the benefits of using AI. According to the subject and purpose, the research approach is cross-sectional and descriptive, which was conducted in several hospitals in Zahedan in 2023. Experts in this field were given a questionnaire to complete as part of this study. Then the most important effects in this field were ranked. Experts ranked the factors of better disease diagnosis, prevention and prediction, advanced treatment methods, and easier access to medical data as the most important factors. The findings of this study indicate that if AI is used in selected hospitals of Zahedan, the rights of patients will be consistent with international validation criteria. The factors covered in this study are necessary for the successful integration of AI in the health system, as well as following the guidelines that apply to any other intelligent system, including technical training and considering organizational, managerial and economic aspects. In order to intelligently adapt these systems, stakeholders in the health sector must use these components.

One of the upcoming challenges in hospital accreditation is using the same and similar standards for all types of hospitals in size and type of activity. We aimed to identify the accreditation modules for all types of hospitals in size (small hospitals) and type of activity (special hospitals).

This research was conducted as a scoping review from Mar to May 2023. "Arsky and O'Malley" six-step protocol was used to conduct this study. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) was used to identify, evaluate, and select research articles. The "framework analysis" method was used to analyze the data.

Of 14 articles, 64% have been published in peer-reviewed scientific journals. Moreover, 36% of them were accreditation organizations' standards at the national level. The accreditation modules of small hospitals are Responsibilities of Management, Care of Patients, Management of Medication, Patient Safety, Infection Control, Continuous Quality Improvement, Patient Rights and Education, Blood and Blood Products, and Partnering with Consumers. The accreditation modules of special hospitals are Governing Body and Administration, Clinical Management, Prevention and Health, Care and Treatment, Diagnostic Services, Patient Rights, and Quality Improvement.

Identifying the main modules of accreditation for small and special hospitals can help policymakers and hospital managers improve the quality and safety of their hospitals by using appropriate standards and help improve the services provided to patients and increase their satisfaction.

Accreditation and ISO 9001 programs in hospitals are widely adopted for quality control and quality improvement in healthcare.

The objective of this study is to identify stakeholders’ perspectives and experiences regarding the implementation of accreditation and ISO 9001 programs in hospitals affiliated with the Social Security Organization in Alborz Province, Iran.

In this qualitative study, participants were selected based on purposive sampling. For data collection, semi-structured one-to-one interviews were conducted with hospital staff in different positions (n = 30). All interviews were digitally recorded, transcribed verbatim, and analyzed using thematic analysis.

Based on the analysis, 10 primary themes and 88 subthemes were identified. The 10 primary themes were categorized as experiences, strengths, weaknesses, effective factors, and recommendations for the implementation of accreditation and ISO 9001 programs in hospitals. Proper planning, benchmarking, physician involvement, increased resources, and more training are suggested for the successful implementation of accreditation in hospitals. Additionally, fostering a positive culture, focusing on the executive dimension, changing managerial attitudes, training, and supporting and motivating staff are the most important recommendations for the implementation of the ISO 9001 program.

The results provide important insights into the dimensions of implementing accreditation and ISO programs in hospitals, which can be used by health policymakers and managers to improve the implementation of these programs in Iranian hospitals.

Hospital health service quality is a fundamental component of the health system. Hospital accreditation is a key approach to enhancing this quality, necessitating the correct implementation of processes.

This study aims to investigate the compliance of the executive processes of Iran’s hospital accreditation program with the requirements of the International Society for Quality in Health Care and to provide corrective solutions.

This qualitative study uses an inductive content analysis technique. A checklist with seven axes was established by extracting and interpreting the requirements of the executive processes from the International Society for Quality in Health Care. By examining existing documents at the Ministry of Health’s Accreditation Office and conducting interviews with managers and experts in the field, challenges in the domain of the executive processes of Iran’s hospital accreditation program were identified using the relevant checklist. Corrective solutions were then gathered through semi-structured interviews with 19 experts, managers, and accreditation field specialists, categorized inductively, and presented using MAXQDA software.

Challenges in seven areas were identified, including governance; strategic, operational and financial management; risk management; human resources management; information management; survey and client management; and the granting of accreditation approval. Subsequently, solutions were categorized into five groups encompassing 26 concepts, focusing on reforming macro policies, addressing implementation challenges, fostering appropriate interactions, improving human resource management, and promoting evidence-based decision-making.

The Iran hospital accreditation program’s adherence to International Society for Quality in Health Care standards is inadequate. Establishing a semi-autonomous, non-profit accreditation body that operates under government control and ensuring the independence of the accreditation office is essential for achieving higher compliance and receiving certification from International Society for Quality in Health Care.

Accreditation means systematic evaluation of health service centers with specific standards. One of the most important goals of the accreditation process is to improve patient safety. Patient safety visits are one of the most important standards for improving safety. One of the ways to increase the effectiveness of visits is holding feedback sessions.

The present study was conducted with the aim of assessing the effect of feedback provision on improving patient safety indices based on the hospital accreditation model in Shahid Rahnemoon Hospital, Yazd.

The present study is a semi-experimental study with a before-and-after design that was conducted in Shahid Rahnemoon Hospital, Yazd, from September to December 2021 and January to August 2022. After each visit, formal feedback sessions were held with the attendance of patient safety team members and officials of the visited wards/units. Evaluation indicators included patient safety indicators in accreditation standards, such as error reporting, rate of unwanted events, and patient safety culture score. These were measured before and after feedback. The tools used were the patient safety standards evaluation checklist based on the accreditation model, the patient safety culture questionnaire, and other indicators extracted using documentation. The Patient Safety Culture Evaluation Questionnaire was completed by 360 nurses working in the hospital in the form of a census. Analysis was done using descriptive statistical tests and paired t-tests with STATA 14.2 software.

Based on the results of the study, safety feedback was provided to increase patient safety indicators in different departments and units of hospitals [t = - 4.8652, w/df = 10, P = 0.0007, (P = 0.05)]. A significant difference was observed in the amount of error reporting (P = 0.031) and patient safety (P < 0.001) before and after the intervention. The degree of compliance with the dimensions of the patient safety culture had a statistically significant difference before and after the intervention (P < 0.001).

Providing a safety feedback program had a significant positive effect on the cons umption and consequences of the patient’s safety culture. Therefore, conducting regular safety visits and setting up a direct feedback program to each department/unit after the visit, and the follow-up of corrective measures, will lead to an increase in patient safety standards.

In Iran’s accreditation program, the patient safety dimension is one of the main dimensions, holding the highest weight among the accreditation criteria. The purpose of this study was to identify the patient safety culture (PSC) in a tertiary referral hospital.

The current study was conducted between March and April 2021 in a tertiary hospital in Iran. The sample size was 628 participants, selected through simple random sampling. The hospital survey on patient safety culture (HSOPSC) was used to assess provider and staff perceptions about patient safety issues, medical errors, and event reporting. The survey included 32 items that measure 10 dimensions of PSC. Normality tests, along with non-parametric Mann-Whitney and Kruskal-Wallis tests, were used to examine the relationship between PSC and demographic variables using SPSS 22 software.

Based on current findings, among the 10 dimensions of PSC, teamwork and organizational learning-continuous improvement received the highest scores (83% positive response), which were higher than these variables in the Agency for Healthcare Research and Quality (AHRQ) data. Conversely, staffing and work pace, as well as hospital management support for patient safety, received the lowest positive scores (43% and 55% positive response, respectively), which were lower than these variables in the AHRQ data. There was a significant positive relationship between dimensions of PSC and older age, female gender, staff with longer working experience, and longer work hours per week (P < 0.05).

The majority of our participants felt that patient safety needs to be enhanced. Based on the findings of this study, it is recommended to emphasize the dimensions of “staffing and work pace” and “hospital management support for patient safety” more in the accreditation criteria to strengthen these dimensions in hospitals. Additionally, we have introduced a comprehensive guide for using an international tool to measure PSC, which hospitals can use to succeed in annual accreditation.

Over the past three decades, healthcare organizations have prioritized enhancing patient care quality (1). The Institute of Medicine (IoM) has highlighted that most medical errors stem from flawed systems and processes rather than individual actions (2). Consequently, initiatives to improve processes and safety in healthcare have explored various quality improvement (QI) methodologies, including healthcare accreditation programs (1). Accreditation is a systematic process that evaluates a healthcare organization’s compliance against pre-defined peer review standards, which are structural, procedural, and outcomeoriented (3). Assessments are undertaken by various governmental or non-governmental entities, using different modalities in voluntary or mandatory approaches. The scope of accreditation may encompass the entire health organization, individual hospitals, health facilities, only a specialty, or even a sub-specialty (4). Accreditation standards cover diverse domains including clinical governance and patient-centeredness, with the consequences of failing to meet these standards variable across different health system contexts (5). First proposed and implemented by the American College of Surgeons in 1917, accreditation has since undergone numerous transformations and adaptations.