ssessing the performance of comprehensive health care centers in Aradan district based on the national accreditation model

Accreditation is the most common approach in evaluating and improving health care performance due to its dramatic positive effects on improving performance areas such as quality and safety. Considering the development of a national accreditation model for primary health care, the present study was conducted to assess the performance of Aradan comprehensive health service centers (Semnan, Iran) based on the national accreditation model.

Four comprehensive health service centers in the Aradan district participated in this cross-sectional study during fall 1399. The research tool was a checklist consisting of 39 standards and 231 evaluation measures defined in twelve performance dimensions extracted from the national accreditation model to comprehensive health care centers. The study was conducted in two stages of self-assessment and external assessment after educating managers and staff of healthcare canters regarding the nature of accreditation, contents of the assessment tool and method of completing it. The performance level of healthcare centers was determined based on compliance of accreditation requirements, which is embedded in the used model. In this regards, the scores of 1, 0.5 and 0 were allocated to "full compliance", "partially compliance" and "no compliance" respectively; therefore, the level of compliance of embedded requirements from healthcare centers in each measure, standard and dimension were calculated as a percentage.

The compliance rate of comprehensive health service centers with accreditation standards/measures in the “self-assessment” and “external evaluation” are 71.47 and 15.43 percent, respectively. The “community-centered services” dimension with a score of 93.75% and the “service delivery evaluation” dimension with a score of 0, had the highest and lowest performance levels in terms of compliance with accreditation standards in the self-assessment part; while in the external evaluation part, the “service continuity” dimension with 29.63% and the dimensions of “community-centered services”, “quality and safety of services” and “health systems research” with a score of 0, had the highest and lowest level of performance, respectively.

The performance of the centers, which took part in this study, has notable weaknesses, which emphasizes the need to design and implement promotional interventions with the participation of experts and process owners.