How Iran’s Hospital Accreditation Program Meets the International Society for Quality in Health Care(ISQua)
,
Abstract
Background: 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.
Objectives: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
1. Organization WH. Quality in primary health care. 2018. Available from: https://www.who.int/publications/i/item/WHO-HISSDS-2018.54.
2. Claver E, Tari JJ, Molina JF. Critical factors and results of quality management: An empirical study. Total Quality Manage Business Excellence. 2003;14(1):91-118. https://doi.org/10.1080/1478336032000044852.
3. Selbmann HK. [Assessment and certification of hospital care in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2004;47(2):103-10. [PubMed ID:15205807]. https://doi.org/10.1007/s00103-003-0769-0.
4. Accreditation Canada. Canadian Health Accreditation Report. 2011. Available from: https://epe.lac bac.gc.ca/100/201/300/cdn_health_accreditation_report/2011%20health-AccreditationReport.pdf.
5. Joint Commission. Facts about hospital accreditation. 2012.Available from:https://www.jointcommission.org/resources/ news-and-multimedia/fact-sheets/facts-about-hospital-accreditation/.
6. Lam MB, Figueroa JF, Feyman Y, Reimold KE, Orav EJ, Jha AK. Association between patient outcomes and accreditation in US hospitals: Observational study. BMJ. 2018;363:k4011. [PubMed ID:30337294]. [PubMed Central ID:PMC6193202]. https://doi.org/10.1136/bmj.k4011.
7. Jha AK. Accreditation, quality, and making hospital care better. JAMA. 2018;320(23):2410-1. [PubMed ID:30561469]. https://doi.org/10.1001/jama.2018.18810.
8. Shaw C, Groene O, Mora N, Sunol R. Accreditation and ISO certification: do they explain differences in quality management in European hospitals? Int J Qual Health Care. 2010;22(6):445-51. [PubMed ID:20935006]. https://doi.org/10.1093/intqhc/mzq054.
9. Sperling D, Pikkel RB. Promoting patients’ rights through hospital accreditation. Isr J Health Policy Res. 2020;9(1):47. [PubMed ID:32958047]. [PubMed Central ID:PMC7504649]. https://doi.org/10.1186/s13584-020-00405-1.
10. Montagu D. Accreditation and other external quality assessment systems for healthcare. DFID Health Systems Resource Centre Working Paper. 2003;1(1):1-38.
11. Nicklin W. The value and impact of accreditation in health care: A review of the literature. Accreditation Canada. 2009.
12. Greenfield D, Braithwaite J. Health sector accreditation research: A systematic review. Int J Qual Health Care. 2008;20(3):172-83. [PubMed ID:18339666]. https://doi.org/10.1093/intqhc/mzn005.
13. Bahadori M, Ravangard R, Aleviohammadzadeh K. The accreditation of hospitals in iran. Iran J Public Health. 2015;44(2):295-6.
14. 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.
15. Reisi N, Raeissi P, Sokhanvar M, Kakemam E. The impact of accreditation on nurses’ perceptions of quality of care in
Iran and its barriers and facilitators. Int J Health Plann Manage. 2019;34(1):e230-e40. [PubMed ID:30156711]. https://doi. org/10.1002/hpm.2642.
16. Saadati M, Bahadori M, Teymourzadeh E, Ravangard R, Alimohammadzadeh K, Mojtaba Hosseini S. Accreditation in one teaching hospital: A phenomenology study among Iranian nurses. Int J Health Care Qual Assur. 2018;31(7):855-63. [PubMed ID:30354883]. https://doi.org/10.1108/IJHCQA-08-2017-0150.
17. Vali L, Mehrolhasani MH, Mirzaei S, Oroomiei N. Challenges
of implementing the accreditation model in military and university hospitals in iran: A qualitative study. BMC Health Serv Res. 2020;20(1):698. [PubMed ID:32727444]. [PubMed Central ID:PMC7392663]. https://doi.org/10.1186/s12913-020-05536-4.
18. Tashayoei N, Raeissi P, Nasiripour AA. Challenges of implementation of hospital accreditation in Iran: An exploratory factor analysis. J Egypt Public Health Assoc. 2020;95(1):5. [PubMed ID:32813055]. [PubMed Central ID:PMC7364711]. https://doi. org/10.1186/s42506-019-0033-6.
19. Jaafaripouyan E, Mosadeghrad A, Salarvand A. Performance of accreditation surveyors in Tehran hospitals: Strengths and weaknesses. J Hospital. 2018;17(3):31-43. 20. Yarmohammadian MH, Shokri A, Bahmanziari N, Kordi A.
Blind spots on accreditation program. J Health System Res. 2014;9(11):1158-66.
21. Mohebbifar R, Rafiei S, Asl AM, Ranjbar M, Khodayvandi M. Association between hospital accreditation and patient satisfaction: A survey in the western province of Iran. Bangladesh J Med Sci. 2017;16(1):77-84. https://doi.org/10.3329/bjms.v16i1.31137.
22. Yousefinezhadi T, Mosadeghrad AM, Hinchcliff R, Akbari-Sari A. Evaluation results of national hospital accreditation program in Iran: The view of hospital managers. J Healthc Qual Res. 2020;35(1):12-8. [PubMed ID:31964614]. https://doi.org/10.1016/j.jhqr.2019.08.008.
23. Mosadeghrad AM. Iran: Hospital accreditation: Future directions. Healthcare Systems: CRC Press; 2018. p. 297-303.
24. Shaw CD, Collins CD. Health service accreditation: Report of a pilot programme for community hospitals. BMJ. 1995;310(6982):781-
4. [PubMed ID:7711585]. [PubMed Central ID:PMC2549168]. https://doi.org/10.1136/bmj.310.6982.781.
25. Rooney AL, Van Ostenberg PR. Licensure, accreditation, and certification: Approaches to health services quality. Center for Human Services, Quality Assurance Project Bethesda, MD, USA; 1999.
26. ISQua. Guidelines and standards for external evaluation organisa-tions. 5th ed.; 2018.27. Mosadeghrad AM, Rahimi-Tabar P. Health system governance in Iran: A comparative study. Razi J Med Sci. 2019;26(9):10-28.
28. Ng GK, Leung GK, Johnston JM, Cowling BJ. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: A SWOT analysis. Hong Kong Med J. 2013;19(5):434-46. [PubMed ID:24088588]. https://doi.org/10.12809/hkmj134063.
29. Mohammad Mosadeghrad A, Akbari Sari A, Yousefinezhadi T. [Evaluation of hospital accreditation method]. Tehran Univ Med Sci J. 2017;75(4):288-98. Persian.
30. Mosadeghrad A. Hospital accreditation: The good, the bad, and the ugly. Inter J Healthcare Manage. 2020;14:1-5. https://doi.org/10.1080/20479700.2020.1762052.
31. Saeed K, Kamal G, Ayan K, Najmeh B, Azad S. Impact of hospitals accreditation on service delivery from the perspective views of experts: A qualitative study. Payavard Salamat. 2013;7(4).
32. Scrivens E. Putting continuous quality improvement into accreditation: Improving approaches to quality assessment. Qual Health Care. 1997;6(4):212-8. [PubMed ID:10177038]. [PubMed Central ID:PMC1055496]. https://doi.org/10.1136/qshc.6.4.212.
33. M P. Standard setting and accreditation literature review and report. Australian Commission on Safety and Quality in Health Care.2003.
34. Greenfield D, Pawsey M, Braithwaite J. What motivates professionals to engage in the accreditation of healthcare organizations? Int J Qual Health Care. 2011;23(1):8-14. [PubMed ID:21084322]. https://doi.org/10.1093/intqhc/mzq069.
35. Organization WH. Report on the expert group meeting on hospital accreditation, Cairo, Egypt, 23-26 September 2002: World Health Organization. Regional Office for the Eastern Mediterranean; 2003 Contract No.: Document Number|.
36. Sunol R, Nicklin W, Bruneau C, Whittaker S. Promoting research into healthcare accreditation/external evaluation: Advancing an ISQua initiative. Int J Qual Health Care. 2009;21(1):27-8. [PubMedID:18835832]. https://doi.org/10.1093/intqhc/mzn045.
37. Scrivens E. Widening the scope of accreditation--issues and challenges in community and primary care. Int J Qual Health Care. 1998;10(3):191-7. [PubMed ID:9661057]. https://doi.org/10.1093/intqhc/10.3.191.
38. Mosadeghrad AM, Ansarian M. Why do organisational change programmes fail? Inter J Strategic Change Manage. 2014;5(3):189-218. https://doi.org/10.1504/IJSCM.2014.064460.
39. Sack C, Lutkes P, Gunther W, Erbel R, Jockel KH, Holtmann GJ. Challenging the holy grail of hospital accreditation: A Cross sectional study of inpatient satisfaction in the field of cardiology. BMC Health Serv Res. 2010;10:120. [PubMed ID:20459873]. [PubMed Central ID:PMC2877683]. https://doi.org/10.1186/1472-6963-10-120.
40. Ho MJ, Chang HH, Chiu YT, Norris JL. Effects of hospital accreditation on medical students: A national qualitative study in Taiwan. Acad Med. 2014;89(11):1533-9. [PubMed ID:25250745]. https://doi.org/10.1097/ACM.0000000000000481.
41. Gharibi F, J.S T, B.A D. [Challenges facing the country’s new accreditation system based on the requirements of the International Society for Quality in Health Services]. (ISQua)Depiction of Health. 2013;3(4):8-14. Persian.
42. Bahmaei J, Bastani P, Keshtkaran A, Mohammadpour M, SarikhaniY. [Challenges of the execution of hospital accreditation in Iran: A critical review]. J Health Res Community. 2020;5(4):82-98. Persian. https://doi.org/20.1001.1.24236772.1398.5.4.8.6.
43. Nandraj S, Khot A, Menon S, Brugha R. A stakeholder approach towards hospital accreditation in India. Health Policy Plan. 2001;16 Suppl 2:70-9. [PubMed ID:11772992]. https://doi.org/10.1093/heapol/16.suppl_2.70.
44. Ramezani M, Kafash poor A, Abadi F, Zendehdel A, Sadeghi T. [Investigating the relationship between service quality dimensions and accreditation results (case study: Khorasan Razavi Hospitals)]. J Med Council Islamic Republic Iran. 2017;35(3):250-8. Persian.
45. Mosadeghrad AM, Ghazanfari F. [Iran hospital accreditation governance: Challenges and solutions]. Payavard Salamat. 2020;14(4):311-32. Persian.
46. Mosadeghrad A, Shakibaei E. [Hospital accreditation implementation prerequisites]. Hospital. 2017;16(3):43-56. Persian.
47. Raiesi A, Sharbafchizade N, Mohammadi F. Challenges of the third generation of hospital accreditation program from the perspective of accreditation officials in Isfahan city, Iran. Health Info Manage. 2021;18(2):53-9.
48. Shaw C. External assessment of health care. BMJ. 2001;322(7290):851-4. [PubMed ID:11290644]. [PubMed Central ID:PMC1120015]. https://doi.org/10.1136/bmj.322.7290.851.
49. Gharibi F, Moshiri E, Tavani ME, Dalal K. Challenges of Implementing an Effective Primary Health Care Accreditation Program: A qualitative study in Iran. BMC Prim Care. 2023;24(1):270. [PubMed ID:38093194]. [PubMed Central ID:PMC10717432]. https://doi.org/10.1186/s12875-023-02232-0.
50. Kabir M-J, Heidari A, Jafari N, Honarvar M-R, Vakili M-A, Aghapour S-A, et al. [Internal environment assessment of hospitals in Gorgan and Gonbad-e Qabus cities, Iran, according to Weisbord’s sixdimension model]. J Mazandaran Univ Med Sci. 2013;23(108):123-32. Persian.
51. Mosadeghrad AM, AKBARI SA, Yousefinezhadi T. Evaluation of hospital accreditation standards. Razi J Med Sci. 2017. Persian.
2. Claver E, Tari JJ, Molina JF. Critical factors and results of quality management: An empirical study. Total Quality Manage Business Excellence. 2003;14(1):91-118. https://doi.org/10.1080/1478336032000044852.
3. Selbmann HK. [Assessment and certification of hospital care in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2004;47(2):103-10. [PubMed ID:15205807]. https://doi.org/10.1007/s00103-003-0769-0.
4. Accreditation Canada. Canadian Health Accreditation Report. 2011. Available from: https://epe.lac bac.gc.ca/100/201/300/cdn_health_accreditation_report/2011%20health-AccreditationReport.pdf.
5. Joint Commission. Facts about hospital accreditation. 2012.Available from:https://www.jointcommission.org/resources/ news-and-multimedia/fact-sheets/facts-about-hospital-accreditation/.
6. Lam MB, Figueroa JF, Feyman Y, Reimold KE, Orav EJ, Jha AK. Association between patient outcomes and accreditation in US hospitals: Observational study. BMJ. 2018;363:k4011. [PubMed ID:30337294]. [PubMed Central ID:PMC6193202]. https://doi.org/10.1136/bmj.k4011.
7. Jha AK. Accreditation, quality, and making hospital care better. JAMA. 2018;320(23):2410-1. [PubMed ID:30561469]. https://doi.org/10.1001/jama.2018.18810.
8. Shaw C, Groene O, Mora N, Sunol R. Accreditation and ISO certification: do they explain differences in quality management in European hospitals? Int J Qual Health Care. 2010;22(6):445-51. [PubMed ID:20935006]. https://doi.org/10.1093/intqhc/mzq054.
9. Sperling D, Pikkel RB. Promoting patients’ rights through hospital accreditation. Isr J Health Policy Res. 2020;9(1):47. [PubMed ID:32958047]. [PubMed Central ID:PMC7504649]. https://doi.org/10.1186/s13584-020-00405-1.
10. Montagu D. Accreditation and other external quality assessment systems for healthcare. DFID Health Systems Resource Centre Working Paper. 2003;1(1):1-38.
11. Nicklin W. The value and impact of accreditation in health care: A review of the literature. Accreditation Canada. 2009.
12. Greenfield D, Braithwaite J. Health sector accreditation research: A systematic review. Int J Qual Health Care. 2008;20(3):172-83. [PubMed ID:18339666]. https://doi.org/10.1093/intqhc/mzn005.
13. Bahadori M, Ravangard R, Aleviohammadzadeh K. The accreditation of hospitals in iran. Iran J Public Health. 2015;44(2):295-6.
14. 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.
15. Reisi N, Raeissi P, Sokhanvar M, Kakemam E. The impact of accreditation on nurses’ perceptions of quality of care in
Iran and its barriers and facilitators. Int J Health Plann Manage. 2019;34(1):e230-e40. [PubMed ID:30156711]. https://doi. org/10.1002/hpm.2642.
16. Saadati M, Bahadori M, Teymourzadeh E, Ravangard R, Alimohammadzadeh K, Mojtaba Hosseini S. Accreditation in one teaching hospital: A phenomenology study among Iranian nurses. Int J Health Care Qual Assur. 2018;31(7):855-63. [PubMed ID:30354883]. https://doi.org/10.1108/IJHCQA-08-2017-0150.
17. Vali L, Mehrolhasani MH, Mirzaei S, Oroomiei N. Challenges
of implementing the accreditation model in military and university hospitals in iran: A qualitative study. BMC Health Serv Res. 2020;20(1):698. [PubMed ID:32727444]. [PubMed Central ID:PMC7392663]. https://doi.org/10.1186/s12913-020-05536-4.
18. Tashayoei N, Raeissi P, Nasiripour AA. Challenges of implementation of hospital accreditation in Iran: An exploratory factor analysis. J Egypt Public Health Assoc. 2020;95(1):5. [PubMed ID:32813055]. [PubMed Central ID:PMC7364711]. https://doi. org/10.1186/s42506-019-0033-6.
19. Jaafaripouyan E, Mosadeghrad A, Salarvand A. Performance of accreditation surveyors in Tehran hospitals: Strengths and weaknesses. J Hospital. 2018;17(3):31-43. 20. Yarmohammadian MH, Shokri A, Bahmanziari N, Kordi A.
Blind spots on accreditation program. J Health System Res. 2014;9(11):1158-66.
21. Mohebbifar R, Rafiei S, Asl AM, Ranjbar M, Khodayvandi M. Association between hospital accreditation and patient satisfaction: A survey in the western province of Iran. Bangladesh J Med Sci. 2017;16(1):77-84. https://doi.org/10.3329/bjms.v16i1.31137.
22. Yousefinezhadi T, Mosadeghrad AM, Hinchcliff R, Akbari-Sari A. Evaluation results of national hospital accreditation program in Iran: The view of hospital managers. J Healthc Qual Res. 2020;35(1):12-8. [PubMed ID:31964614]. https://doi.org/10.1016/j.jhqr.2019.08.008.
23. Mosadeghrad AM. Iran: Hospital accreditation: Future directions. Healthcare Systems: CRC Press; 2018. p. 297-303.
24. Shaw CD, Collins CD. Health service accreditation: Report of a pilot programme for community hospitals. BMJ. 1995;310(6982):781-
4. [PubMed ID:7711585]. [PubMed Central ID:PMC2549168]. https://doi.org/10.1136/bmj.310.6982.781.
25. Rooney AL, Van Ostenberg PR. Licensure, accreditation, and certification: Approaches to health services quality. Center for Human Services, Quality Assurance Project Bethesda, MD, USA; 1999.
26. ISQua. Guidelines and standards for external evaluation organisa-tions. 5th ed.; 2018.27. Mosadeghrad AM, Rahimi-Tabar P. Health system governance in Iran: A comparative study. Razi J Med Sci. 2019;26(9):10-28.
28. Ng GK, Leung GK, Johnston JM, Cowling BJ. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: A SWOT analysis. Hong Kong Med J. 2013;19(5):434-46. [PubMed ID:24088588]. https://doi.org/10.12809/hkmj134063.
29. Mohammad Mosadeghrad A, Akbari Sari A, Yousefinezhadi T. [Evaluation of hospital accreditation method]. Tehran Univ Med Sci J. 2017;75(4):288-98. Persian.
30. Mosadeghrad A. Hospital accreditation: The good, the bad, and the ugly. Inter J Healthcare Manage. 2020;14:1-5. https://doi.org/10.1080/20479700.2020.1762052.
31. Saeed K, Kamal G, Ayan K, Najmeh B, Azad S. Impact of hospitals accreditation on service delivery from the perspective views of experts: A qualitative study. Payavard Salamat. 2013;7(4).
32. Scrivens E. Putting continuous quality improvement into accreditation: Improving approaches to quality assessment. Qual Health Care. 1997;6(4):212-8. [PubMed ID:10177038]. [PubMed Central ID:PMC1055496]. https://doi.org/10.1136/qshc.6.4.212.
33. M P. Standard setting and accreditation literature review and report. Australian Commission on Safety and Quality in Health Care.2003.
34. Greenfield D, Pawsey M, Braithwaite J. What motivates professionals to engage in the accreditation of healthcare organizations? Int J Qual Health Care. 2011;23(1):8-14. [PubMed ID:21084322]. https://doi.org/10.1093/intqhc/mzq069.
35. Organization WH. Report on the expert group meeting on hospital accreditation, Cairo, Egypt, 23-26 September 2002: World Health Organization. Regional Office for the Eastern Mediterranean; 2003 Contract No.: Document Number|.
36. Sunol R, Nicklin W, Bruneau C, Whittaker S. Promoting research into healthcare accreditation/external evaluation: Advancing an ISQua initiative. Int J Qual Health Care. 2009;21(1):27-8. [PubMedID:18835832]. https://doi.org/10.1093/intqhc/mzn045.
37. Scrivens E. Widening the scope of accreditation--issues and challenges in community and primary care. Int J Qual Health Care. 1998;10(3):191-7. [PubMed ID:9661057]. https://doi.org/10.1093/intqhc/10.3.191.
38. Mosadeghrad AM, Ansarian M. Why do organisational change programmes fail? Inter J Strategic Change Manage. 2014;5(3):189-218. https://doi.org/10.1504/IJSCM.2014.064460.
39. Sack C, Lutkes P, Gunther W, Erbel R, Jockel KH, Holtmann GJ. Challenging the holy grail of hospital accreditation: A Cross sectional study of inpatient satisfaction in the field of cardiology. BMC Health Serv Res. 2010;10:120. [PubMed ID:20459873]. [PubMed Central ID:PMC2877683]. https://doi.org/10.1186/1472-6963-10-120.
40. Ho MJ, Chang HH, Chiu YT, Norris JL. Effects of hospital accreditation on medical students: A national qualitative study in Taiwan. Acad Med. 2014;89(11):1533-9. [PubMed ID:25250745]. https://doi.org/10.1097/ACM.0000000000000481.
41. Gharibi F, J.S T, B.A D. [Challenges facing the country’s new accreditation system based on the requirements of the International Society for Quality in Health Services]. (ISQua)Depiction of Health. 2013;3(4):8-14. Persian.
42. Bahmaei J, Bastani P, Keshtkaran A, Mohammadpour M, SarikhaniY. [Challenges of the execution of hospital accreditation in Iran: A critical review]. J Health Res Community. 2020;5(4):82-98. Persian. https://doi.org/20.1001.1.24236772.1398.5.4.8.6.
43. Nandraj S, Khot A, Menon S, Brugha R. A stakeholder approach towards hospital accreditation in India. Health Policy Plan. 2001;16 Suppl 2:70-9. [PubMed ID:11772992]. https://doi.org/10.1093/heapol/16.suppl_2.70.
44. Ramezani M, Kafash poor A, Abadi F, Zendehdel A, Sadeghi T. [Investigating the relationship between service quality dimensions and accreditation results (case study: Khorasan Razavi Hospitals)]. J Med Council Islamic Republic Iran. 2017;35(3):250-8. Persian.
45. Mosadeghrad AM, Ghazanfari F. [Iran hospital accreditation governance: Challenges and solutions]. Payavard Salamat. 2020;14(4):311-32. Persian.
46. Mosadeghrad A, Shakibaei E. [Hospital accreditation implementation prerequisites]. Hospital. 2017;16(3):43-56. Persian.
47. Raiesi A, Sharbafchizade N, Mohammadi F. Challenges of the third generation of hospital accreditation program from the perspective of accreditation officials in Isfahan city, Iran. Health Info Manage. 2021;18(2):53-9.
48. Shaw C. External assessment of health care. BMJ. 2001;322(7290):851-4. [PubMed ID:11290644]. [PubMed Central ID:PMC1120015]. https://doi.org/10.1136/bmj.322.7290.851.
49. Gharibi F, Moshiri E, Tavani ME, Dalal K. Challenges of Implementing an Effective Primary Health Care Accreditation Program: A qualitative study in Iran. BMC Prim Care. 2023;24(1):270. [PubMed ID:38093194]. [PubMed Central ID:PMC10717432]. https://doi.org/10.1186/s12875-023-02232-0.
50. Kabir M-J, Heidari A, Jafari N, Honarvar M-R, Vakili M-A, Aghapour S-A, et al. [Internal environment assessment of hospitals in Gorgan and Gonbad-e Qabus cities, Iran, according to Weisbord’s sixdimension model]. J Mazandaran Univ Med Sci. 2013;23(108):123-32. Persian.
51. Mosadeghrad AM, AKBARI SA, Yousefinezhadi T. Evaluation of hospital accreditation standards. Razi J Med Sci. 2017. Persian.
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| Issue | Vol 8 No 3 (2024) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v8i3.16405 | |
| Keywords | ||
| Accreditation Hospital Quality ISQua Iran | ||
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How to Cite
1.
Shams L, Gharibi F, Poursaki T, Maher A. How Iran’s Hospital Accreditation Program Meets the International Society for Quality in Health Care(ISQua). Health Tech Ass Act. 2024;8(3).
