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Gharibi F, Moshiri E, Tavani ME, Dalal K. Challenges of Implementing an Effective Primary Health Care Accreditation Program: a qualitative study in Iran. BMC PRIMARY CARE 2023; 24:270. [PMID: 38093194 PMCID: PMC10717432 DOI: 10.1186/s12875-023-02232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/01/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Accreditation is a prerequisite for scientific management of the health system, owing to its numerous benefits on health centres' performance. The current study examined Iran's primary healthcare accreditation program to ascertain the challenges to its successful implementation. METHODS This qualitative study examined the perspectives of 32 managers and staff members in the pilot accreditation program (from the Ministry of Health and Medical Education, Semnan University of Medical Sciences, and Aradan District Health Network). Three in-depth group interviews were conducted using a semi-structured questionnaire, and the data obtained were assessed using thematic analysis. As a result of this investigation identified six themes, 29 sub-themes, and 218 codes as challenges to the successful accreditation of primary health care in Iran. RESULTS Six main themes, including "organisational culture", "motivational mechanisms", "staff workload", "training system", "information systems", and "macro-executive infrastructure", were identified as the main domain of challenges, with seven, five, two, four, three, and eight sub-themes respectively. CONCLUSION Accreditation of PHC in Iran faces significant challenges and obstacles that, if ignored, can jeopardise the program's success and effectiveness. By identifying challenges and obstacles and making practical suggestions for overcoming them, the findings of this study can aid in the program's successful implementation and achievement of desired outcomes.
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Affiliation(s)
- Farid Gharibi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Esmaeil Moshiri
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Masoumeh Ebrahimi Tavani
- Academic Research Staff, Quality Improvement, Monitoring and Evaluation Department, Center of Health Network Management, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Koustuv Dalal
- Division of Public Health Science, Department of health Sciences, Mid Sweden University, Sweden and Institute for Health Sciences, University of Skovde, Skovde, Sweden.
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Kelly Y, O'Rourke N, Flynn R, O'Connor L, Hegarty J. Factors that influence the implementation of (inter)nationally endorsed health and social care standards: a systematic review and meta-summary. BMJ Qual Saf 2023; 32:750-762. [PMID: 37290917 PMCID: PMC10803983 DOI: 10.1136/bmjqs-2022-015287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 04/15/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Health and social care standards have been widely adopted as a quality improvement intervention. Standards are typically made up of evidence-based statements that describe safe, high-quality, person-centred care as an outcome or process of care delivery. They involve stakeholders at multiple levels and multiple activities across diverse services. As such, challenges exist with their implementation. Existing literature relating to standards has focused on accreditation and regulation programmes and there is limited evidence to inform implementation strategies specifically tailored to support the implementation of standards. This systematic review aimed to identify and describe the most frequently reported enablers and barriers to implementing (inter)nationally endorsed standards, in order to inform the selection of strategies that can optimise their implementation. METHODS Database searches were conducted in Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), SocINDEX, Google Scholar, OpenGrey and GreyNet International, complemented by manual searches of standard-setting bodies' websites and hand searching references of included studies. Primary qualitative, quantitative descriptive and mixed methods studies that reported enablers and barriers to implementing nationally or internationally endorsed standards were included. Two researchers independently screened search outcomes and conducted data extraction, methodological appraisal and CERQual (Confidence in Evidence from Reviews of Qualitative research) assessments. An inductive analysis was conducted using Sandelowski's meta-summary and measured frequency effect sizes (FES) for enablers and barriers. RESULTS 4072 papers were retrieved initially with 35 studies ultimately included. Twenty-two thematic statements describing enablers were created from 322 descriptive findings and grouped under six themes. Twenty-four thematic statements describing barriers were created from 376 descriptive findings and grouped under six themes. The most prevalent enablers with CERQual assessments graded as high included: available support tools at local level (FES 55%); training courses to increase awareness and knowledge of the standards (FES 52%) and knowledge sharing and interprofessional collaborations (FES 45%). The most prevalent barriers with CERQual assessments graded as high included: a lack of knowledge of what standards are (FES 63%), staffing constraints (FES 46%), insufficient funds (FES 43%). CONCLUSIONS The most frequently reported enablers related to available support tools, education and shared learning. The most frequently reported barriers related to a lack of knowledge of standards, staffing issues and insufficient funds. Incorporating these findings into the selection of implementation strategies will enhance the likelihood of effective implementation of standards and subsequently, improve safe, quality care for people using health and social care services.
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Affiliation(s)
- Yvonne Kelly
- Health Information and Standards Directorate, Health Information and Quality Authority (HIQA), Cork, Ireland
- Catherine McAuley School of Nursing and Midwifery and School of Public Health (SPHeRE programme), University College Cork, Cork, Ireland
| | - Niamh O'Rourke
- Health Information and Standards Directorate, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Rachel Flynn
- Health Information and Standards Directorate, Health Information and Quality Authority (HIQA), Cork, Ireland
| | - Laura O'Connor
- Health Information and Standards Directorate, Health Information and Quality Authority (HIQA), Cork, Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Aloy-Duch A, Santiñà Vila M, Ramos-D'Angelo F, Alonso Calo L, Llaneza-Velasco ME, Fortuny-Organs B, Apezetxea-Celaya A. [Development and validation of standards for quality units of health centers]. J Healthc Qual Res 2023; 38:366-375. [PMID: 37925297 DOI: 10.1016/j.jhqr.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE In Spain, the Quality Units advise health centres, services and professionals on the methodology of continuous improvement of the quality of care. A system based on good practice standards could provide these units with a tool to improve their results and value their work. The objective was to develop, agree on and validate standards, to properly guide and orient the functions, results and continuous improvement of the Quality Units in health centers. MATERIAL AND METHODS A qualitative-quantitative, prospective and cross-sectional study was carried out, applying the Metaplan method, the e-Delphi technique and a simulation study. The participants were coordinators of these units, belonging to 14 Spanish Autonomous Communities and distributed in four experts' panels. They agreed on the standards to be used and evaluated the different types of validity. RESULTS The 204 standards proposed by the scientific committee were reduced to 157 with Metaplan, to 110 with e-Delphi, and to 96 with the committee's final review (87.3% consensus, content validity). The construct validity showed a Cronbach's alpha >0.7 (P<.001); the validity of content was reaffirmed in the simulation workshop (80% "understood" each other, P<.001; and there was "documentary evidence" in 84%, P<.001); face validity was accepted (75% "related to quality dimensions", P<.001); and the validity of the criteria was verified with a sensitivity of 84.2%, a specificity of 98.3%, and a kappa index of 0.84. CONCLUSIONS Valid standards have been developed for Quality Units in health centers.
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Affiliation(s)
- A Aloy-Duch
- Director de Calidad y Planificación, Hospital General de Granollers, Granollers, Barcelona, España.
| | - M Santiñà Vila
- Sociedad Española de Calidad Asistencial (Past President), Investigador del Institut de Recerca Biomèdica August Pi i Sunyer, Barcelona, España
| | - F Ramos-D'Angelo
- Coordinador de Calidad, Hospital Royo Villanova, Zaragoza, España
| | - L Alonso Calo
- Responsable de Calidad y Seguridad del Paciente, Hospital Universitario Central de Asturias, Área Sanitaria IV SESPA, Oviedo, Asturias, España
| | - M E Llaneza-Velasco
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Presidenta de la Asociación Calidad Asistencial del Principado de Asturias - PASQAL, Oviedo, Asturias, España
| | - B Fortuny-Organs
- Unidad de Calidad, Hospital Marina Salud, Denia, Alicante, España
| | - A Apezetxea-Celaya
- Unidad de Calidad, Organización Sanitaria Integrada Bilbao-Basurto, Osakidetza, Servicio Vasco de Salud, Bilbao, Vizcaya, España
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Tabrizi JS, As'habi A, Nazari M, Ebrahimi Tavani M, Haghi M, Gharibi F. Impacts of accreditation on the performance of primary health care centres: A systematic review. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2023; 18:63. [PMID: 38026575 PMCID: PMC10664760 DOI: 10.51866/rv.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction Evidence on the impacts of accreditation on primary health care (PHC) services is inconsistent. Thus, this study aimed to assess the impacts of accreditation on the performance of PHC centres. Method This study systematically reviewed articles published from 2000 to 2019 in the Web of Science, Scopus, ScienceDirect, Springer, PubMed and ProQuest. The following keywords were used: ((primary care OR primary health care) AND (accreditation) AND (impact OR effect OR output OR outcome OR influence OR result OR consequences)). The database search yielded a total of41256 articles, among which 30 articles were finally included in the review. Results Accreditation showed the most positive impacts on the quality, effectiveness, human resource management and strategic management of PHC services. Accreditation also positively affected safety, responsiveness, accessibility, customer satisfaction, documentation, leadership, efficiency and continuity of care. Few negative impacts were noted, including the possibility of accreditation being used as a bureaucratic tool, high cost of acquiring accreditation, difficulties in understanding the accreditation process, high staff turnover rate in accredited PHC centres and weak sustainability of some accreditation programmes. Conclusion Given its numerous positive impacts, accreditation could be used to effectively improve the performance of PHC centres.
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Affiliation(s)
- Jafar Sadegh Tabrizi
- MD, PhD, Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atefeh As'habi
- BSc, MSc, PhD, Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iram
| | - Maryam Nazari
- BSc, MSc, PhD, Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iram
| | - Masoumeh Ebrahimi Tavani
- BSc, MSc, MPH, PhD, Quality Improvement, Monitoring and Evaluation Department, Center of Health Network Management, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mehdi Haghi
- BSc, MSc, PhD, Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farid Gharibi
- BSc, MSc, PhD, Social Determinants of Health Research Centers, Semnan University of Medical Sciences, Semnan, Iran.
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Alotaibi SY. Accreditation of primary health care centres in the KSA: Lessons from developed and developing countries. J Taibah Univ Med Sci 2023; 18:711-725. [PMID: 36852254 PMCID: PMC9957815 DOI: 10.1016/j.jtumed.2022.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/09/2022] [Accepted: 12/13/2022] [Indexed: 01/04/2023] Open
Abstract
Background/Objectives In 2013, the KSA made Central Board for Accreditation of Healthcare Institutions (CBAHI) accreditation mandatory for all healthcare facilities, including primary health care centres (PHCs) and set a target to have 502 PHCs accredited by 2020. However, there is a real gap in knowledge and research on the impact of CBAHI accreditation on PHCs. This absence of research has been linked to the lack of understanding of the accreditation programme. Therefore, it was recommended by scholars that the KSA could learn from the experience of other countries to improve policy implementation and avoid future complications. Methods This study aimed to explore lessons that KSA can draw from developed and developing countries that have implemented accreditation programmes for PHCs. We performed a literature review using a systematic approach to identify articles related to the accreditation of PHCs. The identified articles were examined by applying evaluation criteria in respect of prospective policy transfer. Results The research results yielded 22 publications from different countries. There were variations among the countries in the specific information acquired. However, Denmark had the highest number of articles providing detailed information. Regarding their aims, most studies shared the same goal of improving quality and patient safety. Generally, there was limited discussion of policy failure compared with policy success. In addition, most of the countries were in the process of implementing local accreditation. Almost all of the countries that had implemented external programmes were developing countries. In terms of application criteria, most cases made recommendations for the programme or for PHCs. Conclusion Analysis indicated that because of the differences in information between countries and settings, there is no ideal country-based experience from which the KSA can transfer lessons. Lessons from outside the KSA would need careful consideration when adopting them in the local context of the Kingdom.
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Affiliation(s)
- Shaymaa Y. Alotaibi
- Health Service and Hospital Management Department, College of Business, King Abdul-Aziz University, Rabigh, Saudi Arabia,Health Services Management Centre, College of Social Sciences, University of Birmingham, Birmingham, UK
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ALFadhalah T, Al Mudaf B, Al Salem G, Alghanim HA, Abdelsalam N, El Najjar E, Abdelwahab HM, Elamir H. The Association Between Patient Safety Culture and Accreditation at Primary Care Centers in Kuwait: A Country-Wide Multi-Method Study. Risk Manag Healthc Policy 2022; 15:2155-2169. [DOI: 10.2147/rmhp.s383925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
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Characterization of Communes with Quality Accredited Primary Healthcare Centers in Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159189. [PMID: 35954546 PMCID: PMC9368359 DOI: 10.3390/ijerph19159189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
The accreditation process of primary healthcare centers in Chile has not had the same progress as in hospitals, which show high levels of compliance. The purpose of this research is to characterize the communes that have accredited family healthcare centers (CESFAMs) through socio-economic, municipal management, clinical management, and population variables by performing a principal components analysis (PCA) with biplot analysis and a grouping of communes through a hierarchical analysis. The biplot analysis and hierarchical analysis yielded the formation of three large groups of communes with accredited CESFAMs, characterized mainly by population size, number of people registered in the municipal health system, socioeconomic indicators, and financial management and clinical management variables. It was found that the communes that have accredited CESFAMs are characterized by dissimilar behavior in relation to the variables analyzed. Through the model used, it was possible to establish at least three groups of communes according to their behavior against these variables. Of these, the variables of a municipal financial nature were not decisive in achieving the accreditation of the CESFAMs of these communes. Therefore, it is possible that there are other variables or factors that could be facilitating the achievement of accreditation processes.
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Matovu M, Musiime E, Olak P, Mulindwa M, Namisango E, Songwe K. Impact of accreditation on health care services performance in Kiryandongo district, Uganda: a longitudinal study. BMC Health Serv Res 2022; 22:174. [PMID: 35144593 PMCID: PMC8830999 DOI: 10.1186/s12913-022-07603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 02/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background The COVID-19 pandemic has emphasised the need for quality laboratory services worldwide. There is renewed focus to strengthen country capacities and laboratories to effectively respond to public health emergencies and patient outcomes. Uganda launched the accreditation program for public health facilities in 2016 with sixteen laboratories. As of June 2021, twenty-three public laboratories have attained ISO 15189:2012 accreditation status. Despite the tremendous achievements of accrediting laboratories in Uganda, laboratory services still face challenges like stock out of commodities and limited testing scopes. We conducted this study to evaluate the impact of accreditation on health care services performance in Kiryandongo district, Uganda. Methods We conducted a longitudinal study from January 1, 2020- April 30, 2021 at ten health facilities in Kiryandongo district. We collected health care services performance data from the MoH dhis-2 on selected indicators for HIV, TB, Malaria, Laboratory, Maternal & child health and dhis-2 reporting. We used Generalized Estimating Equations to estimate the impact of accreditation on health care services performance at the different health facilities. Results The odds at the accredited facility in comparison to the non-accredited public facilities were; 14% higher for ART enrolment (OR = 1.14, 95% CI: 1.04–1.25), 9% lower for determine testing kits stock out (OR = 0.91, 95% CI: 0.85–0.97), 28% higher for TB case diagnosis (OR = 1.28, 95% CI: 1.10–1.49), 19% higher for TB case enrolment (OR = 1.19, 95% CI: 1.04–1.36), 104% higher for maternity admissions (OR = 2.04, 95% CI: 1.60–2.59), 63% higher for maternity deliveries (OR = 1.63, 95% CI: 1.39–1.90) and 17% higher for reporting hmis 10:01 data to dhis-2 (OR = 1.17, 95% CI: 1.04–1.31). The odds at the accredited facility in comparison to the non-accredited PNFP facilities were; 26% higher for ART enrolment (OR = 1.26, 95% CI: 1.17–1.36), 33% higher for TB case diagnosis (OR = 1.33, 95% CI: 1.15–1.55), 24% higher for TB case enrolment (OR = 1.24, 95% CI: 1.09–1.42), 136% higher for maternity admissions (OR = 2.36, 95% CI: 1.89–2.94), 76% higher for maternity deliveries (OR = 1.76, 95% CI: 1.51–2.04) and 2% higher for reporting of hmis-10:01 data to dhis-2 (OR = 1.02, 95% CI: 1.01–1.03). Conclusions HIV, TB, laboratory, MCH, and reporting to dhis-2 selected indicators were positively impacted by accreditation. This impact translated into increased health care services performance at the accredited facility as compared to the non-accredited facilities.
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Affiliation(s)
| | | | - Patrick Olak
- Kiryandongo District Local Government, Kampala, Uganda
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Firooznia R, Dargahi H, Jafari-Koshki T, Khaledian Z. Developing an Evaluation Model for Maternity Care: A Mixed-Method Study from Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:160-171. [PMID: 35223637 PMCID: PMC8837886 DOI: 10.18502/ijph.v51i1.8307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/19/2020] [Indexed: 11/24/2022]
Abstract
Background: Maternity care is an integral part of primary health care (PHC) systems worldwide. This study aimed to develop a new model for evaluating the maternity health program (MHP) in Iran. Methods: In this mixed-methods study, first, the challenges of MHP were surveyed through systematic review and expert interviews. Next, to identify the existing shortcomings in MHP evaluation system, the SWOT technique, cross-sectional study and comparative analyses were used. Finally, the Delphi technique was used to reach consensus on developed evaluation standards. Results: The final developed evaluation model contains five dimensions including reproductive health/family planning, maternity health, health records, evaluation, and resources management. Overall, this model has 32 standards and 289 measures. The scores obtained for the sum of the measures in two importance and applicability criteria were 8.24 and 7.85, which these scores are estimated to be equal to 91.55 and 87.22 percent of the highest possible scores, respectively. Conclusion: Considering the comprehensiveness of the obtained model, it is hoped that it could lead to performance improvement of the PHC centers in the area of maternity health.
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Affiliation(s)
- Rozita Firooznia
- Department of Health Care Management, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Dargahi
- Department of Health Care Management, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tohid Jafari-Koshki
- Department of Health Care Management, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Khaledian
- Department of Health Care Management, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Tabrizi JS, Gharibi F. Developing National Functional Accreditation Model for Primary Healthcares with Emphasis on Family Practice in Iran. Korean J Fam Med 2021; 42:232-239. [PMID: 33781061 PMCID: PMC8164929 DOI: 10.4082/kjfm.20.0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/16/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Accreditation is an approach toward quality improvement which has been increasingly implemented in healthcare. This study aimed at developing a national functional accreditation model for primary healthcare with emphasis on family practice in Iran. METHODS This mixed-method study utilizes a set of research methods purposefully. Initially, the reference models were used for benchmarking accreditation standards through a systematic review. Then, the primary accreditation standards were developed and then they were assessed and approved by the experts of the field via Delphi technique. In the following and after developing essential parts of the standards, the necessary changes in developed model were done according to the pilot test results. RESULTS The results of systematic review suggested the superiority of accreditation models of the United States, Australia, Canada, and the United Kingdom globally; and the models of Jordan, Saudi Arabia, Lebanon, and Egypt in Eastern-Mediterranean region. Then, the primary standards including 39 functional standards with 231 measures were developed according to the benchmarked models, and were approved by the experts in Delphi-based study. In pilot test step, the compliance rate of developed standards by primary healthcare centers was calculated 61.61% and 26.37% for self-evaluation and external evaluation phases, respectively. CONCLUSION Regarding the comprehensiveness of developed accreditation model due to its focus on all functional dimensions and the consensus over the developed standards by the experts, it can be an underlying ground for the establishment and evaluation of functional improvement programs in Iranian primary healthcare system.
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Affiliation(s)
- Jafar Sadegh Tabrizi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Gharibi
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran
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Silva LFR, Scholze AR, Pissinati PDSC, Begui JR, Barreto MFC, Galdino MJQ. Estresse ocupacional em equipes saúde da família certificadas e não certificadas com selo de qualidade assistencial. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo comparar o estresse ocupacional em trabalhadores de equipes saúde da família certificadas e não certificadas com selo de qualidade assistencial pela Tutoria da Atenção Primária à Saúde. Métodos estudo transversal realizado com 178 trabalhadores das equipes da Estratégia Saúde da Família de dois municípios do Paraná. Os dados foram coletados por um questionário de caracterização e a Job Stress Scale, e analisados descritiva e inferencialmente por meio de regressão logística bruta e ajustada. Resultados os trabalhadores vinculados às equipes certificadas apresentaram chances significativamente maiores de alta demanda psicológica (p<0,001; ORaj: 4,164) e baixo apoio social (p=0,048; ORaj: 1,896) em relação aos das não certificadas. O controle sobre o trabalho não apresentou diferença significativa (p=0,891; ORaj: 1,047). Os participantes de equipes certificadas apresentaram maior chance de job strain (p<0,001; ORaj: 4,956) e entre aqueles de equipes não certificadas predominou o trabalho passivo (p<0,001; ORaj: 0,293). Conclusão os trabalhadores de equipes de saúde com certificação de qualidade na prestação de serviços apresentaram maiores chances de estresse ocupacional em relação aqueles vinculados a equipes não certificadas. Implicações para a prática torna-se premente que os modelos gerenciais de qualidade da assistência considerem a saúde dos trabalhadores envolvidos.
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Sperling D, Pikkel RB. Promoting patients' rights through hospital accreditation. Isr J Health Policy Res 2020; 9:47. [PMID: 32958047 PMCID: PMC7504649 DOI: 10.1186/s13584-020-00405-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/09/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Over the past decade, hospitals in many countries, including Israel, have undergone an accreditation process aimed at improving the quality of services provided. This process also refers to the protection and promotion of patients' rights. However, reviewing the criteria and content included in this category in the Israeli context reveals definitions and implications that differ from those presented by the law - specifically the Patient's Rights Act 1995. Moreover, the rights included in it are not necessarily equally represented in other legislation. METHODS This study seeks to examine the question of whether and to what extent the scope, contents, and definitions of patients' rights in the JCI Standards are similar to or different from patients' rights as they are addressed and protected in national legislation. The article provides a comparison and examination of the different regulatory frameworks of patients' rights, especially those in the accreditation of healthcare institution and legislation, analyzes the gaps between such frameworks, and suggests possible implications on our understanding of the concept of patients' rights. RESULTS The patients' right chapter in the accreditation process introduces and promotes the concepts of patient and family rights, increases the awareness and compliance of such concepts, and may create greater consistency in their introduction and application. CONCLUSIONS Discussion of the Israeli case not only demonstrates how regulatory frameworks are instrumental - for broader policy purposes, especially in the area of patients' rights and the rights of patients' families - but also calls for a more general examination of the concept of patients' rights in health policies and its contribution to the quality of health services. Reference to patients' rights in accreditation of healthcare institutions may promote and enhance this concept and contribute to the delivery of care, thereby complementing a lacuna in the law.
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Affiliation(s)
| | - Rina B. Pikkel
- International Center for Health, Law and Ethics, Faculty of Law, University of Haifa, Haifa, Israel
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Tomasich F, Oliveira AVDE, Oliveira ADEJ, Correia MITD. The history of quality and safety of the surgical patient: from the initial standards to the present day. Rev Col Bras Cir 2020; 47:e20202650. [PMID: 32638915 DOI: 10.1590/0100-6991e-20202650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 11/22/2022] Open
Abstract
There are currently various concepts related to quality, which have been implemented by many hospitals and other healthcare institutions. The search for continuous improvement, the implementation of a quality culture and hospital accreditation have also been common, in these institutions. However, the history of hospital audits and accreditation is complex and full of dynamic concepts. The American College of Surgeons was pioneer in publishing, more than a century ago, the first document pertaining quality standards. After that, various programs and concepts have been developed and remodeled by distinct entities. In this article, we briefly review the history of quality in the world and Brazil. We also discuss related concepts regarding its assessment in healthcare.
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Affiliation(s)
- FlÁvio Tomasich
- Departamento de Cirurgia, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Dikic M, Nikolic D, Todorovic J, Terzic-Supic Z, Kostadinovic M, Babic U, Gacevic M, Santric-Milicevic M. Alignment of Perceived Competencies and Perceived Job Tasks among Primary Care Managers. Healthcare (Basel) 2019; 8:healthcare8010009. [PMID: 31892238 PMCID: PMC7151202 DOI: 10.3390/healthcare8010009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 12/19/2019] [Accepted: 12/24/2019] [Indexed: 11/29/2022] Open
Abstract
In this study we aimed to explore how managers in primary health care (PHC) organizations assess their managerial knowledge and skills, as well as the importance of these competencies for their job, and to identify whether there is an alignment between these two perceptions; therefore, whether there is a need for management competency improvement. With this study, we tried to address a high demand for information about health managers, especially in health systems in low- and middle-income countries. In a sample of 58 primary health care centers (n = 106 managers) in Serbia, we used a basic managerial competency matrix consisting of the following six competencies—communication, team-building, planning and priority-setting, performance assessment, problem-solving, and leading. Managerial perception of the importance of their job tasks differs by educational level and managerial position. The best alignment between the importance of knowledge and skills was for communication and leading. The study pointed out that managers were aware of the necessity to improve their level of managerial competencies, particularly in the domains of planning and priority-setting, performance assessment, and problem solving. The study highlights the need for formal managerial education for managers in PHC settings and commitment to continuously evaluate and improve management competencies in order to better manage PHC.
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Affiliation(s)
- Milica Dikic
- Center-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.D.); (J.T.); (Z.T.-S.)
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
- University Children’s Hospital, 11000 Belgrade, Serbia
| | - Jovana Todorovic
- Center-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.D.); (J.T.); (Z.T.-S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
| | - Zorica Terzic-Supic
- Center-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.D.); (J.T.); (Z.T.-S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
| | - Milena Kostadinovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
- Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Uros Babic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
- Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Marijana Gacevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
| | - Milena Santric-Milicevic
- Center-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.D.); (J.T.); (Z.T.-S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.K.); (U.B.); (M.G.)
- Correspondence:
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