Developing a Model for Evaluation and Accreditation of Hospitals

Background: Evaluation and accreditation of Health Care organizations has an important role in increasing the effectiveness and efficiency of these organizations and developing the quality of services provided. The current system of evaluation and accreditation of hospitals in Iran is based on structure only with out considering the context, process and output and this cause many problems for both health care providers and customers. Therefore, there is a pressing need for developing a model for health care systems’ evaluation and accreditation, which help these organizations to improve the quality of services. Method: The aim of this article is therefore: “To identify the strengths and weakness of the current system of evaluation and accreditation of hospitals in Iran, determining the ideal system of evaluation and accreditation to develop a model so that health care organizations aiming at achieving effectiveness and efficiency”. A descriptive study using a cross-sectional survey for data collection performed. All of hospital managers and hospital evaluators in Isfahan province were studied via a self administrated questionnaire (53 managers and 30 evaluators). This questionnaire specifies the respondents’ opinions about the current and ideal system of evaluation and accreditation of hospitals. Data was analyzed via SPSS11 software. Findings: The mean score of current system of evaluation and accreditation of hospitals was 3.12 0.83 and 4.41 0.34 (in a 5 scale).The mean score of structure, process and outcome were 3.10.73, 3.120.91and 3.091 in the current system of hospital evaluation respectively. From the view points of hospital managers and evaluators the differences between values of current and ideal scores of evaluation and accreditation system were statistically significant (P< 0.05). Therefore, there is a need for developing a model for hospital evaluation and accreditation. Based on these results an empirical model for Evaluation and Accreditation of Hospitals is developed. In this model, the context, structure (input), process and results (out put) were considered comprehensively. In this model items such as customer participation in treatment process, hospital information system, equity of services, employees’ participation in evaluation process, increasing employees and managers knowledge and capabilities level, risk and safety management and so on are considered. Discussion: The evaluation and accreditation system of Hospitals should be a comprehensive system in order to evaluate the whole dimensions of these organizations

Clinical governance implementation in a selected teaching emergency department: a systems approach

<p>Abstract</p> <p>Background</p> <p>Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED).</p> <p>Methods/design</p> <p>We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders’ views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies.</p> <p>Discussion</p> <p>Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study would contribute to the development of implementation science and be employed by boards and executives governing other clinical settings to facilitate CG implementation.</p

TQM practices and knowledge sharing: An empirical study of Malaysia’s manufacturing organizations

The purpose of this paper is to examine the multidimensionality of TQM practices and its relationship with knowledge sharing as perceived by middle management employees in Malaysia's ISO 9001:2000 certified firms of manufacturing sectors. The data which were collected from a survey of 129 middle management employees in Malaysia were used to test the proposed research framework. Furthermore, confirmatory factor analysis was performed to evaluate the reliability and validity of the measurement model, and the structural analysis was used to examine the research framework. The analytical results revealed that training and development, customer focus, and teamwork showed a positive association with middle management employees' knowledge sharing. This analysis is vital for senior managers of TQM companies that want to establish a knowledge sharing capability. Senior managers could focus their efforts on implementing TQM practices for building competitive knowledge sharing competencies