Determination of Gap in Accreditation Standards Establishment Process Using Zachman Framework at a Health-Educational Hospital

Background: Accreditation is usually a voluntary plan supported by a non-governmental institution and trained evaluators that examine the competency of organizations providing health service according to pre-specified performance standards. Objectives: The current study aimed to determine the degree of establishment of accreditation standards using logical framework of Zachman. Methods: This descriptive research was conducted during year 2015. The population of the study included people involved in the establishment of accreditation standards. Sampling was conducted in the form of complete enumeration according to 36 standards of accreditation. The instrument used for data collection was the “Logical framework of Zachman”. Columns of framework consisted of people involved in conducting the work (Who), the purpose of the work (Why), strategy of the work (What), work time (When), and sub-system of doing work (Where) and way of doing work (How), and rows of framework included the view of hospital chief, director/assistants of hospital, officials and personnel. Test chi-square was used to compare between accreditation standards text and studied hospital gap. Descriptive statistical method was used for variables. Results: People involved in doing work and sub-systems of doing work at the hospital were consistent with specified accreditation standards. In 27% of the standards, time interval of doing work in the hospital was not conducted according to accreditation standards. In terms of way of doing work, 25% of standards had not been established, and 26% of them had been established incompletely. During interviews, it was found that 59% of personnel of purpose of doing work, and 94% of them are not informed about the strategy of doing work, according to accreditation standards in the hospital. Conclusions: Uncertainties in the accreditation standards in dimensions of purpose, people involved, strategy and time interval of doing work, respectively, led to a lack of understanding the intention of author/developers of standards by personnel. As a result, this led to lack of complete establishment of accreditation standards in the studied hospital. Keywords: Accreditation, Establishment, Gap, Hospitals, Tehra

Determine the distribution of human resources that provide direct service in the health sector (doctors, nurses, paramedics and health workers) in Qazvin province in 2014 based on population coverage and compare it with standard or national average

Background: One of the most important priorities of all countries is equitable access and according to the need for health services. Equal and fair distribution of resources, especially human resources for health is a constant challenge to health policy makers. Objective: The objective of this study was to investigate the distribution of human resources for direct service delivery in the health sector (physicians, nurses, paramedics and health workers) in Qazvin province, 2014 and in comparison with standard or national average. Method: This study is a descriptive-analytical and retrospective study. The studied population including: general practitioners, specialist doctors, nurses, paramedics and health workers that are working in academic and non-academic centers of Qazvin province in 2014. The needed data was collected through census by referring to Department of treatment, development and health of Qazvin Medical Sciences University, non-academic centers, governorship and the Medical Council and was recorded in information form. Data processed and analyzed using Excel and spss software. Results: the way of distribution of health forces to separate health centers of Qazvin province and a breakdown of doctors and nurses, paramedics and health workers in rural and urban areas and the size and population of the province were collected in 2016, presented as follows;1. Qazvin province with an area of 15567303 square meters and a population of 1201565 people and 542 physicians, 1882 nurses, 370 paramedic, 560 health workers and 1719 beds that some of them including; 1.in public and private health centers of Qazvin: 1461 beds, 357 physicians, 1755 nurses and paramedics). 2. Takestan: 104 beds, 27 physicians, 132 nurses and paramedics. 3. Boyin Zahra, 50 beds, 11 physicians, 43 nurses and paramedics 4.Alvand: 55 beds, 28 physicians, 49 nurses and paramedics. 5 Abyek, 40 beds, 14 physicians, 58 nurses and paramedics. Conclusion: This study showed that there is an unequal distribution in studied cases to the population covered by the study and its existing beds and However, the variety of emerging diseases are expanding and there is more needs to specialized services and in the absence of reforming the current procedures, the problems of manpower will be raised in the near future (job dissatisfaction and job burnout, etc.) and then the distribution in human resources should be considered again along with the new policies of country and proportional to population growth and new diseases. Key words: population, manpower, physician, nurse, paramedic, health worke