Developing National Functional Accreditation Model for Primary Healthcares with Emphasis on Family Practice in Iran / 가정의학회지

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.

Developing National Functional Accreditation Model for Primary Healthcares with Emphasis on Family Practice in Iran / 가정의학회지

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.

Pay-for-performance challenges in family physician program

@#Objective: This study was conducted to investigate the challenges faced in the implementation of the pay-for-performance system in Iran’s family physician program. Study design: Qualitative. Place and duration of study: The study was conducted with 32 key informants at the family physician program at the Tabriz University of Medical Sciences between May 2018 and June 2018. Method: This is a qualitative study. A purposeful sampling method was used with only one inclusion criterion for participants: five years of experience in the family physician program. The researchers conducted 17 individual and group non-structured interviews and examined participants’ perspectives on the challenges faced in the implementation of the pay-for-performance system in the family physician program. Content analysis was conducted on the obtained data. Results: This study identified 7 themes, 14 sub-themes, and 46 items related to the challenges in the implementation of pay-for-performance systems in Iran’s family physician program. The main themes are: workload, training, program cultivation, payment, assessment and monitoring, information management, and level of authority. Other sub-challenges were also identified. Conclusion: The study results demonstrate some notable challenges faced in the implementation of the pay-for-performance system. This information can be helpful to managers and policymakers.

study of health status in area affected by the earthquake in Azerbaijan through rapid assessment technique in 2012

Iran is a disaster prone country in the world and earthquakes are the most destructive among natural disasters. Thus, a comprehensive plan is necessary in order to guide measures before, during and after earthquake due to the importance of disaster management. Accordingly, this study aims to examine the role of rapid assessment methods in managing of Azerbaijan earthquake in 2012. In this descriptive and cross-sectional study, data were collected by health experts of Azerbaijan province [24 ones]. After earthquake occurrence, the disaster management working groups held sessions and rapid assessment teams organized and dispatch to the affected area. Rapid assessment was determined in epidemiologic and demographic situation, health conditions, and emergency needs. Rapid assessment was done for the affected area by earthquake included Ahar, Heris and Varzeqan. Looking at health, epidemiologic and demographic situation, Heris and Ahar were considered as the highest and lowest needy areas respectively due to their deterioration of health status, high population, severe financial losses and casualties and are needed for more rescue and relief activities. In the following, the amounts and types of relief activities were determined and provided for each region based on rapid assessment results. The rapid assessment technique plays a crucial role through appropriate management of activities in the phase of disaster and post-disaster response; also, it provides a clear picture of disaster consequences and the needs of affected people. This technique could be a suitable model since it was implemented in an acceptable manner in Azerbaijan earthquake

Developing of national accreditation model for rural health centers in Iran health system

The primary health care has notable effects on community health and accreditation is one of the appropriate evaluation methods that led to health system performance improvement, therefore, this study aims to developing of national accreditation model for rural health centers in Iran Health System. Firstly the suitable accreditation models selected to benchmarking worldwide via systematic review, the related books and medical university's web site surveyed and some interviews hold with experts. Then the obtain standards surveyed from the experts' perspectives via Delphi technique. Finally, the obtainedmodel assessedvia the experts' perspective and pilot study. The researchers identified JCAHO and CCHSA as the most excellent models. The obtained standards and their quality accepted from experts' perspective and pilot study, and finally the number of 55 standards acquired. The designed model has standards with acceptable quality and quantity, and researchers' hopeful that its application in rural health centers led to continues quality improvement

[ situation of disaster management in accreditation national model of hospital performance]

Because of specific ecological and geographical location, our country is one of the most disaster prone countries in the world which requires reasonable and special attention to disaster management. Therefore, the role of hospital is essential as the center of disaster management programming and health and care activities in coping with disasters. Regarding the importance of accreditation in improving health system performance, this study aims to construct and design a national accreditation model for hospital with special focus on disaster management. In this descriptive study that done 2 years, after a vast literature review, researchers designed a systematic review in the best databases such as Ovid Medline, Pub Med and SID in order to identify and utilize and benchmark the pioneer and the best accreditation models both in the region and in the world. A questionnaire designed by using Delphi technique and gaining experts opinions in order to determine the best accreditation models, their standards especially disaster management standards. Thereafter, experts give scores to the standards in aspects of 'importance' and 'performance'. In the systematic review section, the health and care accreditation models such as JCAHO [USA], CCHSA [Canada], ACHS [Australia], ANAES [France] and QHNZ [New Zealand] were selected as the best models in order to utilize and benchmark in the world respectively. It should note that Canada model [CCHSA] is known as the most comprehensive one in disaster management. Also, Lebanon and Egypt accreditation models were chosen as the best local models [EMRO]. The Delphi study was done in 2 rounds with high response rate and the standards was exerted in view of experts. However, for all selected model, 'content statement' and 'objective measurable components' were prepared regarding the most common and related model in disaster management. Finally, the designed model was completed by writing of essential parts of standards. The final designed model has 15 standards with 'content statement' and 'objective measurable components'. This is an enrich accreditation model in number, range and diversion of standards according to various aspects of crisis management so that we can claim it is a most complete model in the world. After a preliminary study and final reform, this model will be able to improve the hospital performance especially in terms of crisis management and hospital preparedness in emergencies. There is no doubt that the application of this model in our health system leads to significant improvement in health system performance and clients' satisfaction