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Implementing hospital quality assurance policies in Iran: Balancing licensing, annual evaluation, inspections and quality management systems

Asgar Aghaei Hashjin (Department of Social Medicine, Academic Medical Center (AMC)/University of Amsterdam, Netherlands and School of Health Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran)
Bahram Delgoshaei (School of Health Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran)
Dionne S Kringos (Department of Social Medicine, Academic Medical Center (AMC) / University of Amsterdam (UvA), Amsterdam, Netherlands)
Seyed Jamaladin Tabibi (School of Health Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran)
Jila Manouchehri (Tehran Heart Center Hospital, Tehran University of Medical Sciences, Tehran, Iran)
Niek S Klazinga (Department of Social Medicine, Academic Medical Center (AMC)/University of Amsterdam, Amsterdam, Netherlands)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 11 May 2015

704

Abstract

Purpose

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran.

Design/methodology/approach

A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010.

Findings

The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government’s strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity.

Practical implications

The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries.

Originality/value

This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Keywords

Acknowledgements

The authors thank Dr Hamid Ravaghi and Dr Reza Tooyserkanmanesh for their contributions to the data collection process; Mrs Margot Witvliet for commenting on the draft paper and Professor Dr Karien Stronks for supporting this research project at the Department of Social Medicine, Academic Medical Center (AMC), Amsterdam University.

Citation

Aghaei Hashjin, A., Delgoshaei, B., Kringos, D.S., Tabibi, S.J., Manouchehri, J. and Klazinga, N.S. (2015), "Implementing hospital quality assurance policies in Iran: Balancing licensing, annual evaluation, inspections and quality management systems", International Journal of Health Care Quality Assurance, Vol. 28 No. 4, pp. 343-355. https://doi.org/10.1108/IJHCQA-03-2014-0034

Publisher

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Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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