Academic journal article Iranian Journal of Public Health

Comments on "Iran Hospital Accreditation System"

Academic journal article Iranian Journal of Public Health

Comments on "Iran Hospital Accreditation System"

Article excerpt


School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

*Corresponding Author:

(Received 08 Nov 2015; accepted 21 Dec 2015)

Dear Editor-in-Chief

A paper entitled "The Accreditation of Hospitals in Iran" was published in Iranian Journal of Public Health, Vol. 44, No.2, Feb 2015. The paper lacks reliable, credible and trusted evidences to support the claims that the authors made. For instance, the authors claimed, "In Iran, at first, the hospital accreditation system had only focused on the structural standards and it was a lot of criticism." No evidences for such a claim have been provided. The authors also wrote, "The hospital accreditation system in Iran emphasises too much on documentation. As a result, the link between the hospitals' accreditation degrees and the quality of their services is missing". The sources for such a strong claim (i.e., 6, 8, and 9) are researches conducted in Korea and Kenya. The same can be seen in other sections of the paper. It is mentioned that "Iran national hospital accreditation standards derived from the standards of the JCI" and the reference for this claim (i.e., 6) is about Korea's healthcare accreditation system. The authors did not provide sources for their claims in some other sections. For instance, they mentioned, "The accreditation organizations and bodies in India, Indonesia and Malaysia are independent entities; in Ghana, Nigeria and the Philippines are part of the National Health Insurance Program; and in countries such as Mali and Vietnam are similar to those in Iran." These sharp criticisms without reliable and credible evidences mislead the international audiences of the journal.

Accreditation of a health care organization is an external evaluation of the level of compliance against a set of standards (1). The accreditation process covers all areas of the healthcare organization's operation and practice. It aims to ensure that the healthcare organizations address the quality and safety of patient care. The objectives of a hospital accreditation system are to assess quality and safety of care; to provide external recognition of the quality of care; and finally to improve public confidence in healthcare services provided by hospitals. An accreditation program is an effective strategy for improving the quality of care (2-4) and patient safety (5) and results in better organizational performance (6-7).

There is no visible pattern towards the governmental, non-governmental, mandatory, or voluntary status of the hospital accreditation programmes. However, there is a clear trend of increasing government involvement in the hospital accreditation programmes (8). For example, although hospital accreditation is voluntary in US, it is a requirement for hospitals to have accreditation to become providers in the Medicare programme (9). In France, accreditation is governmental and has been compulsory since 1996 (10).

Iran's national hospital accreditation standards are not a translation of the JCI standards. The US (JCAH), Canada (CCHSA) and Australia (ACHS) have launched their hospital accreditation systems in 1951, 1958 and 1973 respectively (8). Many countries' hospital accreditation systems were in- fluenced by the United States, Canada and Australia accreditation standards. For instance, German's hospital accreditation system is influenced mainly by US, Canada and Australia. Ireland influenced mainly by Canadian hospital accreditation system. Italy was influenced by ISO standards and Scotland influenced by EFQM (8).

For developing Iran's national hospital accreditation standards, a literature review was conducted and the hospital standards of countries such as US, Canada, Australia, France, Lebanon and Egypt were reviewed. Particular attention was paid to those countries, which had the most developed hospital accreditation systems. Following the literature analysis, surveys were conducted to decide areas to be covered. …

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