The patient has a legitimate role in evaluating the healthcare services provided to them; this evaluation can be measured through patient satisfaction, which is considered an effective tool to evaluate the provided services and the quality program for Hospitals. This study aims to examine the association between patient satisfaction and Hospital accreditation status. Cross-sectional design with a random sampling technique for adult Hospitalized patients. The SERVQUAL instrument was utilized to measure the patient's satisfaction. The sample size included 800 patients from the two phases based on the inclusion and exclusion criteria. The obtained data was analyzed using SPSS version 26. The study revealed that patient satisfaction was high both before and after accreditation. The order of the patient satisfaction dimensions was as follows: assurance, reliability, tangibles, responsiveness, and empathy. The highest subscale in this phase was assurance, with a mean of (4.49), and the lowest score was empathy, with a mean of (4.25). In the pre-accreditation phase, reliability was the highest subscale, with a mean of (4.46), and the lowest score was responsiveness, with a mean of (4.13). In addition, the study revealed that there is an association between the satisfaction subscales (tangibles, responsiveness, and assurance) and accreditation status, except for reliability and empathy. The study concludes that the high level of satisfaction in the post-accreditation phase may relate to the high level of patient care standards and safety environment implemented in the Hospital as requirements of accreditation, which gives evidence that the Hospital accreditation status had a positive impact on patient satisfaction.

Background: accreditation is an appropriate strategy for improving the quality, safety and effectiveness of Hospital services. Iran national Hospital accreditation was initiated as a government and mandatory program in 2012. This study aimed to identify the prerequisites of Hospital accreditation implementation in Tehran province Hospitals.Materials and Methods: This qualitative study was performed using semi-structured interviews with 72 managers in different level from 15 university, private, military, social security and charity Hospitals in 2016. Hospitals were selected purposefully through Tehran province Hospitals. Content analysis was used in order to data analysis.Results: Pilot testing of standards before announcing to Hospitals for implementation, education and training of Hospital managers and employees on accreditation standards, providing required resources, allocating enough time for implementing the standards and providing incentives for implementing standards are the main Hospital accreditation prerequisites. Absence of these prerequisites in accreditation implementation resulted in huge challenges for Hospital managers and employees.Conclusion: Providing the accreditation prerequisites for Hospitals facilitates implementation of Hospital accreditation in Hospitals which in turn results in quality improvement, safety and Hospital services effectiveness.

Background: Evaluation and accreditation of Hospitals have important roles in improving the quality, safety, and effectiveness of healthcare services in Hospitals. The effectiveness of an accreditation system depends on appropriateness, quality and consistency of methods, standards and surveyors. This study aimed to evaluate the content of Hospital accreditation standards from the perspective of the Hospital managers.Methods: The study was conduct in 2015 using a valid and reliable questionnaire. 547 Hospital managers were surveyed using stratified random sampling method. Descriptive and inferential statistical methods including Kruskal, Mann-Whitney and logistic regression were used for data analysis.Results: Hospital managers were moderately satisfied with the content of national Hospital accreditation standards (the mean score of 2.64±0.67 out of 5). Only 15.1 percent of Hospital managers were satisfied with the content of the Hospital accreditation standards. Most complaints were related to a lack of transparency of standards and criteria, number of standards and using the same weight for criteria.Conclusion: Reducing the number of standards and criteria, leveling criteria and making them more transparent, changing the scale of scoring, applying functional approach and also considering the diversity of Hospitals in the formulation of criteria help improve the content of accreditation standards.

Background: Hospital accreditation is a systematic external evaluation of a Hospital’s structures, processes and results (outputs/ outcome) by an independent professional accreditation body using pre-established optimum standards. Hospital accreditation has an important role in improving the quality, safety, effectiveness and efficacy of health care services. The effectiveness of an accreditation system depends on the quality and conformity of its methods, standards and surveyors. This study aimed to evaluate the Hospital accreditation method from the perspective of Iranian Hospital managers.Methods: This descriptive, applied and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire. The study population consisted of 914 Hospital managers. Overall 547 Hospital managers were surveyed through stratified random sampling. SPSS software was used for data analysis.Results: Almost 71.7 percent of Hospitals achieved grade one and above in the first round of national accreditation survey. The mean score of managers’ satisfaction of Hospital accreditation method was 3.21±0.63 out of 5 (Average). About 38 percent of Hospital managers were satisfied with the Hospital accreditation method. Most complaints were related to lack of reliability among surveyors and their low knowledge, skills and experience. Hospital managers were satisfied with surveyors’ attitude and adequacy of the number of survey days. Hospital managers mostly believed that accreditation is better to be done by Ministry of Health, compulsory, and every two years. About 95 percent of Hospital managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey.Conclusion: Hospital managers were moderately satisfied with the national accreditation system. Developing job description and person specification for accreditation surveyors and recruiting them accordingly, and providing professional education and training for them help improve the effectiveness of Iranian Hospital accreditation method. The method of Hospital accreditation in Iran has to be changed.Self-assessment, unannounced surveys, review of Hospital key performance indicators and patient satisfaction surveys should be added to the current scheduled on-site surveys to enhance the credibility of the accreditation result.

Objective (s): Hospital accreditation is a systematic external evaluation of a Hospital’ s structures, processes and outcomes by an independent professional accreditation body using pre-established optimum standards. Iran national Hospital accreditation system (i. e., standards, methods, and surveyors) has changed in 2016. This study aimed to evaluate the efficacy of national Hospital accreditation system of Iran. Methods: This cross-sectional study was carried out using a valid and reliable questionnaire covering accreditation standards, methods, surveyors, implementation and effects. The study population consisted of all Hospital managers in Zanjan province, Iran. SPSS software was used for data analysis. Results: The mean score of managers’ satisfaction of Hospital accreditation system was 3. 00± 0. 27 and 2. 98± 0. 36 out of 5 in 2015 and 2017. Hospital managers’ satisfaction of the new accredtation system has decreased by 0. 66 percent in 2017. However, the differences was not statistically significant. Managers’ satisfaction of accreditation standards increased by 1. 8% while their satisfaction of accredtation methods and standards implementation has decreased by 11. 6 and 8. 5 percent respectively. Conclusion: The changes applied to Iran national Hospital accreditation system did not satisfy Hospital managers. Hospital managers’ and employees’ opinions and concerns should be considered in any attemp to revise the Hospital accreditation system.

Objective(s): Hospital accreditation is “ an external evaluation of a Hospital’ s structures, processes, outputs and outcomes by an independent professional accreditation body using pre-established optimum standards” . accreditation is a strategy for ensuring the quality, safety, effectiveness and efficiency of Hospital services. The efficacy of an accreditation program depends on the validity of the accreditation governance, methods, standards, and the surveyors. Iran's Hospital accreditation system faces some challenges. Benchmarking leading international accreditation bodies’ methods benefit the Iranian Hospital accreditation system. Hence, this study aimed to compare the Iranian Hospital accreditation methods with the world leading international Hospital accreditation bodies’ methods. Methods: A comparative research was used in this study in 2019. The Iranian Hospital accreditation methods was compared with those of the Joint commission international, the accreditation Canada international and the Australian Council on Healthcare Standards International. Framework analysis was used for the qualitative data analysis in this study. Results: While the Iranian Hospital accreditation program is governmental and compulsory, the three leading international accreditation programs are private, not for profit, and voluntary. While Iran’ s Hospital accreditation method includes the selfassessment and the on-site survey, the other countries use self-assessment, on-site survey, un-noticed survey, periodic review, examining key performance indicators and measuring patient satisfaction. The international accreditation award levels include “ Fully accredited” , Provisionally accredited” and “ Not accredited” and the accreditation certification is valid for 3-4 years. The Iran’ s accreditation certificate is valid for 2 years and consisted of 7 levels from “ Excellent” to “ Not accredited” . Conclusion: Complementary evaluation methods should be used to strengthen the validity and reliability of Iran’ s Hospital accreditation program. Furthermore, the time period of the accreditation certificate validity should be increased and the awards levels should be decreased.