Developing National Accreditation Model for Comprehensive Health Services Centers with Emphasis on Family Practice

Abstract

Abstract Introduction: Accreditation is one of the main quality improvement approach which has incrasing usage in health care. Objective: Regarding the lack of accreditation model in Iranian primary health care system, this study aimed to develop a national accreditation model for comprehensive health services centers with an emphasis on the family practice program. Methods and Materials: First of all, the impact of accreditation on the performance of primary health care centers, as well as valid benchmarking sources for using in development of accreditation standards was determined through systematic review. After that, the primary accreditation standards were developed based on selected sources and were assesed by experts via Delphi technique. In continue, the essential components of standards were developed and the reguired revision was done on obtained model based on pilot test results. Results: The results of first systematic review indicated that accreditation has positive impacts of performance domains specially on quality improvement, with minor negative impact in primary health care field. The results of second systematic review showed that the accreditation models of the United States, Australia, Canada and UK globally and the accreditation models of Jordan, Saudi Arabia, Lebanon and Egypt in eastern mediterranean region are the best models to benchmarking. In the following, the primary standrds were developed baed on determined resources and the number of ۳۹ functional standards (with ۲۳۱ measures) and ۱٦۳ department standard (with ۱٦۳٤ measures) were approved by experts. In the pilot study, the average of the level of observance of standards in both the self-assessment and external survey were ٦۱٫٦۱ and ۲٦٫۳۷٪, respectively. Conclusion: Given the comprehensiveness of the obtained accreditation model due to its focus on all functional and departmental domains, as well as the consensus of experts on its standards, this model could be a basis for establishing quality improving and family practice program in Iran primary health system.