El-Jardali Fadi, Hemadeh Randa, Jaafar Maha, Sagherian Lucie, El-Skaff Ranime, Mdeihly Reem, Jamal Diana, Ataya Nour
Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon.
BMC Health Serv Res. 2014 Feb 25;14:86. doi: 10.1186/1472-6963-14-86.
In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. The MOPH, with the support of Accreditation Canada, conducted the accreditation survey in 25 PHC centers in 2012. This paper aims to gain a better understanding of the impact of accreditation on quality of care as perceived by PHC staff members and directors; how accreditation affected staff and patient satisfaction; key enablers, challenges and strategies to improve implementation of accreditation in PHC.
The study was conducted in 25 PHC centers using a cross-sectional mixed methods approach; all staff members were surveyed using a self-administered questionnaire whereas semi-structured interviews were conducted with directors.
The scales measuring Management and Leadership had the highest mean score followed by Accreditation Impact, Human Resource Utilization, and Customer Satisfaction. Regression analysis showed that Strategic Quality Planning, Customer Satisfaction and Staff Involvement were associated with a perception of higher Quality Results. Directors emphasized the benefits of accreditation with regards to documentation, reinforcement of quality standards, strengthened relationships between PHC centers and multiple stakeholders and improved staff and patient satisfaction. Challenges encountered included limited financial resources, poor infrastructure, and staff shortages.
To better respond to population health needs, accreditation is an important first step towards improving the quality of PHC delivery arrangement system. While there is a need to expand the implementation of accreditation to cover all PHC centers in Lebanon, considerations should be given to strengthening their financial arrangements as well.
2009年，黎巴嫩公共卫生部启动了初级卫生保健（PHC）认证计划，以提高整个护理连续过程中的质量。在加拿大认证机构的支持下，黎巴嫩公共卫生部于2012年对25个初级卫生保健中心进行了认证调查。本文旨在更好地了解认证对初级卫生保健工作人员和主任所认为的护理质量的影响；认证如何影响工作人员和患者满意度；提高初级卫生保健认证实施的关键推动因素、挑战和策略。
本研究在25个初级卫生保健中心采用横断面混合方法进行；所有工作人员都使用自填式问卷进行调查，而对主任进行了半结构化访谈。
衡量管理和领导力的量表平均得分最高，其次是认证影响、人力资源利用和客户满意度。回归分析表明，战略质量规划、客户满意度和员工参与度与更高质量结果的认知相关。主任们强调了认证在文件记录、强化质量标准、加强初级卫生保健中心与多个利益相关者之间的关系以及提高工作人员和患者满意度方面的好处。遇到的挑战包括财政资源有限、基础设施差和人员短缺。
为了更好地满足人群健康需求，认证是提高初级卫生保健服务提供安排系统质量的重要第一步。虽然有必要扩大认证的实施范围以覆盖黎巴嫩所有初级卫生保健中心，但也应考虑加强其财政安排。
