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医生参与医院认证计划的挑战:伊朗的一项定性研究。

The challenges of physicians' participation in hospital accreditation programs: a qualitative study in Iran.

机构信息

Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

BMC Health Serv Res. 2021 Oct 28;21(1):1171. doi: 10.1186/s12913-021-07182-w.

Abstract

BACKGROUND

Due to the increasing pressure on hospitals to enhance the quality of services, the participation of physicians in accreditation programs has become more important than ever. The present study was conducted to describe challenges of physicians' participation in hospital accreditation programs in Iran using a qualitative approach.

METHODS

We conducted interviews with 11 managers, 9 physicians and 8 experts in the field of hospital accreditation. Interviewees were selected through purposive snowball sampling. In-depth unstructured and semi-structured interviews were conducted for data collection. The data obtained were analyzed in ATLAS.ti using the conceptual framework method.

RESULTS

The results of this study extracted 3 main themes including: cultural, organizational and behavioral factors. Also, this study found 12 sub-themes and 57 items. Sub-themes in the cultural domain were motivation, patient demand, mutual trust and evaluation system. The organizational domain consisted of seven sub-themes, including high workload, understanding the role of quality management unit, unrealistic accreditation, nature of accreditation, empowerment of physicians in the field of quality, effective communication, resource constraint. Sub-themes in the behavioral dimension were ambiguity in the role and uncertainty about how to participate in accreditation program.

CONCLUSION

Physicians' participation in accreditation programs can be increased through culture building and proper training about accreditation activities in the medical community.

摘要

背景

由于医院提高服务质量的压力不断增加,医生参与认证计划变得比以往任何时候都更加重要。本研究采用定性方法描述了伊朗医生参与医院认证计划的挑战。

方法

我们采访了 11 名经理、9 名医生和 8 名医院认证领域的专家。通过有目的的滚雪球抽样选择受访者。为了收集数据,进行了深入的非结构化和半结构化访谈。使用 ATLAS.ti 软件采用概念框架方法对获得的数据进行分析。

结果

本研究的结果提取了 3 个主要主题,包括:文化、组织和行为因素。此外,本研究还发现了 12 个副标题和 57 个项目。文化领域的副标题包括动机、患者需求、相互信任和评估体系。组织领域包括七个副标题,包括工作量大、理解质量管理部门的角色、不切实际的认证、认证的性质、赋予医生在质量领域的权力、有效沟通、资源限制。行为维度的副标题包括角色模糊和不确定如何参与认证计划。

结论

可以通过在医疗社区中建立文化和对认证活动进行适当培训来提高医生对认证计划的参与度。

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