بررسی تاثیر استقرار استاندارهای اعتبار بخشی بر میزان مرگ و میر بیماران در بیمارستان‌های منتخب مشهد
محورهای موضوعی : -مدارک پزشکیزهرا عابدی 1 , پوران رئیسی 2 , لیلا ریاحی 3
1 - کارشناس‌ارشد مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 - استاد، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده مدیریت و اطلاع‌رسانی پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران
3 - استادیار، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
کلید واژه: استانداردها, اعتباربخشی, مرگ و میر, بیمارستان,
چکیده مقاله :
مقدمه: در گروه‌های تخصصی و مراکز پزشکی، بهبود سلامت بیمار از طریق ایجاد استانداردها با استفاده از برنامه‌های اعتباربخشی، از اهداف مترقی محسوب شده است. یکی از نشانگرها برای بررسی سطح سلامت یک جامعه، مرگ و میر می‌باشد. هدف کلی این پژوهش بررسی رابطه استقرار استانداردهای اعتباربخشی با میزان مرگ و میر بوده است. روش پژوهش: این مطالعه به صورت توصیفی - مقطعی در سال 1396 با جامعه آماری کلیه بیمارستان‌های مشهد که 10 بیمارستان به عنوان نمونه انتخاب شدند، انجام پذیرفت. داده‌های این پژوهش را نمرات اعتباربخشی بیمارستان‌ها و نسبت مرگ و میر به پذیرش بستری قبل و بعد از اجرای استانداردهای اعتباربخشی تشکیل می‌داد. روش گردآوری داده‌ها به صورت میدانی با تکمیل چک لیست‌ها توسط محقق انجام شد. برای تحلیل داده‌ها از شاخص‌های آمار توصیفی (درصد‌ها، فراوانی، میانگین و انحراف معیارها) و برای بسط نتایج، از آزمون t-test استفاده شد. یافته‌ها: نشان داد که با توجه به مقدار احتمال معنی داری 0.027 که از 5% کمتر است فرض صفر آماری یعنی برابری میانگین‌ها رد می‌شود و با توجه به مثبت بودن حد پایین و بالای فاصله اطمینان، میانگین نسبت مرگ و میر‌ها در قبل از اجرای استانداردها بیشتر از این نسبت در بعد از اجرای استانداردها بوده است. نتیجه‌گیری: بین اجرای استانداردهای اعتباربخشی با نسبت مرگ و میر در بیمارستان‌های مورد مطالعه رابطه معنی داری وجود دارد؛ استقرار این استانداردها می‌تواند میزان مرگ و میر بیمارستانی را کاهش دهد.
Introduction: In specialized groups and medical centers, improving patient health through the establishment of standards through the use of accreditation programs is considered progressive. One of the indicators for monitoring the health of a community is death. The overall aim of this study was to examine the relationship between the establishment of accreditation standards and mortality rates in selected hospitals. Methods: This descriptive cross-sectional study was conducted in 1396 with a statistical population of all hospitals in Mashhad, in which 10 hospitals were selected as samples. The findings of this study consisted of accreditation scores of hospitals, along with mortality rates, and hospital admissions before and after the implementation of accreditation standards. The method of data collection was fieldwork and the checklist was completed by the researcher. In this research, descriptive statistics (percentages, frequency, mean and standard deviations) were used to analyze the data and t-test was used to extend the results. Results: Findings of the mortality ratio to hospital admission showed that according to the probability value of 0.027, which is less than 5%, the assumption of the statistical zero means the equality of the meanings is rejected. And given the positive upper and lower limit, the mean of mortality ratio has been higher than implementation of standards than this ratio after the implementation of validation standards. Conclusion: There is a significant relationship between the implementation of accreditation standards with the mortality ratio in the hospitals; the establishment of these standards can reduce hospital mortality rates.
1- Mosadeghrad AM. Organization and Health Management. Tehran; Dibagaran 2015: 87-90.
2- Atashkhaneh M. Patient rights. Shiraz, Management of Fars Social Security Treatment; 2001: 110-115
3- Sadaghiani A. Audit and Accreditation Standards of Hospital. Joint Commission on Accreditation of Health Care Organizations. Tehran, High School of Social Security Research; 2004: 120-125.
4- Sadaghiani A. Evaluation of health care and hospital standards .Tehran, Jafari; 2005: 70-78.
5- Agarwal R. A Guideline for Quality Accreditation in Hospitals. Quality Digest Magazine; 2010: 88-95.
6- National Audit Office, Department of Health (NHS): 65-66.
7- Sadaghiani A. Investigating the system of evaluation and accreditation of medical institutions. National Project for the Development of the Country.Tehran, Totak; 2005: 130-140.
8- Diab Salah M. The Extent to which Jordanian Doctors and Nurses Perceive the Accreditation in Private Hospitals. Int. J. of Marketing Studies, 2011; 3(1): 78-94.
9- Arab M. Mosavi M. Ariankhesal A. Akbari sari A. The Impact of Accreditation on Key Performance Indicators of Hospitals in Tehran University of Medical Sciences, Study of discontinuous series of years 91-93. Hospital Journal, 2016; 16(1): 17-26
10- Yarmohammadian MH. Shokri A. Bahmanziari N. Kordi A. The blind spots on Accreditation program. J Health Syst Res, 2013; 9(11): 1158-1166.
11- Abbasi S. Tavakoli N. Moslehi M. The readiness of hospitals with Isfahan quality management system based on the standard functional model of accreditation of the Joint Commission of the International–2012. Health Information Management, 2012; 9(4): 502-512.
12- Ramezani M. Zendedel A. Kafashpor A. Sadeghi T. Review article on accreditation standards and effective implementation strategies in Iran–2014. National Nursing Conference, 2014; HEALTH01_093: 1-7.
13- Hakak M. Hozni A. Shahsiyah N. Akhlaghi T. Pathology of Accreditation in North Hospitals of Iran: A Qualitative Research. Jhosp; 2018: 45-54.
14- Vakilipor M. Shariati A. Kordi M. Investigating the Impact of Establishing Accreditation Program on Crisis Management System. The Journal of Research Committee of Students at Sabzevar University of Medical Sciences; 2012: 41-45.
15- Nasiripour A. Jafari S. The Relationship of Quality Improvement and Patient Safety with Performance Indicators in Shahid Beheshti University of Medical Science Teaching Hospitals. Journal of Paramedical Sciences (Payavard Salamat). Tehran University of Medical Sciences, 2017; 10(4): 311-319.
16- Yosefi mashoof R. Prevention and Control of Nosocomial Infections. 3rd National Conference on Environmental Health. Kerman University of Medical Sciences; 2009: 126-136.
17- Salehil T. Emamzadeh Ghasemi H. The assay of quality of nursing staff development programs at Tehran University medical sciences hospitals from the perspective of nurses. Nursing Research. Tehran; 2014: 39-43.
_||_1- Mosadeghrad AM. Organization and Health Management. Tehran; Dibagaran 2015: 87-90.
2- Atashkhaneh M. Patient rights. Shiraz, Management of Fars Social Security Treatment; 2001: 110-115
3- Sadaghiani A. Audit and Accreditation Standards of Hospital. Joint Commission on Accreditation of Health Care Organizations. Tehran, High School of Social Security Research; 2004: 120-125.
4- Sadaghiani A. Evaluation of health care and hospital standards .Tehran, Jafari; 2005: 70-78.
5- Agarwal R. A Guideline for Quality Accreditation in Hospitals. Quality Digest Magazine; 2010: 88-95.
6- National Audit Office, Department of Health (NHS): 65-66.
7- Sadaghiani A. Investigating the system of evaluation and accreditation of medical institutions. National Project for the Development of the Country.Tehran, Totak; 2005: 130-140.
8- Diab Salah M. The Extent to which Jordanian Doctors and Nurses Perceive the Accreditation in Private Hospitals. Int. J. of Marketing Studies, 2011; 3(1): 78-94.
9- Arab M. Mosavi M. Ariankhesal A. Akbari sari A. The Impact of Accreditation on Key Performance Indicators of Hospitals in Tehran University of Medical Sciences, Study of discontinuous series of years 91-93. Hospital Journal, 2016; 16(1): 17-26
10- Yarmohammadian MH. Shokri A. Bahmanziari N. Kordi A. The blind spots on Accreditation program. J Health Syst Res, 2013; 9(11): 1158-1166.
11- Abbasi S. Tavakoli N. Moslehi M. The readiness of hospitals with Isfahan quality management system based on the standard functional model of accreditation of the Joint Commission of the International–2012. Health Information Management, 2012; 9(4): 502-512.
12- Ramezani M. Zendedel A. Kafashpor A. Sadeghi T. Review article on accreditation standards and effective implementation strategies in Iran–2014. National Nursing Conference, 2014; HEALTH01_093: 1-7.
13- Hakak M. Hozni A. Shahsiyah N. Akhlaghi T. Pathology of Accreditation in North Hospitals of Iran: A Qualitative Research. Jhosp; 2018: 45-54.
14- Vakilipor M. Shariati A. Kordi M. Investigating the Impact of Establishing Accreditation Program on Crisis Management System. The Journal of Research Committee of Students at Sabzevar University of Medical Sciences; 2012: 41-45.
15- Nasiripour A. Jafari S. The Relationship of Quality Improvement and Patient Safety with Performance Indicators in Shahid Beheshti University of Medical Science Teaching Hospitals. Journal of Paramedical Sciences (Payavard Salamat). Tehran University of Medical Sciences, 2017; 10(4): 311-319.
16- Yosefi mashoof R. Prevention and Control of Nosocomial Infections. 3rd National Conference on Environmental Health. Kerman University of Medical Sciences; 2009: 126-136.
17- Salehil T. Emamzadeh Ghasemi H. The assay of quality of nursing staff development programs at Tehran University medical sciences hospitals from the perspective of nurses. Nursing Research. Tehran; 2014: 39-43.