A comparison of hospital quality management systems in Tehran hospitals and European hospitals

Accreditation is a tool for assessing the patients’ safety and quality improvement. The aim of this study was to compare quality management evaluation between Tehran hospitals with Europe hospital with accreditation approach.
This comparative, cross sectional, multilevel study was conducted among 21 systematic selected hospitals and their quality managers and hospital departments and patients between 2016, June and 2017, June. Anonymous Quality management system index (QMSI) questionnaire was conducted among quality managers. Quality management compliance index (QMCI) and clinical quality implementation index (CQII) and Clinical review (CR), specialized expertise and responsibility (SER), evidence base organization (EBO), patient safety strategy (PSS) were used during on- site visits by trained external surveyors. Retrospective and case note reviews, and direct observation were used for patient’s level data gathering. The validity and reliabity of constructs were tested. The choice of instruments was based on “Deeping our understanding of quality improvement in Europe” (DuQuE) project. Instruments were translated and back translated and changed base on third generation of Iran hospital accreditation that was developed by ministry of health and medical education (MOHME). We assessed patient- specific process and outcomes for acute myocardial infarction, stroke, hip fracture and deliveries at patient level.
Management specific indexes at hospital level in Tehran hospitals, alike Europe hospitals, were related. In Tehran hospitals, an association was observed between QMSI and departmental levels in EBOP and CR and SER at four clinical conditions. In Europe hospitals, an association was observed between three levels of hospital quality management.
The comparative evaluation for quality management for hospitals in Tehran and European hospitals showed similar results in terms of quality improvement at the management level.