Hospital
بیمارستان
jhosp
Medical Sciences
http://jhosp.tums.ac.ir
211
godadmin
2008-1928
2228-7450
000
000
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000
000
fa
jalali
1397
8
1
gregorian
2018
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1
fulltext
fa
عارضه یابی اعتبار بخشی بیمارستانهای شمال کشور: یک تحقیق کیفی
Pathology of Accreditation in North Hospitals of Iran: A Qualitative Research
کیفیت خدمات و ایمنی بیمار در بیمارستان
کیفیت خدمات و ایمنی بیمار در بیمارستان
مقاله ی اصیل
Original Article
<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">زمینه و هدف</span></span></strong><span style="font-family:b roya;"><span style="font-size:11.5pt;"> : بیمارستانها به عنوان مهمترین و بزرگترین نهاد ارایه در سیستم سلامت هر کشوری هستند که خدمات درمانی، در سطح وسیعی را آنها انجام می شود. یکی از مهمترین فرآیندهای ارتقا کیفیت خدمات نظام سلامت در کشور اعتبار بخشی است هدف این تحقیق شناسایی چالش</span></span><span dir="LTR">­</span><span style="font-family:b roya;"><span style="font-size:11.5pt;">ها، موانع و ارایه راهکار اعتبار بخشی بیمارستانی بود.</span></span><br>
<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">مواد</span></span></strong><span style="font-family:b roya;"><span style="font-size:11.5pt;"> <strong>و روش</strong></span></span> <strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">ها</span></span></strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">: این</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">پژوهش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نوع</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">پژوهش های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">کیفی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">بود</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">که</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">با</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">استفاده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ازمصاحبه های عمیق</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">رویکرد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تحلیل محتوی در سال 1396در شمال کشور</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">انجام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شد.</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">با</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">استفاده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">رویکرد نمونه گیری</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">هدفمند</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تعداد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">25</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نفر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شامل دوریس بیمارستان،سه مدیر بیمارستان،سه مترون،چهار سوپروایزر،ده پرستارو سه نفر مسوول اعتبار بخشی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">عنوان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مشارکت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">کنندگان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">پژوهش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">انتخاب</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شدند. بعد از انجام مصاحبه با نرم افزار </span></span><span dir="LTR">Maxqda</span><span style="font-family:b roya;"><span style="font-size:11.5pt;"> کدگذاری و تحلیل لازم صورت گرفت. برای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به دست آوردن</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اعتبار</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">روایی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">داده­ها</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">دو</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">روش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">بازبینی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مشارکت کنندگان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مرور</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">خبرگان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">غیر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شرکت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">کننده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در پژوهش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">استفاده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شد.</span></span><span dir="LTR"><span style="font-family:calibri,sans-serif;"></span></span><br>
<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">نتایج</span></span></strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">: داده ها پس از تجزیه و ترکیب در قالب 98 کد اولیه ،16 مفهوم و 5 مقوله اصلی دسته بندی گردید</span></span><span dir="LTR"><span style="font-family:calibri,sans-serif;">.</span></span><span style="font-family:b roya;"><span style="font-size:11.5pt;">کدهای اصلی </span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شامل چالش های منابع،چالش های سازمانی،چالش های فنی،پیامدهای منفی و راهکارها بودند.</span></span><br>
<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">نتیجه گیری</span></span></strong><span style="font-family:b roya;"><span style="font-size:11.5pt;"> :</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">عارضه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">یابی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سازمان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">کمک</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می­کند</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مواردی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">که</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سازمان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">باید</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">روی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">آنها متمرکز</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شود</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">را</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تعیین</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">کند و با گردآوری</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تحلیل</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">داده­ها و شناسایی گره­های کور راه توسعه و حل مشکل را فرا روی مدیران</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">قرار </span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می­دهد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">خصوصا اجرای صحیح فرآیند اعتبار بخشی میتواند به تعالی بالینی همه جانبه منجر شود.</span></span><span style="font-family:b roya;"><span style="font-size:11.5pt;"></span></span><br>
<strong>Background</strong>: Hospitals are the most important and largest institution in each country's health system which health care services are carried out on a large scale. One of the most important processes to improve the quality of health services is accreditation in the country. This study aimed to identify challenges, obstacles and providing solutions in hospital accreditation.<br>
<strong>Materials and Methods</strong>: This research is a qualitative one which conducted using content analysis approach in the north of the country in 2017. Twenty-five people consisted of two heads of hospitals, three hospital managers, three matrons, four supervisors, ten nurses, three people responsible for accreditation selected as contributors to the study using a targeted sampling approach. After the interview with Maxqda software, coding was performed and necessary analysis was carried out. In order to obtain data validity, two methods of reviewing the participants and reviewing experts were used.<br>
<strong>Results</strong>: Analyzed data was categorized in the 98 initial codes, 16 concepts and 5 main categories. The main issues included resource challenges, organizational challenges, technical challenges, negative consequences and solutions.<br>
<strong>Conclusion</strong>: Pathology helps the organization to focus on problems and by collecting and analyzing data and identifying risky spots, managers and planners will find methods to develop and solve the problem. Particularly, the correct implementation of the accreditation process can lead to comprehensive clinical excellence.<br>
اعتباربخشی, تعالی بالینی, سازمانهای سلامت
Accreditation, Clinical excellence, Health organizations
45
54
http://jhosp.tums.ac.ir/browse.php?a_code=A-10-1141-1&slc_lang=fa&sid=1
mohamad
hakkak
محمد
حکاک