Evaluation results of national hospital accreditation program in Iran: The view of hospital managers.

BACKGROUND: Accreditation programs have a crucial role in improving the safety and effectiveness of hospital services. Many factors contribute to achieve accreditation goals. This study evaluated the national Iranian hospital accreditation program from the view of hospital managers in Iran. METHODS: The study was conducted in 2015 using a validated questionnaire designed to collect feedback concerning accreditation processes and impacts. In total, 547 managers were surveyed using a stratified random sampling method. A 5-degree scale Likert from totally disagree=1 to totally agree=5 has been used for the evaluation. Descriptive and inferential statistics were used to analyze the data. RESULTS: Approximately half of hospital managers were satisfied with the accreditation standards and surveying methods. The reason for their dissatisfaction was the high number of measures (2.38). The main challenges to the accreditation method were reported inadequate surveyor training (2.94) their satisfaction with the infrastructure was low because of a lack of hospital resources. Nonetheless, the accreditation program was perceived as being successful in improving patient safety (3.80), patient compliance (3.72), and error reduction (3.53). CONCLUSION: An effective accreditation program requires reducing the number of standards and making them clearer as well as the infrastructure for the implementation of accreditation such as sufficient and sustainable funds, enough human resources and equipment should be provided. Appropriate surveyors should be selected and trained professionally to ensure inter-rater reliability among them.

Understanding novice driver policy agenda setting.

BACKGROUND: Despite the acute impact of road trauma involving novice drivers, there have been few efforts to identify the main factors influencing the novice driver policy agenda. Increasing the transparency of such policy dynamics may help inform future novice driver policy agenda-setting processes, as well as those in other public health settings. METHODS: Forty interviews were conducted between 2007 and 2009 with individuals involved in novice driver policy debates and processes in four Australian states. RESULTS: An increasing body of positive evaluations from other jurisdictions was seen to provide an initial stimulus for Australian novice driver policy activities. The dissemination of evidence by researchers, lobbying and advocacy by other influential stakeholders, and media reporting of multiple-fatality novice driver crashes were seen as other factors central to policy agenda setting. CONCLUSIONS: Australian graduated driver licensing (GDL) policy initiatives may only be acted upon once adequate political support is identified in terms of community demand for action and public acceptance of GDL policy in neighboring states. As such, researcher encouragement of community support for unpopular evidence-based policies during windows of opportunity for policy reform may act as an influential agenda-setting force.

Media framing of graduated licensing policy debates.

BACKGROUND: The overrepresentation of young drivers in road trauma statistics produces significant media interest. Graduated licensing restrictions involving night-time curfews and restrictions on passenger numbers are prominent topics within media coverage. This was particularly apparent in Australia between January 2004 and July 2008, when various models of either restriction were introduced in four states. METHODS: Australian newspaper and Sydney free-to-air television coverage during the peak period were analysed to identify the framing strategies used by news actors supporting or opposing these policies. RESULTS: Fifteen frames were identified. These predominantly assessed the proposed restrictions in terms of their need, evidence base, practicality and the degree to which they were consonant with 'commonsense' perceptions and had community support. While expert road injury reduction news actors primarily emphasised their moral imperative and likely effectiveness, opponents stressed their impracticality and proposed alternative solutions. CONCLUSIONS: Research evidence is only one component of information presented as policy-relevant in policy discourse conducted in news media. Policy reform advocates using the media to advocate for evidence-based policies in road injury prevention need to appreciate that evidence is not the only currency exchanged in such debates and should study opponents' rhetoric in order to anticipate and counteract the framing strategies being used.