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The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran.

A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010.

The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government’s strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity.

The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries.

This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Hospitals need highly trained and competent managers to be responsible for the strategic development, overall operation and service provision. The identification and confirmation of core management competency requirements is a fundamental first step towards developing the competent management workforce for sustainable hospital service provision. This paper reports on the finding of a recent study focusing on identifying managerial competencies required by middle and senior-level managers in the public hospitals in Iran.

The qualitative research design included position description analysis and focus group discussions with middle and senior-level public hospital managers in Iran. When analysing the identified knowledge, skills and attitudes, the validated MCAP framework was used to guide the grouping of them into associating management competencies.

The study identified 11 to 13 key tasks required by middle and senior-level managers and confirmed that the position descriptions used by current Iranian hospitals might not truly reflect the actual core responsibilities of the management positions. The study also confirmed seven core managerial competencies required to perform these tasks effectively. These core competencies included evidence-informed decision-making; operations, administration and resource management; knowledge of healthcare environment and the organisation; interpersonal, communication qualities and relationship management; leading people and organisation; enabling and managing change and professionalism.

Competencies were identified based on managers' perceptions. Views and experiences of other stakeholders were not captured.

The seven core management competency identified in the current study provides a clear direction of competency development among senior and middle-level managers working at the Iranian public hospitals. The study also confirms that position descriptions do not reflect the actual responsibilities of current hospital managers, which are in need to urgent review.

This is the first study that has identified the core managerial competencies required by middle and senior-level hospital managers in Iran.

Accreditation helps to ensure safe and high-quality services in hospitals. Different occupational groups have various hospital accreditation experiences. The purpose of this paper is to investigate nurses’ accreditation experience and its effects on Iranian teaching hospital service quality.

This was a qualitative study involving a phenomenological approach to studying nurses’ hospital accreditation experience and understanding the effects on Iranian teaching hospital service quality. Data were collected using two focus groups in which nurses were selected using purposive sampling. Transcripts were analyzed using content analysis.

Nurses’ experiences showed that hospital administrators and nurses had greater role in implementing accreditation than other occupational groups. Accreditation improved patient-centeredness, patient safety, logistics and managerial processes and decision making. However, a weak incentive system, extra documentation and work stress were negative experiences.

Nurse experience, as the most important care team member, reveals accreditation’s strengths and weaknesses and its effects on service quality.

The author used a phenomenology approach to measure accreditation effects on service quality – a valuable tool for understanding a phenomenon among those that experience hospital accreditation processes.

The purpose of this paper is to study the effect of emotional quotient (EQ) on the organizational citizenship behavior (OCB) of some Iranian hospital staff in 2015. For this purpose, all hospital staff in Zahedan city were studied as the statistical population.

A randomized sampling method was used, and according to the Morgan Table, the statistical population was calculated as 346. This was a descriptive survey with a correlational and causative nature. Two questionnaires, namely, Bradbury and Graves’ Emotional Quotient and Podsakoff’s Organizational Citizenship Behavior, were used to collect the required information; they were distributed among the respondents after testing their validity and reliability. The people in the studied population were classified into classes that were homogeneous in terms of their properties.

The results of testing the hypotheses indicate that all the dimensions of EQ have a direct and significant effect on the emergence of OCB among the hospital staff in Zahedan. Finally, the results indicate the effect of EQ on OCB of the hospital staff.

Hospitals should consider emotional capabilities of the staff at the beginning of the employment period, and increase their sociability by inducting an atmosphere of organizational culture based on cooperation and empathy. It is suggested that a guideline of emotional eligibility and OCB be codified, which can influence job promotion and the promotion system. On specific occasions, hospital managers can honor the staff who have made positive and effective relationships in their career, and have achieved the satisfaction of their patients and colleagues by demonstrating extra-role behaviors. Thus, employees will be encouraged to continue this behavior and also provide a model to the staff. Through pre-service or in-service training classes and job seminars on the control of negative emotions and stresses while acquiring the skills of EQ, hospitals and other organizations can create OCB in the staff. As a result, visitor satisfaction would be gained, leading to better performance of hospitals.

It is suggested that a guideline of emotional eligibility and organizational citizenship behavior has to be codified which can affect the job promotion and promotion system. In specific occasions, the hospital managers can honor and pay tribute to the people who have made positive and effective relationships in their career, and have achieved the satisfaction of their patients and colleagues by showing extra-role behaviors.

The purpose of this paper is to determine accreditation effects on Iranian military hospital health service quality through nurses’ viewpoints.

The paper is a cross-sectional questionnaire-based study. Sampling drew from a hospital nurse census (n=160). Descriptive statistics were used to analyze participant demographics and nurses’ views. Linear regression analysis determined the independent variables’ overall effect on the accreditation quality results dimension (dependent variable).

From the nurses’ viewpoints, accreditation effects on services quality mean score was 3.60±0.61. Linear regression analysis showed that leadership and quality management were identified as the most important accreditation quality predictors. The R² value (0.698) showed that nearly 70 percent of the dependent variable changes were affected by the independent variables.

This study gives hospital managers a deeper insight into accreditation and its effects on military hospital service quality. Military hospitals benefit from military organization such as hierarchy and command chain, so managers should employ these characteristics to adopt appropriate policies to promote human resource management as a competitive advantage. Furthermore, results will guide public and private hospital managers on how to manage organizational variables that benefit from accreditation.

Accreditation was introduced as a hospital quality improvement program. However, implementing accreditation programs should be cost-effective. Hospital managers and employees should feel that accreditation can improve service quality. Nurses had positive viewpoints about accreditation and its effects on military hospital service quality.

Hospital evaluations create competition between healthcare providers. In this study, a multi criteria decision-making (MCDM) method is used to evaluate criteria that affect hospital service quality. The paper aims to discuss these issues.

Criteria affecting hospital service quality are identified. Four Iranian public hospitals are evaluated using these criteria. Four hybrid methods, including modified digital logic–technique for order of preference by similarity to an ideal solution, analytical hierarchy process–technique for order of preference by similarity to an ideal solution, analytical hierarchy process–elimination and choice expressing reality and modified digital logic–elimination and choice expressing reality are used to evaluate hospital service quality. Results are aggregated using the Copeland method and final ranks are determined.

The four main criteria for evaluating hospital service quality are: environment; responsiveness; equipment and facilities; and professional capability. Results suggest that professional capability is the most important criterion. The Copeland method, used to integrate four MCDM hybrid methods, provides the final hospital ranks.

The criteria the authors identified and their weight help hospital managers to achieve comprehensive organizational growth and more efficient resource usage. Moreover, the decision matrix helps managers to identify their strengths and weaknesses.

New and comprehensive criteria are proposed for hospital quality assessments. Moreover, a new hybrid MCDM approach is used to achieve final hospital rankings.

The purpose of this paper is to clarify how enablers of quality management can secure the satisfaction and loyalty of patients through increasing service quality in hospitals.

The current study conducted a review of the existing literature to identify operational dimensions of the research variables. As a result of the review, 17 dimensions were identified; five European foundation for quality management enablers, five SERVQUAL service quality dimensions, four patients’ satisfaction elements and three patients’ loyalty components. To evaluate interrelationships among these 17 research dimensions, decision-making trial and evaluation laboratory technique was applied using experts’ opinions.

Several key relations were found among research dimensions. Research findings could provide a scientific insight for hospital managers to understand how they could increase the level of patients’ satisfaction and loyalty through high-quality services provided by quality management enablers.

This study has been conducted based on the expert’s opinions from private hospitals located in Tehran and Alborz provinces, Iran. Although the results could be useful for hospital managers in different places and could provide them a valuable insight and knowledge, findings are limited to Iranian private hospitals.

It is taken for granted that patients’ satisfaction and loyalty could increase as a result of high-quality medical and treatment services in hospitals. On the other hand, offering excellent services meeting all the needs and expectations of customers could be consequence product of quality management enablers. Even though satisfaction and loyalty of customers, i.e. patients, is the primary target of quality management, there is little research in the literature as to how enablers of quality management can secure the satisfaction and loyalty through increasing service quality in hospitals. The gap is more critical because the specialized dimensions of four research variables have not been previously integrated into a coherent framework and interrelationships among them have not been studied and clarified in detail. The current study attempts to bridge this gap.

During hospitalization, children are faced with physical disorders and many psychological challenges. One important factor affecting children is the environmental design of the hospital. The inappropriate design of hospitals may contribute to an increase in fear, anxiety and behavioral disorders. The purpose of this study is to use children’s perspectives to evaluate the importance and impact of effective environmental factors to generate children’s hospital design guidelines.

In this study, children’s desired atmosphere during treatment was examined via 16 drawings and 24 interviews from children at a children’s hospital in Iran.

The encoding of information extracted environmental components such as window view, color, hobby, playing, decorations, family presence, structure of hospital, presence of nurse, furniture, water features, light and green space. The results indicate that children prefer a hospital environment that provides entertainment facilities while also offering design features such as the presence of light, colorful decorations, the existence of green spaces and conditions suitable for their families to be present.

Depending on the location and their living conditions, the children’s prioritization can be different in any society. In addition, the data of this research was descriptive; thus, the conclusions must be considered tentative.

A number of studies focus on the needs of populations in developed countries. This topic has not been investigated in a major way via professionals in non-western countries such as Iran. Thus, the context of this study and present findings can be deemed unique.

This study aims to identify the status of occupational stress among a sample of hospital employees in Iran. It further intended to reveal the harmful effects of occupational stress on employees’ health and well-being.

The study used a cross-sectional research design. A validated questionnaire was used to collect data from hospital employees.

Job-related, working environment, interpersonal and organisational factors were related to occupational stress. One-fourth of employees rated their occupational stress high. The major sources of occupational stress were inadequate pay, inequality at work, too much work, staff shortage, poor recognition and promotion, time pressure, job insecurity and lack of management support. High levels of occupational stress have been linked to an increased risk of physical injuries, cardiovascular disease, high blood pressure, depression and increases in negative personal behaviours such as anger, anxiety and irritability. Occupational stress was positively associated with employees’ turnover intentions.

The findings of this study are not generalisable to the wider population of hospital employees in Iran due to the small sample size. Thus, future research should involve additional samples.

The study has practical relevance for designing and implementing strategies to decrease occupational stress among hospital employees.

This article contributes to health care theory and practise by identifying factors contributing to employees’ occupational stress and examining the association between occupational stress and two important employee outcomes – health status and turnover intention.

Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran.

The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section.

All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy.

In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.