Customization of the Comprehensive Guide to National Accreditation Standards for Iranian Hospitals for Small Hospitals: A Mixed Methods Study

Abstract

Background: In Iran, in recent years, the criterion for hospital accreditation has been the fifth generation of the Comprehensive Guide to National Accreditation Standards, which is used equally for all types of hospitals regardless of size. This study aimed to adapt the aforementioned guide to the functional structure of small hospitals. Methods: This research was a mixed study of sequential exploratory type which conducted in two phases. The first phase (qualitative phase) was a semi-structured in-depth interview with 22 participants, including internal managers and quality improvement managers of the target hospitals, national accreditation assessors, and experts from the Center for Monitoring and Accreditation of Medical Affairs of the Ministry of Health, who were selected using a purposive sampling method with maximum diversity. In the second phase (quantitative phase), a modified Delphi technique was used to validate the findings. Findings: The Comprehensive Guide to National Accreditation of Iranian Hospitals (5th Edition) has 505 issues, of which, according to the findings of this study, 82 (equivalent to 16.2) can be deleted or edited for small hospitals. Of these, 71 issues can be deleted and 11 issues can be edited. The main reasons for deleting or editing issues were the physical and structural limitations of these hospitals, the lack of medical staff, especially specialist doctors, and the lack of medical equipment. Conclusion: Taking into account the specific characteristics of small hospitals, the fifth generation of the Comprehensive Accreditation Standards Guide can be rewritten. This can simplify the accreditation process and reduce additional costs. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.