Customizing the National Accreditation Standards in Iran for SingleSpecialty Hospitals: A Mixed Methods Study

Abstract

Background and Aim: In recent years in Iran, the criterion for hospital accreditation has been the fifth generation of the Comprehensive Guide to National Accreditation Standards, which is applied uniformly across all hospital types, regardless of size. According to the most recent statistics released by the Ministry of Health, 14.2 percent of the 1066 active hospitals in Iran are special hospitals. The aim of this study was to customize and adapt the aforementioned guide to the unique conditions and characteristics of special hospitals. Materials and Methods: This mixed-methods study was conducted in two phases: 1) a qualitative phase comprising 23 semi-structured interviews with key stakeholders, including internal managers and quality improvement managers at target hospitals, national accreditation assessors, and experts from the Center for Monitoring and Accreditation of Medical Affairs of the Ministry of Health, selected through purposive sampling with maximum diversity; and 2) a quantitative phase using a modified Delphi technique (2 rounds) with 28 participating experts. Results: A total of 18 issues from the Comprehensive Accreditation Guide were identified as editable for special hospitals. Among these, seven issues pertained to ophthalmology hospitals, four to burn hospitals, two to pediatric hospitals, and five applied to all types of special hospitals. Conclusion: Given the unique conditions and characteristics of special hospitals, including the presence of specialist physicians and the use of advanced medical equipment, the fifth edition of the Comprehensive Guide to National Accreditation Standards can be revised to better align with these hospitals. The executive and policy consequence of this action will be to facilitate the accreditation process and reduce accreditation costs for single-specialty hospitals © 2026, Kurdistan University of Medical Sciences. All rights reserved.