Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

摘要

Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays uda crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. udHowever, very little is known on the application of quality assurance (QA) policies in DCSS units. This study udexplores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its udassociation with hospital characteristics.udMethods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 udDCSS units among 84 hospitals. udResults:The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS udunits. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability ud(92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external udauditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood udbank services (83%) reported highest average application rates across all questioned QA strategies. Lowest udapplication rates were reported in human tissue banks (50%). There was no significant difference between udthe reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research udhospitals with the exception of pharmacies and radiology departments. They reported availability of a written udQA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied udsignificantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals udthan in governmental hospitals. udConclusion:There is still room for strengthening the managerial cycle of QA systems and accountability udin the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA udstrategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, udand the application of these strategies in outpatient DCSS units require further policy attention.