Purpose The purpose of this paper is to clarify the effects of the Iranian Hospital Accreditation Program (IHAP) on hospital processes from the viewpoint of the staff charged with establishing the program. Design/methodology/approach This qualitative study is based on the data collected in semi-structured interviews conducted in 2016, which involved eight questions. Interviews were held with 70 staff members at 14 hospitals. Managerial staff were purposively interviewed based on their familiarity and involvement with the program. The hospitals were divided into five groups, comprising public, private, charity, military and social service hospitals. A thematic analysis was carried out using the collected data. Findings Three themes emerged from the data, which together comprise a process management cycle: the establishment, implementation, and control phases of the program. For each phase, various positive trends, as well as hurdles for establishing the program, declared which were framed two sub-themes as positive effects and challenges. Originality/value The findings contribute to the body of evidence used by policy-makers and hospital managers to improve the change management processes related to the Iranian IHAP. Although positive changes in the process management cycles at Iranian hospitals were noted, successful implementation of the program demands a thorough assessment of the hospitals’ technical and financial needs (taking into account disparities between hospitals), and there is an urgent requirement for a plan to meet these needs.

Background: Health tourism industry is a new growing market that developing countries have a large effect on it and noticing this subject has been emphasized by the vision of twenty years strategic plan in Iran. On the other hand, increase of the neighbor countries' attention on this profitable market marker to a basic removal need of present challenges in Kish Free Zone. Objectives: Aim of this paper is to probe about the challenges of Kish health tourism identified in this case study at 2012 by qualitative method. Methods: Effective variables on health tourism were extracted from relative literature and then, variables in 34 groups were combined as a questionnaire with considering the proximity of concept and content. 14 persons were chosen as expert among the present and previous managers of tourism, healthcare system and health tourism areas by Modulation from simple and snowball sampling. Experts in addition to recognized challenges, expressed how significant is each one of health tourism developing factors and gave their expletive ideas about each challenges by Semi-structured interviews which were analyzed by Content Analysis Method. Results: The 13 main challenges of Kish health tourism extracted from interviews were related to policy making and planning, substructure and administrative problems, and macro affaires of country. Conclusions: Kish Free Zone Organization as governance representative in Kish should eliminate the existing challenges of health tourism industry in order to develop Kish health tourism.

Patient safety culture (PSC) has been considered less than its significance within high risk health care facilities so far. The aim of this study was to firstly compare PSC among psychiatric, general, and critical/intensive care systems then, focus on common weaknesses between Middle East countries. The study design was cross-sectional which was executed by using of a two stage sampling frame. Researchers had 298 questionnaire completed (RR=62%) among three groups comprising nurses, nurse's aides, and laboratory personnel. The Farsi version of Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was employed in this study. Descriptive statistics, and One Way ANOVA were used aiming to analyze collected data by using of SPSS 20. The highest percent of composite mean scores in Specialized, Psychiatric, and Generals were 61.49%, 56.67%, and 55.69% respectively. Common weakest dimensions of PSC among the three groups of hospitals included: Non-punitive response to error (24.3%), Staffing (32.18%), and Communication openness (42.44%). There were no significant differences among means and variences of the three groups of hospitals. It can be concluded that health care systems may have no differences in PSC correspond to disparities in amount of risk and job pressure. An implication of this study is the possibility that PSC is mostly local, although some weaknesses between our study and Middle East seemed to be symmetrical.