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Table 5 Descriptive statistics on the investigated challenges

From: Challenges of implementation of hospital accreditation in Iran: an exploratory factor analysis

Code

Variables

Mean

Standard deviation

1

The tastes of the evaluators and the unanimity of their opinions

3.56

0.944

2

The presence of insight and inspect mentality among evaluators and lack of counseling mentality

3.34

0.970

3

The existence of biases in accreditation assessments

2.95

0.981

4

Lack of adequate knowledge and assessment skills in some evaluators

3.18

0.986

5

The interest of the evaluator and its effect on the results (no outsourcing)

2.74

1.057

6

An inappropriate approach to assessors’ approach

2.32

0.972

7

Compact assessment period and insufficient number of days (evaluation within 1–2 days)

2.92

1.188

8

The reality of hospital evaluation scores in some cases

3.45

1.120

9

Too much emphasis on documenting and the possibility of obtaining a great deal only through the provision of documentation

4.35

0.878

10

A large number of measures and confusion of the staff

4.37

0.771

11

There is ambiguity in some measurements

3.99

0.962

12

Failure to pay attention to results and attention is paid to structures

3.65

0.956

13

Inappropriate scoring scale (e.g., 0–1–2) and lack of medium score

3.63

0.921

14

Imbalance and proportionality in measures

3.72

0..973

15

Disregarding communication between departments and interactions between units

3.22

0.983

16

Patient’s dissatisfaction with disregard for them because of the high amount of time required to be documented by nurses and physicians

4.22

0.959

17

Neglecting the spiritual needs of patients and need to treat them with dignity and respect

3.49

1.084

18

The lack of actual completion of forms and documentation by nurses and doctors due to their large volume

3.82

1.060

19

Reduce the duration of direct clinical care by nurses

3.98

0.995

20

Endangering occupational safety in the event of a low privilege in accreditation

3.14

1.185

21

Creating stress and anger in the staff from the pre-evaluation to the announcement of the results

4.30

0.828

22

Creating mental and physical fatigue in the staff

4.30

0.862

23

Lack of time to implement standards

4.39

0.801

24

The existence of idealistic and disproportionate standards with the current conditions of hospitals

4.23

0.880

25

Creating incentives to purchase unnecessary equipment through higher scores

3.41

1.131

26

Establishing a tunnel in the hospital and paying attention only to issues that affect the credibility of a higher score

3.74

1.010

27

Concealment and unrealistic display of hospital facilities

3.51

.1220

28

Forced to deceive the assessors

2.40

1.236

29

Mandatory implementation of hospital accreditation standards

3.92

1.039

30

The temptation and time compression in implementation and implementation of the program

3.99

0.946

31

The lack of staffing of the process and the reasons for the program

3.55

0.971

32

The lack of cultural infrastructures necessary for the implementation of accreditation (organizational culture, staff attitudes)

3.96

1.056

33

Shortage of human resources and increased staff turnover

4.15

1.111

34

Lack of financial resources for implementation of accreditation

3.81

1.188

35

Lack of back up resources such as books and sites to learn how to implement accreditation requirements

3.26

1.024

36

Lack of physical resources required for the implementation of standards, including equipment and physical space

3.65

1.098

37

Non-commitment and participation of some senior managers and physicians

3.83

1.077

38

Integration of the quality improvement and evaluation system with the payment system

3.42

1.048

39

Lack of proper feedback from surveys results and lack of financial incentives

3.83

1.031

40

The unequal competition between hospitals with different facilities and resources

3.92

1.104

 

Total

3.64

0.558