4629150-489839008 Care Accreditation Council (HCAC) and Joint



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Patient’s satisfaction: the difference between double accredited and not accredited private hospitals in Jordan
Prepared By:
Abdullah Mohd Salem Musa
Supervised By:
Abdel-Aziz Ahmad sharabatiThesis Research Proposal Submitted in fulfillment of the Requirements for Ph.D. Business
Business Management Faculty
Bedfordshire University
Amman – Jordan
November 14, 2018
introduction: Research Overview
Private hospitals compose 56.9% of overall hospitals, with general number of 4992 health facility bed in (Jordan department of Statistics 2017). There are two Major accreditation structures followed in Jordan, national Health Care Accreditation Council (HCAC) and Joint Commission International (JCI). Some of the hospitals are accredited with the aid of one of the accreditation structures, others are approved by the tow accreditation systems, and some aren’t accrediting in any respect. Recent study at suggests that higher healthcare outcomes are not associated to the kind of accreditation (Lam et al 2018).
There are two fundamental classes of the standards within the accreditation method: the first is patient associated general and the second one is health care management and leadership governance and managerial related standards (JCI standards 2017, HCAC standards 2013).

Each hospital measures the satisfaction of their patients through unique and customized equipment according to the hospital’s needs. The most vital signs that are thought to affect without doubt the excellent care in the hospital are to satisfy the patient. Thus, the satisfaction of the patient takes on a role as a marker of traditional outcomes indicators like mortality, morbidity or functional status. Patient satisfaction is needed, and hospitals look to patients’ satisfaction as an issue that plays a crucial role in the competitive health care market.
2. STUDY Purpose and Objectives: Theoretical and practical
Hospitals accreditation is broadly popular as measures to enhance high-quality of ordinary hospital services. In addition to lots of high-quality indicators are measured at hospitals like: hospital acquired infections or morbidity and mortality. Therefore, patient satisfaction is considering as an essential measure for quality of care.

Probably lots of people are shaking, when they know about the studies which show no significant impact for the hospital accreditation in patient satisfaction.

there is a totally large competition among non-public hospitals in Jordan, Jordan has 60 private hospitals, five of them accredited with the aid of HCAC (HCAC internet site) and four of them accredit with the aid of JCI (JCI website).

This study aimed to shows the relationship among accreditation and patient satisfaction private hospitals. This study will contain data from 6 private hospitals in Amman/Jordan, three of them are double accredited by means of national accreditation (Health Care Accreditation Council (HCAC)) and global accreditation (Joint commission International (JCI)). The other three hospitals are not accredited at all. However, the 6 hospitals are considered from the best private top hospitals in Jordan.

High level of patient’s satisfaction is considered as the main key of success (Klotz, 1996). Until now there are not studies about the impact of accreditation in patient’s satisfaction in private hospitals (where the patient has to choose the hospital for treatment).

3.Contribution on Work
After getting the last result of this study, if the outcomes confirmed that there’s no positive influence for the accreditation in patient satisfaction, then the recommendation should be for the accreditation bodies, to change in the standards and surveys method.

However, if the final results showed superb impact on patient satisfaction, then the recommendation might be for the private hospitals to go through the journey of accreditation. Considering that a lot of non-public hospitals do not agree with in accreditation.

4. Study Significance and Importance (contribution): Theoretical and practical
Accrediting bodies are requiring patient satisfaction surveys as part of their accreditation technique. But nonetheless there may be no significant effect on the accreditation decisions (Auras and Geraedts, 2010). There may be no doubt that accreditation have an impact on fine of an organization’s revel in accreditation (DESVEAUX, 2017). Additionally, hospital accreditation had a big impact on hospitals’ contamination control performance (Sekimoto et al, 2018).
In one of the large sample study have showed that the literatures reviewed among 1999 and 2012 resulted regular evidence of a positive or negative perspectives and the connection continue to be unclear (Almasabi, Yang and Thomas 2014).
This study will display the relationship between the accreditation and patient’s satisfaction with the following importance.

1) Consist of three accredited and three not accredited for non-public hospitals with almost similar characteristics. The 6 selected hospitals are general hospitals, established more than 10 years, bed capacity above a hundred bed
2) This study will measure the satisfaction of self-payment for patient and will not contain insured patients. the insurance companies ask the hospitals to provide them a medical report and other examinations before giving acclaim for maximum of the medical procedures, the hospitals haven’t any control to overcome this problems, and the patients typically can’t differentiate the cause of delay, this could effect on patient satisfaction. Additionally, some hospitals have liaison personnel for common insurance company and a few have not, to make this study valid the insured patients excluded from the the study.

3) The chosen accredited hospitals are accredited through both the HCAC and JCI; every hospital is accredited and reaccredited for at the least two times by JCI and HCAC.

4) Non-public hospitals voluntarily take part in accreditation. Governmental and army hospitals commonly ordered to take part in accreditation, which may additionally mask the satisfactory of care provided, inside the result no tangible difference between accredited and none accredited.

5) The patient ought to pick the hospital for the treatment, the patient pays for the service. Usually patients have restrained choices when they go for treatment in public hospitals. However, if they want to be treated in a private hospital they can pick out among lengthy listing. Also, patients can choose their health care providers.

5. Problem Statement (Proposition) Including Research Questions
The study aims to detect if there is an association between hospital accreditation and patient satisfaction in private hospitals: A survey of 3 double accredited hospital and 3 non accredited hospitals.

6. Research question:
In private hospital: is there a significant impact for hospital accreditation on patient’s satisfaction?
Private hospitals in Jordan play an important position in medical tourism. In 2014 Jordan represented via the private hospital association won the fine medical Tourism Destination Award, which is provided through the international medical Tourism journal (non-public health facility association, 2014). Private hospitals are a profit enterprise, works to increase go back on investment via increasing the range of inside and outside patients. Patients’ satisfaction is a key to advantage patient’s loyalty in healthcare surroundings enterprise (Mbuthia, M.G. and Thaddaeus, E. 2015).

Literature assessment could be divided into two principal categories one for the research confirmed positive impact for the accreditation on patient satisfaction and the opposite category will display the bad or no impact:

Positive Impact:
Primary research was carried out in Jordan, the first look at the assertion that hospital dependence significantly improves patient satisfaction, this look at became done in different type of health care sectors in Jordan including governmental, military, non-public, and university area (Balqees and Tareq 2015).(Balqis and Tariq 2015). The second method confirmed that patients in public hospitals indicated a useful advantage despite its small impact on Naser 2016. Each research did not determine the impact on private hospitals.

Another have a look at done in Egypt discover a considerably better patient satisfaction some of the accepted non-governmental health units, this examine have been finished in nongovernmental corporation, and inside twelve months aside from accreditation decision (AL TEHEWY et al 2009).

One of the particular studies become executed in India for evaluating patients’ satisfaction earlier than and after accreditation, in a private tertiary hospital, located a tremendous improvement of patients’ satisfaction submit accreditation, the researcher studied the effect of accreditation in lots of regions inclusive such as Out-Patient Department Services (Shaikh 2017a), In-Patient Department Services (Shaikh 2017b), Dietary Services (Shaikh 2017c), Emergency Department Services (Shaikh 2017d), Laboratory Department Services (Shaikh 2017e), Physiotherapy Department Services (Shaikh 2017f) and Pharmacy Department Service (Shaikh 2017g). All of the studies showed significant improvement in patients’ satisfaction post accreditation compared with the pre accreditation, the date was collected (2 months before and 2 months after) the accreditation date.

Another one of the observations showed that dependence could boost inpatients by monitoring 1582 resident patients during the period 2009 to 2012, and the confirmed results of inpatient satisfaction were better but no longer significant in winter rather than in the summer season).

Obstetrics and gynecological sufferers on the authorized health facility were happier with the satisfactory of fitness care furnished for them than sufferers on the non-authorized medical institution (Mona et al 2012).

Negative or no impact:
A scientific review of the research, from 13 international sites on the scene, carried out from 1999 to 2012, in 20 covered papers, the researchers concluded that the effect is uncertain and there is no evidence of good or bad effect. The adoption of health care affects patient satisfaction and Thomas 2014).

Hospital accreditation may represent a step towards great control, but does no longer appear to improve universal patient satisfaction”, this observe were accomplished for discharged cardiology patients from 75 hospitals in rural areas (SACK et al 2010). every other take a look at of 36777 patients treated as inpatients at 73 exceptional hospitals, the examine do now not discover any significant affiliation among accreditation reputation of the sanatorium and patient satisfaction, this examine also carried out for one of a kind styles of hospitals which include public hospitals (SACK et al 2011).

Additionally, there’s no distinction of patients’ satisfaction almost about services provided by using permitted and non-approved governmental hospitals (Hayati 2010). Further no affiliation between hospital accreditation and affected person delight except for emotional aid, this observe have been performed for public and private hospitals and did no longer display specification or differentiation for any of them (Mohebbifar et al 2017).

In Lebanon, we found that the tangible aspect was patient satisfaction, but there was no statistically significant relationship between dependence and patient satisfaction (Wissam et al., 2014).

In a unique way to evaluate the effect of patient satisfaction reliance on forty-one permitted hospitals, a study conducted in America to meet the requirements of a PhD degree identified the relationship between accreditation scores and patient satisfaction ratings. The results showed no association, with the exclusion of any profit organization (Heuer 2002).

In a look at of 4400 hospitals inside the United States of America, of which 3337 had been accredited (2847 by The Joint fee) and 1063 underwent state based review among 2014 and 2017, among approved hospitals among authorized hospitals, The Joint commission did not have drastically different patient revel in scores compared to other impartial companies (Miranda et al 2018).

Summary of literature review:
The consequences of the research as mentioned within the literature reviewed showed that there aren’t any clear positive or bad relation between accreditation software and patients’ satisfaction. The research also mixed the different forms of hospitals and did not consider the effect of accreditation on patient satisfaction in public or non-public hospitals.

7.Limitations and Delimitation:
A wide range of private hospitals accredited in Jordan through HCAC and JCI concurrently is at the same time confined, only 3 available, to overcome this problem, larger sample can be used and longer duration of information collection.

Auras, S., and Geraedts, M. (2010). ‘Patient experience data in practice accreditation – An international comparison’, International Journal for Quality in Health Care, Vol.22, No.2, pp. 132–139
Balqees, S., and Tareq, N. (2015) ‘PATIENT SATISFACTION EVALUATION ON HOSPITALS; COMPARISON STUDY BETWEEN ACCREDITED AND NON ACCREDITED HOSPITALS IN JORDAN’, European Scientific Journal November 2015 edition Vol.11, No.32, pp. 298-314.

C. SACK et al (2011), ‘Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37 000 patients treated by 73 hospitals’, International Journal for Quality in Health Care, Vol. 23, No. 3: pp. 278–283
Cornelia et al (2010) ‘Challenging the holy grail of hospital accreditation: A cross sectional study of inpatient satisfaction in the field of cardiology’, BioMed Central Ltd. License.

Department of Statistics (2017), Statistical Yearbook of Jordan: Department of Statistics.

DESVEAUX, L. et al (2017), ‘Understanding the impact of accreditation on quality in healthcare: A grounded theory Approach’, International Journal for Quality in Health Care, Vol.29, No.7, pp. 941–947
HCAC accredited Hospitals November, 11, 2018, http://hcac.jo/Accreditation/Accredited-OrganizationsHealth Care Accreditation Council Standards for Hospitals, 2nd edition: (2013)
Heuer, A.J (2002), ‘Testing the Relationship between Measures of Patient Satisfaction and Hospital Accreditation Ratings’, Seton Hall University Dissertations and Theses (ETDs). 1493 http://scholarship.shu.edu/dissertations/1493.

JCI accredited Hospitals November, 11, 2018, https://www.jointcommissioninternational.org/about-jci/jci-accredited-organizations/?c=JordanJoint Commission International Accreditation Standards for Hospitals, 6th Edition: (2017)
Klotz, T (1996), ‘The determination of patient satisfaction as a part of quality management in the hospital’, Dtsch Med Wochenschr, 121(28-29):889-95.

MAHI. A. et al (2009), ‘Evaluation of accreditation program in non-governmental organizations’ health units in Egypt: short-term outcomes’ International Journal for Quality in Health Care; Vol. 21, No. 3, pp. 183–189
Mbuthia, M. and Thaddaeus, E. (2015) Validating Customer Loyalty Model Using Structural Equation Modelling in a Kenyan Hospital. Open Access Library Journal, 2: e1213. http://dx.doi.org/10.4236/oalib.1101213Miho. S. et al (2008), ‘Impact of hospital accreditation on infection control programs in teaching hospitals in Japan’, Vol. 36, Issue 3, pp. 212–219
Miranda. L. et al (2018), ‘Association between patient outcomes and accreditation in US hospitals: observational study’ BMJ;363:k4011
Mohammad. G. et al (2014), ‘Inpatient Satisfaction in a Subspecialty Hospital With a View to Accreditation from 2009 until 2012’, Journal of Health Policy and Sustainable Health, Vol. 1, No. 1, pp. 3-5
Mohammed. A et al (2014) ‘A Systematic Review of the Association between Healthcare Accreditation and Patient Satisfaction’, World Applied Sciences Journal, 31 (9): pp 1618-1623.

Mohebbifar. R. et al (2017), ‘Association between Hospital Accreditation and Patient Satisfaction: A Survey in the Western Province of Iran’, Bangladesh Journal of Medical Science Vol. 16 No. 01, pp. 77-84
Mona. A et al (2012), ‘The impact of the status of hospital accreditation on patient satisfaction with the Obstetrics and Gynecology Clinics in the Eastern Province, Saudi Arabia’Journal of Medicine and Medical Sciences Vol. 3(10) pp. 665-673.

Naser Ibrahim Saif, (2016) ‘Quality of Health Services and Patients’ Satisfaction in Accredited and Non-Accredited Hospitals’, International Journal of Business and Management; Vol. 11, No. 10; pp. 298-305.

Private Hospital Association (2014). Available at: https://phajordan.org/View_Article.aspx?type=2;ID=3856 (Accessed: 11 November 2018).
SACK, C. et al (2011), ‘Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37 000 patients treated by 73 hospitals’, International Journal for Quality in Health Care; Vol. 23, No.3: pp. 278–283
Shaikh, Z.M. (2017a), ‘The Impact of Hospital Accreditation on the Patient Satisfaction of Out-Patient Department Services’, IJBMAS, Vol.4, Issue 3, pp 4384-4398
Shaikh, Z.M. (2017b), ‘The Impact of Hospital Accreditation on the Patient Satisfaction of In-Patient Department Services’, International Journal of Emerging Research in Management ;Technology, Vol. 6, Issue 8, pp 368-383
Shaikh, Z.M. (2017c), ‘The Impact of Hospital Accreditation on the Patients Satisfaction of Dietary Services’, IJBMAS, Vol. 4, Issue 4, pp 2349-4638
Shaikh, Z.M. (2017d), ‘The Impact of Hospital Accreditation on the Patients Satisfaction of Emergency Department Services’, IJBMAS, Vol.4, Issue 3, pp 4330-4339
Shaikh, Z.M. (2017e), ‘The Impact of Hospital Accreditation on the Patients Satisfaction of Laboratory Department Services’, IJBMAS, Vol. 4, Issue 2, pp 4257-4289
Shaikh, Z.M. (2017f), ‘The Impact of Hospital Accreditation on the Patients Satisfaction of Physiotherapy Department Services’, IJBMAS, Vol. 4, Issue 4, pp 143-154
Shaikh, Z.M. (2017g), ‘The Impact of Hospital Accreditation on the Patients Satisfaction of Pharmacy Department Services’, IJBMAS, Vol. 4, Issue 4, pp 189-199


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