Quality improvement and performance Evaluation system from 2005 onward
A directive on the measurement of institutional performance was put into effect in the second half of the year 2005. This directive enlarged the PBSP system in an attempt to measure quality. Directives on developing institutional quality cover both internationally accepted criteria and domestic needs. By evaluating these criteria, integral performance of health facilities could be measured and numerical comparison and success rates for hospitals would be available. During the period of institutional performance measurement and its auditing, the aim was to elevate the awareness of quality and enlarge the capacity within the health establishments. In 2007, within the integration of overall quality studies of MoH, the Directive for Improving Quality and Performance Assessment Instruction in Institutions and Agencies Affiliated with the Ministry of Health was issued and put in effect. This directive would be the periodic assessment and grading manual’s prototype for the hospitals, which will achieve further autonomy (MoH 2008, 49).
By this directive, “Province Performance and Quality Coordinating Units” at Province Health Directorates, and “Hospital Performance and Quality Offices” at all hospitals have been established. Those coordinating units and offices are responsible for institutional performance measurement. At this implementation, methods of institutional performance measurement are classified into five groups: (i) access to examination rooms, (ii) auditing of hospital infrastructure and some processes, (iii) measurement of patient satisfaction, (iv) assessment of the institutional productivity and measurement of institutional targets, (v) hospital quality criteria (MoH 2008, 51-55).