An evaluation of the driving and restraining factors affecting the implementation of hospital accreditation standards: A force field analysis

ABSTRACT Background: Integrating accreditation standards in healthcare business operations is context-sensitive and affected by diverse factors. This study explored the driving and restraining factors influencing the implementation of accreditation standards in Saudi Arabian hospitals. Methods: A qualitative design using semi-structured in-depth interviews was employed. Twenty-seven hospital directors and 29 hospital quality directors were interviewed. Interviews were recorded, transcribed verbatim, and thematically analyzed. A force-field analysis framework was adopted to present a visual picture of the various factors influencing the implementation of hospital accreditation standards. Results: The analysis yielded 42 driving and restraining factors affecting the implementation of accreditation standards. The main drivers identified were teamwork, the quality mindset of leaders and staff, employing a continuous readiness model, and commitment toward customers. By contrast, insufficient manpower, infrastructural gaps, workforce recruitment challenges, variability among surveyors, the COVID-19 pandemic, limited financial support, and bureaucratic decision-making procedures were the main reported restrainers. At the national level, perceived restrainers pose a serious challenge to compliance with the existing accreditation model. Conclusion: Exploring the factors affecting accreditation standards implementation assists in assessing accreditation readiness, helps to prioritize efforts to strengthen drivers and weaken restrainers, and contributes to the institutionalization of accreditation standards.