International accreditation of hospitals in Iran: a qualitative study of challenges and strategic solutions

Background International hospital accreditation (IHA) validates compliance with global quality and safety standards, yet hospitals in Iran face major financial, workforce, and regulatory barriers. Given the limited evidence in this area, there is a need to better understand the challenges and potential solutions related to implementing IHA in Iran. Objective This qualitative study aimed to identify key challenges and strategic solutions for implementing IHA in Iran. Methods This exploratory qualitative study was conducted in 2024 using semi-structured, in-depth interviews with 40 key stakeholders involved in hospital accreditation in Iran, including policymakers, hospital managers, accreditation experts, and clinical staff. Participants were selected through purposive and snowball sampling. Data collection continued until data saturation was reached, and interview transcripts were analyzed using inductive conventional qualitative content analysis, with coding and data management facilitated by MAXQDA 2020. Results The analysis identified 38 key challenges to IHA in Iran and classified them into five main categories encompassing governance, resources and capacity, health information infrastructure, organizational culture, and stakeholder engagement. In parallel, 36 participant-derived strategic solutions were organized into five main categories: governance reform, financing and capacity building, organizational empowerment, learning culture and leadership, and partnerships and accountability. Conclusion This study identified systemic and contextual challenges to IHA in Iran, including fragmented governance, resource constraints, weak digital interoperability, and hierarchical organizational cultures. Stakeholders proposed context-sensitive strategies involving governance reform, workforce development, digital transformation, organizational learning, and collaboration. Clinical trial number Not applicable.