Development of a Model for Promoting Continuous Maintenance of Hospital and Healthcare Standards in Community Hospitals, Lampang Province

Abstract

Background: Continuous maintenance of Hospital Accreditation (HA) standards after certification remains a major challenge for community hospitals because of constraints in personnel, resources, workload, and quality-system continuity. This mixed-methods action research aimed to develop a model for promoting continuous HA standard maintenance in community hospitals in Lampang Province and to evaluate changes in personnel knowledge, attitudes, and practices after implementation. The study scope covered 12 HA-accredited community hospitals in Lampang Province from November 2025 to April 2026, focusing on a support mechanism for HA maintenance and personnel outcomes.

Methods: Qualitative data were collected through focus group discussions with 36 purposively selected key informants, including hospital directors, quality-leadership team members, and quality-development officers. Quantitative evaluation was conducted among 95 personnel involved in quality development, selected from a population of 120 by stratified random sampling according to hospital size and level. A one-group pre-test/post-test design was used. Research instruments included a focus group guide, lessons-learned record form, and questionnaires on general information, HA knowledge, attitudes, practices, and open-ended suggestions. Qualitative data were analyzed by content analysis. Quantitative data were analyzed using descriptive statistics and the paired t-test, with statistical significance set at .05.

Results: The developed model comprised six components: a provincial mentoring system, an inter-hospital learning network, HA/CQI capacity building, an easy-to-use low-burden monitoring system, integration of HA into routine work, and support from executives and quality-leadership teams. After implementation, mean knowledge scores increased from 17.10 to 18.67, and mean practice scores increased from 4.14 to 4.33 (p < .001). Mean attitude scores increased slightly from 4.46 to 4.49, but the difference was not statistically significant (p = .414). The findings suggest that the developed model was associated with improved HA knowledge and practice among personnel.