The interactive effect of applying the management-centered standards of Joint Commission International (JCI) and practicing administrative control in improving the quality of health services: a study on three Yemeni hospitals seeking accreditation

Background: The objective of this study is to explore the interactive effect of Joint Commission International (JCI) standards and administrative control on the quality of health services. Healthcare accreditation standards and management control practices are important factors for improving quality of care. However, little is known about their interactive effects. Several theories provide useful lenses for understanding how accreditation standards and management practices alone and in combination may shape health services quality outcomes. Methods: A cross-sectional study was conducted in three hospitals seeking JCI accreditation in Yemen. One sample (n=243) completed a validated questionnaire measuring the application of JCI standards, administrative control practices, and quality outcomes. Structural equation modeling (SEM) was used to examine the relationships between variables. Results: JCI standard implementation (mean score =6.12) and administrative control (mean score =5.98) were both rated highly by respondents. The quality of services was also very high (mean score =6.17). Regression analyses revealed significant positive effects of JCI standards (β=0.639; P<0.001) and administrative control (β=0.565; P<0.001) on quality. An interaction effect between the factors was detected (β=0.075; P=0.04), suggesting that their combined application strengthens quality outcomes. Hospital characteristics did not moderate these relationships. Conclusions: Adherence to JCI accreditation standards and strong administrative control interact positively to improve healthcare quality. Integrating these management approaches may enhance service delivery. This study contributes novel insights into the multidimensional nature of quality improvement strategies in healthcare organizations.