Barriers in Implementing the Accreditation Standards for a Safe Environment in Public Hospitals of Rwanda: A Qualitative Study.

Background: The adherence to hospital accreditation standards in health facilities, which are designed to ensure the delivery of safe and high-quality healthcare services, remains a challenge. Therefore, this study sought to examine the key barriers affecting the implementation of hospital accreditation standards among health professionals in Rwanda. Methods: This was a cross-sectional study in which 40 semi-structured key informant interviews were conducted from January to March 2024, in selected public hospitals. Participants aged 27-48 years were purposively recruited based on their roles and experience in hospital operations. The interviews explored the barriers affecting the effective implementation of Risk Area 3, which addresses ensuring a safe environment for staff and patients. A qualitative phenomenological approach was used to capture participants lived experiences and perceptions of the implementation process. Results: The present study identified the barriers that deterred the implementation of IPC measures such as overwhelming workload, financial constraint, absence of training, turnover of staff, paucity of appropriate infrastructure, lack of enough coordination of IPC measure, lack of enough supervision by EHO, insufficient space for hazardous materials and other related materials. Conclusion: Limited resources are the key contributor to non-compliance with IPC measures. Greater investment in both physical and human resources, along with continuous professional training, is essential to enhance the implementation and compliance with hospital accreditation standards. Policymakers should actively engage multinational organisations and international development partners to provide technical assistance and support capacity-building initiatives that strengthen local efforts toward effective and sustainable accreditation implementation.