Background and Aim: In Iran, in recent years, the criterion for hospital accreditation has been the fifth generation of the Comprehensive Guide to National Accreditation Standards, which is used equally for all types of hospitals regardless of size. According to the most recent statistics released by the Ministry of Health, of the 1,066 active hospitals in Iran, 14.2 percent are special hospitals. The aim of this research was to customize and adapt the aforementioned guide to the unique conditions and characteristics of special hospitals.

Materials and Methods: This mixed-method study was conducted in two phases: 1) a qualitative phase with 23 semi-structured interviews with key stakeholders including internal managers and quality improvement managers of target hospitals, national accreditation assessors, and experts from the Center for Monitoring and Accreditation of Medical Affairs of the Ministry of Health, who were selected using a purposive sampling method with maximum diversity, and 2) a quantitative phase with a modified Delphi technique (2 rounds) with the participation of 28 experts.

Results: A total of 18 issues from the Comprehensive Accreditation Guide were identified as editable for special hospitals. Among these, seven issues pertained to ophthalmology hospitals, four issues were associated with burn hospitals, two issues related to pediatric hospitals, and five metrics applied to all types of special hospitals.

Conclusion: Given the unique conditions and characteristics of special hospitals, including the presence of specialist physicians and the use of advanced medical equipment, the fifth edition of the Comprehensive Guide to National Accreditation Standards can be rewritten to adapt to these hospitals. The executive and policy consequence of this action will be to facilitate the accreditation process and reduce accreditation costs for single-specialty hospitals.