Hospital

Effective Reward System on Hospital Staff Performance: Challenges and Solutions (A Qualitative Study in Hospitals Affilliated to Tehran Universitu of Medical Sciences)

farid Abolhasani

Background: Reward system program is an investment tools in order to improve quality of services. Accordingly, this study was conducted aimed to identify the challenges of the reward system and the solutions for improving that based on the views of stakeholders in Tehran University of Medical Sciences hospitals.
Materials and Methods: This directional content analysis qualitative study was performed in Tehran University of Medical Sciences during 2014and 2015 using content analysis method. Targeted sampling was done and in-depth semi structured and face to face interviews were performed with a wide variety of experts and professionals including managers, faculties and hospital staffs. After word by word transcripting and extracting codes (meaningful phrases), these codes was reviewed again in
order to achieve subcategories. Based on subcategories, information was classified to assossiated categories. For validity and reliability checking, stakeholders and faculties member check and peer debriefing were used.Results: Eventually, a total of 29 interviews were held. The comments were classified within 6 main categories, 19 subcategories and 1100 codes. The main categories included existing arrangements in hospitals in order to improve staff motivation; reward system challenges; derived opportunities from rewarding experiences; rewarding systematic actions; types of appropriate rewards and making
infrastructure for better rewarding system implementation.
Conclusion: Regarding multiple aspects of a reward system which could have an effective role in increasing staff motivation or a contradictory effect when it is inefficient, implementation of an effective reward system in hospitals by designing an appropriate model based on identified key factors in this study, is recommended.

Developing a Probabilistic Two-Stage Model for Hierarchical Healthcare Facility Location by Considering the Service Rate (A Case Study of Tehran Heart Center)

Ali Husseinzadeh kashan

Background: medical centers location is one of the most important problems, which should be considered in different dimensions to improve the services. In this paper, we consider the hierarchical maximum covering problem for bi-level healthcare systems including Clinics and hospitals, by taking the service rates into account. In this problem, the initial objective is minimizing the uncovered demand nodes, and secondary objective is the minimizing the lost demand rate as a measure of potentially patients’ retention in coverage radius.

Methods: In this paper, the serving system in the Tehran heart center hospital is considered for queue analyses. The proposed method is a mathematical optimization model called probabilistic two-stage programming model. To evaluate this model, a number of numerical problems are solved through GAMS software.

Results: according to the results, we have found that the best condition for locating the medical centers is that the clinic are located adjacent to a hospital. Decision making about the location problem by considering the service rate in each healthcare centers, increases the reliability to the result of the optimization model.

Conclusion: The proposed model is able to help the decision makers to attain an optimized decision for locating the medical centers in deprived areas, inspired by the medical centers in areas with similar population. Therefore, if the clinics and hospitals are located by considering the hierarchical mode and their service rates, the patients’ welfare will be enhanced.

The Role of Hospital Services Quality on Hospital Brand Preference in Health Services Marketing

Amin Kohyari haghighat

Background: The growing importance of hospitals in physical and mental health improvement has led to focus on improving service quality; and hospitals have considered it as a major competitive advantage. This study aimed at investigating the role of improving services quality on hospital brand preference in healthcare industry.

Materials and Methods: This applied study was a descriptive one. A sample of 394 patients selected using stratified and convenient sampling from hospitals of Shiraz city. Data gathering using questionnaire; in order to data analysis, LISREL_8.80 and SPSS₁₉ were utilized using confirmatory factor analysis and structural equation modeling techniques. Data analysis was used to confirm the relationships between variables.

Results: Study results indicated that there was a significant positive effect of service quality on patient satisfaction, patient loyalty and brand equity of hospital. Patient satisfaction had positive effect on patient loyalty to the hospital and the loyalty had significant effect on hospital’s brand equity. Finally, the effect of hospital brand equity was confirmed on hospital brand preference.

Conclusion: According to the study results, it can be suggested that hospitals management take some measures for service quality improvement which can be enhanced hospital brand preference among other hospitals, both spreading justly public health in all layers of society as well as increasing profitability.

Keywords: Service quality, Brand Preference, Hospital

Assessing the Effect of Educational Intervention Based on Health Belief Model in Improving Standard Precautions Adherence to Prevent Needlestick among Clinical Staff of Hospitals

Roya Sadeghi

Background: Considering the importance of standard precautions to prevent needle stick injuries and health care staff, this study aimed to determine the effectiveness of educational interventions to improve adherence to standard precautions, health belief model based on professional clinical staff needle stick two hospital "yaftabad" and "Ghiyasi" done.

Materials and Methods: This study was an experimental study of two group. The study population was 90 persons of professional clinical staff Shohada Hospital Yaftabad as the intervention group and 90 patients from the hospital Ghiyasi as compared to randomly selected and three part questionnaire including demographic, structures, health belief model , and practice questions were completed. In analyzing the data, descriptive and inferential statistical methods were used.

Results: At baseline, the two groups regarding demographic variables, health belief model structures and functional do not different between them. After intervention structures perceived severity, perceived susceptibility, perceived barriers, self-efficacy and performance of the experimental group showed statistically significant change (p< 0.05) that the effect of education based on health belief model.

Conclusion: education based on health belief model, you can increase the level of knowledge and capacity building and efficacy in clinical staff needs people to observe standard precautions

Conflict and Its Causes in Hospitals of Tehran University of Medical Sciences

Arezo Mojbafan

Introduction: In the hospital’s environment, conflict is unavoidable due to differences in gender, educations, and Career goals, frequent and complex interactions between their personnels. Both of two extremely level of conflict (minimum & maximum) are preventing desired performance. Appropriate level of conflict should avoid recession, encourage creativity and reduce stress. The present research aims to determine the amount of conflict in Tehran University of Medical Science’s hospitals. (TUMS).

Method: This study is descriptive - analytic. The study population consists of 706 managers (senior, intermediate, basic) from 14 hospitals affiliated with TUMS. Data was collected by a self-made questionnaire and was analyzed with SPSS software.

Results: The level of conflict in Tehran University of Medical Science’s hospitals was average. 84% of total conflict was caused by organizational factors. There were a significant association between conflict and level of management, educations, work experience, type of unit, bed numbers, the number of employee under supervision, conflict management training course

Conclusion: Hospital managers should change their organizational cultures and revise some structural variables such as goals, procedures… In order to maintain the optimal level of conflict.

Keywords: Conflict, a mount of Conflict, Managers, Hospital.

Effect of Spiritual Intelligence on Intentions of Hospital-Maker Benefactors

mohammad javad naeiji

Background: Although the role of Spirituality has been acknowledged in the social entrepreneurship literature, we know of no research that has empirically investigated relationships between spiritual intelligence and health and care benefactors. Thus, this paper aims to propose and empirically test a theoretical model positing relationships among spiritual intelligence and intentions of hospital-makers benefactors. Materials & Methods: This study is descriptive which is conducted with total number of 164 hospital-makers benefactors, and is tested by path analysis. For measuring spiritual intelligence, three questionnaires distributed between every subject and two of his/her acquaintances. Results: The results suggest that spiritual intelligence and other related variables explained 41 per cent of the variance in the rate of hospital-makers benefactors intentions (R2=0/41) that is a sizable amount in behavioral studies. Results provide strong support for the proposition that social mission and social responsibility fully mediate the positive effect of spiritual intelligence on intentions of hospital-makers benefactor. Conclusion: With existence of opportunities for merely finical investments, hospital-makers benefactors should have high levels of spiritual intelligence to gain motivation for social wealth creation. Policy-makers of health system, to increase charitable activities, should focus on heightening spiritual intelligence in health and care sector.

Prioritization of the Influential Factors on Health Care Services Quality Using a Hybrid Approach Based on Analytic Network Process (ANP) and Fuzzy TOPSIS in Public Hospitals

hamed Gheibdoust

Introduction: High quality health care service leads us towards a healthy society. Present paper aimed to use the service quality concept in health care sector based on service quality approach (SERVQUAL) in public hospitals. Methods: In present research a hybrid approach based on Analytic Network Process (ANP) and Fuzzy TOPSIS was used where the former was used for prioritization of healthcare service quality measures and the latter was used to operationalize the hospitals. Questionnaires and ANP and Fuzzy TOPSIS were used for data collection and analysis. Five public hospitals in Rash were evaluated. The time period of the study including data collection was 2014-2015. Results: The service quality criteria comprised of 6 main criteria and 19 sub-criteria in present study. Among five hospitals studied in present research, Rasoul Akram hospital obtained the first rank and other hospitals obtained the other ranks. All criteria and sub-criteria used in present study obtained some rank indicating their importance in the research context. Conclusions: With conducting present research, various criteria and sub-criteria related to service quality (SERVQAL) and their importance were identified and this may contribute to improved performance of health care services

Evaluation of Delivered Services among Selected Hospital Wards: A Case Study Using Multiple Criteria Decision Making Methods (MCDM)

Mohammad Arab

Abstract

Background and Aim: Especially in the case of Hospital services, quality assesment is an complicated and vague issue. For achieving this goal Multiple Criteria Decision Making methods help us. These studies aims to knowledge and prioritize quality indicators and rank selected inpatient wards in an elected hospital of Tehran university of medical science by using Analytical Hierarchy Process and TOPSIS methods.

Materials and Methods: This is a descriptive-analytical and cross-sectional research. At the first, with an overview of the research literature and expert opinion, indicators of quality assessment were selected. Then we did prioritization of these indicators with using of expert opinion and AHP method. In the final stage, selected inpatient wards the Hospital were ranked in terms of quality of service using TOPSIS by a sample consist of 300 of inpatients.

Results: Eight main domains (Responsiveness, Safety and risk management, Tangibles, attention to patient, Health communications, Competency and professionalism, accessibility, Credit and assurance) were selected for quality assessment. Among these indicators, competency had the highest priority and attention to patient had the lowest priority. Also the department of Heart had the highest quality of service and the department of Neurology had the lowest quality.

Conclusion: According to crucial role of the service quality on patients’ satisfaction, the use of appropriate indicators for quality of services, prioritizing them and also proper assessment of the quality of hospital services can play a major role in health policies.

Predictors of Health-Oriented Lifestyle among Health Workers of Amol City

Fereshteh Majlessi

Background: health-oriented lifestyle in today’s world is the best way for preventing illness and healthy life. This study conducted to determine the predictor ofhealth-orientedlifestyle in health workers of Amol city.

Materials and Methods: This study was a cross-sectional research conducted on 222 persons of health workers of Amol city. Instrument was a questionnaire including two parts; demographic information was extracted through 15 questionsand the data collected fromthe reliable and valid questionnaire of lifestyle .Data collection. Health workers filled questionnaires in a self-declaration way. To data analyze,t-tests, Mann-Whitney, ANOVA or Kruskal-Wallis and logistic regression used. Data were analyzed statically using SPSS.

Results: This study showed that there is a significant relationship between living place of Prairie village with dimensions of sport , malnutrition , self-care ; and malnutrition dimension in persons below 35, below diploma degree, suffering a chronic disease , suffering high blood pressure ;and tobacco and alcohol consumption dimension in individuals less than35 years;men with medical advice,sport,Malnutrition,tobacco and alcohol consumption ,Health of buying,daily mobility,proper nutrition and owning a personal car with the consumption of tobacco and alcohol dimension ,safety in driving,Health of buying .

Conclusion: Considering that most of the health workers especially men do not behave based on the health-orientedlifestyle, some actions should be taken to change thebehaviorof these individuals, professional educationalworkshops or workshops that do not need to basic information shouldbe activated, because these individuals have health knowledge but do not behave according to this knowledge.

The Relationship Between Leadership Competencies of Managers and Administrative Staff with Hospitals' Performance

Hasan Darvish

Background: In the current turbulent world of business, organizations have to try and compete to identify, recruit and retain the most qualified managers as a competitive advantage. The aim of this study was to investigate the relationship between leadership competencies of managers and administrative staff with the performance of hospitals.

Materials and Methods: This descriptive correlational study was conducted in2015. This study was done in a public teaching hospital, a public non-teaching hospital and a private hospital in Tehran that were general and in average size. The study population was head for all units and departments in accordance with accreditation standards. Sampling methods was Census and leadership competencies using clinical leadership competency framework(CLCF) questionnaire and hospital performance using evaluation scores based on national accreditation standards in2014 that were used in2015 as the basis for the ranking were assessed. Data using Pearson correlation coefficient and test-t, chi-square, regression and ANOVA analyzed.

Results: results showed significant positive correlation between leadership competencies and performance of hospitals(α=0/001,R=0/556). All components of competency (personal qualities(R=0/446), working with others(R=0/529), managing services(R=0/569), improving services(R=0/445), setting direction(R=0/269)) have also positive and significant correlation with performance. Leadership competencies with education (R=0/368), type of employment(f=5/209) and type of hospital(f=15/252) and performance with marital status(R=0/038), type of hospital(f=4/352) and management experience(R=0/273) have showed a significant positive correlation.

Conclusion: Today, organizations will be success if they able to attract and maintenance the most qualified, and employ their services in proper place. Neglect of this important and non-use of existing potentials could have negatively impact the performance of individuals, units and hospitals.