Hospital

Hospital Site Selection Using a Multi-Objective Model Considering Citizenship Equity Criteria: A Case Study

Ali Bozorgi Amiri

Background: Today, one of the most important issues in hospital site selection is to consider the equity. This study aimed to provide a multi-objective model for fair Hospital site selection considering cost and use for hospitals construction in the future.
Materials and Methods: This study was an analytical-descriptive one conducted to determine the best locations for hospitals construction with respect to criteria of equity in Rasht city. For this purpose, after literature review, a three-objective model consist of p-median, p-envy and equitable loads objects was proposed; and the Rasht city was analyzed by model using the real data. In order to achieve the results and comparisons, the total weighting technique from the multi-objective decision-making techniques was used and solved with GAMS 24.1.1 software.
Results: This research can assist the decision-makers to consider the equity criteria to Hospital site selection in addition to the costs. Citizenship equity establishment and increasing in hospitals efficiency along with cost considerations can be regarded as the major achievements of this research for decision-makers in the health field.
Conclusion: Lack of proper attention to equity criteria hospital site selection, the results can be very unfair and can lead to irreparable consequences. This case study indicated the desirable function of the proposed model in hospital site selection with respect to the citizenship equity criteria in Rasht city. This study results can be given to managers as the proper basis for decision-making.

Hospital Efficiency Using Pabon Lasso Model: A Systematic Review and Meta-Analysis

Masoumeh Erfani Khanghahi

Background: The Pabon Laso Model is one of the most important models of evaluating efficiency. Many studies are implemented with this model in Iranian hospitals. This study aimed to review related articles with systemic review and meta-analysis method.
Materials and Methods: The data was gathered using related keywords in databases such as IranMedex, MagIran, IranDoc, Medlib, SID, PubMed, Google Scholar, Elsevier, and Scopus. The articles were searched during 2001 to 2015. Inclusion criteria were determined as articles published in Persian and English, Pointing at least one of three criteria Pabon Lasso model in Iran and access to full-text articles. Exclusion criteria were articles other than hospital performance assessment, and articles which presented as conferences event, case reports, letters to the editor and educational articles. Meta-analysis method was used for calculating Pabon Lasso indices. CMA: 2(Comprehensive Meta-Analysis) was utilized.
Results: 27 articles out of 396 articles were reviewed. The results of 348 hospitals had shown 79.9(22.9%), 76.8(21.7%), 117.8(33.8%), and 74.6(21.4%) of hospitals were in areas one, two, three, and four, respectively. The average of length of stay, bed occupancy, and bed turnover were 3.4 (3-3.7, 95% CI), 63 (41-95,95% CI), and 78.4 (71.8-85.2, 95% CI) per year, respectively.
Conclusion: Study results revealed that only one-third of hospitals were in area three in Pabon Lasso model. The performance status of three fields were average in the length of stay (approximately standard), bed occupancy (upper than standard), and bed turnover (lower than standard).

Location of the Aerial Ambulances Using Combination of Fuzzy ANP and Fuzzy Dematel in the Environment of ArcGIS: A Case study in Sistan and Baluchestan province

mojtaba ghaderi

Background: Among various emergency services, the air emergency due to access to the extreme areas, possibility to move more patients, providing higher quality treatment to the patient being carried and also access to the hospital without problems such as traffic and sudden crashes, is one of the most important types of emergencies in the health sector. So, the right location according to the scientific principles, enhances the efficiency of the aerial emergency.
Materials and Methods: This descriptive- analytical present study was conducted as an applied research in Sistan and Baluchestan province in 2016. At first, indicators affecting the location of ambulances were identified. Then, the location using deploying a Fuzzy network analysis process model next to the Fuzzy Dematel technique and the integration with geographic information system was performed.
Results: Criteria for selecting the best places for deploying air ambulances in Sistan and Baluchestan province are considered as proximity to the roads, appropriate tilt area, proximity to crowded areas, proximity to high risk passages, and the convenient distance from the medical emergencies. Output weights of the technique used for affecting on GIS software were calculated 0.244, 0.083, 0.435, 0.182 and 0.057, respectively.
Conclusion: Study results revealed that number and coverage of aerial ambulances in cities and roads of Sistan and Baluchestan province are not suitable. Therefore, the map derived from the Fuzzy integration of the information layers identified by the effective factors, illustrated that the districts of Zabol and Iranshahr cities have the best status of selected criteria to establish the air emergencies bases in the province of Sistan and Baluchestan.

Relationship between Accreditation Rank and Technical Efficiency of Hospitals Affiliated to Tehran University of Medical Sciences

Samaneh Esmaeili

Background: Hospital accreditation is assumed as an effective control mechanism for health systems to improve quality and efficiency. Current study thus, seeks to look into the relationship between hospitals’ accreditation and efficiency
Materials and Methods: In order to measure efficiency, hospital inputs and outputs included the ratio of physician and nurse to bed, mortality and nosocomial infection rate and quality of inpatientservices were used. A sample of 554 hospitalized patients selected using stratified random sampling
method. Data gathering instruments were researcher-developed questionnaire and checklists. DEAP and SPSS software deployed to assess correlation between accreditation rank and technical efficiency
Results: Average hospitals’ technical efficiency score was 0.94 indicating an improvement capacityof %5.1 for hospitals efficiency. The mean quality score was 4.13 out of 5( in the range of 3.9-4.3)There was no correlation between hospitals accreditation rank and their technical efficiency
Conclusion: According to the results, it seems efficiency should be also considered in accreditationmetrics. In addition, for measuring efficiency, performance based inputs and specifically outputs tohave reliable results should be chosen

Effect of Communication Skills Training of Nurses on Patient Satisfaction about Nursing Services in Hospitals Affiliated to Shiraz University of Medical Sciences

Ali reza Yusefi

Background: Communication is one of the central concepts and an integral part of the nursing profession. This study aimed to determine the effect of communication skills training of nurses on patient satisfaction with nursing staff services in teaching hospitals affiliated to Shiraz University of Medical Sciences.

Materials and Methods: The Comparative study carried out in 2017. The research population included nurses from educational hospitals and patients referring to them. Four hundred patients were selected through convenience sampling method and one hundred trained nurses and one hundred untrained nurses were randomly chosen. The data collection instruments were a standard questionnaire. Data were analyzed in SPSS₂₃ using T-test, ANOVA, Tukey test, and Pearson correlation coefficient at α = 5% level.

Results: Mean scores of nurse-patient commination and satisfication of nursing services among patients under care of trained nurses were 93.5 ± 21.08 and 176.24 ± 22.14 and mean score of patients under care of untrained nurses the scors 81.76 ± 18.83 and 166.36 ± 41.10, respectively. A significant direct correlation was found between nursing-patient commination score and patient satisfaction score (P= 0.023, r= 0.681). Patients under the care of trained nurses were more satisfied with nursing services than those served by untrained nurses (P= 0.012). The results revealed that patient satisfaction had a significant relationship with age (P<0.001) and marital status (P₌0.031).

Conclusion: Implementation of communication skills training courses for nurses leads to improved patient satisfaction. Hospital directors are recommended to consider holding regular communication skills training courses for their nursing staff.

The Impact of Health Transformation Plan on Deductions Imposed on Imam Khomeini Hospital Complex’s Bills

Mahnaz Afshari

Background: Insurance companies sometimes do not reimburse hospitals completely. Reducing the amount of deduction of bills increases hospital’s income and efficiency. This study compares the deductions imposed by social insurance organization on Imam Khomeini hospital’s bills before and after the implementation of health transformation plan.

Material and Methods: Data of this descriptive-descriptive study calculated from the deductions applied to the hospital of outpatient and inpatient bills of social insurance organization in second six months of 2013 (before implementation of health transformation plan) and the same time of 2014 (after implementation of of health transformation plan). This quasi experimental study was conducted using the data. Data was analyzed by SPSS software using paired t test.

Results: The bill deductions in the second six months of 2013 compare to the same time in 2014 were 2.9 and 11.1 percent, respectively. Hospital bill deductions increased 282.8 percent after the health transformation plan implementation. The deductions on inpatients and outpatients records increased 6 and 12 times, respectively. Most deduction was imposed on surgical and laboratory bills in 2013 and on radiotherapy, chemotherapy and hoteling bills in 2014.

Conclusion: Deductions of hospital bills extremely increased from social insurance organization after implementation of health transformation plan. In order to identify deductions causes, providing related education to staff and physicians and relative process improvement are necessary.

Analysis of Factors Affecting the Patient Effectiveness and Satisfaction level in Therapeutic Spaces: A Case Study in Yazd Hospitals

mohammad reza montazerolhoje

Background: Recent years, many efforts provided to design hospitals ;as the most stressful environments; to reduce stress , improve health , patients' remedy and satisfaction based on patients 'points of view. This study aimed to identify the physical and mental factors effective on patient view in hospitals of Yazd city.

Materials and Methods: Regarding the purpose, this study was an applied one which used survey and correlation methods. In order to determine the normality of data distribution, Kolmogorov – Smirnove, the type, amount and direction of relation between the variables Persons correlation coefficient and linear regression analysis were used, respectively. Additionally, in order to clarify the multi regression model, variance analyze method of ANOVA has been utilized. According to data gathering literature and instrument review have been utilized.

Results: Study results revealed that there was a significant relation between physical factors and individuals' satisfaction (P<0.05). There was no significant association between mental factors and individuals' satisfaction.

Conclusion: It seems it is necessary that conditions and facilities need to be provided regarding physical and subjecting factors improving in wards which can be result in stress reduction and satisfaction increasing in the hospital environment, as well. Also, in patients' point of view, using appropriate colors, providing positive entertainment (films and comic books), proper ventilation and fresh air are some of the most important factors in patients ' satisfaction in wards.

Relationship between Information Technology Capabilities and Responsiveness in Baharlo Hospital of Tehran

leila Nazarimanesh

Background: Responsiveness is one of the main goals of the health system for policymakers and managers. Information Technology (IT) capabilities typically affect organization performance in cases like customer responsiveness and provide high standards of its business. This study aimed to investigate the relationship between information technology capabilities and the responsiveness of Baharlo hospital in Tehran.

Materials and Methods: This study was a descriptive-survey one in terms of method and an applied one in terms of purpose. Data collection tool was a questionnaire. A sample of 248 employees and 381 patients from 26 selected sections of Baharlo Hospital were selected randomly. Data were analyzed using descriptive statistics and inferential statistics such as Pearson correlation coefficient and regression analysis.

Results: According to study results, the overall hospital responsiveness rate was higher than the average (3.82) and the hospital's IT capacity was moderate (3.07). Based on regression analysis at 95% confidence level (error less than 5%), IT capabilities with IT architecture dimensions (p= 0.020), IT infrastructure (p =0.004), IT human resources (p < 0.0001) IT communication resources (p < 0.001) were positively correlated with the responsiveness of Baharlo Hospital.

Conclusion: The positive relationship between all aspects and the overall IT capability with the responsiveness of the illustrated hospital reveale that the capacity of information technology as well as other modern industries in hospitals is considered as a key competence. Therefore, it is obvious hospital managers should pay serious attention to upgrade this key competence to improve responsiveness in their hospital.

Trend of Patients’ Compliance in a Public Hospital Before and After Healthcare Reform Implementation

hossein Rohani

Background: Patient complaints from the healthcare system can be helpful to respond patients’ needs using identifying the weaknesses. In this study, the complaints trend of patients has been investigated before and after healthcare system reform progress in a public hospital.

Materials and Methods: This descriptive-analytic study was carried out to assess trend of patient's complaints in two period of time in a northeast governmental hospital before and after healthcare system reform implementation (2012-2016). In order to collect data, the checklist designed by the ministry of Health was used. Data entered to SPSS version 21 and analyzed using descriptive statistics and analytical tests such as Chi-square.

Results: The study results revealed that the number of complaints were 29 and 198 before and after implementation of healthcare system reform, respectively. Most complaints were related to the emergency sector (31%) and about 40% of the complaints were from physicians. Most of the registered complaints were related to the quality of provided services (33.5%) and personnel exposure (30%), respectively. Accordance to study results, there was a significant difference between the number of complaints before and after implementation of the health system reform with the type of complainant (P <0.05).

Conclusion: Implementation of healthcare reform plan has led to systematic registration and special attention to complaints in assessed hospital. Most of registered complaints were related to the emergency department which requires managers and hospital officials to pay special attention to this sector and take effective steps to improve quality of services.