Hospital

Situation Analysis of Full Time Physicians Plan Using SWOT Model in Iran

Hossein Dargahi

Background: Physicians' full time attendance is related to increment of many hospitals performance. Regarding the present challenges, this study aimed to analyze this plan using SWOT technique and present TOWS model in Tehran University of Medical Sciences (TUMS).

Materials and Methods: This study was a descriptive-analytical and cross-sectional one conducted during 2016-2017. Based on Cochran formula, 234 full time attending physicians randomly selected using simple randomization method. The research tool was a researcher made SWOT questionnaire which confirmed its content validity and reliability. Collected data was analyzed by SPSS software using SWOT technique and suggested TOWS strategic model.

Results: The most valuable weaknesses of mentioned plan were inappropriate coordination of physicians; lack of compensatory system, and the most important strengths were employment of young physicians and better education for medical students. The most important opportunities and threads of mentioned plan were establishment of competitive work between public and private hospitals and burnout and dispensing of experienced physicians moving to private sector, respectively.

Conclusion: Based on study findings, TOWS model strategies can be suggested for improvement of the plan.

Performance Evaluation of the Central Stores of Hospitals Affiliated to Tehran University of Medical Sciences in 2018

Mohammad Arab

Background: Due to the presence of valuable and expensive equipments in hospitals’ warehouses, scientific management and continuous evaluation plays an important role to improve the performance of warehouses and whereby the performance of hospitals’ wards. This study aimed to evaluate the performance of the central stores of hospitals affiliated to Tehran University of Medical Sciences (TUMS).
Materials and Methods: In order to conduct this cross-sectional study, a checklist was designed and validated to examine the warehouses’ status considering structural, process and outcome dimensions of 39 depots in 14 hospitals. The status of hospitals’ warehouses were assessed using descriptive analysis and in order to assess association between performance evaluation score and charchetristics of warehouses and its staff Pearson Correlation Coefficient was utilized.
Results: Although, warehouses’ performance of studied hospitals in general was satisfactory, there were some items in unsuitable condition particularly in structural and process dimensions which should be addressed quickly. Also, performance of warehouses revealed a positive and significant correlation with number of beds, area and size of warehouse and number of staff (p <0.05).
Conclusion: Given that fair warehouses status, some items particularly in structural and process dimensions were in inappropriate condition which needed rapid consideration. Furthermore, hospitals with more beds have more and bigger warehouses achieved better evaluation score, but some of warehouses without these condition should be addressed in priority.

Role of Spiritual Health on Job Stress among Nurses A Cross-sectional Study in an Educational Hospitals of Qazvin City

Sima Rafiei

Background: One of the main important principles of human health is spirituality which its promotion could lead to an effective control of work related stress; can be considered in nurses’ job performance and assurance of their physical and mental health as a crucial factor. This study aimed to explore the effect of spiritual health on job stress among nurses employed in a training hospital affiliated to Qazvin University of Medical Sciences in 2017.
Materials and Methods: This was a descriptive-cross sectional one conducted on 220 nurses at Velayat hospital in Qazvin city. Data gathering was performed using two standard questionnaires including spiritual health and nurses' job stress. Data analysis was carried out with SPSS₂₂ using descriptive statistical methods, Pearson Correlation Coefficient and multivariate regression analysis at a significance level of P < 0.05.
Results: The mean score of spiritual health and job stress assessed at a moderate level 70.5±5.2 and77.5±2.3, respectively. Spiritual health in both religious and intrinsic dimensions, gender, job history and type of employment were statistically related to job stress (p<0.05). Furthermore, multiple regression analysis revealed these variables predict 25% of job stress variation.
Conclusion: Due to the important role of spiritual health on job stress among nurses, strengthen this dimension of health through acknowledging them about its potential effects on physical and mental health and ultimately on successful job performance recommended.

Investigation the Relationship between Professional Behavior and Job Well- Being among Nurses in Shahrekord's Educational Hospitals

masoud lotfizadeh

Background: Nursing is one of the health care base and nursing services are in effect on ill-health indicators. This study aimed to investigate the relationship between professional behavior and job well-being of nurses employed at two Shahrekord educational hospitals in 2018.
Materials and Methods: This descriptive-analytic study was performed on nurses employing at two educational hospitals in Shahrekord. A total of 269 nurses in both sexes were selected using stratified random sampling method. The Goz standard professional questionnaire for nurses and the Demo and Paschoal Survival Questionnaire were used. Data were analyzed by SPSS₂₂ software using independent t-test, ANOVA, Kolmogorov Smearnov, Pearson Correlation Coefficient and simple linear regression at a significant level of 0.05.
Results: Mean age of the respondents was 33.2 years old, 48% were aged between 31 to 40 years old while 3% were aged more than 50 years old, 58% and 42%were female and male, respectively. The average score of professional behavior and job well-being were 17.8 ± 104.5 (moderate to high) and 89.3 ± 12.9 (moderate), respectively. Regression analysis revealed that per unit increasing in the nurses professional behavior, 0.661 units were added to job well-being; and also, there was a significant correlation between "professional behavior" and "job well-being" (R²=0.328).
Conclusion: The comprehensive national plan should be designed paying more attention to creation of the necessary infrastructure to promote professional behavior which can be result in long-range consequences of job well-being improvement; also, promotion of job well-being components should be considered.

Assessing Vision-Related Quality of Life of Older People in Tehran and Associated Factors

Mohammad Arab

Background: Visual disorders in old age is one of the most important factors in decreasing quality of life of older people. This study aimed to access the vision-related quality of life of older people in Tehran and to examine some of the underlying factors.
Materials and Methods: This was a population-based cross-sectional study among 566 older people aged 60 years and over, living in Tehran. A multistage cluster randomized sampling method was used to select study population, data was gathered using interviewing them at their home. NEI-25 VFQ (Visual-Functioning Questionnaire) was used to measure the vision-related quality of life of the participants. Multi-level linear regression analysis was used to data analysis.

Results: The average score of the vision-related quality of life was 80 out of 100. Among 12 dimensions of Visual-Functioning Questionnaire, the dimensions of color vision (CV), vision specificsocial functioning (VSSF) and peripheral vision with the scores of 96.8, 96.7 and 95 gained the highest and the dimensions of driving and vision specific dependency (VSD) with the scores of 42.6 and 50.3 had the lowest scores, respectively. Significant associations were observed between being a women, older, and having a lower education with poorer vision-related quality of life.

Conclusion: This study results provides an evidence for policymakers in prioritizing visual health services based on more impaired visual function and also at risk older people.

Causes of Revenue deficits of University Hospitals and Strategies to Reduce Them

Narges Rafiei

Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences.
Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013).
Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations; analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning and creating an organizational structure.
Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.

Assessing Organizational Culture of Headquarters in Ministry of Health and Medical Education

Amin Aghili

Background: Organizational culture is one of the important predictor of organizational effectiveness, and a key factor success of the organization as a competitive advantage. Todays, a continuous assessment of organizational culture status is considered essential; therefore, this study aimed to identify and measure organizational culture of the Ministry of Health and Medical Education.
Materials and Methods: This descriptive-analytical study was conducted on the headquarters of the Ministry of Health and Medical Education in 2018. The study population consisted of all employees of the Ministry of Health and Medical Education (N=2200), 327 personals were selected through Cochran formula and stratified sampling method. The data collection instrument was a researcher-made questionnaire whose validity and reliability were confirmed (Cronbach's alpha =86.5%). In order to data analysis SPSS₂₄ using descriptive and inferential statistics tests were utilized.
Results: The mean score of total organizational culture was 3.30 ± 0.70 from 5 which was higher than the theoretical average. Also, there was also a significant difference in partnership dimension in terms of employment type and in participation dimensions, accountability to the upstream institutions as well as total organizational culture score in terms of deputy. There was a direct statistical association between dimensions of organizational culture.
Conclusion: According to study results, strong organizational culture will lead to improved performance in the organization and alignment of individuals and activities. Given the importance of specific role of culture in each organization, plans success and change strategies, human resources managers should take appropriate actions to improve internal and external communication and increase teamwork and accountability.

Modelling the Dynamics of Human Resources Capacity in Health Care Services A Case Study of Khatam-al-Anbia Hospital of Mashhad

Alireza Pooya

Background: In service organizations such as hospitals, human resources (HR) play a key role in the quality of service delivery. Lack of a systemic attitude in terms of system dynamics, HR planning have been somewhat distant from reality. In order to solve such a problem, this study aimed to modeling the dynamics of human resources capacity management system in healthcare services.

Materials and Methods: This case study is one of the cases at a clinic of Khatam -al-Anbia Eye Hospital of Mashhad which was used to simulate the system dynamics approach. In the implementation process, after modeling and formulating in Vensim software, the model was validated and appropriate policies were identified based on simulation results.

Results: The simulation results revealed a gap existence between service capacity and desired capacity led to a work pressure. Consequently, time per service relative to the standard time per service (0.333 hours equivalent to 20 minutes) as the core of service quality has been reduced (cutting corners of time). To counteract such a situation, appropriate policies were identified during the time in a dynamic manner using sensitivity analysis based on changing patient acceptance rates and human resource changes.

Conclusion: The proposed model provides the status for hospital managers which allows them to manage appropriate human resources in the same conditions with a viewpoint of causal relationships with respect to system dynamics.