Hospital

Investigating the income changes resulting from the implementation of the book of relative value 2018 in the hospitals of Shahid Beheshti University of Medical Sciences

Bahman Khosravi

Background and Aim: The aim of this study was to investigate the income changes resulting from the implementation of this book in the hospitals of the University of Medical Sciences.
Materials & Methods: This cross-sectional study was conducted based on retrospective information related to the first half of 1398 of Shahid Beheshti University of Medical Sciences. Data related to this study were collected from patients' records using hospital information system and hospital intelligent management system of Shahid Beheshti University of Medical Sciences. In order to analyze the data, the average of Rials per service was used for each hospital and type of admission.
Results: The results showed that with the implementation of the book of relative value 2018, the total income of the studied hospitals will increase by 10.67%. In total, the share of total book codes included in the study is 41% of the total, of which 20% is the professional component, 19% is the technical component and 2.4% is anesthesia. After book codes, hoteling with 26% and consumer goods with 14% and medicine with 11% make up the rest.
Conclusion: The approach of the 2018 book is more towards temporary inpatient services and encourages providers not to admit patients to receive services. Also in this book, the proper growth of the technical component of services will occur, which in other words indicates the approach and encouragement of investment in the hospital sector.

Futures studies of hospital resilience supply chain with the intuitive logics scenario planning

Reza Ahmadi Kahnali

Background: Scenario planning is one of the most crucial future study methods in uncertain and complex situations. Hospital supply chain resilience also requires an understanding of future events due to the complexity of relationships and exposure to unexpected circumstances. The purpose of this study is to formulate scenarios for the future development of hospital supply chain resilience.
Materials & Methods: This research is the second stage of research with a mixed approach, and it is in the category of normative scenarios based on intuitive logic. Participants in this study were purposefully selected from the experts of two hospitals. In the first phase, the impact-uncertainty questionnaire and the effect-uncertainty diagram were used to determine the critical uncertainties. After forming the scenario team, based on the impact diagram and the scenario matrix, The cause and effect relationships of the variables were determined in the second phase.
Results: Drivers of Hospital supply chain resilience were clustered into 14 main categories, and the results of the impact-uncertainty diagram showed that "people's culture" and "accident nature" play a more significant role in scenario development as critical uncertainties. Four scenarios were developed based on the opinion of experts for these two drivers.
Conclusion: four scenarios, "compatible," "turbulent," "broken," and "combative," were developed based on the critical drivers in supply chain hospital resilience. Use the inspirational feature of these scenarios can help managers in health and crisis management be more prepared to face the crisis. Scenarios based on intuitive logic can be used for futures studies in other areas of the health system.

Human Resources Estimation of CT-Scan Department in Iran's Largest Radiotherapy-Oncology Center Based on Workload Indicator of Staffing Need (WISN) in 2019

Seyed saeed Tabatabaee

Background: Human Resources in the health sector not only is the most crucial source in health providing but account for nearly three-quarters of the health sector's costs. The purpose of this study was to estimate the required Human Resources of the CT scan department of the Reza Radiotherapy-Oncology Center based on the workload indicator of staffing needs in 2019.
Materials and Methods: This cross-sectional descriptive study used human resources determination based on staffing needs' workload indicators. The method of conducting expert meetings was used to determine the components of workload and standard time. Also, Interviews and rules, and personnel systems were used to determine the amount and factors related to available working time, and to determine the annual workload, the hospital management system and observation of activity logs were used. Excel and SPSS19 software were used to analyze the data for determining the required human resources and timing data, respectively.
Results: 7 factors related to staff annually available work time were identified. The available work time for CT scans staff was 1113 hours per year. In this study, imaging and simulation were determined as the main activities of the CT scans ward. The results of the workload indicator calculations showed that the CT scan section lacked 3 Personnel.
Conclusion: This study showed that Reza Radiotherapy Oncology Center is experiencing a shortage of professional CT scan staff, and the work pressure is (0.4). Therefore, CT scans are a top priority to provide the human resource.

Hospital financing through the capital market; Explain the underlying factors in financing policy and its ordering

Meghdad Rahati

Background: Hospital, as the largest and most important health system unit, has the highest costs. Governments cannot finance all of the costs of this sector, so reforms are inevitable. In this regard, researchers have explained the underlying factors in financing policy and its commanding.
Materials & Methods: This study is a descriptive study done by qualitatively and quantitatively method in 2019. The statistical population included experts from the health sector, the capital market, and the Social Security Organization. A purposive sampling method was used. Data collection tools were receipts and a semi-structured questionnaire for interviews. MAXQDA 11 software was used to analyze the interviews, and the Delphi technique was used for validation. Walt Gilson and Kingdon models were used for policy analysis and commanding.
Results: Underlying factors in policy-making and commanding the financing of hospitals from the capital market are macro-factors (governance and legal, political, social, and economic factors) and micro-factors (stewardship, financing, and technical factors). The financing problem stream of hospitals, the policy flow that includes public-private partnership models, and the political flow that began with sanctions open a window of opportunity to finance hospitals through the capital market.
Conclusion: Upstream documents and development plans allow the privatization of governmental organizations; therefore, in addition to government budgets and dedicated revenues, hospitals can use private-sector financing strategies. In the meantime, easy and inexpensive financing, transparency, and accountability are the capital market characteristics that introduce it as an appropriate strategy.

The effect of family-centered empowerment model on quality of life and self-efficacy of kidney transplant patients in 2018

Farahnaz Farnia

Background: Quality of life is a mental issue that causes a person to be affected by various factors including self-efficacy. The roadmap in this field is family-centered empowerment, which aims to promote health. The aim of this study was to determine the effect of family-centered empowerment model on quality of life and self-efficacy of kidney transplant patients.
Materials and Method: This study is a randomized controlled clinical trial. 100 kidney transplant patients, who came to Shahid Hasheminejad Hospital, were divided into two groups of control and intervention by initial accidental sampling. Data collection tools were a three-part questionnaire includes of demographic characteristics, quality of life of patients of kidney transplant questionnaire (KTQ-25) and the questionnaire of health empowerment to survey about self-care (SUPPH). These questionnaires were completed by both groups once the study was initiated and another time 1.5 months after intervention. Data were analyzed by SPSS software (version 20), chi-square and T-test.
Results: findings demonstrated that when the study was initiated there was not any significance difference between these two groups in terms of demographic quantitative and qualitative characteristics and mean of quality of life and self-efficacy. In compared with control group, mean of quality of life of intervention group was increased. Statistically, it has a significance difference (0<0.001). Also, in comparison with control group, the score of self-efficacy promoted and it has a significance difference.
Conclusion: Considering the positive effect of family-centered empowerment model on self-efficacy of kidney transplant patients and finally on their quality of life, it is necessary to consider this model with the aim of promoting patients' health.

A qualitative analysis on family physician's program to identify the causes as well as challenges of the failure of program accomplishment

Niloufar Amiri Ghale Rashidi

Background: The Family Physician Program, one of the most important efforts of the Iran health system to establish a referral system, was developed and implemented in several provinces, but it faced challenges due to several reasons that prevented the program's progress. So This study was conducted to analyze the family physician program to identify the causes and challenges of the program failure.
Materials & Methods: This retrospective study of policy analysis is a qualitative study with Purposive sampling. Semi-open interviews and document analysis were used for data collection. Data analysis was performed through thematic analysis in the policy triangle framework using MAXQDA software.
Results: According to the study framework, the challenges of the Family Physician Program in the context are conflict of interest, dependency of plans to oneself, instability in management and plans, insufficient attention to culture, resources, and infrastructure. In terms of content include disproportionate executive approach, Lack of localization, selection of inappropriate tools, insufficient transparency, and ambiguity in goals, tasks, and responsibilities; The challenges of the process were examined based on the policy cycle.
Conclusion: The implementation of the family physician program is influenced by cultural, social, political, managerial, and economic factors. As the Ministry of Health officials has re-introduced this crucial program, reviewing the content and methods of program implementation seems necessary.

Investigating the impact of empowerment training courses on human resources productivity among Tehran University of Medical Sciences employees

Hossein Dargahi

Background: Employees’ empowerment is the best and efficient organizational strategy for improvement of human resources productivity. Therefore, the present study was aimed to investigate the relationship between empowerment training courses with human resources productivity among Tehran University of Medical Sciences employees.
Materials and Methods: This was a descriptive-analytical and cross-sectional study. The study population included 1452 employees of the university deputies. Research sample was calculated 304 according to Krejcie and Morgan table. The research tool consisted of Hersey's empowerment training courses effectiveness translated by Jafari “et al.” and Hersey-Goldsmith's human resources productivity questionnaires. The content and structural validity including convergent and divergent validity of questionnaires were determined, and their reliability was confirmed by Alpha Cronbach with 0.86 and 0.89 coefficient, respectively. Data were analyzed by SPSS version 23, and descriptive results were presented by absolute and relative frequency and analytical results by inferential statistical techniques and Structural Equation Modeling.
Results: The mean of empowerment training courses effectiveness of employees and human resources productivity was relatively desirable. Also, the relationship between empowerment courses effectiveness and human resources productively of employees was confirmed.
Conclusion: Using different procedures of employees’ empowerment in early period of employment including organizational socialization, on-the-job training courses by workshops, distance learning and in-person training for empowerment of self-esteem, compatibility, and innovation of employees’ for promotion of organizational and individual productivity is recommended.

Impact of implementation of LDR system on qualitative indicators of maternity services

Leila Nazarimanesh

Background and Purpose: The importance of hospital quality services in order to best utiliz available resources are not unknown to managers. This is especially important in the maternity sector due to the high density of referrals. Implementation of LDR (Labor, Delivery, Recovery) is one of the new approaches to improve delivery services in the country. The purpose of this study was to evaluate the effectiveness of LDR system on quality of delivery services in two selected hospitals of Qom.
Methods and Materials: This is a descriptive-survey study. Data were collected with a cross-sectional approach to compare the quality of service indicators of a hospital with LDR system as a case and a hospital without LDR system as a control group. Data were collected using a standard questionnaire by Poisson sampling and analyzed by SPSS software.
Results: There was no significant difference between the two hospitals except for LDR implementation. There was no significant association between LDR implementation in delivery sector with overall quality of service indicators (3 vs. 2.5) , input, process and output quality indices. However, LDR implementation had a significant effect on some items of these indices (level of significance = 0.05).
Conclusion: According to the research findings, implementation of LDR did not have a significant effect on overall quality of services, but it did affect the subscales of these indices. Therefore, it seems clear that there is a need for proper management policy to control the costs involved in implementing this system.