Hospital

Investigating the challenges of physicians' participation in Accreditation of the hospital from the point of view of physicians working in social security hospitals

Hassan Niroomand sadabad

Background and purpose: Considering the important role of doctors in the implementation of accreditation standards and the necessity of their involvement in this process, this study was conducted in order to identify the views of doctors regarding the challenges of participating in accreditation programs in social security hospitals in Mashhad.
Materials and methods: This study is a cross-sectional descriptive-analytical research that was conducted in two hospitals of the Social Security Organization of Mashhad, Iran. in 2022. The participants were 56 full-time working doctors with at least one year of work experience in the hospital. Data analysis was done using SPSS version 26 software.
Findings: Among the challenges of doctors' participation in accreditation programs , the dimensions of the motivational mechanism (3.96±0.63) , provision of suitable resources for the implementation of accreditation (3.83±0.78), physician empowerment programs (3.78±0.73) and the role of the quality improvement office in attracting doctors' participation (3.75±0.74) were more important from the doctors' point of view, and patients' demands (2.90±0.75) and role ambiguity 2.77±0.96), were less important in their opinion.
Conclusion: Managers should consider that employee motivation and resource allocation are necessary for the effective implementation of the accreditation standard. Empowering doctors in the implementation of accreditation standards as well as the participation of quality improvement offices to interact with doctors and attract their participation are very important factors.

The reasons of intention to quit of nurses during the covid-19 pandemic in in the hospitals of Isfahan city

MohammadAli Cheraghi

Context: The intention to quit is a step before the actual leaving the job. The complex conditions of treating covid 19 patients, nurses physical pressures and mental tensions during the covid-19 pandemic, encourage them to quit their jobs. The present study was conducted to determine the factors related to the willingness of nurses to quit during the covid-19 pandemic in the hospitals of Isfahan city.
Method: 416 nurses working in the hospitals of Isfahan participated in this cross-sectional descriptive-analytical research in the form of quota sampling and systematic random stratification. The data collection tool was a researcher-made questionnaire with high validity and reliability (0.95) that measured the intention to quit of nurses during the covid-19 pandemic in 4 dimensions of individual, occupational, organizational and transorganizational factors. SPSS version 25 software was used for data analysis.
Findings The average score of nurses' willingness to leave during the corona pandemic in Isfahan hospitals was 2.98 out of 5. The average of Transorganizational factors (3.30) was higher than the average of organizational factors (3.05) in driving the intention to leave of nurses. A relation was seen between demographic information such as; received compensation, secondary job and total income and intention to quit.
Conclusion: During the covid-19 pandemic, several factors lead to the quit in the group of nurses. Since the willingness to leave the job in public hospitals is higher than in private hospitals, managers of these organizations should pay more attention to evaluating factors, determining their impact and making effective decisions.

Medicine Consumption Forecasting in Hospitals using Long Short-Term Memory Model

Rezvan Abbasi

Background and Objectives
In recent years, medicine supply chain management has become more significant, especially after the Covid-19 pandemic. The most important issue is supply chain cost control. If the drug inventory is not properly managed, it will lead to issues such as the lack of inventory of certain drugs, provision of excess inventory, increased costs, and, finally, patient dissatisfaction.
Materials and Methods
In this study, an attempt has been made to predict and manage the pharmaceutical needs of hospitals using an efficient deep-learning algorithm. The drug consumption data for ten years of Besat General Hospital in Hamedan are extracted from the HIS database. As a case study, the accuracy of the predictive model is evaluated, especially for cefazolin. We use a deep model to analyze the medical time-series data efficiently. This model consists of a Long Short-Term Memory network, which can sufficiently recognize the change history in time-series prediction applications. The proposed model with many adjustable parameters in the deep architecture will bring good performance to overcome the complexities of the learning problem.
Results
Using the deep learning method can increase robustness by reducing the effects of complexity and uncertainty in medical data. The average forecasting error for the proposed method is 0.043, and the measured values for RMSE, MAE, and R2 are 0.335, 0.260, and 0.851, respectively.
Conclusion
A comprehensive comparison between some other predictive methods and the implemented model shows the outperformance of the proposed approach. Additionally, the evaluation results indicate the efficiency of the proposed approach.

An analysis of factors affecting the reduction of bullying in the hospital emergency environment using structural-interpretive modeling

Mohamaad sadegh Abolhasani

Background and purpose: Considering the dimensions of organizational bullying and the context of its creation in the emergency department of the hospital, the decrease in the quality of patient care and the increase in dissatisfaction with the services received and the limited research studies in this area, the research was conducted in the emergency department of a hospital of Yazd University of Medical Sciences.
Materials and methods: To carry out this descriptive-analytical research, the interpretive structural modeling method was used. The experts included 30 doctors, nurses, and nurses who were either working in the emergency department of a Yazd University of Medical Sciences hospital or had experience of service in this department. From the extraction of these factors, they were returned to them for scoring, and the effects of these factors were measured from their point of view, and the final analysis was done by MATLAB software.
Results: The results show that the greatest effect in reducing bullying is related to "adequate training for personnel to communicate" and "proper and courteous treatment in the face of clients" (with influence power of 5) and the least effect is related to "creating a suitable comfortable environment". and "Perform appropriate triage" (with penetration power of 1).
Conclusion: Considering the destructive effects of bullying, creating appropriate mechanisms to reduce this phenomenon shown in this research and using the factors identified by the people involved in bullying can prevent this phenomenon, which occurs frequently in the emergency room of the hospital.

Measuring The Quality of Services Provided to Inpatients in University Hospitals in Yazd Province

Sajjad Bahariniya

Introduction and purpose: The main mission of hospitals is to provide quality services for patients. Evaluating the quality of hospital services can lead to the targeted allocation of financial resources to areas that are in worse situation. The aim of the present study was to investigate the quality of services of university hospitals in Yazd province.
Methods: This cross-sectional analytical study was conducted in 2020-2021 in 12 university hospitals of Yazd province. In order to conduct the study, the standard questionnaire of SERVQUAL was used. This questionnaire is made up of two parts, administration and expectations, and each of them contains 28 questions and 6 dimensions. The sampling method was stratified randomly. Data analysis was done in SPSS version 24 software.
Results: 225 patients participated in the study. The majority of patients were over 50 years old (46.7%). The average score of patients' expectations (128.99±8.12) at the high level, the average score of patients' perceptions (107.98±8.62) at the middle level, and the average score of the total quality of hospital services (236.97±12.24) at the high level reported. In both areas of perceptions and expectations, the dimensions of reliability, responsiveness and assurance had a higher mean score and the physical or tangible dimensions, empathy and access had a lower mean score.
Conclusion: The service quality of university hospitals in Yazd province was in a good condition, but the average score of perceptions was lower than the score of expectations. Although there was no deep gap, it is necessary for hospital managers to pay more attention to improving the quality of services.

Simulating the Effect of Advertising on the Attraction of Medical Tourists with a Factor-Based Modeling Approach (Case Study: Yazd Hospitals)

Naser Seifollahi

Background: Nowadays, the medical tourism market is one of the most profitable and competitive industries in the world, and it is one of the new developed fields of tourism. Advertising is one of the methods of increasing tourist attraction and influencing tourists' decision-making to choose a destination. The present research aimed to simulate the effect of advertising on the attraction of medical tourists in the hospitals of Yazd city.
Materials and methods: The present research is applied in terms of research objective, and in terms of methodology, it is in descriptive-analytical research. The statistical community was formed by university professors and experts in the field of medical tourism, and managers of hospitals and medical centers in Yazd. The snowball method was used for sampling. Information was collected through text reviews, questionnaires and semi-structured interviews with experts. The integrated and innovative approach of factor-based modeling and Taguchi method was used for data analysis, and the software used was AnyLogic and MiniTab.
Results: The results of the scenario execution revealed that among the advertising tools, internet advertising is more effective, and television ads, specialized tourism magazines, and seminars and conferences are in the next ranks. As the final output of the research, the investigation of the main effects related to each advertising tool led to identification of the suitable level of each tools and the presentation of the most favorable scenario based on the advertising program of Yazd hospitals.
Conclusion: Based on the fact that among the advertising tools, internet advertising has the greatest effect on attracting medical tourists, hospital management should pay special attention to internet advertising to attract more tourists in the field of medicine. In this way, more information will be provided to tourists and the demand for medical tourism will increase.

Investigating the relationship between the implementation of the strategic plan and the performance of selected hospitals of Yazd University of Medical Sciences in 2018

Ashkan Amraeei

Background and purpose: This research was conducted with the aim of determining the relationship between the implementation of the strategic plan and the performance of the hospital. The importance of knowing the factors affecting the implementation of the strategic plan and its identification leads to better planning and the correct implementation of the strategic planning process.

Methods: The current research is a descriptive analytical research, in terms of cross-sectional time and practical results, and it was carried out in 2018. The research population is all the people who have played a role in the drafting of the strategic plan. This research has used the census, which filled the questionnaire in a high percentage of the statistical population. After collecting the data, the information was entered into the software and SPSS version 16 software was used to analyze the data.

Findings: The relationship between the implementation of the strategic plan and the performance of the hospital is direct and strong. Among all parts of the strategic plan, customer management plays a more important role than other parts of the strategic plan in improving the performance of the hospital.

Conclusion: In order to have optimal performance in a hospital, we need detailed strategic planning, and this plan must be implemented carefully and properly monitored so that it can bring us optimal performance.

Review of Nurse per Bed Rate in Iranian hospital compared with selected countries

Roya Rajaee

Background and purpose: One of the main challenges of human resource management in hospitals is the proper distribution of nurses, which is necessary to improve the efficiency and quality of health services. In this review, this rate is compared in selected countries and Iran in order to provide the necessary evidence for managers and policymakers in human resource management
Materials and Methods: This study was conducted as a field review in 2019 with the aim of comparing the standards of nurse distribution to beds/wards in selected studies. The search was conducted with related keywords in "Scopus", "Web of Science", "PubMed" databases without a time limit.
Results: The distribution of nursing per bed was reported in Australia, England, Northern Ireland, Wales, Israel, America, California, Pennsylvania and New Jersey. In Iran, the rate of nurses to intensive beds was slightly higher than the average and the ratio of nurses to ordinary and emergency beds was lower than the average of selected countries average.
Conclusion: Nurses' distribution was generally lower than the average of other countries, and this ratio was lower in some sectors and higher than the average in some sectors. Recruitment and redistribution of the appropriate nurse in different sectors by benchmarking successful countries are suggested.