Hospital

Epidemiological and correlational investigation of the reasons for requesting inter-hospital transfer of patients in Gilan province under the guidance of the Medical Care Monitoring Center in 1401

Seyed Mohammad Mehdi Baki Hashemi

Background and purpose: Inter-hospital transfer refers to the transfer of patients to receive diagnostic, therapeutic and paraclinical services that can prevent more injuries or more effective treatment. The present study was designed with the aim of collecting and analyzing information related to sent patients and identifying the factors that cause the transfer of patients.
Methods: This cross-sectional study was conducted on 11,362 patient referral forms registered at Gilan University of Medical Sciences. Data were analyzed by Spss statistical software version 22 and Chisquer statistical test.
Results: The amount of patient transfer requests in 1401 compared to 1400 has increased by 9%. There is a relationship between the demand for transfer of patients with inappropriate distribution of specialized human resources, lack of demand feedback mechanisms, ineffective planning of nursing staff and residency of doctors in the hospital of origin, inefficient management of resources and equipment, lack of diagnostic, medical and pharmaceutical facilities, as well as with the seasons of the year. There is significant (p>0.05). There is a significant relationship between non-acceptance of patients and the lack or lack of beds needed by the patient in the destination hospital (p<0.05).
Conclusion: Improper distribution of specialized manpower according to the needs of the region, ineffective planning of resident guards, inefficient management have been identified as the main reasons for the demand for patient transfer. Forming a special working group to identify, evaluate, plan and monitor the removal of obstacles in a centralized manner and forming quality improvement circles can be a solution.

Environmental consequences of corona disease

Maryam Goodarzi

Background: Corona virus is a phenomenon that has faced the world with a crisis due to its rapid spread and uncontrollable nature. Although this crisis is only related to the medicine and health system, it is a multidimensional phenomenon whose effects and consequences can be observed and tracked in various economic, social, and political fields. The purpose of this article is to investigate the results of the Corona Virus on the environment.
Materials & Methods: The current study is a scoping review article that was performed based on the collection of information from articles published in the databases ScienceDirect, Web of Science, Google Scholar, and PubMed in the period from 2019 to 2022 with the aim of investigating the consequences of the Corona crisis on the environment.
Results: The findings of this research illustrate that the corona virus crisis and the quarantine conditions have brought many consequences for the environment. On the one hand, as a result of the cessation of many human activities, there is a significant reduction in the emission of pollutants, including greenhouse gases, and on the other hand, waste, especially medical and plastic waste, has increased.
Conclusion: Despite the positive effects of Covid-19 on environmental factors, its short-term and long-term negative effects are obvious. In addition, it seems that the economic activity of country will intensify after Corona, and therefore, with a comprehensive analysis of the effects of Covid-19 on several sectors, significant proceedings should be taken in this field.

Evaluation and Prioritization of Hospital Management Roles from Experts' Point of View (Study Case: Imam Khomeini Hospital (RA))

Rohollh Hosseini

Background: Achieving goals and developing hospital services depends on competence and optimal management. There will be competent managers who can be successful in performing managerial roles. Playing the roles supports the management in the direction of efficiency, administration and optimal management of the hospital. The purpose of this study is to evaluate and prioritize the roles of management in the hospital from the experts' point of view.
Materials and Methods: This research has a practical purpose and a descriptive and analytical approach. The statistical sample of the research included 65 experts from Imam Khomeini (RA) Al-Shatar Hospital, who were identified based on the snowball and selective sampling method. In this study, a self-made matrix questionnaire whose validity has been confirmed by experts was used to collect data. TOPSIS technique was used to analyze the data. In this study, five criteria and three main roles, which include 10 secondary roles, were identified
Results: The data analysis showed that the promotion of organizational commitment with the percentage of importance (23.2%) with the most important criterion, followed by organizational improvement criteria (20.9%), coordination and coherence (19.4%), promotion of employees' job motivation (7%) 18.00) and improvement of performance efficiency (18.4%) are ranked as effective indicators respectively. Also, the sub-role of analyst supervisor (0.926) was introduced as the most important role among the sub-roles of management in the hospital.
Conclusion: Considering that the role of decision-making was introduced as the most important role, as well as the consequences of decisions on the present and future of the hospital, it is necessary for the hospital management to pay more attention and importance to the role of decision-making in order to make optimal decisions.

Investigating the effectiveness of the architecture of the physical environment of Imam Reza Birjand Hospital on reducing patients' pressure

Reza Mirzaei

Background and purpose: The physical environment of the hospital includes elements and components that improve the quality of the treatment environment and also reduce the stress of the patients. Therefore, this research aims to improve the environmental quality of treatment spaces with the approach of reducing patients' stress.
Materials and methods: Based on the research approach, descriptive-analytical has been done. The selection of the research sample in the General Surgery Department (Imam Reza Birjand Hospital) is considered. To collect data, a questionnaire (patient, patient's companion, doctor and staff) was used to prioritize the variables. The validity of the questionnaire was checked by 3Smart PLS software, and the reliability was measured by Cronbach's alpha. Then the collected data was analyzed in SPSS 26 software.
Results: The results of this study showed that the prioritization of different criteria from the physical factors of the indoor environment of therapeutic spaces including: convenience, flexibility, nature, light, color, fresh air, sound, texture, furniture arrangement, works of art, and scent are different. It is meaningful. Based on the Kruskal-Wallis test, the most significant difference in the patient's stress reduction priority is the criteria of color, material and texture, fresh air, scent. Based on the Yeoman-Whitney test, gender has a significant difference in the variables of scent, color and fresh air.
Conclusion: The results of the research identified that flexibility, convenience, nature, according to the descriptive statistics, have the most influence in reducing the stress of the patients from the perspective of all the participant. Design solutions with the approach of reducing patient stress in medical centers are presented based on the significance of most variables.

Advantages and disadvantages of a comprehensive health information system in healthcare centers a case study of health centers in Boyerahmad city

Bahman Khosravi

Background and purpose: With the establishment of a comprehensive health information system (SIB system) in the health department of Iran's health system, one of the important programs of this country to improve health care through the integration of health information was keyed. This study analyzed the performance of this program from the point of view of the end users of the system in the health centers of Boyar Ahmad city.
Materials and Methods: This study was a qualitative research that was conducted using semi-structured interviews and focus group meetings with 25 system users, support officials and staff experts at different levels, reviewing relevant documents and also observing users' performance. The snowball sampling method was carried out in a targeted and networked manner. Qualitative content analysis was used to analyze the data. MAXQDA10 software was used to record, organize and manage study data after collection.
Results: The findings of this study showed that the deployment of this system from the users' point of view contains many positive and negative points, which can be categorized in five general axes, data management system, caregivers' performance, care management, quality of care and infrastructure. The most important challenges of the system included technical inefficiencies, operational inefficiencies, the challenge of statistics and reporting, and technical and social infrastructure, and the most important benefits were improving the quality of care, tracking and reporting, facilitating the care process, and improving the performance of caregivers.
Conclusion: From the point of view of users, the Sib system can be considered as a positive experience in improving the quality of health care, but due to the existence of many challenges, it is far from its final goals

Designing a Simulation Model for Organizational Agility Development in Hospitals of Ardabil Province, Iran

Hossein Rahimi Klour

Background and objective: As a critical factor for hospital effectiveness, agility uncovers the way such organizations react to internal and external changes. From this perspective, the present study was to design an agent-based model to simulate organizational agility development in the hospitals of Ardabil Province, Iran, in view of the effective factors.
Materials & Methods: Utilizing an exploratory, mixed-methods research design, this study was performed in accordance with inductive-deductive reasoning. For this purpose, the samples included 10 theoretical and experimental experts, selected by purposive sampling of the non-probability type. As well, the data collection tools were interviews and questionnaires. During the qualitative phase, the main factors affecting organizational agility were initially isolated using thematic analysis. Afterward, the given factors were prioritized with the fuzzy Delphi method in the quantitative phase. Ultimately, the model for organizational agility development was simulated through the agent-based approach.
Results: With reference to the study results, 50 primary codes, 15 sub-themes, and 5 main themes were identified, and then “influence in management” was acknowledged as the most significant one shaping organizational agility. Besides, the simulation outputs demonstrated that the proposed model could provide the right estimate of the future of organizational agility development in the hospitals of Ardabil Province, Iran.
Conclusion: Along with the study results, hospital managers are suggested to reflect on the effective factors identified here to better fulfill organizational agility development.

Design and Psychometrics of "Health System Development Scale"

Hossein Dargahi

Background: The development of the health system increases the health level of the society. The present study was carried out with the aim of development of "Health System Development Scale".
Methods: The study was qualitative-quantitative. For qualitative part, a semi-structured interview with 11 experts was conducted in a targeted manner with maximum diversity and the results were analyzed by open, central and selective coding method. For quantitative part, first the validity of the questionnaire was carried out through interviews with 10 experts. Finally, the construct validity was conducted according to the opinion of 220 experts by exploratory factor analysis (with the Kaiser-Meyer-Elkin scale) and confirmatory factor analysis (in the form of divergent, convergent validity and fit indices) using SPSS and Lisrel software. Reliability was also measured by calculating Cronbach's alpha coefficient and composite reliability.
Results: The scale was designed with 40 statements obtained from the findings of the qualitative study. In the quantitative part, the appearance and content validity ratio of the dimensions of the questionnaire was qualitatively confirmed (for all statements between 0.80 and 0.1). Construct validity was done by exploratory and confirmatory factor analysis and convergent validity was between 0.53 and 0.75 and divergent validity was between 0.54 and 1. The internal consistency of the tool was approved with Cronbach's alpha coefficient between 0.75 and 0.86 and composite reliability coefficient was between 0.72 and 0.80.
Conclusion: The validity and reliability of the scale was confirmed. It is suggested to use it to measure the level of development in the health system by experts in this field.

Investigating the factors related to the social stigma of cancer in Tehran in 1401

Mehraban Parsamehr

Background: Cancer is often stigmatized in many societies and this has unfortunate consequences for sufferers. The aim of this research was to know the factors related to the social stigma of cancer.
Materials and Methods: The research method was correlation-analytical, and the sampling method was multi-stage cluster. Data were collected using CSI and CAM standard questionnaires.The statistical population included three categories of ordinary citizens, medical staff, and companions of patients in Tehran; Using Cochran's formula, the sample size was 384, 201, 384 people, respectively. In order to fit the model and measure the relationships between the variables, the method of structural equation modeling was used in the form of AMOS software.
Findings: Goodness of fit indices (chi-square/df=2.851, Rmsea=0.08, Cfi=0.945) all indicated the appropriate fit of the model. Except for the variable of inequality in treatment, other independent variables had a significant relationship with stigma. The r² explanatory coefficient showed that the variables of habitus, optimism, cancer awareness, religiosity, social support, and social capital together predicted 48% of stigma changes. Habitus and social support with standard coefficients (beta) of 0.48 and -0.28 had the highest and lowest contribution in explaining stigma, respectively. Based on the mean difference test, the amount of stigma among ordinary people was more than the other two groups.
Conclusion: Awareness of different aspects of cancer disease (such as symptoms, causative factors), removing false stereotypes about cancer (such as cancer means death), constant communication with cancer patients, and receiving the necessary social support from various sources, were the most important tools necessary to reduce the stigma of cancer.