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Dr Bakhtiar Ostadi, Ms Asrin Navidi,
Volume 15, Issue 2 (6-2016)
Abstract

Background: Since, energy consumption per square meter in hospitals is much higher than other types of service institutions; in this study, some actions performed toward optimizing energy consumption improvement projects based on the definition and prioritization in hospital.

Materials and Methods: The necessity of optimizing energy consumption in hospitals were described according to some scales including the average consumption and cost of water, electricity and gas for bed days and active bed, and these indices calculated in the case. Then, improvement actions were identified using energy audit, interviews with hospital experts and conducted studies in hospitals. Next, projects with high importance were extracted regarding to impact on energy consumption indices, expert opinion, aggregation, feasibility, and limitations such as prerequisite, synchronicity and post-requisite. Finally, specific criteria were identified in three dimensions, i.e., factors affecting the level of energy consumption, trying to execute project and risk and the projects were prioritized using questionnaire and FAHP.

Results: The study results revealed that energy consumption was higher than the world standards in the studied hospital; this confirmed the necessity of optimizing energy consumption and using energy management systems. The results of prioritization also showed the first four priorities.

Conclusion: It seems necessary to save energy consumption through improvement projects implementation in the hospitals. Regarding the number and resources limitation, hospitals can choose to implement some low risk and payback period projects based on existing priority and budget annually.


Maryam Zahedi, Seyed Mohsen Banihashemi, Sedigheh Mohammadesmaeil, Mansour Sharifi,
Volume 19, Issue 2 (8-2020)
Abstract

Technological progress and changes have affected the field of medicine and health. Also, the electronic health record is used for convenience of treatment, prevention and diagnosis, but it has advantages and disadvantages that we have studied them in this research.
Method: Qualitative research methods and Grounded theory  were used for the sociological study of electronic health record, and in order to achieve a comprehensive theory in this field by using the theoretical saturation method, twenty experts in the fields of medicine, policy, sociology and informatics that They were familiar with electronic health records, were selected from the community of experts as the statistical population and by using the three stages of open, axial and selective coding, important concepts and categories were extracted in each stage.
Results: The most important result of the research is multidimensional effects of electronic health record. Electronic health record by reducing emotional interaction and prioritizing registered data reduces the intimacy in the patient- physician relationship, and recording data in the specific political and economic environment of the country bring a fear of social stigma and disclosure, especially when system security, investing, and training employees face some problems, and the constant changes of managers reduce their risk-taking and positive effects.
Conclusion: In order to have a proper system and comprehensive and pervasive use of electronic health record, cultural, managerial and technological changes are necessary. Cultural contextualization in the society and among individuals, risky and efficient management and the use of integrated information systems along with system security can increase efficiency. Moreover, this efficiency will lead to research, development and progress.
Iravan Masoudi Asl, Masoud Aboulhallaje, Meghdad Rahati,
Volume 19, Issue 3 (11-2020)
Abstract

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. 
Sajjad Moshki, Shaghayegh Vahdat, Somayeh Hesam,
Volume 19, Issue 4 (12-2020)
Abstract

Background: The present study aimed to determine the causes of patients' readmission in hospitals affiliated to Bam University of Medical Sciences in 2019.
Materials & Methods: The current study was a descriptive-analytic study and the study population included patients readmitted in Pasteur Hospital in Bam, Javad Al-Aimeh Hospital in Narmashir, and Ayatollah Hashemi Rafsanjani Hospital in Regan in 2019. The samples consisted of 312 patient records which were chosen randomly. Data were collected by a checklist and were analyzed using SPSS software version 23 and descriptive and analytical tests (Chi-square and one-way analysis of variance).
Results: The results showed that the internal medicine department received 34% of readmissions. The average readmission cost was 17,265,353 Rials. The most common reasons for readmissions were having a new disease (46.2 percent) and recurrence of the former disease (39.8 percent). Findings of inferential statistics revealed no significant relationship between the causes of readmissions and gender (P = 0.566), age (P = 0.065), or costs (P = 0.625), but there was a significant relationship between the causes of readmissions and marital status (P = 0.049) and married people had more readmissions than single people.
Conclusion: It is necessary to pay more attention to readmissions caused by disease recurrence. It is also possible to prevent such readmissions and improve the quality of medical services by standardizing hospital processes and tools, standardizing staff training, and employing new diagnostic and treatment methods.
Farzaneh Fouladi, Masoumeh Fouladi,
Volume 20, Issue 4 (12-2021)
Abstract

Background: Covid-19 pandemic peak put additional strains on healthcare system. In this crisis, the resilience of nursing staff is critical. This study aimed to investigate the relationship between burnout and resilience in frontline nursing staff working in high-risk areas during the outbreak of Covid-19 pandemic.
Materials and Methods: The present study is a Descriptive-analytical survey, and the target group is Iranian nurses. According to the Ministry of Health statistics, 125369 people are participated in this study. information is collected from 384 people by cluster distribution using questionnaire. The statistical analysis in this study is performed by SPSS and SMART-PLS software
Results: According to the study, all the collected information is normal. Based on factor analysis, there is an inverse significant relationship between resilience and burnout, and also, the sense of success has a significant effect on resilience as part of burnout.
Conclusion: In order to increase the resilience of nursing staff in such conditions, it is necessary to pay more attention to the factors affecting their burnout and plan to minimize it. Developing educational programs and adding diversity in service delivery might be useful to enhance personal feelings and also reduce burnout.
Mehrak Pourmotahari, Soad Mahfoozpour, Shahram Tofighi, Shaghayegh Vahdat, Irvan Masoudi Asl,
Volume 22, Issue 4 (1-2024)
Abstract

Background and purpose: As health resources face increasing constraints, the use of medical imaging services has risen significantly. On average, diagnostic services account for approximately 10% of total healthcare expenditures, and this figure is steadily increasing. This study aims to identify the causes of irrational utilization of medical imaging services and propose corrective measures.
Methods: This descriptive-survey research was conducted in two phases. In the first phase, a comprehensive literature review was performed using both international and national databases, covering the period from 1990 to November 2021. Relevant studies were identified using specific keywords. In the second phase, a semi-structured questionnaire was developed, and a series of in-depth interviews with experts and professionals were conducted. Data were analyzed using the six-step thematic approach by Braun and Clarke, utilizing MAXQDA software.
Results: A total of 605 studies were initially identified, of which seven met the inclusion criteria after rigorous screening. In the second phase, 12 in-depth interviews were conducted, yielding 65 codes, which were organized into 12 themes. The identified themes included legal issues, conflict of interest, monitoring challenges, poor governance and stewardship, inappropriate policymaking and planning, financial incentives, inadequate service provision infrastructure, health culture, education and continuous training systems, financing and purchasing services, political factors, and inadequate insurance systems. Various strategies for controlling the inappropriate use of diagnostic and therapeutic services were proposed, including policy interventions, monitoring and evaluation, and training.
Conclusion: The irrational use of healthcare services is a significant challenge in many countries. Key contributing factors include incomplete insurance coverage, out-of-pocket payments by patients, defensive medical practices, and gaps in knowledge. Addressing these issues requires targeted interventions and reforms.
Saeede Afshari, Shaghayegh Vahdat, Iravan Masoudi Asl, Somayeh Hesam,
Volume 22, Issue 4 (1-2024)
Abstract

Background and purpose: In today’s competitive organizational landscape, the significance of recruiting and developing competent human resources has become paramount. Organizations not only aim to select and attract capable and efficient personnel but also seek to enhance and expand their capabilities. Consequently, the concept of meritocracy has become a key concern for modern organizations. This study aims to investigate the factors influencing succession planning in the leadership of healthcare organizations in Iran.
Methods: This qualitative study was conducted using content analysis in 2020. The statistical population comprised key decision-makers and policymakers in successful and prominent Iranian organizations known for effective succession planning, such as the Islamic Revolutionary Guard Corps (IRGC) and the public banking system. A total of 15 experts were selected through purposive and snowball sampling, with data collection continuing until theoretical saturation was achieved. Data were gathered through structured interviews, and the analysis and coding were performed using MAXQDA 11 software.
Results: The study identified five main themes: alignment of strategic goals and needs analysis, strategic communication and organizational structure, talent identification and empowerment, development and excellence of qualified individuals, and monitoring of succession planning programs. These were further divided into 13 sub-themes.
Conclusion: Organizations and managers should provide comprehensive support and demonstrate commitment to the effective implementation of succession planning programs. This will lead to improved organizational decisions and policies, ensuring that competent and qualified individuals are placed in key positions. Additionally, this approach will enhance work quality, boost employee motivation, reduce resource wastage, and improve career advancement opportunities for staff.

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