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H Ebrahimipour, S Heidari, L Doshmangir, H Esmailzade,
Volume 8, Issue 2 (23 2009)
Abstract
Background: Priority Setting is necessary. There are different ways of priority Setting. How they are used depend on the situation of the country.
Material and Methods: This research is literature review. Google Scholar, Medline, Iranmedex, SID, Irandoc data base are used to gathering data.
Results: According to this study, there are various standard ways to priority setting such as Essential national health research ( ENHR), combined method, The commission on health research for Development (COHRED), Five-Step Process of the Ad Hoc Committee on Health Research. These methods have their own characteristics. These methods vary from one country to another . However the final impact is the same.
Conclusion: The result shows that it is useful to know about priority setting and strength and weakness of them. Combined method is the best way because it has the strength of other methods and corrects weakness of them.
M Arab, S Fazayeli, M Mohamadpour, V Pirmoazen, M Yousefi,
Volume 8, Issue 3 (7 2010)
Abstract
Background: The admission department as a first point of patients contact with hospital needed special attention. This study has tried to estimate number of needed personnel with work measurement of general functions of admission department.
Material & Methods: This study was a descriptive-analytical and practical research. This study tried to measure real and expected time and determined difficulty degree and skills needed for each task of admission department, then determined total work units and needed personnel in admission department of Children's Medical Center affiliated with Tehran University of medical sciences in 2009.
Results: Total work units in admission department were approximately 10780 units for one month. Counting at least 987 units for every person per month, the number of human resources needed for this unit was 11, while current number of human resources in this department is nine.
Conclusion: Finding of this study show that Children's Medical Center involves with inadequate human resources and multiple pressure due to insufficiency in mentioned department, and tries to promote the technology using in this department and increase the personnel and reset the payment system based on work load
Alireza Ilbeigi, Mostafa Kazemi, Mohammad Taghi Peivandi,
Volume 11, Issue 2 (22 2012)
Abstract
Background: The aim of this research was to measure and compare relative efficiency of general hospitals under supervision of Mashhad University of Medical Sciences (MUMS). The study also seek to investigate the likely relationship between the official evaluating scores reported by MUMS with findings of this study.
Materials & Methods: Data Envelopment Analysis (DEA) is utilized to determine relative efficiency of individual decision making units (DMUs). From state-run general hospitals in this study, 17 were selected based on the criteria suggested by the model. To distinguish efficient hospitals from inefficient ones, revised input-based BCC model was used incorporating ‘number of physicians' and ‘number of nurses' as inputs. Outputs were set as ‘the rate of inpatient days to staffed beds', ‘outpatient visits' and ‘number of surgeries' reported both at emergency and wards.
Results: The findings based on both CRS and VRS simulations indicate that the mean of technical efficiency was 0.823, mean managerial efficiency was 0.931 and subsequently mean scale efficiency was 0.881. It was further noticed that, there was no significant relationship between the performance appraisal outcomes from DEA model, and scores allocated to each hospital through official evaluation system.
Conclusion: Current official appraisal system based on pre-defined checklists may not be a reliable mean for evaluating and ranking efficiency of general hospitals.
Mahboubeh Asadi, Seyed Saeed Tabatabaee, Saeed Khayatmoghadam,
Volume 13, Issue 3 (12-2014)
Abstract
Background & objectives: one of new and unique tools for survival of organizations among their competitors having comprehensive knowledge of all the environmental factors affecting the organization, means organizational intelligence, that with its measurement Strengths and weaknesses of the organization are identified and can affect the performance of organization and in this way, they help to organization in the measurement and evaluating progress in achieving its goals.
Materials and Methods: This descriptive analytical study was performed in 12 general hospitals affiliated to Mashhad University of Medical Sciences in 2012. Study samples were 375 employees who were selected through stratified sampling method. The study Tool of data accumulation was Albrecht organizational intelligence standard questionnaire and checklist of hospital performance indicators that was determined by the Ministry of Health. To determine score organizational intelligence was used the five-point Likert scale. Data were analyzed by SPSS v.16 using Statistical tests and Pearson correlation coefficient (P=0/05).
Results: we found that there was a significant positive relationship between hospitals’ organizational intelligence and all the performance indicators of the exception of “Bed occupancy ratio”, “Ratio of surgeries to operation beds” (P<0.05), and organizational intelligence had the highest correlation with indicators of Bed Turnover Interval (r = 0.739) and the average length of patient stay (0.691)
Conclusion: it seems that attention and planning to strengthen and increase organizational intelligence can be effective in improving the performance of hospitals.
Hosein Ebrahimipour, Ali Vajaee, Gholam-Abas Nouri, Habib-Allah Esmaeili, Sara Jamili,
Volume 14, Issue 1 (6-2015)
Abstract
Background: Process of discharging patients affects patient’s satisfaction .This is one of the serious challenges that hospital managers face. This study is aimed to determine the average waiting time of patient discharge process and identify influential factors of this process in Imam Reza Hospital in Mashhad in the year of 2014.
Materials & Methods: This is a cross-sectional survey in which waiting time of patients who had discharged from clinical wards of the Imam Reza hospital in Mashhad had been studied. 455 of patients had been selected as samples. The amount of time spent during discharge in six different departments such as inside each ward, from each ward to the medical records unit, inside the medical records unit, from medical records unit to accounting department , during cost calculation and also from cost accounting to cost payment unit) had been determined by using stop-watch method. The data had been analyzed by descriptive and analytical statistics in significant level of 0.05 using SPSS16.
Results: Results showed that waiting time was 504.26± 362.96 Minutes. Patients spent most and least proportion of their waiting time in ENT and Burns wards during discharge.
Conclusion: As noticeable number of minutes spent inside wards and cost payment unit by patients, calls for corrective interventions such as changing visit time and predicting schedules for sending medical record to accounting department could reduce waiting time.
Mr Saied Saeed Tabatabaee, Mr Mohammad Reza Ghamari, Mrs Tahereh Sharifi, Mr Ruhola Kalhor, Mrs Mahboubeh Asadi,
Volume 14, Issue 2 (8-2015)
Abstract
Background: Patient safety is one of main indicators in quality control of health services. The most prevalent threatening cause of patient safety is medical errors especially medication errors. This study aimed at assessing the rate and type of nurses’ medication errors.
Materials and Methods: This study was a descriptive – analytical one which performed in a non-public hospital in East North Country. The studied hospital has 180 active beds in the fields such as general surgery, obstetrics and gynecology, infants, cardiology, angiography, CCU, ICU, and NICU. Due to limited population, all the nurses in the hospital (97 nurses) were participated in the study. The instrument was a self-designed questionnaire which was composed of two main parts (demographic data and medication errors information). Its reliability and validity was confirmed. Data were analyzed by SPSS software version 15 using t- test and ANOVA.
Results: Among the studied nurses, 76 nurses (78.3%) were female and 21 (21.7%) were male. The mean of age and work experience of participants were 29.3 and 8.7 respectively. The most frequent of medication errors included medication without prescription 136(23.7%), lack of attention to medical complications 134(23.4%), Giving the medication at the wrong time 128(22.4%). The lowest common of medication errors reported as using expired date medication4(0.7%), wrong medication 5(0.9%) and non administered medication 6(1.1%).
Conclusion: The nursing managers should be consider more attention to reduce medication errors by implementing Training classes, improving nurse's processes and promoting attitudes towards importance of patient safety.
Fatemeh Arabi Basharic , Mohammad Reza Mobinizadeh, Alireza Olyaeemanesh, Morteza Arab Zozani ,
Volume 15, Issue 2 (6-2016)
Abstract
Background: Intravascular imaging is a tool to detect coronary artery atherosclerosis which plays the major role in vessel stenosis degree determination and plaque pathology as a supplement of invasive angiography. This study aimed at comparing Intravascular imaging with invasive angiography.
Materials and Methods: For retrieving second type studies, PubMed, Cochrane Library and Centre for Review and Dissemination (CRD) were searched up to September 2013. Searching was carried out by two persons using angiography and intravascular imaging keywords. Studies which compared intravascular ultrasound technology with invasive angiography were analyzed.
Results: Based on studies which reported the rate of target lesion revascularization (TLR) after one year of follow-up, there was a statistically significant difference between intravascular ultrasound and invasive angiography alone. It seems that TLR rate was lower with intravascular ultrasound (P = 0.02).In terms of cost effectiveness, approximately 54, 000 USD spend per each QALY using IVUS method.
Conclusion: Although, intravascular ultrasound could be able to detect coronary arteries damages and help out physician in selecting the most appropriate treatment, but due to the high cost of an intravascular ultrasound catheter, the invasive angiography is choice of physicians and patients in coronary intervention.
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Volume 16, Issue 1 (4-2017)
Abstract
Background: The emergency department is as heart of hospital and is one of the first points of contact for patients with health care system are facing a variety of challenges. This study aimed to explore the challenges of emergency departments in teaching hospitals of Mashhad University of Medical Sciences.
Materials and Methods: This study was carried out through a qualitative approach and phenomenology method in 2013 in Mashhad, Iran. Twenty nurses and two emergency medicine specialists were recruited from four teaching hospitals in Mashhad Iran using purposive sampling. Data were collected through semi-structured in-depth interviews. Interviews were transcribed verbatim and analyzed using conventional content analysis approach according to colaizzi with MAXQDA 3 software.
Results: The results of this study indicated that challenges of emergency department lay in
Three main aspects including: "challenges in Human resources"(personal characteristics, professional characteristics and human resource limitations), "nurses' dissatisfaction"(less quality hospital hoteling and services for staff, disproportion between the workload and salaries, Lack of support from nurses) and " challenges in human resources management "(Structural challenges, the performance challenges and challenges in human resource management). Each theme included several category and subcategory that explain various aspects of the challenges in emergency department.
Conclusion: Human resource limitations, nurses' dissatisfaction and poor management were the most important challenges. Providing adequate human resources, support of nurses and determination guidelines and process for nursing care can reduce these challenges in hospital emergency departments.
Dr Roghieh Bayrami, Dr Hossein Ebrahimipour, Alireza Rezazadeh,
Volume 16, Issue 2 (7-2017)
Abstract
Background: Pre hospital emergency medical service (EMS) as the first line of emergency care and treatment in the out- of -hospital has a considerable importance in the health care system. Planning on finding about strengths and weaknesses and improve the quality of EMS by exploring the problems of this section has considerable important.This study aimed to explore the challenges of pre hospital emergency medical service in Mashhad.
Materials and methods: A qualitative study was done with 14 personnel working in EMS sites in Mashhad using purposeful sampling. Data was collected by semi structured interview and analyzed using conventional content analysis approach according to Graneheim and Lund man 2004 with ATLAS.ti software.
Results: Three general themes were identified including 1) "challenges in Human resources"( Individual characteristics of human resources and personnel's dissatisfaction 2) "challenges in organization" (Structural challenges, lake of equipment and human resource limitation 3) "socio-cultural challenges"(Environmental-social challenges and cultural challenges) were determined.
Conclusion: personnel's dissatisfaction, structural challenges, human resource limitation, lake of equipment and Environmental-social challenges were the most important challenges in pre-hospital emergency system. Organizational independence , create organizational rows, regulation of laws and administrative regulations reform in relation to the range of services offered by emergency personnel, attention to the facilities and cooperation And the participation of other organizations, such as media and traffic to enhance pre-hospital emergency services at the community level can be effective in reducing the challenges in hospital emergency system.
Dr Hossein Darghahi, Kamran Irandoust, Seyyed Morteza Mojtabayan,
Volume 18, Issue 2 (8-2019)
Abstract
Background: The present research aimed to assess the readiness of selected hospitals of Tehran University of Medical Sciences to implement quality improvement programs and clinical audits from the viewpoint of managers.
Materials and Methods: A descriptive-analytic study was conducted in May 2017 in four selected hospitals of Tehran University of Medical Sciences. The study population of this study was 20 managers of selected hospitals who were selected by census sampling method and entered the study. The data gathering tool was a two-part questionnaire whose validity and reliability were confirmed. In this study, we used SPSS software version 23 and statistical tests to analyze the data.
Results: The effectiveness and readiness of hospitals to implement a clinical audit program was equal to 60% in the field of data and information, cardiology and feedback; 55% in resources, design and implementation, clinical audit management, and evidence and standards; 50% in illness and education; and 45% in manpower. Also, with increasing frequency of clinical audits, hospital readiness for quality improvement processes increases.
Conclusion: Due to the effectiveness and low readiness of hospitals in implementing a clinical audit program, especially in the field of human resources (45%), it is necessary that managers and planners of clinical audit programs in hospitals have a precise knowledge of these factors in order to control the organizational environment and help improve the effectiveness of audit programs.
Elyas Sanaeifar, Javad Moghri, Bahram Mohaghegh, Fatemeh Kokabi Saghi, Seyed Saeed Tabatabaee,
Volume 19, Issue 3 (11-2020)
Abstract
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.
Hassan Niroomand Sadabad, Ali Vafaee Najar, Elahe Houshmand, Jamshid Jamali, Zahra Keyvanloo, Mahdi Dehnavi,
Volume 21, Issue 4 (1-2023)
Abstract
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.
