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Volume 7, Issue 3 (1 2008)
Abstract
Roohollah Askari, Hamid Reza Dehghan, Mohammad Amin Bahrami, Fatemeh Keshmiri,
Volume 9, Issue 3 (7 2011)
Abstract
Background: The hospitals are the most significant providers of health care services. According to more health funds spending by hospitals, economic management in hospitals is necessary. Determining the causes and rates of insurance under reimbursement bills was the objective of this study.
Materials and Methods: This research is a descriptive cross-sectional survey was done in 2008. The samples of study were the al records' patients who undertaken of social security insurance system in the teaching hospitals of Shahid Sadoughi University of Medical Science. The data complied in SPSS 16 software and then analyzed.
Results: In this study, 9.8% cases of all hospitalization bills were deducted. The highest rates of under reimbursement bills was in Afshar hospital (12.7%), followed by burn hospital (12.5% ), Shahid Sadoughi hospital (10%), and Shahid Rahnemoon hospital (8.2%). The highest rates of under reimbursement bills imposed to the surgeon fees (28.4%), treatment fees (15.06%), and medicine (14.3%) costs. However assistant surgeon fees had no under reimbursement. The most important causes of under reimbursement were defects in the insurance records of patients and noncompliance with insurance organization regulations.
Conclusion: Training of human resources and optimized use of hospital information systems could be helpful to hospitals for reducing insurance reimbursement to ultimately improve hospitals to financial statements.
M Arab, M Hosseini, M Ranjbar, A Rashidian, A Pourreza, M Varmaghani, M Tajvar,
Volume 9, Issue 3 (7 2011)
Abstract
Background: The elderly population in Iran is increasing . The aim of this study is the survey of satisfaction rate and the effective factors on the elderly - aged peoples satisfaction regarding to the given services in the hospitals affiliated to the Tehran university of medical sciences.
Materials & Methods: This research is a descriptive - analytical study with applied results. It shows the problems cross - section ally.The research society involves the whole elderly - aged people whit 65 years old and more than that used the bedridden services of the hospitals affiliated to the Tehran university of medical sciences. The sample involves 360 elderly. For collecting the data, a questionnaire with three parts was used. The validity of questionnaire by the content measurement and the reliability of questionnaire by test re test (r = 0.84) were achieved. And also we used SPSS software for data analysis.
Results: : Results showed that 25/6%patients from management type, 41/9%from facilities ,17/2% from behavior personality and 30/3% from public services are dissatisfaction. A total of 12 variable were analyzed, and the results showed that: The education level, age, sex, type of refer, dealing with the bed shortage and occupations have the meaningful relation with their satisfaction rate. The one - variable - analyzers in the logistic regration model showed that among the whole meaningful variables, the education level has the strongest relation with satisfaction. With increasing the education level, the satisfaction rate have been decreased.
Conclusion: Due to results satisfaction rate among participant of this study is good and accepted. Using of results is effective step in increase productivity services and further evaluation needed to be done for functional styles patient elderly satisfaction.
Zohreh Kalani, Zahra Pourmovahed, Ali Akbar Vaezi, Seyede Felor Vaziri,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Using vein by Peripheral Catheter is one of the important ways to provid water, electrolytes, medications and nutrients to patients in hospitals and other therapeutic centers. Phlebitis is an important complication of using peripheral cannula. This study performed to determine the incidence of phlebitis related to peripheral cannulae, and its effecting factors.
Materials and Methods: This prospective and analytical study was conducted in adult's medical- surgical units of Shahid Sadoughi Yazd. Two hundred ninety seven cannulae of 297 patients were assessed. Phlebitis was identified by the presence of at least two following symptoms including local pain, redness, swelling, warmth and palpable venous cord.
Results: The mean of patients' age was 40.82±19.48 (12-91 yrs.). The phlebitis incidence rate was 14.1%. Some factors such as smoking (P=0.007), diabetes (P=0.001) had positive and significant association with phlebitis incidence rate. Odd Ratio for smoking and diabetes were 3.107(CI=1.310-7.372, 95%) and 3.736(CI=1.736-8.039, 95%) respectively.
Conclusion: Study findings revealed that overall incidence rate of phlebitis compare with other similar studies was low. Study results indicated high phlebitis incidence in smokers, diabetic patients, and elder patients which can be prevented by considering phlebitis incidence in impatiens.
Milad Shafiee, Mohammad Hossein Ghafoori, Fatemeh Aboee, Sara Forootan, Mohammad Arab,
Volume 15, Issue 4 (1-2017)
Abstract
Abstract
Background and Aim: Especially in the case of Hospital services, quality assesment is an complicated and vague issue. For achieving this goal Multiple Criteria Decision Making methods help us. These studies aims to knowledge and prioritize quality indicators and rank selected inpatient wards in an elected hospital of Tehran university of medical science by using Analytical Hierarchy Process and TOPSIS methods.
Materials and Methods: This is a descriptive-analytical and cross-sectional research. At the first, with an overview of the research literature and expert opinion, indicators of quality assessment were selected. Then we did prioritization of these indicators with using of expert opinion and AHP method. In the final stage, selected inpatient wards the Hospital were ranked in terms of quality of service using TOPSIS by a sample consist of 300 of inpatients.
Results: Eight main domains (Responsiveness, Safety and risk management, Tangibles, attention to patient, Health communications, Competency and professionalism, accessibility, Credit and assurance) were selected for quality assessment. Among these indicators, competency had the highest priority and attention to patient had the lowest priority. Also the department of Heart had the highest quality of service and the department of Neurology had the lowest quality.
Conclusion: According to crucial role of the service quality on patients’ satisfaction, the use of appropriate indicators for quality of services, prioritizing them and also proper assessment of the quality of hospital services can play a major role in health policies.
Dr Roohollah Askari, Naeimeh Keyghobadi, Fateme Jafari Nodoushan, Dr Sima Rafiei,
Volume 16, Issue 3 (11-2017)
Abstract
Background: One of the main principles in comprehensive care giving in nursing is spirituality and spiritual care which has been addressed to have a crucial role in providing more effective treatment in patients. This study aimed to assess nurses’ attitude toward spirituality and spiritual care in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016.
Materials and Methods: This descriptive, cross-sectional study was conducted among 133 nurses employed in three selected teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016. Data collection was performed through a two- section standard SSCRS questionnaire (The Spirituality and Spiritual Care Rating Scale) including spirituality (n=15 items) and spirituality care (n=8 items). To data analyze SPSS software version 22 was utilized. Significance level was set less than 0.05.
Results: The mean score of attitude toward spirituality and spiritual care were calculated relatively 31.15±7.89 and 21.05±5.5, respectively. Furthermore, there was a significant statistical association between nurses’ attitude with gender (p=0.01) and job category (p=0.03). given that, there was no significant association between age, educational level, employment and marital status.
Conclusion: Based on study findings, attitude toward spirituality were more desirable compare to spiritual care among nurses. Thus, more training and awareness can have affecting effects on clinical care and treatment quality potentially in spite of positive attitude toward spirituality.
Ramin Dastab, Farahnaz Farnia, Somayeh Zare,
Volume 19, Issue 3 (11-2020)
Abstract
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.
Moslem Mohsenbeigi, Mohamad Zarezade, Khadije Nasiiani, Mohamad Ranjbar, Mohammad Reza Vafaeenasab,
Volume 21, Issue 1 (5-2022)
Abstract
Introduction: Despite many challenges, public-private partnership in hospitals is recognized as one of the most attractive investment platforms for the private sector. This study conducted to assess the challenges of private sector partnership with public hospitals using the public-private partnership model in public hospitals in Yazd.
Methods: The present qualitative research conducted in 2021. The viewpoints of 15 faculty members, directors, managers and operational experts on the participation of the private sector, those related to the transfer and contracts and the parties of the private sector are extracted through a semi-structured interview guide and analyzed using content analysis in three stages.
Results: A total of 10 main themes including economic and policymaking problems, insufficient manpower readiness, lack of support authority, weak partnership laws, lack of knowledge and experience of managers in partnership, lack of financial transparency, conflict of interest, poor coordination, lack of cultural readiness and trust-building and lack of plans and supervision in the field of partnership in 28 sub-themes extracted.
Conclusion: There are challenges related to policymaking issues and the resulting instability, incoordination of different units, unpreparedness of manpower and contract details in using different models of public-private partnership in hospitals, in which the use of the same procedures, transparency and the meeting requirements of the private sector are recommended for partnership and the formulation of laws and contracts free from any shortcomings and weaknesses that could lead to the loss of the public sector.
Mehdi Raadabadi, Mohammad Sadeghi, Masoud Saffari, Mohadeseh Karimizadeh, Ezat Dehghan Manshadi, Mehdi Jabinpour, Elham Haji Maghsoudi,
Volume 21, Issue 2 (9-2022)
Abstract
Introduction& Purpose: One of the challenges that organizations face today is the issue of retaining employees in the organization. Meanwhile, addressing the causes of early retirement among health workers is doubly important. The aim of this study was to investigate the causes of early retirement in retirees of Yazd University of Medical Sciences.
Methods: The present descriptive research was conducted to find the causes of early retirement among retirees of staff of Yazd Medical Sciences between 2016 and 2018. Collecting dada was done by examining the personnel file, retirement system and through interviewing people. Data description was done using descriptive statistics and SPSS.21 software.
Results: The average number of years of service lost was 3.7 years. In total, there were more than 528 years of service lost. Regarding job characteristics, the majority of retirees were employed in service and nursing positions (4701%), in hospital (45%) and health centers (42.9%). The study of the causes of early retirement showed that the most common causes of retirement were related to boring work environment (55.7%), physical problems and underlying diseases (40.7%) and lack of support from officials (24.3%).
Conclusion: According to the findings, multilateral support in the organization, promotion of rewards and economic benefits, creating morale in the organization, observing the principles of mental health, reducing anxiety and creating hope and increasing participation of employees in the decision-making process can be effective in reducing early retirement.
Noushin Kohan, Fatemeh Keshmiri, Roohollah Askari,
Volume 21, Issue 3 (12-2022)
Abstract
Background: It is expected that graduates of healthcare management have the necessary skills to perform various managerial and administrative positions. This study was carried out with the aim of designing and compiling an evaluation framework for students based on educational standards in the internship period.
Materials &Methods: The current study was conducted in four phases: In the first phase, in order to identify the problem and assess the needs, the existing curriculum and topics were examined, as well as the studies conducted in this field. In the second phase, the perspective of the stakeholders was used to complete and modify the initial framework. In the third phase, worksheets for registering internship learning activities were prepared for students and a checklist of educational and learning objectives, personal and management skills, and skills for developing professional qualifications was compiled. Finally, a specialized panel was used to determine the type of formative and final exams.
Results: The problems and challenges of internships can be investigated in 4 areas: inappropriate planning of the course, faculty, group - professors and hospital. In designing the evaluation tool, 9 criteria were taken into consideration. Also, tests designed in a compilation framework were used as formative tests and reasoning tests were used as final tests.
Conclusion: The compiled framework can be used as a valid and comprehensive tool to evaluate the practical competence and capabilities of healthcare management students during the internship period.
Mohammad Ziaaddini, Mohamaad Sadegh Abolhasani, Mohamaad Zarezadeh, Elahe Salarikhah, Homa Khazaei, Farzaneh Ghorbani,
Volume 21, Issue 4 (1-2023)
Abstract
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.
Raziyeh Montazeralfaraj, Sajjad Bahariniya, Sara Jambarsang, Fatemeh Sadat Hashemi,
Volume 21, Issue 4 (1-2023)
Abstract
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.
Mohammad Zarezadeh, Ashkan Amraeei, Mohammad Sadegh Abolhasani,
Volume 21, Issue 4 (1-2023)
Abstract
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.
Seyed Masoud Mousavi, Sajjad Bahariniya, Aisa Mardani, Najmeh Baghian,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Organizational commitment among nurses, a critical aspect of hospital workforce management, is influenced by various factors, including job attachment. This attachment fosters motivation and commitment, which ultimately enhances the quality of healthcare services. This study investigates the relationship between organizational commitment and job attachment among nurses working in selected teaching hospitals affiliated with Shahid Sadoughi University of Medical Sciences in Yazd in 2022.
Methods: This descriptive-analytical study involved all nurses at Shahid Sadoughi Hospital in Yazd. A sample size of 298 nurses was determined using Cochran's formula. Data collection was conducted using the Job Descriptive Index (JDI) by Edwards and Kilpatrick (1984) and the Organizational Commitment Questionnaire (OCQ) by Allen and Meyer (1990). The data were analyzed using the Chi-square test with SPSS version 21 software and structural equation modeling via LISREL software.
Results: Among the nurses surveyed, 43.17% reported being satisfied with their jobs, while 40.17% exhibited organizational commitment. The findings revealed a significant relationship between job attachment and organizational commitment (P<0.001). The average scores were 3.75 ± 0.76 for the affective dimension, 3.97 ± 0.26 for the continuance dimension, 3.65 ± 0.36 for the normative dimension, and 3.74 ± 0.93 for overall job attachment.
Conclusion: The significant direct relationship between job satisfaction and organizational commitment highlights the importance of managerial focus on enhancing job satisfaction to increase employee responsibility and commitment. Managers should prioritize factors that improve job satisfaction as a means to strengthen organizational commitment.
Roohollah Askari, Hassan Jafari, Arefeh Dehghani Tafti, Neda Futuhi Tafti,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: Nurses, as the closest healthcare providers to patients, hold significant popularity and trust. Strengthening their competence in spiritual care is critical in ensuring holistic healthcare delivery. This study aimed to evaluate the spiritual care competence of nurses working in selected teaching hospitals of Shahid Sadoughi University of Medical Sciences in Yazd in 2023.
Methods: This cross-sectional study was conducted on 262 nurses employed in three selected teaching hospitals (Shahid Sadoughi, Shahid Rahnamoun, and Afshar hospitals). Data were collected using the Standard Spiritual Care Competence Questionnaire (SCCS) and analyzed through ANOVA, Mann-Whitney, Kruskal-Wallis tests, and Spearman's correlation coefficient using SPSS version 21 software.
Results: The overall mean score and standard deviation of spiritual care competence among nurses were 83.9±18.2, indicating an optimal level of competence. Among the dimensions of spiritual care competence, the "personal support and consultation with the patient" dimension scored the highest (18.8±5.2), while the "communication" dimension scored the lowest (7.3±1.6). The highest overall competence score was observed at Shahid Rahnamoun Hospital (88.5±17.7)
Conclusion: While the overall competence in spiritual care among the nurses studied was favorable, the low score in the communication dimension highlights the need for workshops focused on effective nurse-patient communication. Developing these skills can significantly enhance nurses' roles in improving patient health outcomes.
Fatemeh Dehghani, Adel Eftekhari,
Volume 23, Issue 1 (5-2024)
Abstract
Nursing is one of the most sensitive and important jobs in the health system, which in recent years has led to dissatisfaction and strikes among nurses due to the increasing demand for services, shortage of nursing staff, and forced overtime. This study aimed to look at the causes and consequences of forced overtime among nurses.
Khatere Khanjankhani, Tina Seirafi, Sajjad Bahariniya, Atefeh Ebrahimi, Seyed Masood Mousavi,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Medication errors, which are more commonly committed by nursing staff compared to other hospital personnel, can lead to severe and sometimes irreparable complications for patients. This study aimed to investigate the factors contributing to medication errors among nurses in selected hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd.
Methods: This descriptive-analytical cross-sectional study was conducted in 2021. A total of 302 nurses were selected from four teaching hospitals affiliated with Yazd University of Medical Sciences. Data were collected using a standardized questionnaire designed to examine medication errors across three domains: managerial, human, and environmental factors. Data analysis was performed using t-tests, ANOVA, and Pearson's correlation coefficient with SPSS version 26 software.
Results: Managerial factors emerged as the most significant contributors to medication errors. The leading causes of errors within the managerial, human, and environmental domains were: nurse shortages relative to patient numbers (mean ± SD: 4.34 ± 2.44), fatigue due to workload (4.17 ± 0.98), and high work density during shifts (6–12 hours), respectively. A statistically significant relationship was observed between environmental factors and gender (p=0.008)
Conclusion: Strategies to mitigate fatigue from workload, such as balancing nurses' shifts and increasing staffing levels, are recommended to enhance nurses' performance and reduce errors. Additionally, developing standardized protocols, implementing continuous monitoring of medication administration, and fostering a culture of teamwork are critical in minimizing medication errors.
Hasan Jafari, Mohammad Kazem Rahimi, Farnoosh Ghomi, Atiye Dehghan Niri ,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Political intelligence is critical for enhancing managerial performance and organizational productivity, while effective communication skills are essential for successful leadership. This study aims to examine the relationship between political intelligence and communication skills among managers and officials in teaching hospitals in Yazd City.
Methods: This descriptive, cross-sectional, and applied study was conducted on 65 hospital managers, selected via census. Two standardized questionnaires were employed to measure political intelligence and communication skills. Data were analyzed using descriptive statistics and analytical tests in SPSS version 26.
Results: The mean (±SD) score for political intelligence was (107.15±11.96), and for communication skills, it was (59.46±7.46)—both above average. No significant relationship was found between political intelligence scores and any demographic variables. However, a significant association was observed between overall communication skills and the gender variable (p=0.029). Spearman’s correlation analysis revealed a positive correlation between political intelligence and communication skills (r=0.527).
Conclusion: The findings underscore the importance of enhancing both political intelligence and communication skills among hospital managers. In particular, the lower scores in the sub-dimensions of social games (within political intelligence) and feedback skills (within communication skills) indicate a need for targeted improvement programs. These enhancements could contribute to better managerial performance and overall organizational effectiveness.
Morteza Ghaderi Azarkhavarani, Mohammadreza Khajeh Aminian, Milad Ahmadi Marzaleh, Mohammad Hosein Yarmohammadian, Seyed Masood Mousavi, Hassan Nouri Sari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The Emergency Operations Center (EOC) is a centralized facility designed to coordinate disaster management activities across all phases of the disaster management cycle. EOCs play a vital role in facilitating efficient and effective responses by coordinating information and resources. This study aims to highlight the importance of establishing a standardized framework for EOCs in Iranian universities of medical sciences and to examine its key dimensions.
Methods: This study is a commentary article that compiles information from published literature on the framework of emergency operations centers. It focuses on two prominent global frameworks: the World Health Organization’s Public Health Emergency Operations Center Framework and the U.S. Federal Emergency Management Agency’s Emergency Operations Center Guidelines. The study emphasizes the necessity of creating a standardized framework for emergency operations centers in Iranian universities of medical sciences.
Results: EOCs across different countries vary in terms of their missions, authorities, and resources. Consequently, the frameworks used in these centers are not uniform, and are largely shaped by the governance and regulatory requirements specific to each country.
Conclusion: A standardized framework, tailored to the specific needs and conditions of Iran, is essential for EOCs at universities of medical sciences. Such a framework could enhance the operational capabilities of these centers during incidents and disasters, improving their responsiveness and effectiveness.
