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Volume 7, Issue 1 (1 2008)
Abstract
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Volume 7, Issue 1 (1 2008)
Abstract
Sanaz Sohrabi Zadeh, Peyvand Bastani, Ramin Ravangard,
Volume 9, Issue 1 (9 2010)
Abstract
Background: Organizational Citizenship Behavior
indicates an individual cautious behavior that although is not known by formal organizational reward system directly, can have a positive and effective role on the organizational performance and lead to functional improvement. In this study the relationship between Organizational Citizenship Behavior and its determinant factors has been surveyed.
Materials & Method: This is a cross- sectional study that was done on an accidental sample of 130 staff working in Shiraz University of Medical Sciences (SUMS). The required data was gathered by using a questionnaire and descriptive statistics and person regression test were applied in significant level of 0.05.
Results: Results showed that there were statistically positive significant differences between OCB and organizational culture, personality and internal control focus (p<0.001) in contrast with the reversed and significant differences between OCB and job stress (p<0.001).In addition there were statistically positive significant differences between various dimensions of OCB with each other (p<0.001). furthermore , between courtesy and organizational culture, control focus and personality, citizenship behavior and organizational culture, sacrifice with culture and personality and between conscience and culture, the statistically positive significant differences were observed in spite of the statistically negative significant differences between courtesy, citizenship behavior, conscience with job stress and also between conscience and personality(p<0.05).
Conclusion: reducing job stress , existing organizational justice and the group oriented organizational culture and also staff` characteristics the same as personality , control focus, etc can have an effective role on the incidence rate of Organizational Citizenship Behavior shown by staff in Shiraz University of Medical Sciences . So attention to each of these dimensions and key factors and attempts for amplifying and supporting them by managers can develop these behaviors and lead to functional improvement in the organizations.
Ma Rezaei , F Ghahramani, Gh Sadravi,
Volume 11, Issue 1 (20 2012)
Abstract
Background: Medical diagnostic laboratories play an important role in diagnosis, treatment and prevention of the diseases. Today’s without assisting of the laboratories, conserving of public health and outbreaks prevention of infectious and genetic diseases is impossible. In this research the cases determined by the department of health and medical education questionnaire in quality control of public and private laboratories.
Materials and Methods: This study is a cross sectional (descriptive and analytic) in which 20 private medical diagnostic laboratories and 16 training centers were selected. The quality control standards were reviewed and compared.
Results: From 12 items of the questionnaire the two following items, rules and regulations in both private and public laboratories gained the highest priorities with 100% private and 93% governmental laboratories respectively. The lowest score was related to testing quality control of the laboratories with that of public and private ones, 82% and 75.7 percent respectively. In all that cases, governmental laboratories and training centers were rated lower than private labs.
Conclusion: This study showed that both private and public laboratories’ score were under below of standards. Governmental laboratories were rated lower than private labs. In private laboratories, identifying errors and in the governmental laboratories, testing quality control should be considered
J Moghri, A Ghanbarnezhad, M Moghri, A Rahimi Forooshani , A Akbari Sari, M Arab,
Volume 11, Issue 2 (22 2012)
Abstract
Background: Patient safety is one of the most important components of health care quality. Given that assessing the current culture of patient safety is the first step in improving patient safety, we decided to translate and validate one of the most used patient safety culture assessment tool (HSOPS questionnaire) for the first time in Iran, and in this way take a step toward improving patient safety in our hospitals.
Materials & Methods: This cross sectional study was done among four general hospitals of Tehran University of Medical Sciences (TUMS), which were selected purposefully. Questionnaires randomly distributed among 420 members of the study population, and were collected after completion. Results were analyzed using Confirmatory Factor Analysis (CFA), internal Consistency and correlation.
Results: The value of Fitness function (FF) was 14.25 and according to that, the value of Goodness of Fit Index (GFI) was 0.96. Almost in all of the dimensions, the internal consistency of items in the translated Persian questionnaire was lower than the original one and ranged between 0.57 to 0.8.
Conclusion: Regarding to the findings of this study the Persian translation of the HSOPS questionnaire is a valid tool for the assessment of patient safety culture in Iran's hospitals.
S.h Rahimi, M Masoumpour, E Kharazmi, Z Kavousi,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Hospital Emergency ward plays a pivotal role in hospital and health care system regarding necessity of immediate,qualicative and effective performance due to numerous and complicated processes happens in the emergency ward. QFD is one of the most effective methods used for designing and improving the quality in order to fulfill customers' expectations and improve their satisfaction from provided service.
Materials & Methods: This study is aimed to investigate following subjects : 1)identifying the customers' expectations (n=80) and service`s components (n=15) through interviews, 2) defining the relationship between patients' expectations and the service`s components, and also relationship between the service`s component themselves 3) designing the service quality model based on the house of quality diagram”
Results: After identifying 13 components of customers' expectations and 20 components of service, 9 components of service were prioritized as parts of service quality model in 3 levels: 1) Physician's office physical environment
2) Improving Nursing performance`s and hospital hotel`s service facilities ,equipping inpatient` room, physician`s room and triage space 3) Improving guide systems, providing adequate welfare for the patients' families, and facilitating the waiting room.
Conclusion: The current quality model designed in this study can be a general guide to improve the quality of services provided by the emergency ward. However, using this model has its limitations such as being complex and time-consuming.
Key words: QFD, House of Quality, Services of Emergency Ward
R Ravangard, V Keshtkaran, Sh Niknam, A R Yusefi, A R Heidari,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Hospital managers' decision-making styles indicate the usual pattern managers use to make their decisions. This paper is aimed to determine the variety of managers' decision-making styles` in public and private hospitals in Shiraz.
Materials & Methods: In this cross-sectional study, 106 administrative, financial, internal and nursing managers were selected from 28 public and private hospitals through census sampling technique to participate in this study. The data were collected by a 22-item questionnaire (α = 0.86) and analyzed using T-Test and ANOVA in significance level of 0.05.
Results: Studied managers used rational decision-making style more often than avoidance of decision-making style. Older and official managers and private hospital managers used the intuitive decision-making style more often.Managers who had not attended management training courses used the intuitive and dependent decision-making styles more often. Managers who were teaching in the fields of nursing and midwifery used rational decision-making patterns more often.
Conclusion: It seems necessary to provide sufficient ground for scientific and evidence-based decision making for all hospital managers. Therefore identifying present obstacles and providing an environment in which managers could improve their decision-making skills is recommended.
Mohammad Khammarnia, Dr Ramin Ravangard, Mohadeseh Ghanbari Jahromi, Asra Moradi,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Nowadays, Medical error as a major challenge has been attention of health authorities and community. The main purpose of this study was survey of medical errors in Shiraz public hospitals.
Materials & Methods: This study was a survey which conducted as analytical in 2013. Study population was Shiraz public hospitals which 10 hospitals were examined. Standard checklist was used for collecting data of medical error documentations. Data entered in SPSS software version 21 and used of descriptive, spearman and chi-square test for data analysis.
Results: the number of medical errors in hospitals during the one year was 4379 recorded and the most of error was related to larger hospitals. Nurses committed wrong more than other groups and systemic error had the highest frequency. There was a significant relationship between trespassing, time and type of error, (P=0.000). Moreover, there was a significant relationship between type of error with wards and hospitals). P=0.000, P=0.011 respectively)
Conclusion: The number of errors occurring in hospitals is symptoms of poor performance, therefore to prevent and reduce the medical errors and costs, managers should pay more attention to hospital performance and treatment guidelines are revised. Moreover, the hospital staff, especially nurses should pay more attention to their activities.
Sakineh Alizadeh, Mohammad Reza Maleki, Rahim Khodayari Zarnaq , Sajad * . Darzi Ramandi , Ahmad Sadeqi,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Strategy is one of the important factors affecting the organizational structure. Taking the relationship between these two mentioned factors into consideration is essential. This study surveys the relationship between organizational structure and strategies of public and private hospitals in Tehran.
Materials & Methods: This study is a descriptive and analytical study of 20 selected public and private hospitals conducted in Tehran in the year 2012. The statistical population included supreme hospitals managers .We did a complete count because the sample size was small(60 managers). Research instrument was Miles and Snow strategy and Robbins's organizational structure questionnaire. A panel of experts were used for validity of questionnaires while the estimation of their reliability was calculated by Cronbach`s Alpha which was 0.75. The data analysis was conducted with descriptive statistics and Spearman correlation test.
Results: Among the structural dimensions, “centralization” was between was 85% and 75%, “formality” was 92% and 88% and “complexity” was 81% and 100% public and private hospitals respectively. Dominant strategy for both groups of hospitals was analytic. Correlation coefficient between strategy and organizational structure in public hospitals was -0.2 and in private hospitals was +0.3 which showed that relationship was not significant.
Conclusion: There was not a significant relationship between dimensions of organizational structure and the dominant strategy (analytical strategy) in public and private hospitals. If these hospitals tend to follow analytical strategies, they should reduce their complexity. Moreover, centralization could be towards analytical strategies if there is a strict control on current activities and little on new ones.
Fateme Setoodehzadeh1, Mohsen Bayati, Zahra Kavosi, Mohammad Khammarnia,
Volume 14, Issue 2 (8-2015)
Abstract
Background: Approximately, more than 60 percent of the hospital costs allocate to hospital human resources. The study aimed at determining the number of nurses in the poisoning department of a general hospital in Shiraz.
Methods: This study was an applicable one based on hospital information. Study population was patients who referred to a hospital poisoning department of Shiraz in 2012. The medical records were checked up. Monthly stratified data was obtained from the statistics office and patient records (physician's orders and nursing notes) using a monthly systematic data collection randomly. Linear programming techniques using lingo version 8 software were performed to data analysis in order to calculating appropriate number of nurses.
Results: Two nurses in morning, two in evening, three in night and seven in all shifts were at least required nurses in the poisoning department of the general hospital. The number of available nurses was more than estimated number in the department.
Conclusion: The numbers of nurses were over the approximated number in the department in morning and evening shifts. Besides, the estimated of nurses from quantitative methods such as linear programming were lower than those calculated experimentally by nursing managers. It is recommended to Hospital administrators considering these techniques calculation to achieve appropriate distribution of staff in departments.
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Volume 14, Issue 4 (1-2016)
Abstract
Background: Three aspects of health, responsiveness rate and equitable financing introduced as the main goals of health systems. In this study, responsiveness rate was assessed among private and social security hospitals in 2013.
Materials and Methods: The descriptive-analytical study conducted as a cross-sectional one among 10 hospitals in Tehran city (20 percent of total social security and private, 8:2 respectively) in 2013. Study population consisted of all inpatients and outpatients referee to eight private and two social security hospitals and 333 subjects selected to data gathering randomly. The valid and reliable World Health Survey questionnaire was utilized. Data was analyzed by SPSS17 using descriptive statistic, Mann–Whitney and Kruskal–Wallis tests.
Results: In points of view among inpatient and outpatient, the mean score of responsiveness rate were 4.1±0.71 and 3.7±0.60 respectively. These amounts estimated 4.4±0.46 and 3.2±0.82 for inpatient and 3.8±0.58 and 3.5±0.63 for outpatient in private and social security hospitals respectively. Also, the mean score of responsibility rate assessed 4.4 in private hospital which was higher than social security ones (3.2); and this difference was statistically significant (P<0.001).
Conclusion: Responsiveness rate dimensions were evaluated moderate to high among assessed hospitals. These results were enhanced in private hospitals rather than social security ones. It is recommended that hospital managers should pay more attention to client and mechanisms to improve responsiveness rate and providing more services quality.
Alireza Jabbari, Maryam Gholami, Zahra Kavosi, Parisa Chamanpara,
Volume 15, Issue 3 (8-2016)
Abstract
Background: The subjects' demographic characteristics are factors influencing their viewpoints about healthcare quality and have a positive association with the clients’ satisfaction. This study aimed at investigating the role of demographic variables on medical tourists' viewpoints about service quality of hospitals in Shiraz.
Materials and Methods: This descriptive-analytical and cross-sectional study was conducted on 200 foreign patients who referred to Shiraz hospitals during the first six months of 2013. Data collection tool was a questionnaire consisting of two parts. In the first part, medical tourists' information was collected and in the second part, their expectations and perceptions of services quality were measured using adapted SERVQUAL scale. The validity was checked out by experts and reliability confirmed by Cronbach’s Alpha test for expectations and perceptions separately (90% and 89%). Finally, data analyzed through SPSS v.16 software using independent t-test and ANOVA.
Result: According to the results, the mean score of the quality gap was estimated -0.26 for people over the age of 50 years, as it was lower than other groups. Also, the lowest total values of this quantity were related to the individuals with low level of literacy and those who stayed less than 7 days for treatment which were estimated -0.32 and -0.36 respectively. In addition, based on statistically significant dimensions, married tourists, people from Oman and those who had received eye surgery had lower gap mean score than the other patients as their total values were estimated -0.42, -0.21 and -0.22, respectively.
Conclusion: In order to develop the medical tourism industry, the demographic characteristics of the subjects should be considered in policy making and service design which can be result in majority satisfaction.
Dr Zahra Kavosi, Fateme Setoodehzadeh, Mozhgan Fardid, Maryam Gholami, Marzie Khojastefar, Mahbube Hatam, Zahra Tahiati, Gholamreza Fardid,
Volume 16, Issue 3 (11-2017)
Abstract
Background: Reduction of errors is necessary to improve the quality of healthcare, promoting communication between the hospital staff and patients, and decreasing the patient's complaints in hospitals. Due to the high probability of error in the operating room (OR), this study aimed to detect the potential errors in the OR of Nemazee hospital using FMEA.
Materials and Methods: This study was a qualitative one which assessed Failure Mode and effects of OR in six steps using FMEA technique. At First, the OR activities were listed, then the failure modes were recognized. Next, the Risk Priority Number (RPN) of each error was calculated according to the indicators of Occurrence (O), Severity (S) and Detectability (D).
Results: Totally,204 failure modes in 36 activities in five process in surgery ward were recognized.15.7 percent of failure modes classified as high risk factors (RPN ≥ 100). The most and the least distribution of origin factors were related to human and organization and technical errors, respectively.
Conclusion: The majority of errors in OR was set in of human skills category. Besides, the most and the least failure modes were belonged to “patient anesthesia by circular activity number 20, RPN=1795.23)” and “not to oxygenation for patients (the activity number 36, RPN=99.33) respectively. Identification of 36 activities and 204 errors in the 5 processes of Operating Room represents the comprehensiveness of HFMEA method in the identification, classification, evaluation and analysis of the health system errors.
Dr Peyvand Bastani, Mohammad Ghasem Nezhad , Ali Reza Yusefi, Dr Ahmad Sadeghi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: One of the main components of the quality of health services is patient safety. This study aimed to determine safety culture status of psychiatric patients from the viewpoint of the medical staff of Ibn Sina and Hafez hospitals in Shiraz.
Materials and Methods: This descriptive-analytic study performed as a cross-sectional one in 2017. The study population included 165 health care personnel of the hospitals which were selected by census sampling. The study tool was a standard questionnaire for the hospital's safety culture. Data were analyzed using descriptive statistics and independent t-test, ANOVA, Pearson correlation coefficient and multivariate linear regression using SPSS version 23 software at a significant level of α = 5%.
Results: The average of safety status of the patients calculated 154.62 ± 19.74. The patient safety culture was estimated at an acceptable level (64.1%). The dimensions of personnel affairs (36%) and non-punitive responses to errors (34.7%) were in an unfavorable situation. There was a significant association between the employment status of personnel and patient safety (P<0.05).
Conclusion: Despite the acceptable condition of the patient's safety culture, however, the dimensions of the non-responsive response to the mistakes and issues related to the personnel were in an unfavorable situation and require prompt and appropriate actions. It is suggested that hospital authorities to provide the necessary interventions including cultures for reporting of errors, organizing comprehensive training programs, and continuously improving the clinical governance system.
Parnian Nikmanesh, Dr Zahra Kavosi, Dr Ahmad Sadeghi, Ali Reza Yusefi,
Volume 17, Issue 2 (9-2018)
Abstract
Background: Communication is one of the central concepts and an integral part of the nursing profession. This study aimed to determine the effect of communication skills training of nurses on patient satisfaction with nursing staff services in teaching hospitals affiliated to Shiraz University of Medical Sciences.
Materials and Methods: The Comparative study carried out in 2017. The research population included nurses from educational hospitals and patients referring to them. Four hundred patients were selected through convenience sampling method and one hundred trained nurses and one hundred untrained nurses were randomly chosen. The data collection instruments were a standard questionnaire. Data were analyzed in SPSS23 using T-test, ANOVA, Tukey test, and Pearson correlation coefficient at α = 5% level.
Results: Mean scores of nurse-patient commination and satisfication of nursing services among patients under care of trained nurses were 93.5 ± 21.08 and 176.24 ± 22.14 and mean score of patients under care of untrained nurses the scors 81.76 ± 18.83 and 166.36 ± 41.10, respectively. A significant direct correlation was found between nursing-patient commination score and patient satisfaction score (P= 0.023, r= 0.681). Patients under the care of trained nurses were more satisfied with nursing services than those served by untrained nurses (P= 0.012). The results revealed that patient satisfaction had a significant relationship with age (P<0.001) and marital status (P=0.031).
Conclusion: Implementation of communication skills training courses for nurses leads to improved patient satisfaction. Hospital directors are recommended to consider holding regular communication skills training courses for their nursing staff.
Ali Reza Yusefi, Zahra Ebrahim, Behjat Mohammadzadeh, Dr Peivand Bastani,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Brand loyalty is one of the most important factors in maintaining and success of huge organizations such as hospitals. This study aimed to survey the factors that affect the patients’ loyalty to hospital brands in teaching hospitals affiliated to Shiraz University of Medical Sciences (SUMS).
Materials and Methods: This cross-sectional descriptive-analytic study conducted in 2017. The study population consisted of 385 clearance patients who were admitted to educational hospitals in Shiraz using stratified sampling method in February 2017 to March 2018. Information was collected using a researcher-made questionnaire and data analyzed by descriptive statistics, T-test, ANOVA, and multiple regressions using SPSS version 23 at a significant level of α = 5%.
Results: Patients’ satisfaction (β=0.333, P<0.001), trust in brand (β=0.265, P=0.007), and commitment (β=0.181, P=0.011) had a direct and positive effect on the patients’ loyalty to the hospital brand.
Conclusion: According to this study results, hospital managers should pay an attempt to inform the patients about their treatment procedure, follow up the patients’ health after discharge, and increase the communication between personnel and patients. These could contribute to better image and experience for patients resulting in loyalty to the hospital brand.
Farhad Lotfi, Erfan Kharazmi, Mohsen Bayati, Hajar Alipour, Saeid Lohivash, Ali Jajarmizadeh,
Volume 19, Issue 2 (8-2020)
Abstract
Background: Estimation of cost functions is an appropriate tool for optimal resource allocation in hospitals. The present study aimed at estimating cost function for hospitals affiliated to Shiraz University of Medical Sciences.
Materials & Methods: In the current cross-sectional study, inputs, costs and resources data for 28 hospitals were gathered from hospital statistics and information system. Required data were collected monthly for two years (2015-2016). Then, The Cobb-Douglas cost function was estimated using panel data analysis. STATA 14 was used for data analysis.
Results: Estimates showed that hospitals' cost elasticity concerning the inpatient and outpatient admission were 0.555 and 0.058 for large hospitals, and 0.769 and 0.099 for small hospitals (P<0.01). Among hospitals inputs, the cost of a physician with coefficient 0.175 in large hospitals and 0.481 in small hospitals (P<0.01) was most cost driver. In studied hospitals, average cost (36,406,480 Rial) was higher than marginal cost (26,548,020). Moreover, scale economies index were in small, large, and all hospitals were 0.868, 0.613 and 0.729, respectively. The number of active bed, length of stay and teaching activity had a positive effect on hospitals cost (P<0.01).
Conclusion: According to the findings, to control costs, the hospital should manage most cost drivers, such as physicians and pharmaceutical costs. Moreover, According to the average and final cost and scale economies index, hospitals should expand their service provisions with current inputs and resources in order to reach the optimum point of output.
Zinab Shaker, Zohreh Shaker, Mohsen Barouni, Asma Sabermahany,
Volume 21, Issue 1 (5-2022)
Abstract
Background and Aim: Hospital is organization which its performance improvement is very important. In order to do this, we must evaluate the allocated resources and performance of hospitals. Calculating hospitals efficiency is one of the possible ways to evaluate the performance of them. In this study, the efficiency of allocated financial and human resources of public hospitals by provinces is examined.
Materials and Methods: This study was conducted in 2017-2018. Data were collected from 31 provinces of Iran. Input (including: number of physicians, number of nurses and number of active beds per ten thousand population) and output (number of hospitalizations and number of outpatients per ten thousand people). Data were collected from studies. The efficiency analyzing of the provincial treatment department was performed with DEAP software.
Results: The input population (nurse, doctor, bed) is related to hospitals and health centers in Semnan, Yazd and Mazandaran provinces And the least amount of input was related to Sistan and Baluchestan, Khuzestan, North Khorasan provinces. The highest output (inpatient and outpatient) belongs to East Azarbaijan province and the lowest output belonged to Hamedan province. Efficiency score, variable return to scale and constant return to scale for all hospitals in the country are 0.565, 0.813 and 0.47, respectively.
Conclusion: proper and correct distribution of resources between provinces may increase efficiency of resource distribution.
Mahshid Zare, Zahra Kavosi, Sedighe Sadat Tabatabaei Far,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The COVID-19 pandemic has brought a significant shock to healthcare systems worldwide, including Iran. The mental health of nurses, who have been at the forefront of the fight against the virus, has been profoundly impacted. This study aims to examine the mental health status of Iranian nurses during the pandemic.
Methods: This rapid review was conducted by searching keywords such as "Mental Health," "Nurse," and "COVID-19" in databases including Google Scholar, PubMed, ScienceDirect, ProQuest, Mag Iran, and Civilica. Articles were selected based on their titles, abstracts, and full texts in alignment with the study’s research objectives.
Results: The reviewed studies revealed a range of mental health disorders among nurses working in COVID-19 wards, with stress, anxiety, and depression being the most common. Several factors, such as demographic variables and the specific departments where nurses served, were identified as influencing their mental health. Given that the mental health of nurses affects the quality of care, resilience, and job satisfaction, various strategies have been proposed to improve their mental health.
Conclusion: The findings suggest that the mental health status of nurses is not at an optimal level, and neglecting this issue could lead to long-term harm to the healthcare system and its economic stability. It is recommended that healthcare managers and policymakers implement appropriate measures to address this critical concern.
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.
