Dr Abbas Ziari, Dr Kambiz Abachizade, Dr Maryam Rassouli, Dr Mohamad Ali Haidarnia, Dr Mariam Mohseny,
Volume 13, Issue 4 (3-2015)
Abstract
Background:
Different approaches have been suggested to improve the quality of health care and the clinical governance is one of the main models. In the country, Clinical governance is initiated as a national model in 2009 and hospitals were forced to implement it. Only two hospitals of Shahid Beheshti University of Medical Sciences were approved according to evaluation of clinical governance implementation. This study aimed to describe and explain the barriers of clinical governance implementing in educational hospitals of Shahid Beheshti University of Medical Sciences.
Materials and methods:
In this qualitative study, conventional content analysis has been done. Twenty five participants involved in implementing clinical governance, including nurses, physicians, managers and the experts of hospitals and Ministry of Health, have been selected through purposive sampling method and interviewed in a semi-structural way till data saturation. Data were collected and analyzed simultaneously. Member check and peer check have done for data rigor.
Result:
Nine themes include human resource challenges, financing resource shortage, incomplete records and documentation systems, inappropriate organizational culture, lack of awareness of managers and employees, incomplete documented policies and procedures, inappropriate monitoring and evaluation, lack of inter-sector coordination and weak leadership were obtained and were placed in two domains input and process.
Conclusion:
The findings of this study indicate that there are several barriers for implementing clinical governance in hospitals that there is need to prioritize needs and to provide them appropriate solutions.
Sahba Sarvandi, Kambiz Shahroodi,
Volume 15, Issue 3 (8-2016)
Abstract
Background: Enhancing the need for health care services and its related costs, lead hospitals to improve and organize their processes. The aim of current study was to assess the Patients' Hospitalization and Discharge Processes Based on Kaizen approach and Multiple-Criteria Decision Making (MCDM) in an internal ward of one Hospital.
Materials and Methods: In this descriptive analytical study, ten managers completed the hospitalization and discharge questionnaires and answered three open questions according to Kaizen principles. Then, satisfaction score was measured for 100 patients using a reliable questionnaire (α=0.93). At third phase, after evaluating the proposed solutions using Analytic Hierarchy Process (AHP), the managers prioritized them based on cost, time and effectiveness considering indicators.
Results: Study findings revealed that mean scores of activity in hospitalization and discharge processes were 88.52 and 90.33 (out of 100) respectively, which showed high conformity with Kaizen approach. Also, mean scores of hospitalization and discharge satisfaction which indicated desirable satisfaction were 76.75 and 78.6 (out of 100), respectively. Based on managers' view points, results of MCDM and AHP methods indicated that effectiveness was the most important indicator and time as well as cost gained next priorities for solutions implementation.
Conclusion: This study showed that although, hospitalization and discharge processes were relatively desirable in the internal ward in mentioned hospitals, it is still a necessary to seek the best solutions in terms of effectiveness, time and cost for patients' satisfaction.
Samaneh Zarin Khalili, Hamidi Kambiz, Zahra Shirazian, Ali Asghari Sarem, Javad Niknafs,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: The simultaneous presence of multiple generations with diverse values and expectations has created significant human resource management challenges in hospitals, most notably intergenerational conflicts. This highlights the necessity for context-specific models to manage generational diversity effectively. Accordingly, this study aimed to develop an organizational "multigenerational gravity" model for hospitals affiliated with Hamadan University of Medical Sciences.
Methods: This exploratory and developmental study employed a qualitative design based on the interpretive paradigm and grounded theory methodology. Data were collected in 2024 through semi-structured interviews with 20 experienced hospital managers, as well as organizational and academic experts at Hamadan University of Medical Sciences. Participants were selected using purposive sampling until theoretical saturation was reached. Data analysis was conducted using a rigorous three-stage coding process: open, axial, and selective coding.
Results: The analysis yielded 6 main categories and 28 subcategories explaining multigenerational gravity. These were structured into a paradigm model comprising: causal conditions (e.g., structural and supportive constructs, leadership and governance, active intergenerational convergence); contextual factors (e.g., organizational culture, intergenerational adaptability, technological dynamism); intervening conditions (e.g., psychological and behavioral factors, resistance to change, generational gaps); strategies (e.g., strengthening organizational learning, developing participatory networks, promoting justice-based coordination); the core phenomenon (purposeful intergenerational coexistence and the reproduction of knowledge capital through organizational deliberation); and consequences (e.g., job satisfaction, development of a diversity-driven organizational culture).
Conclusion: This study provides a tailored model for managing generational diversity within the Iranian healthcare context. The proposed multigenerational gravity framework equips hospital managers with actionable insights to foster generational convergence, mitigate conflicts, and boost staff motivation and retention, ultimately enhancing service quality and organizational productivity.
