Showing 21 results for Mohammadi
F Ebadi Fard Azar, A Choopani , H Saberi Anari , N Mohammadi, Sh Arkian , F Choopani ,
Volume 11, Issue 1 (20 2012)
Abstract
Background: The existed difference statistical indicators is necessary to measure the efficiency of the health organization and as an exact strategy, could be removed the developed problems in heath services sectors.
Materials and methods: This is a descriptive research as a cross sectional study throughout obstetric and gynecology wards in the general hospital of RASOOL. The questionnaires and statistical Forms applied for data gathering. The methods were completed questionnaires, statistical Forms, face to face interviews and observation. The Delphi technique, standardized questionnaires and references’ text books used to determining the reliability and validity. Data analysis was done by using likret ranking.
results: The results showed that some indicators, such as inpatient bed occupied rate (63%), bed turnover interval(5) & mean length of stay(4), patient per nurse(19), meanwhile service education(10),staff per active bed(1for 12), midwife per delivery bed(0), staff(50.9%) and patient satisfaction(89%)
were lower than expected. Some indicators such as rooming in technique(100%), breast feeding(100%), patient information access from HIS system(100%), emergency and hostelling medicine access(100%), round and morning reports(100%), the mean admitted time in the ward(30 minutes), Infant and maternal mortality rate per total deliveries(0), and the percentage of trained patient(100%) were as expected. Some indicators such as expert physician per active bed (1 for 7) and C/S per total delivery ratio (69%) which was higher than expected, and the necessary data for calculating book & papers per assistant professor & non colonial infection rate were not found.
Conclusion: Hospital indicators showed the performance of hospitals in the various bases. Therefore,the broad attentions to these indicators are necessary. Meanwhile, it should be compared them and to distinct time periods.
A A Nasiripour, J Tabibi, F Mohammadi,
Volume 12, Issue 1 (21 2013)
Abstract
Background: In the absence of medical facilities in Social Security Organization (SSO) hospitals in provinces, the patients will be dispatched to Tehran. This will dissatisfaction and intellectual and emotional tensions and imposes a lot of costs upon SSO for dispatching the patients . The objective of this study is to compare franchise elimination of medical services in hospitals in contract with social security organization in Provinces with costs of patients dispatching to Tehran .
Materials and Methods: The study was done as retrospective and analytical research. The neurosurgical patients dispatched to Tehran were selected for the study (using the census method). The data were collected in information forms. Research finding were analyzed by SPSS software.
Results: Among studied provinces, Khuzestan province ,with 233 cases, had the highest frequency of patients dispatched and Zanjan and Golestan provinces with 2 cases had the lowest frequency. There was a significant difference between average of dispatching costs paid by SSO and the average franchise paid by patients (p<0.001) such that patients dispatching cost was higher than the franchise paid by patients. There was also no significant difference between average dispatching costs and franchise margin among studied provinces.
Conclusion: Considering the fact that cost of studied dispatching patients was higher than the franchise paid by them in exchange of medical services from hospitals in contract with SSO, elimination of medical services` franchise and treatment of patients in their provinces could decrease in the SSO costs compared with dispatching them to Tehran.
M Amiri, M Raei, Seiyed D Nasrollahpour Shirvani, Gh R Mohammadi, A Afkar, Ma Jahani-Tiji, Sh Aghayan,
Volume 12, Issue 1 (21 2013)
Abstract
Background: In case of disasters hospitals as one of the first centers to admit casualties need to be well prepared. This study aimed to determine the scale of preparedness of the hospitals located in the northern areas of Iran to deal with disasters.
Materials and methods: This applied and cross-sectional study was carried out in 2011. In this study all therapeutic-educational affiliated hospitals of Universities of Semnan, Shahroud, Mazandaran, Babol, and Guilan were investigated using the census method (53 hospitals). The data were collected using instruments were a managers' awareness Questionnaire (40 items) and a 141-item checklist which were filled using the self-assessment method. The data were analyzed using SPSS statistical software and Mann-Whitney , Kruskal Wallis and Pearson correlation coefficient statistical test.
Results: The average score of managers' awareness of the disaster confronting Preparedness status was 41.89±9.12 and hospital`s preparedness to confront disasters was 56.88±5.12 which show a mediocre level in all hospitals studied. There was a significant relationship (P=0.007) between the awareness of managers and receiving training on management of disasters. The least score was related to field of planning for decreasing structural risks (40.56±29.4 ).Significant relationships were observed between preparedness of hospitals in different universities and management plans for unanticipated events (P=0.047), hospital training program (P=0.019), planning for supporting vital services (P=0.005) and environmental health measures to deal with unanticipated events (P=0.001).
Conclusion: Regarding the previous of disasters in the studied provinces and the mediocre preparedness of the hospitals, educational planning to confront disasters, strengthening the hospital buildings and organizing practical maneuvers will be effective in enhancing the preparation of the hospitals.
Mr Dinmohammadi , A Hushmand , Ma Cheraghi , H Peyrovi ,
Volume 12, Issue 2 (9-2013)
Abstract
Background: Oppression as a phenomenon experienced by most of nurses might have a background in the historical, social, cultural, political and economic structures of a country. This study aimed to criticize and explore the phenomenon of oppression in nursing literature in order to find an explanation to manage the problem.
Materials & Methods: A literature review was conducted by performing a search on scientific databases (Pub Med, CINAHL & Ovid) using the key terms such as ―nurse/ nursing‖, and ―oppression‖ systematically. Eventually 31 articles published during recent two decades were selected to get reviewed.
Results: In this study, there has been an effort to define the terminology of oppression`s concepts and its historical background, attributes, and consequences. Furthermore, this study considered introducing available models and theories and preventive approaches and managing this phenomenon in nursing profession.
Conclusion: Hierarchal structures in hospital environment provide conducive conditions for the oppression to emerge. Presence and consistency of the phenomenon and its consequences have irreparable effects on nurses as well as their organization, patients and care quality. Adopting practical and effective strategies in a framework of supportive, informative, and educational actions and managerial policies from authorities and related organizations could create an effective environment, which will result in unity, empowerment and self-confidence of nurses.
M Mahboubi, A Jalali, M Mohammadi,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Job environment is a strong stimulus for created of emotions and there are several stressful situations which could causes dissatisfaction, low work performance, quit or job-changing. The purpose of this study is to determine the relationship between sensation seeking with job stress among emergency medicine workers and non emergency medicine workers.
Methods: In this cross-sectional study, 60 emergency medicine workers chosen the census method and 60 non emergency medicine workers chosen the convenience sampling method, in border cities of KUMS, were selected for study. Data were collected by valid and reliable questionnaires of job stress and sensation seeking. Data were analyzed using descriptive and analytical statistics.
Results: The most rate of job stress among emergency medicine workers was in the level of moderate (46.6percent) and in the non-emergency medicine workers was the low level (56.4percent) and the most rate of sensation seeking among emergency medicine workers was in the level of lower the moderate (35 percent) and in the non-emergency medicine workers was lower the moderate level (40 percent). There were indirect relationship between job stresses with to be thrilled, to be experienced and to be diversity of the variable of sensation seeking and there was a direct relationship between to be blues and to be scope of inhibition of the variable of sensation seeking.
Conclusion: Results can be regarded managers to decrease of losses due to job stress and increase productivity, especially in emergency medicine workers across the country
Mohammad Arab, Farugh Mohammadian, Abdolrasoul Rahmani, Abbas Rahimi, Leyla Omidi, Parvin Abbasi Brojeni, Mehdi Asghari,
Volume 13, Issue 3 (12-2014)
Abstract
Background and Objective: The operating room is one of the main units in hospital, where the most important phase of patient treatment is performed. This study aimed to investigate the safety attitude among the staff of operating room in selected hospitals of Tehran University of Medical Sciences.
Methods: In this descriptive - analytical study, 230 staff of operating room of hospitals affiliated to Tehran University of medical sciences were selected by Random cluster sampling. Research tool was a safety attitude questionnaire (Cronbach’s alpha 0.854) that classified in 3 categories: demographic questions (11questions), quality of communications (14questions) and safety attitude questions (58 questions). All data collected were analyzed using SPSS18. T-test, Spearman correlation, analysis of variance (ANOVA) and Chi-square have been used for data analyzing.
Results: The results indicated that 90.9% of staffs had moderate safety attitude and the average of the safety attitude score was 188.52(± 22.4). As the results showed, there was a positive and significant relationship between the safety attitude score and age, total work experience and work experience at hospital (p 046/0=, r =±0.141). There were significant differences between: average of the safety attitude score among men and women (P=0.047) average of the safety attitude score among staffs who have been trained and untrained safety (P=0.004).
Conclusion: The safety attitude score among the staff. It is therefore necessary to implement the effective interventions to improve safety attitude among operating room staff in understudy hospitals.
Keywords: Safety attitude, Operating Room, Hospital, Staff
Faramarz Pourasghar, Jafarsadegh Tabrizi, Nesa Kavakebi, Ahad Banagozar Mohammadi,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Patient transfer requires the wide variety of functions such as collaboration, appropriate communication and coordination between hospitals and the Center for Treatment Guidance and Information (CTGI). This study aimed at determining the influencing factors in the coordination of patient transfer and also explaining the situation of the CTGI in patient transfer process coordination.
Materials and Methods: This study was a qualitative study (phenomenology) conducted using three Focus Group Discussions (FGD) and thirty interviews with participants who were involved in the process of patient transfer in a referring hospital, six patient receiver hospitals and CTGI in Tabriz. Purposive sampling was used to select study participants. Data was analyzed using content analysis.
Results: The effective factors of the patient transfer coordination were categorized in four main themes including weakness in the exchange of clinical information, data constraints, legal protections weakness and guidelines implementation and lack of clinical empowerment in managing patient. Eighteen sub-themes were identified which include legal protections weakness and guidelines implementation in center for treatment guidance as sector problems.
Conclusion: There are some problems in coordination of patient transfer process which is relate to non adherence a specific procedure for admission , ineffective interactions and information exchange. In order to achieve uninterrupted medical treatment, the patient transfer coordination should be improved. The center for treatment guidance and information should be obtained its position as a supervising authority.
Dr. Nader Markazi Moghaddam, Reyhaneh Rahmati, Dr. Mojgan Mohammadimehr, Ebadollah Shiri, Dr. Sanaz Zargar Balaye Jame,
Volume 16, Issue 1 (4-2017)
Abstract
Background: Beside qualified and capable nursing personnel, nursing care development requires motivated nurses to work in an appropriate environment. This study aimed at determining the relationship between organizational climate and nurses' job motivation in selected Army hospitals of Tehran city in 2015.
Materials and Methods: In this study was a descriptive -analytical and cross sectional one. The sample size consisted of 340 employed nurses in hospitals with at least one year work experience which were stratified randomly selected based on work experience among four army hospitals in Tehran. Data were collected using two questionnaires including job motivation and organizational climate. In order to data .analysis, descriptive and analytical tests such as Pearson correlation coefficient were utilized.
Results: One hundred and eighty nine of participants (55.4%) were female. Mean age of nurses’ average was 32.22 ±9.8 years. More than half of nurses had evaluated group spirit as high level and hindrance, engagement, intimacy, consideration, spacing, thrust and production emphasis as moderate level. There was a direct significant relationship between all components of job motivation and engagement, intimacy, consideration, spacing, thrust and production emphasis (P<0.05). Furthermore, mental and official components of job motivation had an inverse significant relationship with hindrance component respectively (P=0.014, P=0.019).
Conclusion: Regarding the relationship between all components of the organizational climate with job motivation, attempt to improve these components will have significant impact on motivation improvement, reducing absenteeism and job dissatisfaction.
Hojat Sheikhbardsiri, Gholamreza Khademipour, Mohsen Aminizadeh, Roholallah Fatemian, Mohammad Mahdi Doustmohammadi ,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Physical and verbal violence against hospital personnel is very critical problems that could influence the quality of clinical and nursing cares. Today, problem prevention and identification of related factors with domestic violence against women have been considered as a health priority in many countries. Therefore, due to the importance of this issue, this study aimed to determine related factors with domestic violence against women in educational hospitals affiliated to Isfahan University of Medical Sciences.
Materials and Methods: This cross-sectional study was a descriptive-analytical one which conducted on 836 female employees using census method. Data collection performed using a researcher-made questionnaire. This questionnaire consisted of 34 items in four dimensions (physical, verbal and mental, sexual) and violence experienced by the husband. Data were analyzed using SPSS version 16 with descriptive statistics and analytic statistics such as Kolmogorov–Smirnov, ANOVA, independent t test, and Pearson correlation coefficient and multivariate regression.
Results: Study results revealed that verbal and mental (55.33%), physical (36.16%), and sexual (6.66%) violence were the most common type of violence against women, respectively. There was a significant statistically association between age gap, forced marriage, husband’s addiction, income and precedent violence Experience and violence against women.
Conclusion: This study presented prevalence and related factors of demotic violence among women. Therefore, it is imperative that health authorities, especially hospital managers, pay attention to this phenomenon assessing further investigation of factors related to violence against women in order to take the necessary steps to mitigate and reduce related factors using life skills workshop, training and counseling for couples.
Dr Aboulghasem Pourreza, Dr Batoul Ahmadi, Dr Jamil Sadeghifar, Mohsen Mohammadi, Mohammad Veysi,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Femoral fracture surgery is one of the most common and expensive surgical procedures and forearm fracture surgery is common performed by Ilam Imam Khomeini Therapeutic Center. This study conducted to analyze the difference in actual cost and global surgery tariffs in this hospital.Also, the related factors acutal cost of mentioned surgery were identified.
Materials and Methods: This cross-sectional and descriptive study was conducted on factors related to the actual costs of femoral and forearm fractures. The Activity-Based Costing approach identifies the related cost associated with these surgeries in through six steps. Data analysis was performed using Excel 2016 software.
Results: The avarage actual cost of the femur fracturs , the code 2 forearm and the code 1 forearm were 953 thousand and 700 tomans, 444 thousand and 400 tomans and 337 thousand and 800 tomans , respectively. The actual cost of surgery for femoral fracture per unit surgery was 406,000 and 400 tomans lower than the Ministry of Health's tariff. But ,the real cost of the code 2 forearm was 33 thousand tomans higher, as well as the code 1 forearm 20 thousand tomans higher than the global tariff.
Conclusion: Overall, there are significant differences between hospital costs and the Ministry of Health's global tariff. That can be corrected by improving the hospital's performance, as well as carefully examining the cost of global surgical procedures for amending the system of tariff regulation and make the actual amount closer to the tariff level.
Saeide Alidoost, Dr Aziz Rezapour, Rahim Sohrabi, Roghayeh Mohammadibakhsh, Dr Ali Sarabi-Asiabar, Narges Rafiei,
Volume 18, Issue 1 (5-2019)
Abstract
Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences.
Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013).
Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations; analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning and creating an organizational structure.
Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.
Niloufar Amiri Ghale Rashidi, Dr Alireza Namazi Shabestari, Alireza Arab Yarmohammadi, Maryam Mazinani, Sepideh Masoud Sinaki,
Volume 18, Issue 3 (10-2019)
Abstract
Background & Aim: The purpose of this study was to investigate the current organizational culture in Tehran University of Medical Sciences, which is to be considered in order to strengthen organizational culture.
Material & Method: The present study is a descriptive cross-sectional study and an applied research-based survey that was conducted in Tehran University of Medical Sciences in 2019. The sample size was calculated and analyzed using Cochran's formula for 306 people. In this study, Denison's Organizational Culture Questionnaire was used to collect data. Data were analyzed using SPSS software, descriptive statistical methods, one-sample mean and Pearson Correlation Tests.
Results: The average of organizational culture in Tehran University of Medical Sciences, in each component, culture of Involvement (2.29), culture of consistency (2.63), culture of adaptability (2.66) and culture of mission (2.58), Which represented a higher-than-average culture in all aspects of Denison's view.
Conclusion: The organization should do some corrective actions with respect to the components of adaptability (subculture of organizational learning) and Involvement (Capability Development), which has earned a lower score.
Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 20, Issue 2 (9-2021)
Abstract
Background: The outlook for hospital care is changing rapidly. Supply and demand stimuli in the health service system are changing dramatically. The health department of the Social Security Administration has also been challenged by the growing number of patients. This study was conducted to help this organization with the aim of designing a conceptual causal model of the interaction between supply and demand of health care.
Materials and Methods: This research is a qualitative study that was conducted in 2020. It presented a conceptual model in two steps in the first step, semi-structured interviews were used to extract important factors in the supply and demand of health services in hospitals. In the second step, the system simulation approach was used and the feedback relationships between the patient's routes to the hospital and the provision of medical services were presented.
Results: According to the study hypothesis, the prevalence of disease and budget allocation as an indicator of medical need and expected medical demand, positively affect the number of visits to hospitals of the Social Security Organization. Accordingly, four sub-models of patient flow, health care budget, treatment staff (physician, nurse) and hospital capacity were extracted.
Conclusion: Medical budgets allocated to hospitals to improve medical facilities and increase the number of staff, have created positive expectations among social security insured regarding the use of hospital services. Paying attention to providing sufficient manpower (doctor, nurse) and bed capacity with the budget which is spent for this service are the indicators of improving the quality of services.
Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 21, Issue 1 (5-2022)
Abstract
Background: The use of simulation models can help elucidate the intuitive behavior of complex health care problems. Today, the complexity of problems goes far beyond our capacity to solve them manually. System simulation is considered as a wise option by approaching structural problems and understanding the complex interactions within the problems and their changes. The purpose of this study is to review the most advanced applications of system dynamics in healthcare.
Materials and methods: This study is a systematic selection of articles that explored the applications of system dynamics in health care in 11 databases between 1999 and 2019. The focus of this research was on articles with the keywords including system dynamics in health care, dynamic health care analysis, continuous health care simulation or dynamic health care simulation.
Results: 79 articles related to system dynamics applications in healthcare were identified in databases. Eighty-five percent of the articles focused on finance, politics, government, regulation, public health, and health care planning. Among the articles, the patient's treatment path, obesity and demand for healthcare workforce were examined.
Conclusion: The tendency to use continuous simulation in healthcare has increased. However, the power of hybrid simulation can take advantage of the inherent strength of the system dynamics overview perspective, and in a hybrid model it can utilize a holistic perspective for managing health care systems. Potential areas with the application of systems dynamics in future research include planning and policy-making in public health decision-making, purchasing quality management, care and risk.
Saied Moradi, Mohammadreza Rabiee Mandejin, Mohammad Mohammadi,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The implementation of key components in the selection of meritorious candidates, ensuring they possess the necessary capabilities for key and sensitive positions, and adhering to the principle of meritocracy in the distribution of power and division of duties and responsibilities among society’s elites, not only contributes to the stability, growth, and development of the country but is also one of the secrets to the success and longevity of leaders. Therefore, this article aims to explain the factors influencing the competence development of public hospital managers, guided by the general policies of the health system.
Methods: The research was developmental in purpose and qualitative in method, utilizing thematic analysis. The statistical population included books, articles, documents, and knowledgeable human resources, comprising government management experts, hospital managers with a master's degree or higher, and at least ten years of experience in hospital management. The study employed a purposive approach with semi-structured interviews, continuing until theoretical saturation was reached (16 interviews)
Results: A total of 18 competence development factors were identified, categorized into 75 components and 671 dimensions. The implementation of the Strauss-Corbin model revealed that causal conditions included leadership, doctors, and staff. Intervening conditions encompassed the economy, research technology, and education. In addition to goals and missions, organizational platform, creativity, services, and structure were considered contextual conditions. Human resource management, public relations, and religion were identified as strategies, while the resulting consequences were classified into expertise, a knowledge-based economy, and internationalization.
Conclusion: According to the research findings, it appears that to advance, upgrade, and excel in hospitals that play a critical role in the health of society, these identified factors can be utilized to enhance the competence of public hospital managers.
Farokhlegha Mohammadi, Mandana Sahebzadeh, Yahya Hematyar Tabatabaei,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The complexity and extreme fluctuations in the healthcare environment, along with the occurrence of unforeseen disasters and risks, have increased the likelihood of disruptions in hospital supply chains. Strengthening supply chain resilience is a key strategy to mitigate these challenges and ensure the continued delivery of efficient and effective hospital services during crises. This study aims to conduct a structural analysis of the factors influencing the resilience of the hospital medical equipment supply chain using the Fuzzy MICMAC approach.
Methods: This mixed-method (qualitative-quantitative) study included faculty members knowledgeable in the field, heads of medical equipment departments in universities and hospitals, senior managers from medical equipment manufacturing and importing companies, and healthcare administrators. Data were collected through checklists and semi-structured interviews. Fuzzy matrix completion and MICMAC analysis were used for data processing, performed using Fuzzy MICMAC software.
Results: Among the identified factors, logistics management was found to have the highest impact on the resilience of the hospital medical equipment supply chain. In contrast, factors such as integration and coordination, cooperative relationships, competition, flexibility, human resource management, and risk/crisis management had the lowest direct impact. Environmental conditions, transparency and protection, information-sharing systems, and human resource management were identified as the least affected factors. Economic factors emerged as a highly influential indirect factor, significantly affecting supply chain resilience.
Conclusion: To enhance the resilience of hospital medical equipment supply chains, logistics management and economic factorsmust be prioritized. Additionally, agility and speed, risk/crisis management, competition, and the development of integrated and cooperative relationships play a moderately indirect role and should be considered in strategic planning.
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.
Niloufar Amiri Ghale Rashidi, Farin Razaghi Kashani, Ramin Rahimnia, Ebrahim Jaafari Pooyan, Alireza Arab Yarmohammadi, Hadi Mokhtare, Masoud Rafati, Zohreh Jabari Moghadam,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: In Iran’s health system, the lack of a systematic process for selecting managers based on the specific competencies required in medical universities and the health sector has long been a challenge. To address this gap, Tehran University of Medical Sciences took the lead as the first institution to design a competency mapping framework for frontline and middle managers, aiming to align managerial selection with the strategic goals of the health system.
Methods: Firstly, a succession planning committee was formed in the university’s Vice-Chancellor for Management Development and Resource Planning. Following an extensive review of relevant models and strategies by several expert panels, this committee proposed guidelines for selecting selecting managers based on merit and developed a competency mapping process.
Results: The competency mapping process was structured into eight steps, including: candidate eligibility screening, assessment of general and technical competencies, 360-degree performance evaluation, review of prior experience, and participation in a mentoring-based empowerment program.
Conclusion: Using this merit-based selection model, top-performing candidates could be successfully appointed to managerial roles. A key achievement of this process is fostering a culture of meritocracy and advancing the organizational maturity of the university. Competency and talent mapping can serve as a robust framework for succession planning and managerial development in medical universities and the broader health system. This approach might significantly contribute to optimizing the selection and development of future leaders for critical positions via identifying skill gaps, assessing development needs, evaluating performance, and enhancing talent identification.
Fateme Mohammadi, Hossein Dargahi, Sara Emamgholipour Sefiddashti, Mohammad Mehdi Aladdin,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: The healthcare sector is undergoing a profound transformation driven by rapid scientific, economic, and social advancements. The World Health Organization (WHO) emphasizes the necessity of medical equipment and supplies for reducing health disparities and achieving strategic health system objectives. However, there is a notable gap in the literature regarding this cost component within the Iranian health system. This study, therefore, aims to quantify the share of pharmaceutical and medical consumable costs in Iran's total health system expenditure.
Methods: This retrospective, cross-sectional study analyzed outpatient and inpatient medical records from 2018 to 2020. Data on the costs of pharmaceuticals and medical consumables were extracted from Iran's National Health Accounts (NHA) and the SPAS dashboard. The collected data were statistically analyzed to determine the proportional costs of these items relative to total national health expenditure.
Results: Between 2018 and 2020, inpatient pharmaceutical and medical consumable costs constituted 12% of the total health expenditure, demonstrating an annual decrease of 1.8%. In contrast, outpatient costs accounted for 19.5% of the total, with an annual increase of 0.7%. Basic health insurance allocated approximately 10.3% of its budget to cover these items, which corresponds to 31.5% of the nation's total healthcare spending.
Conclusion: The findings highlight the critical need for strategic interventions within Iran's health system. Key implications include the necessity for effective supply chain management, strategic planning to reduce import dependency, and robust mechanisms for monitoring prices. Mitigating the adverse effects of inflation and sanctions is paramount. Furthermore, increasing the healthcare budget's share of the Gross Domestic Product (GDP) and expanding insurance coverage are essential for ensuring financial protection for the population and advancing towards Universal Health Coverage (UHC).
Sara Emamgholipour, Fateme Mohammadi, Behzad Raei,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: Evaluating hospital efficiency serves as a critical tool for assessing the preparedness and responsiveness of health systems in times of crisis. Accordingly, this study examines the performance of hospitals affiliated with Tehran University of Medical Sciences in response to the COVID-19 pandemic during the years 2019 to 2022.
Methods: This analytical study assessed hospital efficiency using the Pabon Lasso model over the period 2019–2022. Additionally, statistical correlation analysis was employed to explore the relationship between changes in COVID-19 admissions and variations in hospital expenditures, revenues, average length of stay, and bed occupancy rates.
Results: The outbreak of COVID-19 led to a temporary improvement in performance indicators and more optimal utilization of hospital resources. However, following the subsidence of the crisis, hospitals reverted to their previous inefficient structures. In 2022, the operational structure of hospitals returned to pre-pandemic conditions, with only 14% of hospitals falling within the efficient zone. Compared to 2019, a 33% increase in hospitals located in Zone 1 and a 17% decrease in those in Zone 4 indicated a lack of progress in enhancing systemic efficiency. Moreover, the rise in COVID-19 admissions was associated with increased expenditures and subsidies, yet had no significant impact on hospitals’ direct income from patients. Functional effects were limited to a slight reduction in average length of stay and a modest increase in bed occupancy rates.
Conclusion: The findings highlight the absence of mechanisms necessary to sustain crisis management achievements and promote long-term efficiency. Health system preparedness for future crises requires continuous integration of crisis experiences, proactive planning, resource allocation, and the establishment of frameworks to maintain and enhance productivity under all conditions. Therefore, crisis management should not be viewed as a temporary response but rather as an integral component of the strategic and permanent structure of healthcare organizations.
