Journal of

Background: Nowadays, researchers pay special attention to patients' satisfaction with emergency care services, as the first line of hospital health care services. However, few researches have been done about its related factors in our country. The aim of this study was assessment of patients' satisfaction with emergency care services in six military hospitals in our country and its related factors.

 Material and Methods: In this cross-sectional study, Satisfaction level of 360 patients of emergency care services in six military hospitals of Iran in 2007 was assessed. After discharge from emergency ward, a checklist containing basic information and a 12-item questionnaire about their satisfaction level with emergency care services was completed for each patient. A 5-level Likert scale was used for the response of each item. 20 to 100 scores were allocated to each response (completely dissatisfied to completely satisfied), respectively.

 Results: 3559/4220 responses (82.4%) were completely satisfied or satisfied. In respect to priority "Observation of moral points", "giving information" and "behavior of reception personnel" had the highest and on the other hand, "variety of medical specialists", "emergency ward facilities" and "speed in calling doctor" had the lowest satisfaction scores. The total satisfaction score which was reported by patients older than 35 yr(p=0.022), insurance coverage(p=0.002) and with history of previous referring to that emergency ward(p=0.017) were significantly higher than others. Sex, marital status and educational level had no statistical correlation with the total satisfaction score(p>0.05).

 Conclusion: The findings of this study revealed favorable satisfaction level of patients with emergency care services in military hospitals. However, it seems that using a variety of expert physicians and more facilities and also improvement in the process of calling doctor in emergency ward are the aspects which need the most amount of concern of health care managers in emergency centers.

Background: Deciding on the number of hospital beds is one of the most serious challenges managers face. More hospital beds result in higher running cost although less hospital beds might cause disorder in patients flow.  Minimizing total cost besides maximizing the patients flow in a hospital network, considering the practical limitations is the main objective of this survey.

Materials & Methods: This study had main steps to investigate following: identifying current limitations of changing capacity of each ward, by conducting interview with hospital managers and other personnel of Modares hospital, analyzing cardiac patient flow analysis, simulating current flow, determining practical scenarios and choosing the best among them by mathematical modeling could minimize total cost and maximize patient flow.

Results: 31 practical scenarios have been determined and analyzed by surveying limitations among all existing scenarios. Finally, eight best scenarios had been selected. Results showed that decreasing the number of beds in CCU and increasing the number of beds in Post-CCU can improve patients flow, considering cost limitations.     

Conclusion: A recommended approach in this study can be a general guide for capacity planning with taking practical limitations into consideration. This survey could be useful for the managers who are against the benefits of post CCU  by comparing the patient flow with and without this ward.

Background: Strategic plan in hospitals will not be run spontaneously and managers encountered with some barriers in order to have a successful strategic planning implementation. This study aimed at recognizing the barriers of strategic plan implementation from hospital managers' perspective.

Materials and Methods: This cross-sectional study was performed in all Kerman hospitals in 2014. Fifty three individuals including chairmen, internal administrators, quality improvement managers, matrons and strategic plan executers participated by census sampling method. Data was collected using a questionnaire including demographic information and human, processes, structures and institutions factors affecting the strategies implementation. Data analysis was performed by SPSS software version21.

Results:  Study results revealed that the barriers to strategic plan implementation were structural factors (27.71±6.68), process agents (19.54±10.06), human factors (19.09±5.37) and institutional factors (15.73±4.52) respectively. There was no significant association between management background and barriers of strategic plan implementation in hospitals (P < 0.05).

Conclusions: In order to achieve desired results, chairmen and hospitals managers should be entirely conscious about barriers /failure factors of strategic decisions concerning foresight and appropriate managing or approaches change during strategic management process implementation.