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Volume 3, Issue 12 (1 2003)
Abstract
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Volume 7, Issue 1 (1 2008)
Abstract
F Behzadi, S Vatankhah, S Zargar, F Hosseini,
Volume 8, Issue 2 (23 2009)
Abstract
Background: Medical Equipments have main rule in patients diagnosis and therapy trend and society health. In addition, technology development and increasing prices of these equipments cause vast quantity of exchange is designated to equipments import. Regarding to present level of economical development ability of manufacturing for different kinds of medical equipments is high in our country, there is no need to import in many cases, of course we can have export in this area. The aim of this research is survey of quantity development of medical equipments export emphasizing on 87 article of fourth economical, social and cultural development plan law.
Material and Methods: This research is descriptive applied study. Data have been gathered from checklists, meetings with related experts, library and internet studies and eventually former research documents investigation. Finally data have been analysis through comparative and adaptive tables and comparison of statistics calculated from statistical forms and checklists.
Results: Export rate of medical equipment from 1/08% of import rate, before the fourth economical, social and cultural development plan law, has increased to1/77% of import rate, after that .This rate had a growth rate equal to 63/88%.The ratio of number of certifications on number of medical equipment companies from 1/4, before the law, has increased to 2/12 after that .This ratio had a growth rate equal to 85/96%.The number of medical equipment companies have been presented at international exhibitions has increased too, from 13 to 71.
Conclusion :In quantity development area, the actualized growth rate in medical equipment export in first two years of fourth development plan law, in spite of increasing import, is remarkable. In quality development area as results showed, while increasing in number of companies, the number of certifications that will increase export rate, has increased too. The number of companies have been presented at international exhibitions also has a considerable growth that shows medical equipment quality has improved that plays main role in medical equipment industry presentation to the international market.
H Ebrahimipour, S Heidari, L Doshmangir, H Esmailzade,
Volume 8, Issue 2 (23 2009)
Abstract
Background: Priority Setting is necessary. There are different ways of priority Setting. How they are used depend on the situation of the country.
Material and Methods: This research is literature review. Google Scholar, Medline, Iranmedex, SID, Irandoc data base are used to gathering data.
Results: According to this study, there are various standard ways to priority setting such as Essential national health research ( ENHR), combined method, The commission on health research for Development (COHRED), Five-Step Process of the Ad Hoc Committee on Health Research. These methods have their own characteristics. These methods vary from one country to another . However the final impact is the same.
Conclusion: The result shows that it is useful to know about priority setting and strength and weakness of them. Combined method is the best way because it has the strength of other methods and corrects weakness of them.
M Mohammadnia, B Delgoshaei, Sh Tofighi, L Riahi, A Omrani,
Volume 8, Issue 3 (7 2010)
Abstract
Background: However nurses are responsible for patients quality care legally and ethically, in other side, patients have rights to receive appropriate and quality care. The aim of this descriptive study was to explore SERVQUAL dimensions (Reliability, Responsiveness, Assurance and Empathy) of Nursing Service Quality (NSQ) at Tehran Social Security Organization (SSO) Hospitals.
Material and Methods: This study was carried out as an applied, descriptive and cross- sectional study during the summer and autumn of 2009 in Tehran SSO hospitals. Study tool was prepared on the basis of the standard and modified questionnaire of SERVQUAL based on Parasuraman, Zeithaml and Berry questionnaire (1988) for NSQ and consisted of 4 dimensions which were Reliability, Assurance, Empathy, and Responsiveness. The population for this study included of all inpatients of selected Tehran SSO hospitals who were selected by random sampling (N=200). For accounting Means, Standard Deviations and percents SPSS (ver. 16) have been used.
Result:The total percentage of NSQ was upper middle (66), prescriptively Reliability (74), Assurance (69) and Empathy (64) were the most ones and Responsiveness (58) was the lowest.
Conclusion: The results of this study showed that NSQ was in desired degree from patients` perspective in selected hospitals. The health care managers should have been attention to nursing as an important workforce of a hospital for raising the service quality of their organizations .Nurses are main role in quality care improvement and patients satisfaction. So, actions regarding to improve their performance are useful and necessary. Due to lowest score of Responsiveness among nursing staff, we suggest training courses for improving organizational culture on responding and effective communication to achieve high quality performance of all nursing group staff.
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Volume 8, Issue 5 (21 2009)
Abstract
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.
Dr. Hamid Ravaghi, Dr. Zhaleh Abdi, Dr. Ali Heyrani,
Volume 13, Issue 4 (3-2015)
Abstract
Abstract
Background: Hand hygiene is the simplest and most effective preventive measures to reduce cross infection in hospitals. However, compliance with recommended instructions is commonly poor among healthcare workers. The present study aimed to explore potential behavioral determinants of hand hygiene compliance among healthcare workers in intensive care units.
Methods and Materials: A qualitative study was conducted, consisting of 42 semi-structures interviews with physicians (attending physicians, non-attending physicians, residents), nurses, nursing students and medical students, who worked in the intensive care units.
Results: Participants mentioned self protection as the main reason for the performance of hand hygiene. According to the participants, hand hygiene was often performed after direct contacts and tasks that were perceived to be dirty. Participants were most concerned about knowledge gaps in hand hygiene practice. Most participants believed that having a good theoretical knowledge of hand hygiene guideline may strengthen healthcare workers' attitudes toward hand hygiene. Junior practitioners believed that the superiors' hand hygiene practice could influence their performance both negatively and positively. Participant also believed that the lack of formal and informal control may hinder compliance among healthcare workers. High workload, interruptions, and limited access to hand hygiene products were mentioned as primary barriers to hand hygiene.
Conclusion: The findings revealed that a number of factors can influence had hygiene practice. Recommendations of the current study are of value to future researches aiming to improve compliance with hand hygiene behavior among healthcare workers.
Mahdi Farzadkia, Somayeh Golbaz, Haniye Sadat Sajadi,
Volume 14, Issue 1 (6-2015)
Abstract
Background: There are various departments in hospital that produce hazardous, infectious, pathological and radioactive wastes. Utilizing proper methods of waste management is of high priority in order to prevent from releasing these wastes to environment. This study aimed to evaluate waste management efficiency in Karaj hospitals.
Material & Methods: This cross - sectional study was conducted in Karaj during 2011-2013. All hospitals of Karaj had been selected as statistical population of this study (n=8) by census. The data had been collected by separating and weighting produced hospital wastes for 4 month (during one week at each month) and filling related checklists of health ministry. Collected Data had been analyzed using SPSS software.
Results: The daily capita of waste was 4.1 kg per active bed, 5.6 kg per occupied bed and 9.4 kg per patient. The overall percentage score of present status of hospital waste management was assessed 88% and in 12% which indicate moderate and weak levels respectively. Hospital waste management had been evaluated weak in terms of collection, transportation and personnel but seen from the viewpoint in the separation and temporary storage, it was assessed moderate. However, in terms of disposal, assessment of hospital waste management showed it is in a desirable status.
Conclusion: The present status of hospital waste management was far beyond the expectations among studies hospitals. Thus, developing an operational plan and monitoring its implementation is highly recommended to. Given the main weakness of hospital waste management was related to production, collection, separation, and transportation, taking these areas consideration is of high priority.
Seyed Hesam Seyedin, Mohammad Mohseni, Agha Fatemeh Hossaini, Mehdi Gharasi Manshadi, Heshmatollah Asadi,
Volume 14, Issue 2 (8-2015)
Abstract
Background: hospital is one of the most key institutions in the modern health care system and accountability is the most essential organizational functions. Accountability strengthens the main factors to responsibility regarding functions by pushing them up. This study aimed at assessing the situation analysis of performance accountability in teaching hospitals affiliated to Tehran University of Medical Sciences
Materials and Methods: This descriptive and analytical study performed at 12 teaching hospitals of Tehran University of Medical Sciences in 2013. Data collection performed by performance accountability checklist. Analysis was done by SPSS software version 19 using descriptive and analytical statistics test (Pearson correlation coefficient).
Results: In general, the condition of accountability for hospitals' performance (Mean =1.5 from 2) measured "good"(moderate to high). Strategic planning dimension achieved the highest score (Mean±SD:1.85±0.21) and Stakeholder Participation had the lowest score (Mean±SD: 1.12±0.46). There was a positive significant correlation between all variables (except Motivation) and performance accountability.
Conclusion: Weakness in any part of performance can affect other parts and have negative impact on total hospital performance. Mentioning the current situation of accountability for hospitals' performance and its importance, reinforcing weak dimensions and addressing deficiencies in performance accountability should be consider as managers' top priority.
Edris Hasanpoor, Bahram Delgoshie, Hassan Gorji, Masoomeh Khogam, Mobin Sokhanvar,
Volume 14, Issue 3 (9-2015)
Abstract
Background: one of the most essential components in patient- physician relationship is the length of visit. Short time visit can affect visit quality and patient- physician relationship. This study aimed at comparing specialists visit length with standards in general hospitals of Qazvin.
Materials and Methods: This cross-sectional study conducted in general hospitals of Qazvin in 2013. 428 patients were randomly selected to participate who were referred to the outpatient clinics of selected general hospitals. Studied specialties were including Internal Medicine, Surgery, Pediatrics and Obstetrics and Gynecology. In order to data collection, a Checklist including physician and patient related items was used and data analysis performed using SPSS version 19.
Results: The study results revealed the mean score of outpatients' visits length was 4.67±2.43 minutes which had a significant difference from standards (p<0.0001).Higher mean score was relate to pediatrics (2.55±7.08) and the lower one was internal physicians (1.82±3.93).
Conclusion: In this study, Visit time in developed countries was lower than developing ones. Several factors were identified which affect visit time. Thus, decision makers should use the results to improve outpatients visit quality.
Mahdi Kouchakzadeh, Zohreh Sohrabi, Ali Mohamad Mosadegh Rad,
Volume 14, Issue 3 (9-2015)
Abstract
Background: The emotional intelligence of nurses has several effects on their behavior skills. In this study, the relation between Emotional Intelligence (EI) and Communication Skills (CS) among emergency unit nurses was assessed.
Materials and Methods: In the descriptive analytical study, 253 nurses of fifteen IUMS hospitals were selected using census sampling method. The Golmans instrument for EI assessment and self -administered CS questionnaire filled by study participants. Validity and reliability of the questionnaire confirmed. SPSS software version 18 utilized to analysis using ANOVA, Spearman correlation test and Pearson correlation coefficient.
Results: mean of total EI estimated 78.31 which the highest and lowest score were in self-cognitive dimension (20.83) and self-management dimension (18.19) respectively. The total mean of CS was 70.90. There was a significant statistical correlation between EI and CS (r=0. 775, p<0.001). Moreover, there was a significant statistical correlation between CS and four dimensions of EI.
Conclusion: Based on study results, emotional intelligence and its dimensions had positive effect on communication skills among emergency unit nurses. Hospital managers can reinforce emotional intelligence by providing educational sessions. They should promote communication skills in emergency unit nurses and provide improvement emergency services quality.
Mohammad Noori, Nader Markazi Moghaddam, Reza Goudarzi, Zahra Meshkani,
Volume 15, Issue 1 (6-2016)
Abstract
Background: Suitable budget allocation of organizational activities can deliver the resources distribution, enabling operational monitoring and providing expected access to the cost results. The aim of this study was to calculate the cost of final units in one of the Armed Forces Hospitals.
Materials and Methods: One of the Armed Forces Hospitals selected in 2013.Data gathered from all cost centers to costs calculation and evaluated based on theory of Activity-Based Costing analysis. General wards and intensive care units, operating rooms, dental, emergency and dialysis were considered as final units. Cost calculation performed using Excel software version 2007.
- Total cost of hospital was 244,416 million rails in 2013 which direct and indirect allocated costs were 52% and 48%, respectively. The CCU, surgery ward, ICU and operating rooms had the highest and clinics and dental had the lowest in case of costs. More than 50 percent of the direct costs of all the units have been spent on manpower except the operating room. After labor costs, medication costs accounted for the largest percentage of direct spending units.
Conclusion: Paying attention to human resources in terms of number and distribution of all units especially in the final units, also considering medications use particularly in middle units and consumables in overhead ones especially can be result in reduction and adjusting hospital costs.
Seyed Hesam Seyedin, Ruholah Zaboli, Zeynab Malmoon, Fatemeh Rajabifard ,
Volume 15, Issue 2 (6-2016)
Abstract
Background: Today, due to the diversity of organizational structure and culture, the diversity is one of the basic principle in crisis management.Crisis management consists of six components including flexibility, inclusion, trust, risk perception, adaptability and equity.This study aimed at investigating the managers' perception about components of crisis management in hospitals affiliated to Tehran and Iran University of Medical Sciences.
Materials and Methods: This study was a cross-sectional one. A questionnaire was used to collect data using five likert scale. Validity and reliability of questionnaire assessed by content validity and Cronbach's alpha coefficient. Sixty six questionnaire were collected. Data analysis was performed by SPSS software using ANOVA and independent t-test.
Results: The highest and the lowest level of managers' perception were inclusion and equity(3.19 ± 0.51) and adaptability(2.73 ± 0.75), respectively. There was a statistical significant difference between crisis management components with gender and job type. The highest level of importance was regarded to inclusion and mutual trust between personnel and managers, and the lowest level was related to flexibility in hospital crisis management .
Conclusion: Employees in diverse positions have different definitions of adaptability in crisis. It is necessary to perform further research and educate hospital manager’s duties.
Raziye Beyranvand, Farbod Ebadi Fard Azar, Sara Emamgholipour, Mohammad Arab,
Volume 15, Issue 2 (6-2016)
Abstract
Background: Todays, hospitals are facing with shortage of resources and increasing costs challenges, So, cost information and cost calculation of hospital delivered services can be effective in efficient resources allocation and tariff rates reforming and budget. This study aimed at calculating the cost of services and physiotherapy department's income of Sina hospital and comparing with approved tariffs in 2013-2014.
Materials and Methods: This study was a cross sectional and retrospective one. The cost price of 13 physiotherapy services calculated using Activity Based Costing method for physiotherapy unit of Sina hospital of Tehran in 2013-2014. Data collection tool included some forms related to services costs of physiotherapy and related activity centers. Also, in order to estimate cost proportion of other wards in physiotherapy unit, the proportional allocation bases was determined, then direct allocation method was utilized.
Results: The most costs of 13 provided services were less than tariffs in 2013. Generally, the costs pertain of physiotherapy services computed 794286777 Rials which workforce costs (48.4 percent) was the most proportion and then energy buildings depreciation and equipment costs. This issue is due to equipment dependency in physiotherapy unit services.
Conclusions: study results revealed there was difference between real cost of services and approved tariffs, therefore, in order to more accurate pricing, exact calculation methods such as Activity Based Costing recommended. Considering high personnel and capital costs pay special attention to these resources, appropriate use, identifying and omitting wasted costs can be effective in increasing efficiency and saving costs.
Fatemeh Arabi Basharic , Mohammad Reza Mobinizadeh, Alireza Olyaeemanesh, Morteza Arab Zozani ,
Volume 15, Issue 2 (6-2016)
Abstract
Background: Intravascular imaging is a tool to detect coronary artery atherosclerosis which plays the major role in vessel stenosis degree determination and plaque pathology as a supplement of invasive angiography. This study aimed at comparing Intravascular imaging with invasive angiography.
Materials and Methods: For retrieving second type studies, PubMed, Cochrane Library and Centre for Review and Dissemination (CRD) were searched up to September 2013. Searching was carried out by two persons using angiography and intravascular imaging keywords. Studies which compared intravascular ultrasound technology with invasive angiography were analyzed.
Results: Based on studies which reported the rate of target lesion revascularization (TLR) after one year of follow-up, there was a statistically significant difference between intravascular ultrasound and invasive angiography alone. It seems that TLR rate was lower with intravascular ultrasound (P = 0.02).In terms of cost effectiveness, approximately 54, 000 USD spend per each QALY using IVUS method.
Conclusion: Although, intravascular ultrasound could be able to detect coronary arteries damages and help out physician in selecting the most appropriate treatment, but due to the high cost of an intravascular ultrasound catheter, the invasive angiography is choice of physicians and patients in coronary intervention.
Hamid Ravaghi, Sima Rafiei, Maryam Mohseni, Peigham Heidarpour, Mohammad Arab,
Volume 15, Issue 3 (8-2016)
Abstract
Background: Clinical Governance (CG) is a framework which obligates heath care system to responsiveness regarding maintaining and improving health care services' quality. Purpose of this study was to exists challenges in Clinical Governance establishment evaluation based on national assessors' aspect.
Materials and Methods: This qualitative study was conducted with national assessors' participation of Clinical Governance plan in 2014.Data collection was carried out using face to face interviews with assessors and analyzed based on content analysis.
Results: Three main themes were categorized including problems related to clinical governance standards, Existing challenges in assessment process and recommendations to improve quality assessment process.
From the assessors' aspects, the main existing challenges were lack of knowledge and adequate skills in some assessors towards CG, lack of sufficient accordance among assessors team, resistance of some universities and health care systems, lack of existing comprehensive guidelines with the purpose of responsiveness in related ambiguity in assessment and direction process among assessors.
Conclusion: Reinforcement of quality improvement culture in hospitals and increasing susceptibility in plan continuation, correct assessors election and ensuring about knowledge in responsibilities, updating assessors' training and putting to use equal indices in improving clinical governance assessment can be a considerable assist to improve assessment process and resolve related problems.
Monireh Koohsari , Dr Bahram Mohebbi, Dr Roya Sadeghi, Dr Azar Tol , Dr Abbas Rahimi Forooshani ,
Volume 15, Issue 4 (1-2017)
Abstract
Background: Considering the importance of standard precautions to prevent needle stick injuries and health care staff, this study aimed to determine the effectiveness of educational interventions to improve adherence to standard precautions, health belief model based on professional clinical staff needle stick two hospital "yaftabad" and "Ghiyasi" done.
Materials and Methods: This study was an experimental study of two group. The study population was 90 persons of professional clinical staff Shohada Hospital Yaftabad as the intervention group and 90 patients from the hospital Ghiyasi as compared to randomly selected and three part questionnaire including demographic, structures, health belief model , and practice questions were completed. In analyzing the data, descriptive and inferential statistical methods were used.
Results: At baseline, the two groups regarding demographic variables, health belief model structures and functional do not different between them. After intervention structures perceived severity, perceived susceptibility, perceived barriers, self-efficacy and performance of the experimental group showed statistically significant change (p< 0.05) that the effect of education based on health belief model.
Conclusion: education based on health belief model, you can increase the level of knowledge and capacity building and efficacy in clinical staff needs people to observe standard precautions
Mahnaz Afshari , Dr. Alimohammad Mosadeghrad , Dr. Mohammad Arab ,
Volume 16, Issue 1 (4-2017)
Abstract
Background: The health system of Iran is suffering from resources shortage. The health insurance companies (payers) do not confirm all hospitals’ claims (bills) and as a result do not reimburse them completely. Decreasing the amount of these deductions helps healthcare managers to use their resources efficiently. This study aimed to examine the impact of a quality management model on reducing the amount of healthcare insurance deductions at operating theatre department of Valiasr hospital in 2014-2015.
Materials and Methods: A participatory action research was used for the intervention. A quality improvement team was established and using the ten-step quality management model improved operational processes at operating theatre department. Related data were collected before and after the intervention to determine the effect of quality management system on deductions.
Results: The average deduction per patient at the beginning of the study was 339572 Rials. Illegible and uncompleted patient’s medical records, using wrong codes of surgery and anesthetics in documents and miscalculation were the main reasons of deductions. The reasons for deductions were identified and appropriate solutions were applied to decrease the amount of deductions at operating theatre department. The average deduction per patient at the end of study was 262818 Rials. The amount of deductions has decreased from 6.9 % to 3.8 %. The quality management system helped reduce the amount of deductions by 44.9%.
Conclusion: Implementing an appropriate quality management model appropriately helps reduce deductions in hospitals effectively
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.
