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Dr Mohammad Arab, Seyed Masood Mousavi, Dr Aidin Arian Khesal, Dr Ali Akbarisari,
Volume 16, Issue 1 (4-2017)
Abstract
Background: in order to quality improvement, accreditation standards implemented with focus on the clinical and non clinical services. A nationwide intervention such as hospital accreditation can affect on measures related to the provision of high quality services. Indeed, such devices can be considered as effective tools in macroeconomic health sector policymaking. The main objective of current study was to investigate the effect of accreditation system on the key performance indicators of hospitals affiliated to Tehran University of Medical Sciences.
Materials and Methods: The study was a semi-experimental and descriptive-analytical one which conducted longitudinal using an Interrupted Time Series Analysis approach. Data related to the key performance indicators including average long of stay, Caesarean percent, turnover rate, patient satisfaction percent, bed occupancy rate, self-ordered discharge from emergency room and net death rate) was accumulated through multiple visits to the hospitals during 2012-2014. STATA software was used for data analysis.
Results: The study results revealed that based on implementation of accreditation model, the average stay of patients in the hospitals cesarean section rate and turn-over intervals decreased, while the percentage of patient satisfaction and bed occupancy average increased. Moreover, self-ordered discharge from emergency room and average of net death rate indicator showed no change.
Conclusion In general, it can be concluded that the health system partially has achieved a part of their objectives means key performance indicators promotion as a result of hospital accreditation implementation in hospitals affiliated to Tehran University of Medical Sciences. In order to assess more accurate investigation and understanding the nature of the system effectiveness, analysis of different aspects of hospitals performance indicators and the nature of their changes in longer period seems to be helpful.
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
Yeganeh Hayati , Dr Elham Movahed , Dr Mohammad Arab ,
Volume 16, Issue 1 (4-2017)
Abstract
Background: Hospital managers inevitably have a major impact on their employees' health and because professional cohesion acheives in the shadow of psychological balance; possessing mental health is important among hospital staff. Therefore, current study aimed to determine the status of managers' leadership style and its relationship with mental health staff of hospitals affiliated to Tehran University of Medical Sciences in 2014.
Materials and Methods: This study was a cross-sectional and descriptive-analytical one and sample size consisted of 91 executives, intermediate managers and 320 employees of hospitals affiliated to Tehran University of Medical Sciences. Fiedler leadership style instrument and general health questionnaire were used. Collected data was analyzed by SPSS software version 22 using descriptive and inferential statistics tests.
Results: Responsive rate was85% (272/320). Most of managers adopted task-oriented leadership style. There was a statistically significant relationship between leadership style and mental health, physical problems, anxiety, social function and depression among staff (P<0.05).
Conclusion: Managers can be effective on mental health staff using relationship-oriented leadership style adoption and it seems necessary to train managers in adopting appropriate leadership models and styles in order to prevent and reduce mental health disorders among employees in different situations.
Dr Afsaneh Keramat, Dr Forozun Olfati, Dr Saeed Asefzadeh, Dr Nasrin Changizi, Dr Masoud Yunesian,
Volume 16, Issue 2 (7-2017)
Abstract
Background: Because of the current population policies adopted in Iran followed by increasing the number of births, this study aimed to investigate the current situation of safe delivery and proposed a model based on clinical governance.
Materials and Methods: This study is a combinatorial-exploratory research (Mixed Method) conducted in four hospitals in Qazvin and Semnan provinces including two stages in 2014. The first stage was the assessment of current situation; clarifying safe delivery, reviewing literatures, providing two checklists, assessment of current situation based on assessment of continuous quality improvement and assurance of the quality and the second stage was presenting the model including codification of safe delivery model in seven axes of clinical governance, the approval of the model on the panel using nominal group technique.
Results: In quality assurance, hospital (4) and hospital (2) obtained the maximum score (1431) and minimum score (1237) respectively. All hospitals in continuous quality assessment, admission in the intensive care unit (P < 0.001), mothers with severe consequence of pregnancy (P = 0.004) and 16 cases out of 27 errors had significant statistical difference.
Conclusions: In order to improve the quality of Maternity ward, hospitals' accreditation also should be based on the principles of clinical governance. In addition to evaluations based on quality assurance and annual accreditation, assessment using continuous quality improvement methods based on clinical governance is essential. The proposed model includes seven axes of clinical governance.
Sara Salehi, Dr Farnaz Khatami, Dr Siyamand Anvari, Dr Negar Omidi, Dr Mojtaba Sedaghat Siyahkal, Dr Mohammad Effatpanah,
Volume 16, Issue 2 (7-2017)
Abstract
Background: Decision to stop or continue the treatment after awareness about complications and risks is patients' rights. On the other hand, patient`s discharge against medical advice could threaten patients' health. This study aimed to determine the causes of patient`s discharge against medical advice to prevent negative effects on patients and health costs.
Materials and Methods: In this study, 342 patients who left hospitals regarding discharge against medical advice were enrolled. Up to 48 hours of leaving hospital, the patients were received telephone contact, and if consented, were asked about the potential causes and whether or not the explanation of nurses or physician about the risks and side effects of discharge against medical advice. Furthermore, causes of discharge against medical advice were categorized as patient, hospital condition and combined causes.
Results: Study findings revealed that 48.5% of patients with personal reasons, 26% because of dissatisfaction with the service and 25.5% due to a combination of causes left the hospital. Most of the patients were in emergency department (p<0.001). There was relationship between type of disease (p= 0.037) and referred shift of patients (p=0.002) with type of discharge.
Conclusion: Given to the study results, it seems that planning for providing and maintaining human resources, training staff especially new entrance, monitoring medical team performance and organizing the triage system are essential in patient`s discharge against medical advice.
Mobin Sokhanvar, Dr Alimohammad Mosadeghrad,
Volume 16, Issue 2 (7-2017)
Abstract
Background: Organizational culture has a crucial role in hospitals’ productivity. The success or failure of strategies and plans in organisational change depend on organizational culture. This study aimed to examine the organizational culture of Tehran hospitals in 2014.
Material and Methods: This descriptive-analytical study was carried out in 18 hospitals (public, private and semi-public hospitals) that were selected out of 114 hospitals of Tehran using quota- randomized sampling method. About 696 employees in diagnostic, curative, administrative and logistic departments participated in the study. Data was collected through a valid and reliable questionnaire and analyzed using SPSS20. Spearman, U Man- Whitney and Kruskal- Wallis statistical tests were applied.
Results: The mean score of organizational culture was 3.62 out of 6 (moderate). There was a significant relationship between organizational culture and the type of hospitals (p=0.002). The mean score of organizational culture was higher in Private and Semi-public ecurity hospitals respectivey. Attention to details and customer orientation dimensions were high in public and semi-public hospitals and private hospitals respectively. The most and the least mean score of organizational culture was related to administrative and support services units.
Conclusion: Organization culture was evaluated in moderate status in hospitals of Tehran city. Thus, it is recommended that hospital managers improve hospitals 'organizational culture specially in creativity, innovation, integration and teamwork dimensions using organizational engineering culture plans.
Elham Haghshenas, Dr Mohammad Arab, Dr Abass Rahimi, Dr Elham Movahed,
Volume 16, Issue 2 (7-2017)
Abstract
Background: The quality of services is a comparison of the customer´s perspective (expectations) with what it has received. If the expectations are more than perceptions, the quality of received services is not sufficient based on customer´s view which resulted in his/her dissatisfaction. The present study performed with the purpose of determining the quality of provided and excepted services to outpatients among hospitals affiliated to Tehran University of Medical Sciences.
Material and Methods: The present study is a descriptive- analytics and cross sectional one which has been done in 2015. The study population included all outpatients attending hospital clinics affiliated to Tehran University of Medical Sciences.The sample size was calculated 225 participants based on formula. In order to data gathering in quality of provided and expected services, a 22-items standard questionnaire of Servqual was utilized. Data analysis performed by SPSS using paired t-test, Mann-Whitney and Kruskal-Wallis tests.
Results: The study findings represented that there was a negative gap in the quality of services provided. The highest gap was related to accountability (-0.97) and the lowest gap related to tangibles factors (-0.69) .Moreover, regarding to relationship between demographic variables with perceived service quality, there were significant relationship between insurance type with reliability and empathy dimensions and supplementary insurance with tangibles factors and reliability.
Conclusion: Negative gap (higher expectations than perception) in all aspects of quality improvement is required in all dimensions. Especially, it is necessary to adopt some strategies in the accountability dimension. Reforming management processes, reducing waiting times and increasing employees' motivation in order to achieve appropriate accountability are in this kind of strategies.
Dr Ebrahim Jaafaripooyan, Dr Golrokh Atighechian, Ameneh Saradar,
Volume 16, Issue 2 (7-2017)
Abstract
Background: Hospitals directly affected by disasters and crises which will be provided services facing with crises by well-informed and high performing personnel. This study aimed to determine self-efficacy level in disasters among senior managers of hospitals.
Materials and Methods: This study was a descriptive-analytical and applied one which was conducted in all public and private hospitals affiliated to Tehran University of Medical Sciences in 2015. Study population was all senior managers of hospitals and data was collected by a researcher-developed, valid and reliable questionnaire. Data analyzed using descriptive and Inferential statistics.
Results: Self-efficacy facing with crisis was assessed on average level (101 out of 130) and high among married men with previous experience in disasters. Also, self-efficacy level reported high among aged and position of ED managers. Nevertheless, there was no significant relationship between self-efficacy and participation in educational course and hospital ICS membership.
Conclusion: Given the relationship of self-efficacy with the aged and prior experience in disasters, these variables should be considered in selecting proper people for these positions. Moreover, having successful experiences dealing with challenges enhances the level of Self-efficacy among managers. Hence, using some techniques such as simulation or providing maneuvers can acquaint managers with the possible conditions facing with disasters.
Dr Mohammad Arab, Serajadin Gray, Pejman Hamouzadeh, Farhad Habibi,
Volume 16, Issue 3 (11-2017)
Abstract
Background: This study was conducted to validate the "staff attitude toward the use of coercion in the treatment of mentally ill patients" questionnaire and assessed their attitude in selected public psychiatric hospitals in Tehran city.
Materials and Methods: This is a descriptive and analytical study which was carried out on three hospitals of Tehran University of Medical Sciences, Iran University of Medical Sciences and social welfare and Rehabilitation University in 2015. The questionnaires were distributed to the participants and finally 273 questionnaires were used. Data were analyzed using confirmatory factor analysis test. Moreover, ANOVA and independent t-test were applied to evaluate the participants' attitude on using coercion for treatment of mentally ill patients.
Results: Study findings revealed that 61% of participants were nurse and 11% were physicians. According to the study results, three final obtained factors explained 61.93% of the total variance; this variance reflects the proper and appropriate selection of the questions. In addition, there were statistically significant differences between marital status and offending attitude domain; between job and education and offending attitude; and security and treatment domains.
Conclusion: The current questionnaire has a high validity and reliability and is also appropriate for the context of Iran. The attitude of the studied participants was a bit towards using coercion in treatment of mentally ill patients. Therefore, it is recommended that authorities take some steps toward changing health services providers' attitude of using coercion.
Dr Alimohammad Mosadeghrad, Erfan Shakibaei,
Volume 16, Issue 3 (11-2017)
Abstract
Background: Accreditation is an appropriate strategy for improving the quality, safety and effectiveness of hospital services. Iran national hospital accreditation was initiated as a government and mandatory program in 2012. This study aimed to identify the prerequisites of hospital accreditation implementation in Tehran province hospitals.
Materials and Methods: This qualitative study was performed using semi-structured interviews with 72 managers in different level from 15 university, private, military, social security and charity hospitals in 2016. Hospitals were selected purposefully through Tehran province hospitals. Content analysis was used in order to data analysis.
Results: Pilot testing of standards before announcing to hospitals for implementation, education and training of hospital managers and employees on accreditation standards, providing required resources, allocating enough time for implementing the standards and providing incentives for implementing standards are the main hospital accreditation prerequisites. Absence of these prerequisites in accreditation implementation resulted in huge challenges for hospital managers and employees.
Conclusion: Providing the accreditation prerequisites for hospitals facilitates implementation of hospital accreditation in hospitals which in turn results in quality improvement, safety and hospital services effectiveness.
Yeganeh Hayati , Dr Hojjat Rahmani , Dr Mohammad Arab,
Volume 16, Issue 3 (11-2017)
Abstract
Background: Health of hospital staff has a determinant role in increased productivity and since the main mission of hospitals is community health promotion, in order to achieve this important issue, monitoring, maintaining and improving general health is essential; this study developed to assess general health of staff affiliated to Tehran University of Medical Sciences and identify its related factors.
Materials and Methods: This Cross-Sectional, Descriptive-analytical study was conducted among 320 staff members of the Tehran University of Medical Sciences who selected using random sampling. In order to data collection, the General Health questionnaire was used. Collected data were analyzed using SPSS software through t-test and ANOVA tests.
Results: Study findings revealed that 47.5% of participants had psychological disorders suspiciously; prevalence of physical symptoms, anxiety, social dysfunction and depression were 53.9%, 49.3%, 79.5% and 14.6% respectively. There was a significant relation between general health and demographic features such as gender, marital status, major, job department, housing situation and type of employment (p<0.05). Also, the personal characteristics of managers influenced on the general health staff.
Conclusion: General Health of staff in hospitals Tehran University of Medical Sciences in comparison with similar studies at inside and abroad is not in good condition, therefore, it is recommended that policy makers and managers concerned the programs and solutions towards priorities in order to promote health personnel.
Yousef Pashaei Asl, Dr Ali Janati, Dr Masoumeh Ghliadeh, Dr Ebrahim Jaafaripooyan , Mohammad Taghi Khodayari, Dr Mohammad Arab,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Necessity of development, quantity and quality improvement needs of medical tourists had been unavoidable based on medical tourism growth with its competitive function. This study aimed to determine satisfaction rate of medical tourists referee to Tabriz hospitals to get treatment services.
Materials and Methods: This descriptive and analytical study was conducted on 82 medical tourists referee to all wards of selected hospitals using convenient sampling method in Tabriz city. Data was collected using a-28 items valid and reliable researcher made questionnaire. Cronbach’s Alpha was calculated 0.708. In order to data analysis, SPSS Software version 23 was utilized. Also, Spearman’s correlation coefficient was used to assess the association between different aspects of patients’ satisfaction.
Results: Satisfaction rate was obtained in five main aspects including cultural problems (51.88%), structural issue (57.50%), insurance payment system (16.04%), information system and communication channels (41.34%) the economic challenges (50.35%). The information system and communication channels had high effect on economic aspects (p<0.001).
Conclusion: It seems necessary that health policy makers and managers pay more attention to foreign medical tourists and faced challenges correction in order to change Tabriz city to a medical tourism center of excellence and improving regional economic development.
Soodabeh Khosravi, Dr Sayed Abolfazl Zakerian , Dr Khadijeh Adabi Bavil Aliaei , Dr Kamal Azam, Abolfazl Aliari,
Volume 16, Issue 4 (2-2018)
Abstract
Background:Human reliability assessment consists ofusing quantitative and qualitative methods to predict human contribution to the occurrence of error;so, using reliability assessment techniques is necessary to prevent and limit the consequences of errors in sensitive work environments.Healthcare considers as the high-risk areas.With due attention to the high rates of cesarean section in Iran, this study aimed at evaluating human reliability during this operation.
Materials and Methods:This was a qualitative-descriptive study which was performed as a cross-sectional one using the EMEA technique. At first, the process of operation was divided in to tasks and sub-tasks using the method of hierarchical task analysis. Then, according to the EMEA instructions, the work sheet was completed for all personnel in the operating room.
Results: A total of 126 errors, including 40 errors (31.75%) related to circular nurse activities, 34 errors (26.98%) related to anesthesia activities, 33 errors (26.19%) related to scrub nurse activities and 19 errors (15.08%) related to the activities of the surgeon, were identified.In general, skill-based errors (51.59%) and judgment-based errors (1.59%) were the highest and the lowest amount, respectively.
Conclusion:According to the study results, among three working groups, skill-based errors forcircularand scrub nurses and anesthesiology expert with the most frequency, and knowledge-based errorsfor surgeon tasks, with the highest frequency should be considered as priorities tocontrol errors.
Dr Hojjat Rahmani, Ghasem Rajabi Vasokolaee , Dr Jalal Saeidpour, Dr Mehdi Rezaei , Dr Somayeh Niakan, Bahman Khosravi ,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Considering the key role of human resource management in health care organizations, assessing human resources and its pathology are essential. Therefore, this study aimed to evaluate human resources pathology in Imam Khomeini Hospital complex in Tehran.
Materials and Methods: The present study was conducted using descriptive-analytical method in 2016. In this research, 342 employees of Imam Khomeini Hospital complex were selected. The data were collected using a standard three-dimension questionnaire, then, descriptive (frequency, percentage, mean, standard deviation) and analytical statistics (Pearson Correlation Coefficient) were used to data analysis.
Results: Study results revealed that the highest and the lowest mean and standard deviation were obtained for the variable of motivation and job satisfaction (3.51 ± 1.02) and improvement methods (2.81 ± 0.84), respectively. Among all studied variables, behavioral (3.29) and contextual (2.91) factors scored the highest and lowest points respectively. Correlation between structural, behavioral and contextual with demographics revealed a statistically significant association with sex.
Conclusion: According to study findings, considering the importance and role in providing the desired services, human resource managers should pay special attention to identify all organizational factors, especially organizational culture, motivation and job satisfaction, employee training, job security and customer orientation.
Saeid Mahmoudi, Zeinab Gholampour Noghondar , Farhad Habibi Nodeh, Hossein Safari, Parvin Abbasi Borogeni,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Length of stay is one of the most important and practical indices used in hospitals today which represents the performance and efficiency of the hospitals. This study aimed to identify the factors affecting length of stay in hospitals affiliated to Tehran and Iran Universities of Medical Sciences based on Hierarchical Analysis Technique.
Materials and Methods: This descriptive cross-sectional study was conducted in 2013. Study population consisted of 40 participants using purposive sampling method in the two groups including 13 matrons (nursing managers) and 27 supervisors (Clinical and educational) of hospitals affiliated to Tehran and Iran Universities of Medical Sciences. Data collection tool was the paired comparisons questionnaire which was confirmed validity by experts using Lawshe and reliability by Inconsistency Ratio. Data analysis was performed using Expert Choice software version 11.
Results: In general, in the studied hospitals, study results revealed that the "diagnostic, treatment and care methods (treatment efficacy)” with the mean of 21.4% and "admission and discharge in the end days of the week and the days off” with an average of 0.36 were the highest and the lowest priority is given to other factors affecting the length of stay of the patient,respectively.
Conclusion: Efficacy of provided treatment through using equipment, appropriate diagnostic and therapeutic procedures and factors related to hospital manpower were effective on length of stay in quantitative and qualitative dimensions. These important issues need more planning and pay attention by hospital officials.
Serajeddin Grey, Abolfazl Rouzbeh, Bahman Khosravi, Farhad Habibi Nodeh , Arezo Rahbari, Hosein Safari,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Administrative violations of employees at their workplace create a conflict between individual and organizational goals. Due to the long process of handling these violations, this study aimed to identify and present some suitable solutions in order to reduce delay in the health sector.
Materials and Methods: This study was carried out at three steps. At the first step, causes of delay in handling of administrative violations were extracted along with the proposed solutions using interviews. In second step, Delphi method was applied in order to find out the agreement of experts on the suggested solutions. In third step, practical solutions were prioritized using the analytic hierarchy process.
Results: Overall, 23 out of 39 solutions were certified after consultation with experts running the first round of Delphi using the interview. These solutions were presented to 15 experts using a self-constructed questionnaire and 18 solutions were approved by the experts finally.Solutions were divided into six groups of motivational, organizational, administrative, process, and research group solutions.
Conclusion: Training as the main key to prevent the delay can work effectively at all levels and processes of service delivery. Hiring well-informed and conscious managers at various organizational levels as well as having experienced and mindful research group on administrative violations can speed up the process of handling these violations.
Dr Ebrahim Jaafaripooyan, Dr Abolghasem Pourreza, Dr Abbas Rahimi Foroshani , Rahele Maleki ,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Hospital managers' success depends not only on internal of the hospital environment, but also on the external. Considering the importance of the social responsibility of hospitals as an external organizational issue, this study aimed to assess the importance of social responsibility and the implementation status of hospitals.
Materials and Methods: This analytical descriptive study was conducted in Kermanshah educational hospitals in 2016. The study population consisted of management team of each hospital in middle and first-line level, of which 150 were selected using census sampling method. The data gathering tool was a researcher-made questionnaire. Validity and reliability of the instrument was confirmed. Data analysis was performed using SPSS20 software, descriptive and inferential statistics.
Results: The mean score of importance and status of social responsibility implementation were high (86.20 ± 9.98) and moderate (60.62 ± 12.41), respectively. Among the domains, the highest and the least attention were paid to environment (11.65 ± 88.30) and suppliers (13.47 ± 81.48) domains, respectively. The highest level of accountability in patients was (68.87 ± 26/14) and the least was found in organizational processes (14.47 ± 42.02). There was a significant statistically difference in social status according to organizational status and employment type (p <0.05).
Conclusion: The results revealed that the rate of social responsibility of hospitals was moderate. It seems that providing a systematic assessment of managers performance and authorities, functional feedback and using the successful experiences of organizations in the field of social responsibility are necessary.
Dr Hossein Dargahi, Seddigheh Asadi , Dr Batoul Ahmadi, Dr Mahmoud Mahmoudi ,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Today, the organizations have found their need to a strategic planning for valuation of knowledge management. One of the most important elements for knowledge management is organizational creativity and innovation. Therefore, this study aimed to determine the relationship between knowledge management and organizational creativity and innovation among Tehran University of Medical Sciences.
Materials and Methods: This cross-sectional study was a descriptive-analytical one which conducted in 120 employees of teaching hospital in 2015-2016. The study questionnaire included three questionnaires as Probst’s knowledge management questionnaire, researcher made questionnaire for organizational creativity, Patchen’s organizational innovation questionnaire and demographic information. SPSS software version 21 utilized to data analysis using descriptive statistics, independent t-test and Pearson correlation coefficient at the significant level of less than 0.05.
Results: The study results revealed that there was a relationship between knowledge management and creativity (r=0.661, P<0.001) and organizational innovation (r=0.325, P<0.001). Also, there was a significant association between organizational creativity with innovation (P=0.02).
Conclusion: Development of knowledge management could increase the rate of organizational creativity and innovation. Therefore, the policymakers, leaders and managers of hospitals should establish the knowledge management system to improve the organizational creativity and innovation, and finally promote the efficiency and effectiveness of hospital practice.
Dr Nader Tavakoli, Milad Amini, Dr Mahsa Mahmodinejad, Mohammad Veisi, Dr Hasan Amiri, Yousef Sadat, Ali Tahmasebi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Assessment of appropriate and inappropriate services offered at the hospital is a very important topic to improve resource allocation. Thus, this study performed to assess inappropriate admission and length of stay to modify extra costs and effective resource management.
Materials and Methods: This study was a descriptive-analytic one which conducted as a cross sectional study in the first half of 2017. The Appropriateness Evaluation Protocol(AEP) was used to collect data. A total of 420 patients hospitalized in Haft Tir and Firoozgar Hospitals were selected using stratified sampling method. collecting data was analyzed using descriptive and analytical statistics by SPSS18.
Result: 391 individuals were admitted appropriately and 29 were classified as inappropriate admission. The rate of inappropriate admission estimated about 7% in the hospitals. female Sex, type of admission, the length of admission and place of patient residence had effect on prediction of inappropriate admission rate (p ≤ 0.05).
Conclusion: Considering the high percentage of inappropriate admission and stay length of patients as well as high costs of health services in these hospitals, the problems can be greatly reduced using proper planning, admissions management between the hospital units.
Dr Alimohammad Mosadeghrad, Dr Ebrahim Jaafaripooyan , Mahdi Abbasi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: The success of organizations depnds on their managers’ performance. This study aimed to measure hospital managers’ performance in the city of sari in 2017, Iran.
Materials and Methods: About 294 top, middle and first-line managers working in the hospitals in Sari (including four public, two private and one social security hospital) particaipated in this descriptive and cross-sectional study. A valid and reliable questionnaire was used to assess managers’ performance in eight functions including decision making, planning, organizing, coordinating, leadership, communication, budgeting and control. SPSS software, the 21st version, was used for data analysis.
Results: The mean score of hospital managers’ performance was 3.87 out of 5. Managers scored high in organizing (4.12), leadership (4.06), and decision making (3.97) and low in budgeting (3.27), planning (3.83), and coordinating (3.84). Managers’ performance was linked to their age, marital status, education level, and educational background. Those managers who worked in a position related to their educational background had better performance.
Conclusion: Hospital managers rated their performance as good. Measuring managers’ performance, determining their strengths and weaknesses and applying corrective actions are beneficial to the improvement of hospitals’ performance.
