Showing 255 results for Hospital
Ebrahim Bahrami Nia, Reza Shams Allahi, Sedigheh Gholamrezaee, Mohamad Mehdi Zare Shahne,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: Radiology departments are among the most critical units in hospitals due to their significant role in diagnosing and treating diseases. Given the high cost of radiology equipment and the revenue these departments generate, improving service delivery and enhancing efficiency are of paramount importance. This study aimed to evaluate the economic efficiency of radiology units in hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd.
Methods: This descriptive-survey research was conducted as an applied study. Data on input and output variables were collected from nine hospitals under Shahid Sadoughi University of Medical Sciences. Input variables included the number of expert staff, the number of radiologists, the number of radiology devices, and the number of CT scan devices. Output variables comprised the number of admitted patients, the number of registered radiological images, and the total revenue generated.
Results: The average technical and scale efficiency score was 0.910. Among the radiology units studied, 55% were found to be economically inefficient. Shahid Sadoughi Hospital exhibited decreasing returns to scale, while Shahid Beheshti Taft, Khatam al-Anbia Abarkouh, Waliasr (AS) Bafq, and Ziaei Ardakan hospitals showed increasing returns to scale. Additionally, Dr. Rahman, Afshar, Fatemeh Al-Zahra (S) Mehriz, and Imam Jafar Sadiq (AS) hospitals demonstrated constant returns to scale.
Conclusion: Eliminating surplus manpower, based on the results of the Data Envelopment Analysis (DEA) method, plays a crucial role in reducing hospital and healthcare sector costs and enhancing hospital efficiency.
Roohollah Askari, Hassan Jafari, Arefeh Dehghani Tafti, Neda Futuhi Tafti,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: Nurses, as the closest healthcare providers to patients, hold significant popularity and trust. Strengthening their competence in spiritual care is critical in ensuring holistic healthcare delivery. This study aimed to evaluate the spiritual care competence of nurses working in selected teaching hospitals of Shahid Sadoughi University of Medical Sciences in Yazd in 2023.
Methods: This cross-sectional study was conducted on 262 nurses employed in three selected teaching hospitals (Shahid Sadoughi, Shahid Rahnamoun, and Afshar hospitals). Data were collected using the Standard Spiritual Care Competence Questionnaire (SCCS) and analyzed through ANOVA, Mann-Whitney, Kruskal-Wallis tests, and Spearman's correlation coefficient using SPSS version 21 software.
Results: The overall mean score and standard deviation of spiritual care competence among nurses were 83.9±18.2, indicating an optimal level of competence. Among the dimensions of spiritual care competence, the "personal support and consultation with the patient" dimension scored the highest (18.8±5.2), while the "communication" dimension scored the lowest (7.3±1.6). The highest overall competence score was observed at Shahid Rahnamoun Hospital (88.5±17.7)
Conclusion: While the overall competence in spiritual care among the nurses studied was favorable, the low score in the communication dimension highlights the need for workshops focused on effective nurse-patient communication. Developing these skills can significantly enhance nurses' roles in improving patient health outcomes.
Seyed Mohammad Mahdi Heydari Baghdadabad, Alireza Maetoofi, Ali Farhadi Mahalli , Mojtaba Tabari,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Hospitals play a critical role in promoting public health and well-being in social contexts. This necessitates codified standards aimed at maintaining treatment quality and enhancing social satisfaction. Hospital accreditation policy evaluation is considered a systematic process that can have significant social and functional implications for hospitals. This study aims to present an evaluation model of hospital accreditation policy based on the process of paradigmatic phenomenology.
Methods: Using Husserl's (1970) phenomenological approach, this study developed a paradigmatic evaluation model in five analytical steps. First, through interviews with experts and open coding, propositional themes related to the phenomenon under study were identified. A focus group was then formed to discuss and analyze these propositions. Each proposition was scored using the Q-method checklist, with scores ranging from +6 to -6, to identify paradigmatic clusters.
Results: During the qualitative analysis, 16 interviews resulted in 138 open codes. After eliminating redundancies and overlapping codes, 50 propositional themes were finalized. These themes were organized into conceptual clusters within the framework of paradigmatic phenomenology, following Husserl's methodological steps.
Conclusion: The study's findings underscore the formation of a hospital accreditation policy evaluation model structured around causal, intervening, contextual conditions, strategies, and outcomes. This model has the potential to enhance the effectiveness of healthcare service delivery and improve the overall quality of treatment in society.
Khatere Khanjankhani, Tina Seirafi, Sajjad Bahariniya, Atefeh Ebrahimi, Seyed Masood Mousavi,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Medication errors, which are more commonly committed by nursing staff compared to other hospital personnel, can lead to severe and sometimes irreparable complications for patients. This study aimed to investigate the factors contributing to medication errors among nurses in selected hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd.
Methods: This descriptive-analytical cross-sectional study was conducted in 2021. A total of 302 nurses were selected from four teaching hospitals affiliated with Yazd University of Medical Sciences. Data were collected using a standardized questionnaire designed to examine medication errors across three domains: managerial, human, and environmental factors. Data analysis was performed using t-tests, ANOVA, and Pearson's correlation coefficient with SPSS version 26 software.
Results: Managerial factors emerged as the most significant contributors to medication errors. The leading causes of errors within the managerial, human, and environmental domains were: nurse shortages relative to patient numbers (mean ± SD: 4.34 ± 2.44), fatigue due to workload (4.17 ± 0.98), and high work density during shifts (6–12 hours), respectively. A statistically significant relationship was observed between environmental factors and gender (p=0.008)
Conclusion: Strategies to mitigate fatigue from workload, such as balancing nurses' shifts and increasing staffing levels, are recommended to enhance nurses' performance and reduce errors. Additionally, developing standardized protocols, implementing continuous monitoring of medication administration, and fostering a culture of teamwork are critical in minimizing medication errors.
Leila Vali, Hojat Farehmandnia, Ahmadreza Mohammadpour,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose:
As people age, physical dysfunction often increases, leading to various challenges and a heightened need for urgent medical services. Elderly individuals are among the primary users of healthcare and pre-hospital emergency services. Their subjective experiences during emergencies are influenced by their need for timely and relevant information regarding emergency procedures and their clinical condition—a need that is also shared by their caregivers. This study aims to elucidate the experiences of elderly individuals who have used pre-hospital emergency services in Shiraz.
Methods:
This qualitative study was conducted in two phases. In Phase 1, semi-structured interviews were conducted with 21 elderly participants using purposeful and snowball sampling until data saturation was achieved. The interview transcripts were analyzed using Colaizzi’s method to extract key themes. In Phase 2, a panel of experts was convened to further discuss the findings and provide recommendations.
Results:
Analysis of the interviews revealed several themes related to the elderly’s experiences with pre-hospital emergency services. These themes were categorized into sub-themes including ambulance condition, performance of technicians, timeliness of emergency response, and issues related to emergency rules and regulations. In Phase 2, the expert panel offered practical solutions to address the identified challenges.
Conclusion:
The findings indicate that elderly patients face significant challenges when accessing pre-hospital emergency services, such as poor ambulance conditions, suboptimal technician performance, delayed emergency response times, and restrictive emergency protocols. The recommendations provided by the expert panel could inform policy development and lead to improvements in the quality of pre-hospital care for the elderly.
Hasan Jafari, Mohammad Kazem Rahimi, Farnoosh Ghomi, Atiye Dehghan Niri ,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Political intelligence is critical for enhancing managerial performance and organizational productivity, while effective communication skills are essential for successful leadership. This study aims to examine the relationship between political intelligence and communication skills among managers and officials in teaching hospitals in Yazd City.
Methods: This descriptive, cross-sectional, and applied study was conducted on 65 hospital managers, selected via census. Two standardized questionnaires were employed to measure political intelligence and communication skills. Data were analyzed using descriptive statistics and analytical tests in SPSS version 26.
Results: The mean (±SD) score for political intelligence was (107.15±11.96), and for communication skills, it was (59.46±7.46)—both above average. No significant relationship was found between political intelligence scores and any demographic variables. However, a significant association was observed between overall communication skills and the gender variable (p=0.029). Spearman’s correlation analysis revealed a positive correlation between political intelligence and communication skills (r=0.527).
Conclusion: The findings underscore the importance of enhancing both political intelligence and communication skills among hospital managers. In particular, the lower scores in the sub-dimensions of social games (within political intelligence) and feedback skills (within communication skills) indicate a need for targeted improvement programs. These enhancements could contribute to better managerial performance and overall organizational effectiveness.
Ali Ghaffarian, Azam Cheraghi, Masoud Ferdosi,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Accreditation is one of the most widely recognized and reliable methods for evaluating the quality of hospital services. However, its implementation is often accompanied by various challenges for hospitals. This study aimed to identify the challenges associated with accreditation in small and single-specialty hospitals from the perspective of those involved in the process.
Methods: This qualitative descriptive study was conducted with the participation of 30 individuals, including hospital staff, national accreditation evaluators, and experts from the Ministry of Health's Monitoring and Accreditation Office. Data were collected through semi-structured interviews and individual sessions. Content analysis was used to process the data, which was analyzed using Max-QDA software (version 20).
Results: The accreditation challenges of small hospitals were categorized into four main themes: "accreditation process," "human resources," "structural issues," and "financial constraints." For single-specialty hospitals, challenges were grouped into three themes: "accreditation process," "human resources," and "uniformity of accreditation standards." Common challenges for both hospital types included low staff motivation, insufficient training in accreditation procedures, and issues related to evaluators.
Conclusion: In addition to general accreditation challenges, small and single-specialty hospitals face unique obstacles due to their specific conditions and inherent differences from other hospitals. To ensure the successful implementation of accreditation programs in Iran, policymakers should thoroughly examine the identified challenges and incorporate these insights into national hospital accreditation planning and implementation strategies.
Elaheh Torabi, Reza Mirzaei, Ahmad Heydari, Jalil Jarrahi Feriz,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: The physical and environmental characteristics of hospital spaces play a crucial role in influencing patient stress levels, particularly before and after surgery. This study aims to examine the impact of architectural elements in hospital environments on reducing stress among surgical patients, contributing to the enhancement of healthcare environments and patient well-being.
Methods: This descriptive-analytical study was conducted in the general surgery department of Razi Hospital. Data were collected through a structured questionnaire administered to patients before and after surgery. The validity of the questionnaire was assessed using Smart PLS 3 software, and reliability was measured using Cronbach's alpha. The collected data were analyzed using structural equation modeling.
Results: Among male patients, sensory elements had the greatest effect on reducing stress before surgery, while form-based elements had the least impact. After surgery, sensory elements remained the most influential, whereas spatial configuration had the least effect. Among female patients, symbolic components (e.g., cultural and religious symbols) had the most significant impact before and after surgery, while form-based elements had the least influence.
Conclusion: The gender of patients and the physical design of hospital spaces significantly influence stress reduction among surgical patients. Designing hospital environments with calming elements such as soothing colors, natural light reflections, relaxing sounds, pleasant scents, and culturally relevant symbols can enhance the overall patient experience and improve recovery outcomes.
Shadi Khalilolahi, Nasrin Kazemi, Saeid Besharati, Atefe Abedini, Mohammad Varharam,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The globalization of medical tourism has intensified competition among destinations, making it crucial to identify key success factors. While research emphasizes the role of host communities in tourism development, non-medical aspects of medical tourism remain underexplored. This study examines healthcare staff perspectives to identify the drivers and barriers affecting medical tourism in public hospitals.
Methods: This qualitative study employed structured interviews with 16 healthcare staff at Masih Daneshvari Hospital, selected through purposive sampling. Interviews were conducted in person during the summer of 2024 until data saturation was reached. Data analysis followed an inductive content analysis approach using MAXQDA software for coding, grouping, and categorization of themes into drivers and barriers.
Results: Key drivers of medical tourism development include skilled human resources, strong medical potential, affordable healthcare and associated costs, and the presence of complementary attractions. Conversely, major barriers include inadequate welfare services for medical tourists, managerial and institutional inefficiencies, hospital infrastructure deficiencies, and political and cultural challenges.
Conclusion: Developing a successful medical tourism sector requires a holistic approach. Identifying, prioritizing, and implementing strategic plans to strengthen facilitators and address obstacles are essential steps toward sustainable growth in this field.
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.
Abbas Jahangiri,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: Pharmaceutical pollutants in hospital wastewater pose significant environmental and public health risks. This study aimed to identify and prioritize effective strategies for removing these contaminants from the wastewater of selected hospitals in Markazi Province, Iran.
Methods: This descriptive-analytical study employed a multi-criteria decision-making (MCDM) approach. Initially, a comprehensive review of scientific literature, expert interviews, and consultation with professionals in environmental health and wastewater treatment was conducted. Relevant strategies and prioritization criteria were identified using MAXQDA 2022. Subsequently, the Analytic Hierarchy Process (AHP) method was applied using Expert Choice version 11 software to assign weights to criteria and rank the identified strategies.
Results: Five key treatment strategies were identified: (1) integrated biological, physical, and chemical treatment methods (hybrid systems), (2) advanced oxidation processes (AOPs), (3) aerobic and anaerobic biological reactors, (4) membrane filtration, and (5) activated carbon adsorption. The prioritization was based on five criteria: (1) pollutant removal efficiency (0.357), (2) environmental compatibility (0.241), (3) implementation and operational costs (0.198), (4) technology durability and sustainability (0.123), and (5) implementation complexity and feasibility (0.081). The final priority scores of the strategies were 0.312, 0.256, 0.211, 0.134, and 0.087, respectively.
Conclusion: The findings indicate that hybrid treatment systems combining biological, chemical, and physical processes offer the most effective strategy for eliminating pharmaceutical pollutants in hospital wastewater. These insights can guide healthcare policymakers and hospital administrators in selecting optimal wastewater treatment methods, contributing to environmental protection and water quality improvement.
Amirhossein Abdolalipour, Masoumeh Mikailiy, Khadijeh Alizadeh,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: This study proposes an integrated model to explore the mediating role of financial performance in the relationship between quality indicators, learning and growth, and the overall performance of hospital facility management services.
Methods: The statistical population included hospital managers across West Azerbaijan Province, Iran. Based on Cochran’s formula, 147 participants were selected using a simple random sampling method. Data were analyzed using Structural Equation Modeling (SEM) via SmartPLS software. Standardized factor loadings were used to assess model fit, and the Z-test was applied to evaluate the statistical significance of the relationships. Predictive power was assessed using the adjusted R² and Stone-Geisser Q² criteria.
Results: The indirect effects of quality indicators (t = 2.41), learning and growth indicators (t = 2.20), and internal process indicators (t = 2.39) on hospital service performance—mediated by financial performance—were all statistically significant (t > 1.96). Standardized path coefficients of 0.201, 0.344, 0.359, and 0.805 further confirmed the model's empirical robustness and goodness of fit.
Conclusion :The findings suggest that improvements in internal processes, service quality, and organizational learning and growth significantly enhance financial performance, which in turn improves the effectiveness of hospital facility management services. These enhancements contribute to increased patient satisfaction, strengthened hospital reputation, reduced operational costs, and ultimately improved revenue and financial efficiency.
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.
Abbas Jahangiri,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: Hospital wastewater infrastructure is critical for safeguarding public health and protecting the environment. Deficiencies in the management of these systems can precipitate severe public health and environmental crises. This study aimed to identify and prioritize investment risks associated with hospital wastewater infrastructure.
Methods: This applied case study was conducted in a general hospital in Arak, Iran, during April 2025. Initial risk identification involved a comprehensive literature review and semi-structured interviews with 14 experts, with data analysis facilitated by MAXQDA 2022 software. Subsequently, a Failure Mode and Effects Analysis (FMEA) approach, utilizing a customized checklist, was employed to score each identified risk based on its severity, probability of occurrence, and detectability. The Risk Priority Number (RPN) for each risk was then calculated using Microsoft Excel. Finally, risks were ranked in descending order according to their RPN values.
Results: A total of 23 key risks were identified and categorized into five principal areas: design, technical, environmental, operational, and managerial. The highest RPNs were attributed to "lack of pre-treatment systems," "insufficient capacity planning," and "wastewater leakage into surrounding soil". Additionally, managerial and operational risks, such as "insufficient budget for maintenance" and "shortage of skilled personnel," were recognized as significant aggravating factors for other risks.
Conclusion: The findings underscore that many critical risks within hospital wastewater infrastructure originate from fundamental weaknesses in initial design and ongoing management. The FMEA method proved to be an effective and systematic tool for identifying and prioritizing these risks, thereby facilitating improved engineering and managerial decision-making and enhancing the overall effectiveness of investments in this vital infrastructure.
Fatemeh Zarezadeh Mehrizi, Adel Eftekhari,
Volume 24, Issue 2 (9-2025)
Abstract
Alireza Rahimi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Pre-hospital Emergency Medical Services (EMS) play a pivotal role in managing life-threatening conditions. However, evidence suggests that the Iranian EMS system faces multifaceted challenges across human, managerial, and infrastructural dimensions. This study aimed to conduct a comprehensive meta-synthesis to identify and analyze the challenges characterizing pre-hospital EMS in Iran, based on research evidence published between 2014 and 2025.
Methods: This study employed a meta-synthesis approach utilizing the seven-step framework by Sandelowski and Barroso (2006). A systematic search of major domestic and international databases using relevant keywords yielded 414 initial records. Following a rigorous screening process based on inclusion/exclusion criteria and quality appraisal, 25 articles were selected for the final analysis. Data were synthesized and categorized using thematic analysis.
Results: The findings revealed that the challenges facing the Iranian pre-hospital EMS can be categorized into six main themes: human resources, logistics and infrastructure, organizational and managerial barriers, socio-cultural issues, and educational deficits. A deeper analysis highlighted the multifaceted and intertwined nature of these obstacles. The results indicate that these challenges do not exist in isolation but are interconnected within a complex network of cause-and-effect relationships.
Conclusion: The findings confirm that the challenges within Iran's emergency system mirror global trends and overlap significantly with issues reported in other low- and middle-income countries (LMICs). Addressing these problems requires a holistic and systemic approach that simultaneously targets human, logistical, organizational, and socio-cultural dimensions, while ensuring system preparedness for potential accidents and disasters.
Samaneh Zarin Khalili, Hamidi Kambiz, Zahra Shirazian, Ali Asghari Sarem, Javad Niknafs,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: The simultaneous presence of multiple generations with diverse values and expectations has created significant human resource management challenges in hospitals, most notably intergenerational conflicts. This highlights the necessity for context-specific models to manage generational diversity effectively. Accordingly, this study aimed to develop an organizational "multigenerational gravity" model for hospitals affiliated with Hamadan University of Medical Sciences.
Methods: This exploratory and developmental study employed a qualitative design based on the interpretive paradigm and grounded theory methodology. Data were collected in 2024 through semi-structured interviews with 20 experienced hospital managers, as well as organizational and academic experts at Hamadan University of Medical Sciences. Participants were selected using purposive sampling until theoretical saturation was reached. Data analysis was conducted using a rigorous three-stage coding process: open, axial, and selective coding.
Results: The analysis yielded 6 main categories and 28 subcategories explaining multigenerational gravity. These were structured into a paradigm model comprising: causal conditions (e.g., structural and supportive constructs, leadership and governance, active intergenerational convergence); contextual factors (e.g., organizational culture, intergenerational adaptability, technological dynamism); intervening conditions (e.g., psychological and behavioral factors, resistance to change, generational gaps); strategies (e.g., strengthening organizational learning, developing participatory networks, promoting justice-based coordination); the core phenomenon (purposeful intergenerational coexistence and the reproduction of knowledge capital through organizational deliberation); and consequences (e.g., job satisfaction, development of a diversity-driven organizational culture).
Conclusion: This study provides a tailored model for managing generational diversity within the Iranian healthcare context. The proposed multigenerational gravity framework equips hospital managers with actionable insights to foster generational convergence, mitigate conflicts, and boost staff motivation and retention, ultimately enhancing service quality and organizational productivity.
Beheshteh Jebelli, Mohammad Varahram, Fatemeh Keyvani Rad, Solmaz Zarrineh, Elham Ghazanchaei,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Hekmat (Wisdom) implies deep knowledge, understanding, and sagacity. Hospital services are uniquely dependent on human resources; therefore, beyond technical expertise, staff commitment is essential for maximizing efficiency and effectiveness. A "Hekmat-based hospital" is defined as an institution delivering care founded on three pillars: human dignity, medical knowledge/wisdom, and Islamic ethics. This study aims to identify the key factors influencing hospital accreditation through the lens of the Hekmat-based hospital approach.
Methods: This qualitative study employed conventional content analysis based on the Graneheim and Lundman approach. Data were collected through purposive sampling and semi-structured interviews with 62 participants (32 physicians and 30 patients) from various departments until data saturation was reached. Additionally, a comprehensive review of 20 upstream documents related to health, medicine, education, and culture within the Iranian health system (post-1979 Revolution) was conducted to supplement the field data.
Results: The analysis of interviews yielded 10 main categories representing the components of accreditation in a Hekmat-based context. These categories included: social, cultural, and religious issues; facilities, equipment, and human resources; communication skills; patients' financial and livelihood challenges; knowledge and education; tangible environmental factors; economic factors; cultural dynamics; patients' psychological resilience; and service reliability.
Conclusion: The findings suggest that mutual understanding of emotions and beliefs, patience, reciprocal respect, and effective knowledge exchange are core expectations shared by both physicians and patients. Addressing these primary and secondary needs is a prerequisite for achieving a standardized hospital model aligned with the vision of Hekmat-based medicine.
Adel Eftekhari, Najmeh Baghian, Nahid Khoddami, Maryam Zamani Faradonbeh,
Volume 24, Issue 3 (12-2025)
Abstract
Background and purpose: Time management is a fundamental skill in healthcare professions, particularly in nursing, playing a crucial role in enhancing productivity, alleviating stress, and elevating the quality of patient care. This competency is exceptionally vital in emergency departments (EDs) due to high workloads, severe time constraints, and the necessity for rapid decision-making. This study aimed to evaluate the time management competency of nurses working in the EDs of teaching hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd, in 2025.
Methods: This descriptive cross-sectional study included 223 nurses employed in EDs across the targeted teaching hospitals. Data were collected using the Time Management Competency Questionnaire for Clinical Nurses (Talebi et al.), which comprises 29 items across six dimensions. Data analysis was conducted using SPSS software (version 27). Independent t-tests and one-way Analysis of Variance (ANOVA) were utilized for normally distributed variables, while Spearman’s rank correlation coefficient was employed to examine the relationships between the competency components.
Results: The findings indicated that the nurses’ overall time management competency was at a moderately low level. Specifically, 12.6% of the nurses demonstrated relatively optimal competency, 64.1% exhibited weak competency, and 23.3% showed poor competency. The highest mean score was recorded in the dimension of 'adjusting responsibilities and norms' (18.39 ± 15.67), whereas the lowest was observed in 'emotional management' (20.58 ± 12.31). While significant positive correlations were found among most time management dimensions, the correlation between 'adjusting responsibilities and norms' and 'emotional management' was not statistically significant.
Conclusion: The time management competency of emergency nurses is currently suboptimal, a situation likely exacerbated by systemic issues such as staffing shortages and high patient turnover. Given the interconnected nature of time management components, implementing comprehensive educational programs and targeted managerial interventions is imperative to cultivate this skill. Such measures are essential for enhancing the quality of emergency care and mitigating occupational burnout among nurses.
Halimeh Salarnia, Halimeh Salarnia,
Volume 24, Issue 3 (12-2025)
Abstract
Background and purpose: Hospital service quality plays a vital role in patient and caregiver satisfaction, and accreditation standards have emerged as a tool to improve quality and patient safety. This study aimed to examine the relationship between the implementation of accreditation standards and perceived service quality from the perspective of patient caregivers at Taleghani Pediatric Hospital, Gorgan, in 2024.
Methods: This descriptive-analytical study was conducted in 2024. The study population included companions of hospitalized patients in various wards of Taleghani Pediatric Hospital, Gorgan. A stratified random sampling method was used, and a total of 250 participants were selected. Data were collected using the SERVQUAL questionnaire and the official hospital accreditation checklist. Descriptive and analytical analyses, including percentages, means, standard deviations, paired t-tests, ANOVA, Pearson correlation, and multiple regression, were performed using SPSS software.
Results: The mean perceived service quality was 3.87 ± 0.98, indicating a negative gap compared to expected quality (4.53 ± 0.56, p < 0.001). The overall implementation rate of patient-centered accreditation standards was 84%. Regression analysis showed that all dimensions of accreditation standards were significantly associated with perceived service quality. The model’s coefficient of determination (R²) was 0.593.
Conclusion: Implementation of accreditation standards in patient-centered and clinical care areas is associated with hospital service quality. However, gaps in empathy and assurance highlight the importance of human and interpersonal factors. Therefore, improving hospital service quality requires simultaneous attention to both standards and professional staff behavior.
