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S Rezaei, T Miraki, N Jahanmehr, F Gharibi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: the using of economic tools such as production function is one of the ways to improving performance and efficient use of hospital resources. The aim of this study was the estimation of production function in educational hospitals of Kurdistan University of Medical Sciences during 2007- 2011.
Material & Methods: the number of inpatient as dependent variable and the numbers of active beds, nurses, doctors and other staffs as explanatory variables was considered. These data For 12 of hospitals since 2007 to 2011 was collected by production form. Also with Eviews software version 6 and panel data, the production function of hospitals was estimated.
Results: the elasticity and marginal of production for all variables explanatory was positive. The marginal of production for bed active, physician, nurse and other staff was 16.7, 54, 23.6 and 40.9 respectively. The total of input coefficient was equal 1.08 and the return to scale was increasing.
Conclusion: according to the positive marginal of production for all variables explanatory, for improving of productivity and efficient use of hospital resources is suggested that the managers of hospitals in exposure to regular and irregular demand can be used elasticity of production.
M Keshavarz, A Akbari Sari, A Rahimi Foroshani, M Arab,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Accreditation is a program that is designed for evaluation of health care organizations and measured processes and structures according to predetermined standards. The purpose of this study is to survey the safety situation and quality of care in selected hospitals of Tehran University of medical sciences based on the Joint Commission International (JCI) standards and determination of their strengths and weaknesses.
Materials and Method: This descriptive, analytical and cross-sectional study was carried out in 5 hospitals. Translated Joint Commission International (JCI) questionnaire checklist with 14 standards was used as the study tool. Data entry and statistical analysis were performed using the SPSS.13 and K Independent Samples tests were used to compare hospitals.
Results: Highest quality and safety of care score belonged to the hospital B (84%) and then to hospitals C (83%), A (72.75%), E (72%) and D (70.5%). Central indices like patient and family rights, quality improvement and patient safety, infection prevention and control standards in the studied hospitals are completely different according to the statistical results.
Conclusion: Study results show that the status of hospitals in terms of safety and quality of care are almost appropriate but in some cases there is a large distance between JCI standards and their current status and the studied hospitals have to make appropriate and related policies in order to plan and implement proper programs to improve their situation in quality and safety of care.
S Rafeiyee, A Pour Reza, A Rahimi,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Human resource management has a critical role in organizations and organization culture is an outcome of human resource management performance. One of the dimensions of the organizational culture is power distance. This study aims to investigate the attitude of employees of selected hospitals of Tehran University of medical sciences towards the power distance in the organization and its consequences.
Materials and Method: This is a cross sectional study with a descriptive research design conducted in a sample of 306 employees and managers from Tehran University of Medical Sciences hospitals located in Tehran, Iran. A distinctive questionnaire for each group was developed, distributed and collected as a main procedure to gather data. Data were analyzed using SPSS 16.
Results: Study results indicates that there is a positive and significant relationship between power distance and employee participation, organizational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities in the level of 95%(p value<0.05). The moderated multiple regression results also supported the hypothesis that managers’ attitude towards power distance had a significant relationship with their manner with the employees, noticing their qualifications and abilities, giving them independence and responsibility and supporting them in their role.
Conclusion: A limited power distance in an organization will result in more committed and satisfied employees with positive perception toward justice in the organizational interactions and ready to accept job responsibilities and movement toward the organization objectives.
Z Farahnaki, A Pournajaf, A Karami, A Abbasi, M Karchani,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Shift work can be associated with decreasing performance, changing eating habits, getting into conditions such as fatigue and insomnia, developing individual and social life disorders and health problems. This study is aimed to investigate the prevalence of shift work disorders among nurses working in Ilam’s teaching hospitals in order to provide solutions for dealing with these disorders.
Materials and Methods: This is a descriptive – analytical study in which 84 nurses of Ilam’s teaching hospitals had been chosen by simple random sampling. The data had been collected by “Survey of Shift Worker” (SOS) questionnaire and analyzed using SPSS (version 18) and descriptive statistics and Chi-2 test.
Results: Results indicated that shift work disorders are prevalence among nurses. Emotional and Mental problems (96.4%), Social Life (84.5%), digestive problems (81%) have the highest prevalence rate respectively. Nurses who volunteered to work shifts have more job satisfaction than the ones who were obliged to do that (P<0.05). In addition prevalence of problems was far less among nurses who get satisfaction from shift work than the others who do not.
Conclusion: Choosing shift work voluntarily results in more satisfaction with shift work which eventually decrease problems caused by shift work.
H Dargahi, F Forouzanfar, M Bakhtiari, Z Rajabnejad,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Nowadays Medical devices have an important role in diagnosis, treatment, rehabilitation of patients and also in medical education. However, in the recent years usage and maintenance of these devices have not been in a good situation in developing and even some developed countries. Therefore fundamental changes and reprocessing has begun among management and usability of medical devices in these countries. This research is aimed to determine the management situation with the approach of usability evaluation in order to change and reprocess the management system among Tehran University of Medical Sciences general teaching hospitals at 2012-2013.
Materials& Methods: This study was a descriptive and cross sectional research among eight general teaching hospitals of Tehran University of Medical Sciences in 1391. The research tool was a self-made check list consisting of 38 questions about medical devices management condition and Nielsen questionnaire about usability of these devices which were completed by head nurses of CCU, ICU and OR departments with the help of medical devices supervisor in 56 departments of these hospitals. Data were collected and analyzed by SPSS software.
Results: We found that medical device management and the usability of these devices were not in a good situation in these hospitals as well as usage of electronic information technology.
Conclusion: Regarding the results of this research specially in the usability of medical devices, we recommend that users and supervisors of medical devices should be trained about usability criteria and evaluation procedures of these criteria, and the relationship between management styles and applications of quality improvement and pay attention to reprocessing of medical devices management among hospitals administrators and healthcare policy makers to select and purchase the best devices.
J Saeidpour, M Ghazi Asgar, H Rahmani, M Khoshkho,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Educating patients and improving their self-care skills are main factors to achieve maintaining and improving health as health care organizations prime priorities all over the world. This study is aimed to assess nurses and doctors viewpoints on obstacles and facilitators of educating patients.
Materials and Methods :This quasi experimental research were undertaken in Kermanshah Razi hospital.85 nurses and doctors were selected by Simple Random Sampling method. The data were collected by a questionnaire based on Likert scale consisted 32 questions in 3 parts. Validity and reliability of the questionnaire were confirmed by Content validity and Test-Retest methods respectively.
Results : Shortage of nurses and lack of sufficient financial resources among inhibiting factors and holding seminars on teaching and learning strategies and also considering educating patients as a annual evaluation determinant among enhancing factors were the most important ones .
Conclusion: Providing efficient resources and facilities and running personnel`s training courses seems necessary to overcome current obstacles.
A Hajihasani, M Mohammadzadeh, H Zeraati, M Rahbar, M Alavimoghaddam, M Sabzi, S Ghoorchian, A Ramezani, M Soltandallal, M Douraghi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Non-fermentative, gram-negative bacilli (NFGNB) have emerged as a factor of
nosocomial infections and mortal epidemics . Hospital environment is one of the most important
sources of NFGNB`s colonization and diffusion. This study is aimed to assess the frequency of
NFGNB in various wards of selected hospitals of Tehran.
Materials & Methods: 469 samples were randomly selected from various wards from two hospitals
during a period of 11 weeks. All isolations had been identified using standard microbiological,
biochemical and phenotypic tests. The data were analyzed by SPSS software (version 11.5).
Results: Fifty three specimens were positive for NFGNB. Stenotrophomonas maltophilia and
Burkholderia cepacia complex were found as predominant bacteria in hospital I(28%) and II
(28.6%).The highest rate of NFGNB isolated from surfaces was 60.3% .The pediatric ward was
identified as the most contaminated ward (50%).
Conclusion: Several genus of NFGNB are found in hospitals. Therefore, identifying other NFGNB`s
genus and training health care staff are of prime importance. NFGNB`s distribution depends on type of
ward, surface, and equipment. Periodic sampling of hospital environment can be effective against
spreading infection.
M Arab , M Sharifi , M Mahmoudi , B Khosravi , R Hojabri , A Akbari Sari , B Ahmadi , F Eftekhar,
Volume 13, Issue 2 (8-2014)
Abstract
Background:In recent years, clinical governance introduced as amodel to determine continuous quality improvement principals in health services. This study considers assessing the readiness of selected hospitals clinical governance programsimplementation by using CGCQ instrument.
Material and Methods: The survey was conducted in 14 private and public Hospitals in order to assess hospitals’ readiness to clinical governance programs implementation in Tehrancity. In this regards, 800 health professionals including physicians and nurses were inquired. Collected data analyzed by SPSS17 using correlation coefficient, mean comparison and descriptive tests.
Results:Based on study results, both private and public hospitals had readiness to implement clinical governance program. Results of field survey revealed mean score of organizational climate of clinical governance (3.14) is higher than average score (2.5) in selected Hospitals.
Conclusion: This survey demonstrated the necessary readiness to implement clinical governance programs is in an acceptable rangein assessed hospitals. Moreover, there is a big effort to use a unique and comprehensive strategy with the intention ofcontinuous quality improvement in health services.
Sh Nosratnejad , A Purreza , M Moieni , H Heydari ,
Volume 13, Issue 2 (8-2014)
Abstract
Background: Nowadays Social health insurance does not cover all health expenditures because of increasing cost of diagnosis and treatment services which results in private insurer entry to health market. This study is aimed to determine key indicators which have important effect on the demand for private health. This identification of indicators leads to better planning for prospering private health insurance.
Material & Method: This is a a descriptive and analytical study. The data were collected by questionnaires which has been filled by a sample of 950 households .The samples had been chosen by three-stage cluster sampling. The model had been estimated by econometric methods based on models of Probit and extreme value distribution..
Result: The result indicated that having basic health insurance, doing exercise each day routinely, having regular medical checks, being landlord and being retired raised the probability of demand for private health insurance. On the other hand, demanding private health insurance is less common among older adults and people who use to wear seat belts.
Conclusion: Identification of important factors which influence the demand for private health insurance would assist policy makers to provide essential structures for expanding private health insurance coverage.
Rahmani, Eftekhar, Saeedpour, Sharifi , Hojabri,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: This study attempts to review dimensions and indicators of organizational culture in Petroleum Industry Health Organizations utilizing Denison navigation framework and provide practical solutions to improve the situation based on strengths and weaknesses identification.
Material and Methods: Thisapplied study was a descriptive - analytical one which performed using field assessment.Population study included all staffs of the organization's headquarters in Petroleum Industry Health Organization using systematic random sampling based on employeeslist and 110 staffs were selectedfinally. SurveyingOrganizational Culture Denison (DOCS, 2007) was used for data collectionin which the overall cultureOrganization and its characteristics and indicators were measured and the results compared with the global average.
Results:The overall score of the corporate culture was in the middle status (2.8) and score of four maincharacters had fluctuation in the range 2.6 to 2.9. Fundamental values (3.1) had the most score and customer orientation (2.2) and development of capabilities (2.4) obtained the least scores in 12th indicators which these two indicators were identified as significant points to improve organizational culture.
Conclusion:The scores revealed considerable distance with average global rates, but the scores are similar to other Iranian studies. The weakness of organizational culture in two indicators including “customer orientation” and “development of capabilities”can affect optimal organization performance through organization's compliance ability with environmental changes
F Akbari Haghighi, Z Koohi Rostamkalaee, A Pourreza , A Rahimi Forshani ,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: Organizational commitment is an important occupational attitude which demonstrates personnel staffs liability for their organization. This study aimed at assessing the level of nurses’ organizational commitment in selected hospitals of Tehran University of Medical Sciences in 2011.
Materials and Methods: In this cross - sectional study, 363 nurses with BS and MS degree who employed in selected hospitals of TUMS were chosen using random sampling method. Data were collected using a 2-section questionnaire including demographic variables and organizational commitment. With the intention of data analysis, descriptive statistics, independent t -test, chi square, Kruskal-Wallis, Mann-Whitney tests were conducted. Significant level assumed at 0.05.
Results: Study results confirmed that organizational commitment and its all dimensions (affective, continuous and normative) were in moderate level (65.87± 15.32). The Level of organizational commitment had significant relation to job position (P<0.001), ward type (P<0.001), years of experience (P=0.03), and the hospitals (P=0.004). There was no significant relationship between demographic variables and organizational commitment (P>0.05).
Conclusion: Since, None of the demographic variables revealed significant association with organizational commitment and occupational and organizational factors had significant relation with organizational commitment, it seems that personal factors should not be considered as the main criteria of recruiting committed nurses
A Outofi , E Kharazmi , A Yousefi , A Heidari ,
Volume 13, Issue 2 (8-2014)
Abstract
Background: Managers can provide manpower motivations activity contexts and real efficiency through identifying and anticipating according to organizational goals. Since, today’s working motivations have not been realized in hospitals, this study aimed at determining and comparing the importance of hygiene-motivational factors in both Kosar and Faghihi hospitals in Shiraz.
Materials and Methods: In this cross-sectional survey, study populations included all staffs of Kosar and Faghihi hospitals in Shiraz. One hundred fifty selected by stratified randomly sampling participated in the study.The study questionnaire was designed based on Herzberg theory. Questionnaire validity proved by available experts and Cronbach alpha calculated 0.95. Statistical analysis was done using SPSS software and independent t-test.
Results:The most important hygiene factors were "job security" and "supervision" and the most significant motivational factors were "success" and "appreciation". Hygiene factors are more important than motivational ones in both hospitals. Hygiene and motivational factors had more mean score in Kosar hospital compare to Faghihi hospital.
Conclusion: In the Kosar charity hospital hygiene-motivational factors were significant more than faghihi governmental hospital from the staff viewpoints. Hence, the directors of the hospitals should organize appropriate incentive actions owing to differences in terms of ownership toward quality improvement and efficiency of hospitals.
E Zarei , F Farzianpour , B Pouragha , P Abbasi Borogeni , M Mohammadzadeh ,
Volume 13, Issue 2 (8-2014)
Abstract
Background: Identification of development needs is a first important step in a systematic management development effort. This study aimed at assessing management development needs from the viewpoint of middle managers of hospitals affiliated to Tehran University of Medical Sciences. Material and Methods: This cross-sectional study was conducted in the hospitals affiliated to Tehran University of Medical Sciences. The population study was 227 of middle managers employed in 16 hospitals. Data were collected using a 42-items questionnaire which its reliability and validity was confirmed. Data were analyzed using main components analysis in software SPSS17. Results: designing and innovation indicator among managerial roles, human skills indicators in managerial skills, psychological abilities among managerial talents, social trust in personal characteristics, comprehensive thinking indicator in philosophic mindedness and leadership in managerial knowledge components were the most important from the perspective of the middle managers Conclusion: managers play the specific managerial roles in order to perform their managerial tasks. They need to develop administrative skills, abilities, knowledge, personality and philosophic mindedness to play the best managerial roles.
Mohammad Arab, Farugh Mohammadian, Abdolrasoul Rahmani, Abbas Rahimi, Leyla Omidi, Parvin Abbasi Brojeni, Mehdi Asghari,
Volume 13, Issue 3 (12-2014)
Abstract
Background and Objective: The operating room is one of the main units in hospital, where the most important phase of patient treatment is performed. This study aimed to investigate the safety attitude among the staff of operating room in selected hospitals of Tehran University of Medical Sciences.
Methods: In this descriptive - analytical study, 230 staff of operating room of hospitals affiliated to Tehran University of medical sciences were selected by Random cluster sampling. Research tool was a safety attitude questionnaire (Cronbach’s alpha 0.854) that classified in 3 categories: demographic questions (11questions), quality of communications (14questions) and safety attitude questions (58 questions). All data collected were analyzed using SPSS18. T-test, Spearman correlation, analysis of variance (ANOVA) and Chi-square have been used for data analyzing.
Results: The results indicated that 90.9% of staffs had moderate safety attitude and the average of the safety attitude score was 188.52(± 22.4). As the results showed, there was a positive and significant relationship between the safety attitude score and age, total work experience and work experience at hospital (p 046/0=, r =±0.141). There were significant differences between: average of the safety attitude score among men and women (P=0.047) average of the safety attitude score among staffs who have been trained and untrained safety (P=0.004).
Conclusion: The safety attitude score among the staff. It is therefore necessary to implement the effective interventions to improve safety attitude among operating room staff in understudy hospitals.
Keywords: Safety attitude, Operating Room, Hospital, Staff
Feizollah Akbari Haghighi , Ebrahim Jafari Poyan , Negar Aghighi,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Monitoring and/or control are the management main duties. This duty is so important which some of authorities believed that efficient management depends on Effective Control System (ECS).This study aimed at identifyingbarriersandfacilitators of performance monitoring and providing some strategies for effective health care monitoring.
Materials and Method: This study was a qualitative one which data was collected bySemi-structured questionnaire filled by interview in2011-2012 and analyzed usingframeworkanalysis. Study population consisted of 25 experts and directors of care/treatment performance monitoring.
Results:Based on study results, nineconceptswere extracted as following:specialized nature of treatment performance monitoring, health assessors’ education, work experience in line units, prerequisites for new treatment performance monitoring, personal characteristics of care monitoring expert, managerial support of assessors, culture of monitoring process acceptability, facilitators and barriers of monitoring. Based on these concepts, 28 codes were identified.
Conclusion: Experienced assessors’ assessment, based on their specialty professionals’accurate and applied systematic education and management support are main items which will be result in more effective care/treatment performance monitoring.
Shabnam Ghasemyani, Abollghasem Pourreza, Sara Forotan,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Organizations need dedicated human resource to achieve their goals. Doing justice to personnel result in increasing job satisfaction and organizational commitment. This study is aimed to determine the relationship between organizational justice and organizational commitment among Shariati and vali Asr (as) hospital staff in the year 1390.
Materials and Methods: This survey has been done using a cross-sectional descriptive analytical method. 140 of personnel of Shariati and vali asr hospital were involved in the survey. Nyhvf and Moorman (1993) and Meyer (1990) questionnaire were used. The former was used for measuring dimensions of organizational justice and the latter was used for determining the level of organizational commitment. The data were analyzed descriptively inferentially using SPSS version 18.
Result: The mean and standard deviation of organizational justice were 2/84 and 0/72 respectively and the mean and standard deviation of organizational commitment were 2/89 and 0/66 respectively. The results showed a direct significant relationship between organizational justice and organizational commitment .The value of correlation coefficient indicates a direct relationship between variables.
Conclusions: According to the results of study, organizational Justice and organizational commitment were in average level among samples. These variables merit further consideration as their direct and significant relationship and also their crucial role in increasing efficiency of organizations especially hospitals. Managers would have to give increasing organizational justice serious consideration
Habibullah Danaee, Hojat Rahmani, Leyla Torkzade, Mohsen Nazari ,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Industry growing and work load of financial turnovers are one of the medical tourism’s reason. Because of additional capacity building in health domain especially in medical levels, medical tourism can be solved some problems similar to extra capacityby means of an essential strategy. The aim of this study was to Segment external clients based on their benefits expectations about health services in four hospitals in Iran.
Materials andMethods:In current study, library reviewing and health care experts’ viewpoints were used in order to determine the characteristics of healthcare services.After determining the variables, factor analysis was performed to brief variables.Then, cluster analysis was performed on extracted factors using K MEANS algorithm and characteristics of each cluster was determined.
Results: Four factors were extracted by factor analysis .Then, Cluster analysis was done on the factors andPatients were divided into four sections whilethe first section respect with health care services efficacy, the second and fourthparts tend to get care with respect and the third parthave a tendency to have individual ability
of hospitals.
Conclusion: Individuals obtained the most important percent to care providing with respects among four extracted clusters. Thus, hospitals should have the most focus on communication quality regarding their marketing efforts with their clients.
Seyed Omid Khalilifar , Bayram Nejati Zarnaghi, Mohammad Bakhtiari Aliabad, Ameneh Valadkhani,
Volume 13, Issue 4 (3-2015)
Abstract
Background: Today, one of the effective ways of providing services is contracting with outside of organization and outsourcing.
Objective: The current study aimed to investigate effect of outsourcing on performance of nutrition unit in studied hospitals.
Methods: The current descriptive – analytical study performed in 2013, in two non-military hospitals and two military hospitals. 602 patients and 930 personnel were selected by simple randomized sampling. Data gathering performed by Patient and personnel satisfaction questionnaire, check list of kitchen's hygiene condition and check list of assessing the time spent by hospital manager for nutrition unit. Data on personnel cost were collected through accounting department. Data analysis performed by spss19 software.
Findings: Patient and personnel satisfaction with food services of non-military specialized hospital (4.03±0.45) were more than military specialized hospital (p= 0/03 for patients & p= 0/021 for personnel) and in non-military general hospital were more military general hospital (p= 0/039 for patients & p= 0/028 for personnel). Hygiene condition of non-military hospitals kitchen was better than military hospitals, the time spent by hospital manager for nutrition affairs in military specialized hospital was 1.5 times more than non-military specialized hospital and in military general hospital it was 6.5 times more than non-military general hospital. Personnel cost in nutrition unit of military hospitals were 1.5 times more than non-military hospitals.
Conclusion: Regarding the positive impact of outsourcing on performance of nutrition unit in hospitals, it is recommended that this strategy be applied in nutrition unit of military hospitals.
Dr Mohammad Arab, Farhad Habibi Nodeh, Dr Abbas Rahimi Foroushani, Dr Ali Akbari Sari,
Volume 13, Issue 4 (3-2015)
Abstract
Background: Hospital waste need a very sensitive and cautious attention due to holding hazardous, toxic, and pathogenic factors such as infectious, pharmaceutical, pathological, chemical and radioactive left-overs. Thus, this study aimed to evaluate the observance of safety measures by workers responsible for collecting hospital wastes in the public hospitals affiliated to Tehran University of medical sciences.
Methods and Materials: This cross-sectional and descriptive-analytic study was conducted in 1391. Data were collected through using a questionnaire. According to the frequency distribution, total score for participants was divided into three weak (<26), average (26-30), and high (>30) categories. Data were analyzed by the SPSS 18 software using T-Test, one-way ANOVA and regression analysis.
Findings: Based on the results, 33.3% of hospitals received suitable, 55.5% received average and the remaining (11.2%) received a weak score regarding safety measures. Moreover, there was a statistically significant correlation between cleaning staff’s characteristics (education, age, work experiences and their training) with their safety status score.
Conclusion: Implementing current national principles and standards and conquering shortages, proper planning, using young workers alongside with experienced ones, more training courses and respecting and paying enough attention to cleaning staff would help to improve the safety of collecting hospital wastes.
Zhila Najafpour, Mahmood Mahmoodi, Abolghasem Pourreaza,
Volume 13, Issue 4 (3-2015)
Abstract
Background: There is now a global concern about significant numbers of patients who are harmed or faced financial problems.Therefor, interving in organized approach to provide safe services seems necessary. This study is aimed to assess the basic indicators of patient safety in hospitals affiliated with Tehran University of Medical Science.
Materials and Methods: This descriptive–analytical study was conducted in the 5 selected hospitals affiliated with Tehran University of Medical Sciences. The data were collected using patient safety assessment protocol published by WHO(WORLD HEALTH ORGNAZIATION) tool.The questionnaires were filled using variety of different ways such as : interview, observation and documents investigation. The data were analyzed using SPSS software and also with descriptive and analytical tests.
Results: The results showed total average of maintaining the standards was 51.1% which categorized as weak level based on the protocol . The highest and lowest rates of the domains studied were safe environment (68.8%) and continuing education (24.8%) respectively. Farabi and Rasul Akram hospitals had the best and the worst levels of maintaining indicators of patient safety standards .It is worth mentioning that the status of all the hospitals was in the same level. Statistical tests indicate that maintaining the standards does not differ significantly between participating hospitals.
Conclusion: All participating hospitals has a poor performance through developing basic patient safety indicators .Managers` support and staff participation can be helpful to solve the mentioned issues. Paying attention to patient safety in managerial plans and putting equal value to various aspects of patient safety are pivotal
