Showing 251 results for Hospital
Dr Alimohammad Mosadeghrad, Mahnaz Afshari, Rahman Nasrolahi, Sareh Daneshgar, Rasoul Corani Bahador ,
Volume 17, Issue 2 (9-2018)
Abstract
Background: Insurance companies sometimes do not reimburse hospitals completely. Reducing the amount of deduction of bills increases hospital’s income and efficiency. This study compares the deductions imposed by social insurance organization on Imam Khomeini hospital’s bills before and after the implementation of health transformation plan.
Material and Methods: Data of this descriptive-descriptive study calculated from the deductions applied to the hospital of outpatient and inpatient bills of social insurance organization in second six months of 2013 (before implementation of health transformation plan) and the same time of 2014 (after implementation of of health transformation plan). This quasi experimental study was conducted using the data. Data was analyzed by SPSS software using paired t test.
Results: The bill deductions in the second six months of 2013 compare to the same time in 2014 were 2.9 and 11.1 percent, respectively. Hospital bill deductions increased 282.8 percent after the health transformation plan implementation. The deductions on inpatients and outpatients records increased 6 and 12 times, respectively. Most deduction was imposed on surgical and laboratory bills in 2013 and on radiotherapy, chemotherapy and hoteling bills in 2014.
Conclusion: Deductions of hospital bills extremely increased from social insurance organization after implementation of health transformation plan. In order to identify deductions causes, providing related education to staff and physicians and relative process improvement are necessary.
Bahareh Jafaei, Dr Leila Nazarimanesh, Dr Kamran Hajinabi,
Volume 17, Issue 2 (9-2018)
Abstract
Background: Responsiveness is one of the main goals of the health system for policymakers and managers. Information Technology (IT) capabilities typically affect organization performance in cases like customer responsiveness and provide high standards of its business. This study aimed to investigate the relationship between information technology capabilities and the responsiveness of Baharlo hospital in Tehran.
Materials and Methods: This study was a descriptive-survey one in terms of method and an applied one in terms of purpose. Data collection tool was a questionnaire. A sample of 248 employees and 381 patients from 26 selected sections of Baharlo Hospital were selected randomly. Data were analyzed using descriptive statistics and inferential statistics such as Pearson correlation coefficient and regression analysis.
Results: According to study results, the overall hospital responsiveness rate was higher than the average (3.82) and the hospital's IT capacity was moderate (3.07). Based on regression analysis at 95% confidence level (error less than 5%), IT capabilities with IT architecture dimensions (p= 0.020), IT infrastructure (p =0.004), IT human resources (p < 0.0001) IT communication resources (p < 0.001) were positively correlated with the responsiveness of Baharlo Hospital.
Conclusion: The positive relationship between all aspects and the overall IT capability with the responsiveness of the illustrated hospital reveale that the capacity of information technology as well as other modern industries in hospitals is considered as a key competence. Therefore, it is obvious hospital managers should pay serious attention to upgrade this key competence to improve responsiveness in their hospital.
Mohammad Reza Montazerolhoje, Dr Ahmad Ekhlasi,
Volume 17, Issue 2 (9-2018)
Abstract
Background: Recent years, many efforts provided to design hospitals ;as the most stressful environments; to reduce stress , improve health , patients' remedy and satisfaction based on patients 'points of view. This study aimed to identify the physical and mental factors effective on patient view in hospitals of Yazd city.
Materials and Methods: Regarding the purpose, this study was an applied one which used survey and correlation methods. In order to determine the normality of data distribution, Kolmogorov – Smirnove, the type, amount and direction of relation between the variables Persons correlation coefficient and linear regression analysis were used, respectively. Additionally, in order to clarify the multi regression model, variance analyze method of ANOVA has been utilized. According to data gathering literature and instrument review have been utilized.
Results: Study results revealed that there was a significant relation between physical factors and individuals' satisfaction (P<0.05). There was no significant association between mental factors and individuals' satisfaction.
Conclusion: It seems it is necessary that conditions and facilities need to be provided regarding physical and subjecting factors improving in wards which can be result in stress reduction and satisfaction increasing in the hospital environment, as well. Also, in patients' point of view, using appropriate colors, providing positive entertainment (films and comic books), proper ventilation and fresh air are some of the most important factors in patients ' satisfaction in wards.
Fariba Asadi, Seyyedeh Sara Afrazandeh, Maryam Ebrahimi,
Volume 17, Issue 3 (11-2018)
Abstract
Background: One of the hospitals’ goals is providing high quality of health for patients and patient satisfaction is one of the indicators of quality of health care in hospitals in all countries. The present study aimed to evaluate patients’ satisfaction about performance of health transformation plan in teaching hospitals affiliated to southern Khorasan province in 2016.
Materials and Methods: This study was a cross-sectional, descriptive-analytic one which 410 patients admitted to seven public hospitals of south Khorasan province were evaluated using a standard questionnaire on patient satisfaction during one month. Data analysis was performed by SPSS22 software using descriptive and inferential statistics.
Results: level of 51.5% patients ‘satisfaction was assessed high, 37.1% in a good, 9.9% moderate and 1.6 low level. Regression analysis revealed that average score of satisfaction with education level and economic situation had a significant association (p <0.05) which patients with higher education level and better economic status had less satisfaction. There was no significant relationship between other demographic variables and satisfaction level.
Conclusion: According to study results, it can be concluded that the health transformation plan can achieve its goals and success regarding patients’ satisfaction and patient costs reduction due to patients' perspective. In order to increase patients’ satisfaction, paying more attention to welfare and nutrition and evaluating satisfaction in other groups (nurses, physicians and personnel) recommended.
Dr Abdolreza Shaghaghi, Hassan Mahmoodi, Hossein Shahriari,
Volume 17, Issue 3 (11-2018)
Abstract
Background: The Health Promoting Hospitals (HPH) initiative emphasizes on changes in traditional hospitals’ approach in care provision. This study aimed to provide scientific evidence required for successful planning and implementation of the HPH in the country’s educational hospitals.
Materials and Methods: In this descriptive-analytical study, opinions of 300 frontline health professionals working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences were examined using validated tools in 2016. Descriptive data analysis procedures and logistic regression analysis (using Enter method) were applied by SPSS software version 22. The level of significance was considered less than 0.05.
Results: The mean scores and SD for applicability of the HPH standards were 66.06±17.51. Gender (OR=3.19 95%CI: 1.33- 8.40), occupation type (OR= 1.50 95% CI: 0.65- 0.70), hospital type (general vs. specialized) (OR= 1.59 95%CI: 1.10- 1.25), number of active beds (OR=3.84 95% CI: 1.56-9.42) and having prior knowledge about the HPH program (OR=2.81 95% CI: 1.31-4.80) were identified as significant predictors of the HPH standards’ feasibility in the studied hospitals.
Conclusion: Given that study findings, at least the baseline subjective inclination to adapt the HPH standards in the educational hospitals do not exist through the Iranian health care providers’ points of view. As the first step in progress towards preparation for implementing the HPH standards, planning of tailor-made educational programs for hospitals’ staff in Iran is recommended.
Dr Ebrahim Jaafaripouyan, Dr Alimohammad Mosadeghrad, Abbas Salarvand,
Volume 17, Issue 3 (11-2018)
Abstract
Background: Accreditation is one of the health sector evaluation methods that used to promote healthcare quality. The study aimed to identifiy the strength and weakness of accreditation surveyors and the impact of their performances.
Materials and Methods: This study is a qualitative research which conducted between hospital accreditation stakeholders in 2016- 2017. Data were gathered using semi-structured interviews and analyzed by a thematic analysis method.
Results: The findings of in strengthen were categorized in 7 themes. The main strengthen was acceptance of accreditation by surveyors, educational approach, reputation, personal effort to develop knowledge and skills, and existence of senior surveyors. Our results for weakness were classified in 8 themes. The main weaknesses were lack of sufficient knowledge, experience, skills and weakness in personal characteristics. Based on the findings, the accreditation surveyors’ performance was evaluated as under-moderate in past two periods of hospital accreditation. The interviewees announced that weakness of surveyors’ performances was one of the main effective factors of low stability of accreditation results.
Conclusion: Recruitment of surveyors based on main competence, education and empowerment of surveyors, and assessing the surveyors can lead to more validity of accreditation results and finally lead to increasing the commitment of hospitals to quality.
Dr Edris Hasanpoor, Dr Ali Janati, Dr Masumeh Gholizadeh, Dr Elaheh Haghgoshayie,
Volume 17, Issue 3 (11-2018)
Abstract
Background: Evidence-based Management (EBMgt) has been developed as a management model to improve the quality of management decisions. Hospital managers’ decisions can have a significant impact on service effectiveness and hospital success. Hence, this study aimed to survey sources of evidence among public hospitals' managers for decision-making in Iran.
Materials and Methods: This cross-sectional study was conducted with 183 managers of public hospitals in eight educational centers of the Ministry of Health and Medical Education in 2017. The research tool was an evidence-based management questionnaire with 20 items and 6 main domains. Data analysis was performed using descriptive and inferential tests by SPSS21.
Results: One hundred seventy-two (94%) out of 183 participants were male. The mean age and work experience were 45.28 and 19.30 years, respectively. The lowest score was related to "the academic journals" (52.56%), While managers relied heavily on "Ministry of Health programs" (80.98%). The average use of scientific-research evidence, fact and hospital information, political-social development plans, managers’ professional expertise and ethical-moral evidence and values and expectations of all stakeholders were 59.70%, 62.43%, 75.30%, 71.36%, 71.83% and 73.7%, respectively.
Conclusion: The study results revealed that hospital managers utilized the scientific-research evidence less than other evidence, which it is a matter of concern; so, managers need to improve their education and research level. Using hexagon of evidence sources, managers can identify the best available evidence for hospital decisions and they make the best decision in the process of evidence-based decision making.
Mahdieh Tavakoli, Mohssen Ghanavatinejad, Fatemeh Jalalifar, Dr Elham Yavari,
Volume 17, Issue 4 (2-2019)
Abstract
Background: The admission unit is the main entrance of the hospital and the first patient communication with the hospital is through this unit. The waiting time of patients, which is one of the main consequent of this unit, is not only one of the important factors affecting the satisfaction of the patients, but also is one of indicators of the quality of service of the hospital. This study aimed to provide scenarios at reducing patients’ waiting times.
Materials and Methods: This research in terms of methods and goals was a descriptive and an applied one, respectively. This study performed on 110 patients who had been admitted to the Mohb-e-Mehr hospital during 70 days and were uniformly trained on all days of the week. Information was also obtained using observation and data recording in prepared forms. The simulation model was designed and implemented with the Arena 14 software.
Results: Based on research findings, the para-clinical unit and the waiting room for hospitalization were two main bottlenecks in the studied system. In order to solve the problem, for each of the above units, a scenario designed and simulated. The implementation of these tests revealed that the proposed scenarios in comparison with the existing conditions had better results in reducing the waiting time and also increasing the number of admitted patients.
Conclusion: Improvement of the therapeutic processes will occur through the recognition of the hospital services system and analysis of the bottlenecks and its weakness points. According to the results, an increase in the number of para-clinical unit staff and hospital beds improves the hospital admission function. The implementation of mentioned scenarios reduces waiting time for patients by about 78% and reduces the waiting time for emptying the bed by about 50%.
Dr Bakhtiar Ostadi, Reza Mokhtarian Daloie, Dr Mohamad Mahdi Sepehri,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Today, hospitals have faced many requests for quality services, while their costs are increasingly growing as well. These facts; Therefore, necessitate much more attention from hospital mangers in order to reduce healthcare costs. Moreover, the urgent need for a precise costing approach is more evident. Activity-based costing provides useful information on the activities required to achieve services with desirable quality. However, given that the basic information for ABC system is provided under conditions of certainty, the possibility of using this approach in terms of uncertainty would be greatly decreased. This study aims to propose a new framework called FL-ABC.
Materials and Methods: Since, costing processes environment happen under conditions of uncertainty in the hospital, fuzzy logic in the ABC model was used in order to make more accurate estimates of hospital costs and increase the reliability of the results.
Results: This proposed model was used in a hospital lab unit and the results were compared with the standard ABC system. The results showed that the maximum difference in the prescribed costs was 77708951.89 and 67508112.57 IRR in serology and parasitology tests, respectively, mostly due to uncertainty in the assigned costs to each activity.
Conclusion: The FL-ABC system, in terms of taking into account the uncertainty in the parameters of cost, provides more accurate estimates of the cost of activities under conditions of uncertainty which estimates the costs of health care services more accurately.
Ali Reza Yusefi, Zahra Ebrahim, Behjat Mohammadzadeh, Dr Peivand Bastani,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Brand loyalty is one of the most important factors in maintaining and success of huge organizations such as hospitals. This study aimed to survey the factors that affect the patients’ loyalty to hospital brands in teaching hospitals affiliated to Shiraz University of Medical Sciences (SUMS).
Materials and Methods: This cross-sectional descriptive-analytic study conducted in 2017. The study population consisted of 385 clearance patients who were admitted to educational hospitals in Shiraz using stratified sampling method in February 2017 to March 2018. Information was collected using a researcher-made questionnaire and data analyzed by descriptive statistics, T-test, ANOVA, and multiple regressions using SPSS version 23 at a significant level of α = 5%.
Results: Patients’ satisfaction (β=0.333, P<0.001), trust in brand (β=0.265, P=0.007), and commitment (β=0.181, P=0.011) had a direct and positive effect on the patients’ loyalty to the hospital brand.
Conclusion: According to this study results, hospital managers should pay an attempt to inform the patients about their treatment procedure, follow up the patients’ health after discharge, and increase the communication between personnel and patients. These could contribute to better image and experience for patients resulting in loyalty to the hospital brand.
Reza Jahanbazi, Dr Masoud Lotfizadeh,
Volume 18, Issue 1 (5-2019)
Abstract
Background: Nursing is one of the health care base and nursing services are in effect on ill-health indicators. This study aimed to investigate the relationship between professional behavior and job well-being of nurses employed at two Shahrekord educational hospitals in 2018.
Materials and Methods: This descriptive-analytic study was performed on nurses employing at two educational hospitals in Shahrekord. A total of 269 nurses in both sexes were selected using stratified random sampling method. The Goz standard professional questionnaire for nurses and the Demo and Paschoal Survival Questionnaire were used. Data were analyzed by SPSS22 software using independent t-test, ANOVA, Kolmogorov Smearnov, Pearson Correlation Coefficient and simple linear regression at a significant level of 0.05.
Results: Mean age of the respondents was 33.2 years old, 48% were aged between 31 to 40 years old while 3% were aged more than 50 years old, 58% and 42%were female and male, respectively. The average score of professional behavior and job well-being were 17.8 ± 104.5 (moderate to high) and 89.3 ± 12.9 (moderate), respectively. Regression analysis revealed that per unit increasing in the nurses professional behavior, 0.661 units were added to job well-being; and also, there was a significant correlation between "professional behavior" and "job well-being" (R2=0.328).
Conclusion: The comprehensive national plan should be designed paying more attention to creation of the necessary infrastructure to promote professional behavior which can be result in long-range consequences of job well-being improvement; also, promotion of job well-being components should be considered.
Saeide Alidoost, Dr Aziz Rezapour, Rahim Sohrabi, Roghayeh Mohammadibakhsh, Dr Ali Sarabi-Asiabar, Narges Rafiei,
Volume 18, Issue 1 (5-2019)
Abstract
Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences.
Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013).
Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations; analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning and creating an organizational structure.
Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.
Zahra Tahmasebi, Dr Maryam Tajvar, Dr Mohammad Arab,
Volume 18, Issue 1 (5-2019)
Abstract
Background: Due to the presence of valuable and expensive equipments in hospitals’ warehouses, scientific management and continuous evaluation plays an important role to improve the performance of warehouses and whereby the performance of hospitals’ wards. This study aimed to evaluate the performance of the central stores of hospitals affiliated to Tehran University of Medical Sciences (TUMS).
Materials and Methods: In order to conduct this cross-sectional study, a checklist was designed and validated to examine the warehouses’ status considering structural, process and outcome dimensions of 39 depots in 14 hospitals. The status of hospitals’ warehouses were assessed using descriptive analysis and in order to assess association between performance evaluation score and charchetristics of warehouses and its staff Pearson Correlation Coefficient was utilized.
Results: Although, warehouses’ performance of studied hospitals in general was satisfactory, there were some items in unsuitable condition particularly in structural and process dimensions which should be addressed quickly. Also, performance of warehouses revealed a positive and significant correlation with number of beds, area and size of warehouse and number of staff (p <0.05).
Conclusion: Given that fair warehouses status, some items particularly in structural and process dimensions were in inappropriate condition which needed rapid consideration. Furthermore, hospitals with more beds have more and bigger warehouses achieved better evaluation score, but some of warehouses without these condition should be addressed in priority.
Dr Hossein Darghahi, Kamran Irandoust, Seyyed Morteza Mojtabayan,
Volume 18, Issue 2 (8-2019)
Abstract
Background: The present research aimed to assess the readiness of selected hospitals of Tehran University of Medical Sciences to implement quality improvement programs and clinical audits from the viewpoint of managers.
Materials and Methods: A descriptive-analytic study was conducted in May 2017 in four selected hospitals of Tehran University of Medical Sciences. The study population of this study was 20 managers of selected hospitals who were selected by census sampling method and entered the study. The data gathering tool was a two-part questionnaire whose validity and reliability were confirmed. In this study, we used SPSS software version 23 and statistical tests to analyze the data.
Results: The effectiveness and readiness of hospitals to implement a clinical audit program was equal to 60% in the field of data and information, cardiology and feedback; 55% in resources, design and implementation, clinical audit management, and evidence and standards; 50% in illness and education; and 45% in manpower. Also, with increasing frequency of clinical audits, hospital readiness for quality improvement processes increases.
Conclusion: Due to the effectiveness and low readiness of hospitals in implementing a clinical audit program, especially in the field of human resources (45%), it is necessary that managers and planners of clinical audit programs in hospitals have a precise knowledge of these factors in order to control the organizational environment and help improve the effectiveness of audit programs.
Abbas Jahangiri, Mohammad Jahangiri,
Volume 18, Issue 2 (8-2019)
Abstract
Background: One of the most important ways to promote the quality and attractiveness of the journal for readers is the accurate evaluation of the published articles research methodology in the journals. The purpose of this study was to investigate the research methods of the articles published in the Journal of Hospital.
Materials & Methods: In this descriptive study, the research methods of all articles published in the Journal of Hospital from Fall 2016 to Fall 2018 including qualitative or quantitative, field or library research , data collection methods, data analysis software, location of research, nature of the research (descriptive or analytical, etc.), topics, as well as the number of authors were investigated.
Results: Data of 55.29% of papers was qualitative that was turned to quantitative, 47.06% of articles had descriptive-analytical method, and 68.24% of papers had employed a field research method. In addition, 51.76% of articles had used questionnaire and the SPSS software was used in 52.08% of the articles. The location of 45.45% of researches was in Tehran province. Finally, the subject of 23.53% of papers was policy making, planning, leadership, and management in hospitals.
Conclusion: Most authors of the articles have followed a very similar research method during the mentioned period. So, creating diversity in the nature of the researches, using other methods of collecting information rather than questionnaires, doing more library research, and not limiting the researches to Tehran province are the most important suggestions for future researchers.
Abbas Jahangiri, Dr Hojjat Rahmani, Shiva Tolouei Rakhshan,
Volume 18, Issue 2 (8-2019)
Abstract
Background: Iranian health system transformation plan has been implemented since 2014 with the aim of financial protection of people, equity establishment in access to health services and quality improvement of hospital services. Hospital performance evaluation is essential in order to monitor the health system transformation plan. One of the tools for evaluating hospital performance is the dynamic multi-attribute decision-making method. The purpose of this study was to use the dynamic multi-attribute decision-making method to evaluate the performance of the hospital before and after the implementation of the health system transformation plan.
Materials and Methods: In this cross-sectional study, the performance of Shariati Hospital in Tehran was evaluated for 48 consecutive months (24 months before and 24 months after the Health System Transformation plan, 2012-2016). Each month was addressed as an option in the decision-making matrix and ,with considering six important health indicators, the hospital performance was dynamically assessed using the weighted aggregated sum product assessment and through EXCEL software 2010.
Results: Hospital performance scores had some fluctuations over time; however, in general, it had an increasing trend over forty-eight months. The highest and lowest values were for months 42 and 13 (0.4932 and 0.9408, respectively). In addition, in the first month of the solar year, the hospital performance score declined significantly for each year.
Conclusion: Changes in hospital performance scores during the study period show improvement in hospital performance. Nevertheless, this incremental process cannot be considered as a positive outcome of the health system transformation plan. Therefore, while improving the current process, continuing the hospital performance evaluation can lead to the hospital's performance promotion.
Afsaneh Khademi Jolgehnejad, Dr Reza Ahmadi Kahnali, Dr Ali Heyrani,
Volume 18, Issue 2 (8-2019)
Abstract
Background: The complexity and intensity of environmental fluctuations combined with unexpected accidents and dangers have increased the probability of hospital supply chain disruptions. Supply chain resilience has been suggested as a strategy for dealing with such challenges and for continued provision of appropriate and efficient services in hospital at the time of disaster. The present study intends to identify the factors influencing hospital supply chain resilience.
Methods and Materials: This qualitative study was based on the content analysis of semi-structured interviews with 14 experts in the university hospitals in Bandar Abbas in 2018. Participants were selected through purposive and snowball sampling. The interviews continued until data saturation was reached. The obtained data from interviews were coded and analyzed using MAXQDA Software.
Results: After analyzing the data, the factors influencing hospital supply chain resilience were identified and classified into six main components and 30 themes. The main components included: staffs’ attendance, suitability, infrastructures safety, disaster management, support and capacity systems, and external factors.
Conclusion: Based on the obtained results, it can be concluded that staff training, disaster management planning, command system, and surge capacity are the key factors influencing hospital supply chain resilience. Therefore, they should be taken into consideration while planning to promote hospital supply chain resilience.
Dr Hosein Dargahi, Sajjad Alahdadi, Abbas Salarvand,
Volume 18, Issue 3 (10-2019)
Abstract
Background: Human resources form the basis of health care systems and nurses are a large part of this community; therefore, paying attention to factors affecting the performance of nurses is necessary. The aim of this study was to investigate the relationship between mental health dimensions with organizational commitment and work ethics among nurses working in general hospitals affiliated to Tehran University of Medical Sciences. The mental health status among nurses was also investigated.
Materials and Methods: This is a descriptive-correlation study and the study population included nurses from general hospitals affiliated to Tehran University of Medical Sciences. 242 nurses were selected from Vali-Asr, Imam-Khomeini, Baharlu, Sina, and Amir-Alam hospitals using stratified sampling and responded to self-monitoring questionnaires including GHQ-28, Allen & Meyer's organizational commitment (OCQ), and work ethics (Petty, 1995). Data were analyzed using SPSS-23 software as well as Pearson correlation coefficient, ANOVA, one sample t-test, and independent t-test.
Results: Dimensions of social impairment(r=-0/19, p<0/01) and depression(r=-0/33, p<0/01) correlated with work ethics. Dimension of hypochondriasis correlated with nurses organizational commitment (r=-0/15, p<0/05). The mean of dimensions of hypochondriasis (7.45±0.28), anxiety and insomnia (6.97±0.27) and social impairment (6.33±0.19) among female nurses was higher than the average.
Conclusion: The dimensions of mental health of nurses are related to their organizational commitment and work ethics. Also, the mental health status among nurses is undesirable. Therefore, it is essential to address the issues of nurses at high levels, such as the Ministry of Health and the Nursing Organization, and low levels such as hospitals nursing management.
Dr Mohsen Shafiei Nikabadi, S. Fereshteh Hoseini,
Volume 18, Issue 4 (1-2020)
Abstract
Background: Hospitals are considered as the largest and most costly unit of the health system. The present study aims to determine the efficiency of hospitals in Mashhad.
Materials and Methods: This is a descriptive-survey study that was carried out in 2016-2017. The population of the study consisted of patients referring to hospitals in Mashhad. For data collection, records were used in hospitals and the SERVQUAL questionnaire. Data analysis was performed in soft Gams software.
Results: The results of the study indicate that in the SERVQUAL section, three dimensions of empathy response and Warranty were the most important dimensions. Also, 3 characteristics of 26 qualitative features of the service were classified as "attractive". 4 qualitative features are classified as "essential" and 16 features in "single-dimensional". The rankings obtained in the bilingual network method are approximately the same and only in the case of the last four ranks of the final ranking is done by the voting method with equal weights. And it was determined that the hospital number (3) is the lowest and hospital number (5) has the best performance.
Conclusion: By combining the fuzzy SERVQUAL method with network data envelopment analysis, we can eliminate weaknesses in the selection of indicators in different layers of network analysis and calculate the efficiency of such networks. Hospitals need to increase and plan appropriately by designing a hospital that has the highest efficiency and optimal utilization of its resources and cost-effectiveness.
Dr Faramarz Pourasghar, Nesa Kavakebi,
Volume 18, Issue 4 (1-2020)
Abstract
Background: Information technology application in health care is increasing. The aim of this study, is to introduce a scientific model for designing an electronic system for managing patient transfer.
Materials and Methods: This study is an exploratory qualitative study. At first a review of literature was carried out for identifying clinical, managerial and process indicators necessary for patient transfer. Then 30 experts, who had vast experiences on patient transfer, were selected using purposive sampling approach and their informational needs were extracted using focus group discussion and semi-structured interviews. Then clinical indicators extracted from literature review and informational needs collected from interviews were distributed among 51 experts in the form of Delphi questionnaires. Process indicators were also distributed among 35 experts to summarize all necessary indicators for designing patient transfer system. At the final step an expert panel approved the model.
Results: Thirty eight process indicators and 249 clinical and managerial components were finalized for designing the system. The process indicators were used for designing “monitoring and reports sections” of the system. The clinical indicators were used for designing “main sections” of the system including request for patient transfer, automatic algorithm for selecting destination hospital, information flow cycle, communicating clinical data and documentation. Final model also includes user interfaces relevant to responsibility of the user.
Conclusion: The proposed model, which contains necessary indicators for patient transfer, can communicate clinical information among hospitals and by providing proper infrastructure, will be able to improve patient transfer process.
