Showing 251 results for Hospital
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.
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.
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.
