Showing 251 results for Hospital
A A Nasiripour, P Raeissi, N Yazdani,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Several factors have an impact on hospitals` crisis preparedness including the status of “internal factor ”. This study is aimed to investigate the relationship between the status of hospitals `internal factors and their level of preparedness in crisis.
Materials and Methods: This correlative, applied, and cross-sectional study was conducted in 12 hospitals of Kurdistan University of Medical Science in 2008. The data were collected using the standard Weisbord questionnaire and hospital preparedness checklist to measure the status of internal factors and the hospitals` level of crisis preparedness ,respectively. The data were analyzed using descriptive and analytical statistical methods.
Results: Changing internal factors would result in 74% of the changes in level of hospital preparedness in crisis in all studied hospitals . The preparedness level and the organizational structure of the hospital had strongest relationship and preparedness level and personnel’s attitude to changes had the weakest respectively .
Conclusions: Hospitals should analyze their internal factors status in order to improve their preparedness level in crisis. Concentrating on different aspects of internal factors, reviewing objectives, improving increasing teamwork, involving personnel in decision-making, using performance-based rewards, forming communication committee, improving leadership styles, training organization `s managers and leaders, and facilitating internal and external coordination could be effective .
H Jabbari Beirami, A Jannati, Y Mousazadeh,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Hospitals are the most important health organization and consume major part of health system`s budgets. Downsizing is one of the strategies used for providing suitable services in hospitals. This study was conducted to do a systematic search for hospital downsizing methods and theirs consequences in order to choose suitable method for Iran.
Materials & Methods: Related Articles were identified by systematic search on databases such as Medlib, SID, Pub Med, Science Direct and Google Scholar meta search engine using keywords like Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merger, Hospital Reorganization and Persian equivalents. 379 articles were extracted and refined step by step. Finally, 25 articles were selected according to study`s goals.
Results: The identified downsizing methods included reducing the number of employees and hospital beds, outsourcing, merging hospital wards and combination of fore mentioned methods. The most important consequences of using these methods were: cost, revenue, outpatient visits and surgery, length of stay and hospital admission rates, mortality rate, stakeholder satisfaction, workload of employees mental health and absenteeism .
Conclusion: study results indicated that different methods of downsizing are used for providing suitable services and decreasing costs in hospitals. Using Merger and outsourcing are suggested among different methods in hospital wards according to current situation of our country.
M Mahdavi, M Arab , M Mahmoudi , A Fayazbakhsh , F Akbari ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: This study is aimed to compare organizational commitment and intention to leave among employees in Teheran`s hospitals.
Materials and Methods: In this survey 3 hospitals with different ownership`s type were examined included: A public hospital, a hospital owned by Social Security Organization, and a private hospital. The data were collected by distributing 450, questionnaires among 450 employees, which were randomly chosen.
Results: Among all studied subjects few employees allocated high score of organizational commitment to themselves .This average rate is nearly 20%. Committed employees were impressively low in the Social Security hospitals compared to others. Comparing intention to leave indicate revealed the Public hospital`s employees have lowest scores among all subjects. There is a statistical significant correlation between commitment`s components and intention to leave.
Conclusion: Generally the majority of employees have average and low organizational commitment. Employees with high level of commitment and high level of intention to leave make a small proportion of all hospital employees. Social security hospitals must be taken into consideration due to the levels of commitment and intention to leave.
R Baradaran Kazemzadeh , M Sepehri , F Firouzi Jahantigh ,
Volume 12, Issue 4 (3-2014)
Abstract
Background and purpose: Hospital is the largest and most important executive unit of healthcare system therefore, full consideration of how to assess its quality is of particular importance. A question is always raised as how to evaluate the quality of the services. The current study seeks to provide a fuzzy model for assessing the service quality in this healthcare sector.
Material and method: The present cross-sectional study was conducted in two hospitals in Zahedan 2012.Via reviewing the related literature, the dimensions and components of service quality assessment were identified. The SERVQUAL questionnaire for hierarchical analyses was designed and the fuzzy AHP (Analytical Hierarchy Process) model was presented. SPSS v 10.0 and Fuzzy TOPSIS Solver 2013 software were used to analyze data.
Results: The findings indicated that the most important dimension for estimating the quality of healthcare services was empathy. Responsiveness, assurance, and tangible assets were the last important factors. The hospitals were compared using fuzzy AHP. According to the calculations, the ranking of the hospitals based on their performance was as follows: Imam Ali hospital with 31% compared to Social Security hospital with 29% had a better performance in service quality.
Conclusion: The results revealed that hospitals needed to focus more on empathy, expertise and reliability than providing high quality and satisfactory services. By considering their weaknesses, each of these hospitals can enhance service quality and consequently, provide a better service for patients.
R Shahrabadi , B Moeini , Gh Roshanai , S Dashti , V Kafami , M Haghighi ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Health care providers`culture about the patient safety means accepting and considering patient safety as the first priority and organizational core value or health center`s staffs beliefs, perceptions and trends of on patient safetywhich is reflected in their behavior. This study is aimed to assess nurses perceptions of patient safety culture`s dimensions which is working in hamadan`s hospital.
Materials & Methods:The method of this study is descriptive- analytical type and statistical society includes 215 nurses of 3 hospitals of Hamadan which had been selected by random sampling. Stanford patient safety culture questionnaire was used to assess dimensions of patient safety culture.The data were analyzed by SPSS 15 software and descriptive tests.
Results: The result indicated that all dimensions of patient safety culture through nurses` perception are weak . Among these dimensions, the " Unit Leadership for Safety " with 25.21 percentage and "Learning and Feedback " with 41.82 percentage were the lowest and highest positive rating in all three hospitals respictively .
Conclusion: According to weak rate of all patient safety culture`s dimensions in studied hospitals, performing training programs by head nurses is suggested in order to improve cultural concepts such as establishing “supportive mechanisms for patients families” and "culture of discussion of errors among nurses" .
E Zeraatkar , H Rahmani , M Ghazi Asgar , J Saeid Pour , S Azami , A Aryankhesal , M Pakdaman ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Hospital waste is one of the environmental problems .Ignoring the proper management of these wastes can lead to outbreak of diseases and epidemics which threat the public health and rise high costs as a result. This study is aimed to assess the level of staff awareness and hospital performance concerning waste management in selected hospitals of Tehran University of Medical Sciences in 2010.
Materials & Methods: This is a descriptive-analytical study. The data were collected by distributing a multipartite Likert scale questionnaire among 351 individuals which had been used to measure hospital awareness and performance. The collected data were analyzed by SPSS software. Among Descriptive tests Chi-Square test was used to determine the correlation of qualitative variables and Pearson correlation coefficient was used for quantitative variables. The significance level was considered at 0.05.
Results: Significant differences had been seen among different professions` level of awareness .There were no significant difference among different hospitals ` average awareness level although there were significant statistical differences among each hospital`s performance level (p ≤ 0.001).
Conclusion: Due to relatively poor status of hospital`s waste management and hospital staff `s performance , better planning for proper management and wastes `excretion is needed to achieve sustainable development, public health protection and the environmental preservation. Staff Training and their performance monitoring and improving is one of the most important factors of hospital waste management plan success.
M Mehrolhasani , V Yazdi Feyzabadi , T Barfeh Shahrbabak ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: A method of performance assessment is required to improve Productivity and reduce hospital costs . Pabon Lasso diagram is known as a tool for performance assessment. The current study is aimed to assess and compare Kerman province`s hospitals performance by using Pabon Lasso diagram.
Materials & Methods: This descriptive and cross-sectional study was conducted retrospectively between 2008 and 2010. All hospitals of Kerman province in three groups of public, social security and private were selected by census method (N=23). The data were gathered from statistics unit and entered into SPSS 18.0. Three indicators include bed occupancy rate, bed turnover and average of length of stay were calculated and then hospitals` performance were analyzed by Pabon Lasso diagram.
Results: In first two years, seven and eight hospitals out of twenty-three and in third year nine hospitals out of twenty-two located in third zone of the model (desired productivity) respectively. Among all hospitals, regarding number and ownership type, social security hospitals had better performance in 2008. Additionally Public hospitals had better performance than others in 2009 and 2010,.
Conclusion: Public hospitals had better performance.Although studied hospitals` performance experienced growing trend, only one third of the them had desired performance. It can be caused by changing the provided services type from inpatient to outpatient services.It seems that Considering type of ownership and assessing past trend of 3 studied indicators concurrently is necessary for Planning for development of a broader range of inpatient services and diversified medical services based on province`s need.
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.
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.
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.
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.
H Yaghfoori , A Sahrai , S F Khalifelo ,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: Zone 3 of Zahedan City includes the most deprived areas in province and country. The purpose of this research was assessing the distribution of the health care center (hospitals) and determining the underserved areas based on hospital locating concidering standards and criteria.
Materials and Methods: In order to achieve accurate results based on GIS software, spatial and descriptive data using statistics and field observation gathered and connected to database. Besides, AHP Model used to set priorities in locating the optimal urban spaces for building hospitals in the city.
Results: Suitable zone with special symbol severance divide from another zones was determine to develop landuse based on dependency to health care centers aimed at providing services in local level . Similarly, two Places recommended constructing health care centers in complete suitable zone. Unsuitable and compeletly Unsouitable zones was determined in zone three of zahedan city in finaly map.
Conclusion: study analysis based on urben percapita, population and needed availibilty to health care centers suggests that Zahedan city need two new hospitals setting which has been indexed on final map.
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.
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.
S J Tabibi, S Heidari , A A Nasiri-Pour , M Hosseinishokouh , A Ameryoun , F Mashayekhi ,
Volume 13, Issue 2 (8-2014)
Abstract
Background:Hospital is the most important health care services provider center.Undoubtedly, properand effective management performance can be very important. This study aimed at assessing professional and non-professional managers’ performance among selected hospitals in Tehran.
Materials and Methods: In thisdescriptive study the population was staffs of ten selected hospitals in Tehran. With the intention of performing the study, a 41-items questionnaire was used which confirmed its validity by experts and its reliability by Cronbach alpha(=90).After data entry in SPSS software,frequency distribution tables, diagrams and central tendency and dispersion were used. With the intention of measure probable correlation Contingency Correlation Coefficient - C was utilized.
Results:The comparison betweenprofessional managers’ responses with non-professional ones revealed an incremental trendfrom “seldom” to “always” in all domains of management functions (including planning, organizing, coordinating and control)and Contingency Correlation Coefficient - C indicated statisticallysignificant relation between domains and types of managers (professional and non-professional)P = 0.003, P = 0.006, P = 0.001, P0.0001 respectively.
Conclusion:Managers’ professional education is inevitable for hospital managing duties.
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.
Habib Ebrahimpour, Hassan Khalili, Mohammad Pourali,
Volume 13, Issue 3 (12-2014)
Abstract
In many countries, different methods and tools for improving the quality of health cares have been used. Among these methods, the NHS clinical governance provided by the NHS British government as a strategy to enhance the quality of clinical cares was introduced in 1998. Clinical governance both responsibilities for maintain the current level of cares and improving the quality of future care are emphasized.
Materials & Methods: The aim of this study was to investigate the relationship between clinical governance and organizational performance of hospitals in Ardabil. The research is an applied one questionnaire is used to collecting data. The population comprises patients, doctors employees and hospitals managers of Ardabil 180 were selected as the sample. To investigate the hypothesis test, correlation and regression analysis were used.
Results: According to data, there is a significant relationship between organizational performance and clinical governance. On the other hand, the results of F test showed meaningful level for the components of %99, so we can use linear regression. Furthermore, the coefficient of all the components of clinical governance has a positive and significant effect on performance. Among the components of clinical governance, clinical audit component has %163 of the minimum amount, and staff management component 908 percent has the most effect on hospital performance.
Conclusion: According to the results, are considered essential patient’s engagement in treatment, the use of information and patients' family’s experiences to provide more services to patients, credit allocation for staff training and staff expertise in the field of employees training.
Mahboubeh Asadi, Seyed Saeed Tabatabaee, Saeed Khayatmoghadam,
Volume 13, Issue 3 (12-2014)
Abstract
Background & objectives: one of new and unique tools for survival of organizations among their competitors having comprehensive knowledge of all the environmental factors affecting the organization, means organizational intelligence, that with its measurement Strengths and weaknesses of the organization are identified and can affect the performance of organization and in this way, they help to organization in the measurement and evaluating progress in achieving its goals.
Materials and Methods: This descriptive analytical study was performed in 12 general hospitals affiliated to Mashhad University of Medical Sciences in 2012. Study samples were 375 employees who were selected through stratified sampling method. The study Tool of data accumulation was Albrecht organizational intelligence standard questionnaire and checklist of hospital performance indicators that was determined by the Ministry of Health. To determine score organizational intelligence was used the five-point Likert scale. Data were analyzed by SPSS v.16 using Statistical tests and Pearson correlation coefficient (P=0/05).
Results: we found that there was a significant positive relationship between hospitals’ organizational intelligence and all the performance indicators of the exception of “Bed occupancy ratio”, “Ratio of surgeries to operation beds” (P<0.05), and organizational intelligence had the highest correlation with indicators of Bed Turnover Interval (r = 0.739) and the average length of patient stay (0.691)
Conclusion: it seems that attention and planning to strengthen and increase organizational intelligence can be effective in improving the performance of hospitals.
Mohammad Khammarnia, Dr Ramin Ravangard, Mohadeseh Ghanbari Jahromi, Asra Moradi,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Nowadays, Medical error as a major challenge has been attention of health authorities and community. The main purpose of this study was survey of medical errors in Shiraz public hospitals.
Materials & Methods: This study was a survey which conducted as analytical in 2013. Study population was Shiraz public hospitals which 10 hospitals were examined. Standard checklist was used for collecting data of medical error documentations. Data entered in SPSS software version 21 and used of descriptive, spearman and chi-square test for data analysis.
Results: the number of medical errors in hospitals during the one year was 4379 recorded and the most of error was related to larger hospitals. Nurses committed wrong more than other groups and systemic error had the highest frequency. There was a significant relationship between trespassing, time and type of error, (P=0.000). Moreover, there was a significant relationship between type of error with wards and hospitals). P=0.000, P=0.011 respectively)
Conclusion: The number of errors occurring in hospitals is symptoms of poor performance, therefore to prevent and reduce the medical errors and costs, managers should pay more attention to hospital performance and treatment guidelines are revised. Moreover, the hospital staff, especially nurses should pay more attention to their activities.
