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Ghasem Abedi, Zeynolabedin Rahmani, Ehsan Abedini, Farideh Rostami,
Volume 13, Issue 4 (3-2015)
Abstract

Background: Services marketing mix (7Ps) is one of the most important concepts of management and marketing. This study has surveyed the role of services marketing mix components in patients` tendency towards the public and private hospitals in Sari. Materials and methods: In this cross-sectional study, 900 patients were selected from sari`s public and private hospitals based on non-probability quota sampling. Data were collected using a questionnaire including the marketing mix components of which the validity and reliability was confirmed. The data were analyzed using the SPSS V.16 software with a multiple regression hypothesis. Results: The results showed that among the components of the services marketing mix, the price had the maximum effect (49.2%) and the physical assets had the minimum effect (14.1%) on patients` tendency to public hospitals. On the other hand, staff had the maximum effect (48.4%) and the promotion had the minimum effect (18.6%)on the patients` tendency to private hospitals. Conclusion: Price is a determining factor in patient’s tendency to refer to public hospitals compared to private hospitals because of delivering services with lower rates. On the other hand, the main reason for patient’s reference to private hospitals is their staff that could be due to their sense of responsibility, accuracy and speed in providing services to patients
Master Science Mohsen Afsahi, Dr. Mohammad Mehdi Sepehri, Master Ehsan Ameri,
Volume 14, Issue 1 (6-2015)
Abstract

Background: Deciding on the number of hospital beds is one of the most serious challenges managers face. More hospital beds result in higher running cost although less hospital beds might cause disorder in patients flow.  Minimizing total cost besides maximizing the patients flow in a hospital network, considering the practical limitations is the main objective of this survey.

Materials & Methods: This study had main steps to investigate following: identifying current limitations of changing capacity of each ward, by conducting interview with hospital managers and other personnel of Modares hospital, analyzing cardiac patient flow analysis, simulating current flow, determining practical scenarios and choosing the best among them by mathematical modeling could minimize total cost and maximize patient flow.

Results: 31 practical scenarios have been determined and analyzed by surveying limitations among all existing scenarios. Finally, eight best scenarios had been selected. Results showed that decreasing the number of beds in CCU and increasing the number of beds in Post-CCU can improve patients flow, considering cost limitations.     

Conclusion: A recommended approach in this study can be a general guide for capacity planning with taking practical limitations into consideration. This survey could be useful for the managers who are against the benefits of post CCU  by comparing the patient flow with and without this ward.


Hosein Ebrahimipour, Ali Vajaee, Gholam-Abas Nouri, Habib-Allah Esmaeili, Sara Jamili,
Volume 14, Issue 1 (6-2015)
Abstract

Background: Process of discharging patients affects patient’s satisfaction .This is one of the serious challenges that hospital managers face. This study is aimed to determine the average waiting time of patient discharge process and identify influential factors of this process in Imam Reza Hospital in Mashhad in the year of 2014.

Materials & Methods: This is a cross-sectional survey in which waiting time of patients who had discharged from clinical wards of the Imam Reza hospital in Mashhad had been studied. 455 of patients had been selected as samples. The amount of  time spent during discharge in six different departments  such as inside each ward, from each ward to the medical records unit, inside the medical records unit, from medical records unit to  accounting department , during cost calculation and also from  cost accounting to cost payment unit) had been determined by using stop-watch method. The data had been analyzed by descriptive and analytical statistics in significant level of 0.05  using SPSS16.

Results: Results showed that waiting time was 504.26± 362.96 Minutes. Patients spent most and least proportion of their waiting time in ENT and Burns wards during discharge.

Conclusion:   As noticeable number of minutes spent inside wards and cost payment unit by patients, calls for corrective interventions such as changing visit time and predicting schedules for sending medical record to accounting department could  reduce waiting time.


Edris Hasanpoor, Bahram Delgoshie, Hassan Gorji, Masoomeh Khogam, Mobin Sokhanvar,
Volume 14, Issue 3 (9-2015)
Abstract

Background: one of the most essential components in patient- physician relationship is the length of visit. Short time visit can affect visit quality and patient- physician relationship. This study aimed at comparing specialists visit length with standards in general hospitals of Qazvin.

Materials and Methods: This cross-sectional study conducted in general hospitals of Qazvin  in 2013. 428 patients were randomly selected to participate who were referred to the outpatient clinics of selected general hospitals. Studied specialties were including Internal Medicine, Surgery, Pediatrics and Obstetrics and Gynecology. In order to data collection, a Checklist including physician and patient related items was used and data analysis performed using SPSS version 19.

Results: The study results revealed the mean score of outpatients' visits length was 4.67±2.43 minutes which had a significant difference from standards (p<0.0001).Higher mean score was relate to  pediatrics (2.55±7.08) and the lower one was internal physicians (1.82±3.93).

Conclusion: In this study, Visit time in developed countries was lower than developing ones. Several factors were identified which affect visit time. Thus, decision makers should use the results to improve outpatients visit quality.


Faramarz Pourasghar, Jafarsadegh Tabrizi, Nesa Kavakebi, Ahad Banagozar Mohammadi,
Volume 14, Issue 3 (9-2015)
Abstract

Background: Patient transfer requires the wide variety of functions such as collaboration, appropriate communication and coordination between hospitals and the Center for Treatment Guidance and Information (CTGI). This study aimed at determining the influencing factors in the coordination of patient transfer and also explaining the situation of the CTGI in patient transfer process coordination.

Materials and Methods: This study was a qualitative study (phenomenology) conducted using three Focus Group Discussions (FGD) and thirty interviews with participants who were involved in the process of patient transfer in a referring hospital, six patient receiver hospitals and CTGI in Tabriz. Purposive sampling was used to select study participants. Data was analyzed using content analysis.

Results: The effective factors of the patient transfer coordination were categorized in four main themes including weakness in the exchange of clinical information, data constraints, legal protections weakness and guidelines implementation and lack of clinical empowerment in managing patient. Eighteen sub-themes were identified which include legal protections weakness and guidelines implementation in center for treatment guidance as sector problems.

Conclusion: There are some problems in coordination of patient transfer process which is relate to non adherence a specific procedure for admission , ineffective interactions and information exchange. In order to achieve uninterrupted medical treatment, the patient transfer coordination should be improved. The center for treatment guidance and information should be obtained its position as a supervising authority.


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Volume 14, Issue 4 (1-2016)
Abstract

Background: Three aspects of health, responsiveness rate and equitable financing introduced as the main goals of health systems. In this study, responsiveness rate was assessed among private and social security hospitals in 2013.

Materials and Methods: The descriptive-analytical study conducted as a cross-sectional one among 10 hospitals in Tehran city (20 percent of total social security and private, 8:2 respectively) in 2013. Study population consisted of all inpatients and outpatients referee to eight private and two social security hospitals and 333 subjects selected to data gathering randomly. The valid and reliable World Health Survey questionnaire was utilized. Data was analyzed by SPSS17 using descriptive statistic, Mann–Whitney and Kruskal–Wallis tests.

Results: In points of view among inpatient and outpatient, the mean score of responsiveness rate were 4.1±0.71 and 3.7±0.60 respectively. These amounts estimated 4.4±0.46 and 3.2±0.82 for inpatient and 3.8±0.58 and 3.5±0.63 for outpatient in private and social security hospitals respectively. Also, the mean score of responsibility rate assessed 4.4 in private hospital which was higher than social security ones (3.2); and this difference was statistically significant (P<0.001).

Conclusion: Responsiveness rate dimensions were evaluated moderate to high among assessed hospitals. These results were enhanced in private hospitals rather than social security ones. It is recommended that hospital managers should pay more attention to client and mechanisms to improve responsiveness rate and providing more services quality. 


Leila Azimi, Nader Markazimoghaddam, Khalil Rostami, Atefe Talebi, Atoosa Eskandari, Abdallah Mirzaiy, Mohammad Esmail Azimi,
Volume 15, Issue 2 (6-2016)
Abstract

Background: Nowadays, Patient Safety is considered as a fundamental concept of the healthcare system. Hence, recognizing the effective factors such as illegible orders, dosage errors, and drug usage can reduce serious side effects leading to the patients' disability, prolonged hospitalization and even death.

Materials and Methods: This descriptive-analytical study performed as a cross-sectional one. 1800 inpatient records selected in a teaching hospital during one year. The physician  first order was examined through a self-adminstrated checklist including physicians’ ID and workshifts, and variables  like legibility and recorded dosage. Data analysis conducted via SPSS using descriptive statistics and analytical statistics tests.

Results: Among 1800  studied records, there were 66.3% recorded by male, 17.6% illegible, 3.2% with no  stamp, 8.2% without signing, 11.9% without time and 4.9% with no date.23% of physician records didn't have coherence and logical sequence, 69.5% did not indicate to the primary items, 17.8% with no medicine dosage, 21.8% without pharmaceutical forms, 11.5% with no usage time, 25.9% without usage method, 14.3% had scribbles and 13% were devoid of numbering.  Also, there were a significant relation between demographic variables and some medical recording errors. 

Conclusion: it is necessary to endeavor physicians in patient records documentation improvement and can be used some strategies such as educating the newly arrived residents, considering commendatory techniques and record periodic evaluation.


Dr. Mahammad Arab, Pejman Hamouzadeh, Mani Yousefvand, Faroogh Namani, Mahsa Abdi,
Volume 15, Issue 3 (8-2016)
Abstract

Background: One of the main pillars of quality in health services is patient-centered that brings the best outcomes for patients. This study was aimed at comparing the patient-centered situation in selected hospitals affiliated to Tehran University of Medical Sciences (TUMS) from the viewpoint of nurses and patients in 2014.

Materials and Methods: This descriptive cross-sectional study was done among 220 nurses (n=103) and hospitalized patients (n=117) in selected hospitals of TUMS. The data gathering instrument was a researcher-made questionnaire which measured seven dimensions of the patient-centered. The validty was confirmed by the opinions of experts and its reliability was 0.96 by Cronbach's alpha. Data analyzes were performed by SPSS software and using one-way ANOVAtest.

Results: Mean score of patient-centered in the studied hospitals from the nurses and patients viewpoint was 2.79 (±0.50) and 2.87 (±0.58), respectively. From the viewpointof nurses and patients, the highest and the lowest mean score were related to the confidentiality and dignity dimension and the patient choice dimension, respectively. Based on ANOVA analysis, there was a significant difference between the mean scores of nurses and patients in quality of amenity and social support dimension (p<0.05).

Conclusion: Patient choice, quality of amenity and prompt attention were identified as priorities for action to improve patient-centered situation in studied hospitals. It is recommended that hospital authorities should be place in a matter of priority the dimensions of the patient-centered which are in poor condition in order to increase the level of patient satisfaction and loyalty.


Abdorrahman Mosahneh, Batol Ahmadi, Ali Akbarisari, Abbas Rahimi Foroshani,
Volume 15, Issue 3 (8-2016)
Abstract

Introduction: Medication process to patients is one of the most important tasks of nurses and doing in correct way can play a significant role in patient safety. This issue is the most significant part of quality care which consisted of patient safety as the impotant element. Medication errors are the main threatening factors of patients' safety. This study aimed at assessing the causes of medication errors from the nurses' viewpoints

Materials and Methods: This study was a descriptive-sectional-analytical one which was done in 2013. The study population consisted of 232 nursing staff of Abadan hospitals(Imam khomeini,Taleghani,Shahidbeheshti ,17shahrivar) which were covered by Ahvaz University of Medical Sciences,Oil Company and Social Security Organization ,respectively. Study instrument was a two part questionnaire including demographic - occupational information and causes of medication errors in 28 items in four fields (nurse, ward, nursing management and pharmaceutical causes).Content validity of questionnaire provided by review of related papers and experts'openion and required correction was performed.reliability of questionnaire was estimated 0.91 using Cronbach's alpha method.

Results: the most important causes of medication errors included shortage of nurses in propration to patient(%44),compression of work in ward(%36.2),fatigue due to over work(%35.8),illegible physician oder(%24.5),anxiety and stress due to work(%25),noise in ward(%22.4),nurse dissatisfaction of salary(%29.7) and similarity in medicine shape(%14.7) respectively.

Conclusion: Management causes such as nursing shortage, organizational factors such as compression of work in ward and some factors like nurses' fatigue had the most effect on occurance of medication errors among nurses. Thus, organizational processes reform and hospital organization to improve service quality and patient safety in order to resolve nurses' problems.


Sahba Sarvandi, Kambiz Shahroodi,
Volume 15, Issue 3 (8-2016)
Abstract

Background: Enhancing the need for health care services and its related costs, lead hospitals to improve and organize their processes. The aim of current study was to assess the Patients' Hospitalization and Discharge Processes Based on Kaizen approach and Multiple-Criteria Decision Making (MCDM) in an internal ward of one Hospital.

Materials and Methods: In this descriptive analytical study, ten managers completed the hospitalization and discharge questionnaires and answered three open questions according to Kaizen principles. Then, satisfaction score was measured for 100 patients using a reliable questionnaire (α=0.93). At third phase, after evaluating the proposed solutions using Analytic Hierarchy Process (AHP), the managers prioritized them based on cost, time and effectiveness considering indicators.

Results: Study findings revealed that mean scores of activity in hospitalization and discharge processes were 88.52 and 90.33 (out of 100) respectively, which showed high conformity with Kaizen approach. Also, mean scores of hospitalization and discharge satisfaction which indicated desirable satisfaction were 76.75 and 78.6 (out of 100), respectively. Based on managers' view points, results of MCDM and AHP methods indicated that effectiveness was the most important indicator and time as well as cost gained next priorities for solutions implementation.

Conclusion: This study showed that although, hospitalization and discharge processes were relatively desirable in the internal ward in mentioned hospitals, it is still a necessary to seek the best solutions in terms of effectiveness, time and cost for patients' satisfaction.


Milad Shafiee, Mohammad Hossein Ghafoori, Fatemeh Aboee, Sara Forootan, Mohammad Arab,
Volume 15, Issue 4 (1-2017)
Abstract

  Abstract

  Background and Aim: Especially in the case of Hospital services, quality assesment is an complicated and vague issue. For achieving this goal Multiple Criteria Decision Making methods help us. These studies aims to knowledge and prioritize quality indicators and rank selected inpatient wards in an elected hospital of Tehran university of medical science by using Analytical Hierarchy Process and TOPSIS methods.

  Materials and Methods: This is a descriptive-analytical and cross-sectional research. At the first, with an overview of the research literature and expert opinion, indicators of quality assessment were selected. Then we did prioritization of these indicators with using of expert opinion and AHP method. In the final stage, selected inpatient wards the Hospital were ranked in terms of quality of service using TOPSIS by a sample consist of 300 of inpatients.

  Results: Eight main domains (Responsiveness, Safety and risk management, Tangibles, attention to patient, Health communications, Competency and professionalism, accessibility, Credit and assurance) were selected for quality assessment. Among these indicators, competency had the highest priority and attention to patient had the lowest priority. Also the department of Heart had the highest quality of service and the department of Neurology had the lowest quality.

  Conclusion: According to crucial role of the service quality on patients’ satisfaction, the use of appropriate indicators for quality of services, prioritizing them and also proper assessment of the quality of hospital services can play a major role in health policies.


Dr. Sima Marzban, Mahshid Moeini Naini, Sayed Hossein Ardehali, Jaber Hekmatyar, Aliamir Savadkouhi,
Volume 16, Issue 1 (4-2017)
Abstract

Background: Injuries related to failures and errors due to clinical interventions in patient hospitalization period in hospital are the main reasons of mortality and mortality in worldwide. This study tries to identify and description ICU care failures and assessing the causes of risks, Severity, Occurrence and identifying risk probability ratio and risk prioritizing using FMEA method.

Materials and Methods: This study was carried out in order to evaluating existing situation using Failure Mode and Effect Analysis and utilizes volere logic to plan the patient safety management system. This study performed in the intensive care unit of Loghman Hakim hospital in Iran.

Results: Study finding revealed sixteen routine failures and its priorities which the five main issues were documented as error in decision phase for patients admission or in-admission (PRN 1000), error in discharge time of patient from ICU (PRN 1000), insufficient infection control (PRN 1000) and error in clinical ordering and prescriptions (PRN 800).

Conclusion: The main requirements of the patient safety management identified as planning standards and clinical guidelines, developing evidence based admission and non admission indicators, enacting infection control rules and education of anticipating standards places, hand washing and disinfecting instrument and equipments.


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Volume 16, Issue 1 (4-2017)
Abstract

Background: The emergency department is as heart of hospital and is one of the first points of contact for patients with health care system are facing a variety of challenges. This study aimed to explore the challenges of emergency departments in teaching hospitals of Mashhad University of Medical Sciences.

Materials and Methods: This study was carried out through a qualitative approach and phenomenology method in 2013 in Mashhad, Iran. Twenty nurses and two emergency medicine specialists were recruited from four teaching hospitals in Mashhad Iran using purposive sampling. Data were collected through semi-structured in-depth interviews. Interviews were transcribed verbatim and analyzed using conventional content analysis approach according to colaizzi  with MAXQDA 3 software. 

Results: The results of this study indicated that challenges of emergency department lay in

Three main aspects including: "challenges in Human resources"(personal characteristics,  professional characteristics and human resource limitations), "nurses' dissatisfaction"(less quality hospital hoteling and services for staff, disproportion between the workload and salaries, Lack of support from nurses) and " challenges in human resources management "(Structural challenges, the performance challenges and challenges in human resource management). Each theme included several category and subcategory that explain various aspects of the challenges in emergency department.

Conclusion: Human resource limitations, nurses' dissatisfaction and poor management were the most important challenges. Providing adequate human resources, support of nurses and determination guidelines and process for nursing care can reduce these challenges in hospital emergency departments.


Elham Haghshenas, Dr Mohammad Arab, Dr Abass Rahimi, Dr Elham Movahed,
Volume 16, Issue 2 (7-2017)
Abstract

Background: The quality of services is a comparison of the customer´s perspective (expectations) with what it has received. If the expectations are more than perceptions, the quality of received services is not sufficient based on customer´s view which resulted in his/her dissatisfaction. The present study performed with the purpose of determining the quality of provided and excepted services to outpatients among hospitals affiliated to Tehran University of Medical Sciences.

Material and Methods: The present study is a descriptive- analytics and cross sectional one which has been done in 2015. The study population included all outpatients attending hospital clinics affiliated to Tehran University of Medical Sciences.The sample size was calculated 225 participants based on formula. In order to data gathering in quality of provided and expected services, a 22-items standard questionnaire of Servqual was utilized. Data analysis performed by SPSS using paired t-test, Mann-Whitney and Kruskal-Wallis tests.

Results: The study findings represented that there was a negative gap in the quality of services provided. The highest gap was related to accountability (-0.97) and the lowest gap related to tangibles factors (-0.69) .Moreover, regarding to  relationship between demographic variables with perceived service quality, there were significant relationship between  insurance type with reliability and empathy dimensions and supplementary insurance with tangibles factors and reliability.

Conclusion: Negative gap (higher expectations than perception) in all aspects of quality improvement is required in all dimensions. Especially, it is necessary to adopt some strategies in the accountability dimension. Reforming management processes, reducing waiting times and increasing employees' motivation in order to achieve appropriate accountability are in this kind of strategies.


Dr Mohammad Arab, Serajadin Gray, Pejman Hamouzadeh, Farhad Habibi,
Volume 16, Issue 3 (11-2017)
Abstract

Background: This study was conducted to validate the "staff attitude toward the use of coercion in the treatment of mentally ill patients" questionnaire and assessed their attitude in selected public psychiatric hospitals in Tehran city.
Materials and Methods: This is a descriptive and analytical study which was carried out on three hospitals of Tehran University of Medical Sciences, Iran University of Medical Sciences and social welfare and Rehabilitation University in 2015. The questionnaires were distributed to the participants and finally 273 questionnaires were used.  Data were analyzed using confirmatory factor analysis test. Moreover, ANOVA and independent t-test were applied to evaluate the participants' attitude on using coercion for treatment of mentally ill patients.
Results: Study findings revealed that 61% of participants were nurse and 11% were physicians. According to the study results, three final obtained factors explained 61.93% of the total variance; this variance reflects the proper and appropriate selection of the questions.  In addition, there were statistically significant differences between marital status and offending attitude domain; between job and education and offending attitude; and security and treatment domains.
Conclusion: The current questionnaire has a high validity and reliability and is also appropriate for the context of Iran.  The attitude of the studied participants was a bit towards using coercion in treatment of mentally ill patients. Therefore, it is recommended that authorities take some steps toward changing health services providers' attitude of using coercion. 


Dr Peyvand Bastani, Mohammad Ghasem Nezhad , Ali Reza Yusefi, Dr Ahmad Sadeghi,
Volume 17, Issue 1 (5-2018)
Abstract

Background: One of the main components of the quality of health services is patient safety. This study aimed to determine safety culture status of psychiatric patients from the viewpoint of the medical staff of Ibn Sina and Hafez hospitals in Shiraz.
 
Materials and Methods: This descriptive-analytic study performed as a cross-sectional one in 2017. The study population included 165 health care personnel of the hospitals which were selected by census sampling. The study tool was a standard questionnaire for the hospital's safety culture. Data were analyzed using descriptive statistics and independent t-test, ANOVA, Pearson correlation coefficient and multivariate linear regression using SPSS version 23 software at a significant level of α = 5%.
 
Results: The average of safety status of the patients calculated 154.62 ± 19.74. The patient safety culture was estimated at an acceptable level (64.1%). The dimensions of personnel affairs (36%) and non-punitive responses to errors (34.7%) were in an unfavorable situation. There was a significant association between the employment status of personnel and patient safety (P<0.05).
 
Conclusion: Despite the acceptable condition of the patient's safety culture, however, the dimensions of the non-responsive response to the mistakes and issues related to the personnel were in an unfavorable situation and require prompt and appropriate actions. It is suggested that hospital authorities to provide the necessary interventions including cultures for reporting of errors, organizing comprehensive training programs, and continuously improving the clinical governance system.
 
Dr Ahmad Sadeghi, Dr Hossein Rohani, Sareh Davarzani, Zahra Davarzani,
Volume 17, Issue 2 (9-2018)
Abstract

Background: Patient complaints from the healthcare system can be helpful to respond patients’ needs using identifying the weaknesses. In this study, the complaints trend of patients has been investigated before and after healthcare system reform progress in a public hospital.
 
Materials and Methods: This descriptive-analytic study was carried out to assess trend of patient's complaints in two period of time in a northeast governmental hospital before and after healthcare system reform implementation (2012-2016). In order to collect data, the checklist designed by the ministry of Health was used. Data entered to SPSS version 21 and analyzed using descriptive statistics and analytical tests such as Chi-square.
 
Results: The study results revealed that the number of complaints were 29 and 198 before and after implementation of healthcare system reform, respectively. Most complaints were related to the emergency sector (31%) and about 40% of the complaints were from physicians. Most of the registered complaints were related to the quality of provided services (33.5%) and personnel exposure (30%), respectively. Accordance to study results, there was a significant difference between the number of complaints before and after implementation of the health system reform with the type of complainant (P <0.05).
 
Conclusion: Implementation of healthcare reform plan has led to systematic registration and special attention to complaints in assessed hospital. Most of registered complaints were related to the emergency department which requires managers and hospital officials to pay special attention to this sector and take effective steps to improve quality of services.
Parnian Nikmanesh, Dr Zahra Kavosi, Dr Ahmad Sadeghi, Ali Reza Yusefi,
Volume 17, Issue 2 (9-2018)
Abstract

Background: Communication is one of the central concepts and an integral part of the nursing profession. This study aimed to determine the effect of communication skills training of nurses on patient satisfaction with nursing staff services in teaching hospitals affiliated to Shiraz University of Medical Sciences.
 
Materials and Methods: The Comparative study carried out in 2017. The research population included nurses from educational hospitals and patients referring to them. Four hundred patients were selected through convenience sampling method and one hundred trained nurses and one hundred untrained nurses were randomly chosen. The data collection instruments were a standard questionnaire. Data were analyzed in SPSS23 using T-test, ANOVA, Tukey test, and Pearson correlation coefficient at α = 5% level.
 
Results: Mean scores of nurse-patient commination and satisfication of nursing services among patients under care of trained nurses were 93.5 ± 21.08 and 176.24 ± 22.14 and mean score of patients under care of untrained nurses the scors 81.76 ± 18.83 and 166.36 ± 41.10, respectively. A significant direct correlation was found between nursing-patient commination score and patient satisfaction score (P= 0.023, r= 0.681). Patients under the care of trained nurses were more satisfied with nursing services than those served by untrained nurses (P= 0.012). The results revealed that patient satisfaction had a significant relationship with age (P<0.001) and marital status (P=0.031).
 
Conclusion:  Implementation of communication skills training courses for nurses leads to improved patient satisfaction. Hospital directors are recommended to consider holding regular communication skills training courses for their nursing staff.
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 Sodabeh Vatankhah, Ghasem Rajabi Vasokolaei, Dr Sogand Tourani, Samira Raoofi, Susan Rahimi,
Volume 17, Issue 4 (2-2019)
Abstract

Background:  Development of the tourism sector and health tourism specifically can improve the Non-Oil GDP. In this regard, in accordance with the policies of the Ministry of Health and Medical Education, international patient department establishment has been facilitatated health tourism development in the affiliated hospitals. This study aimed to evaluate the performance of international patient department  and its effect on the attraction of medical tourists among hospitals affiliated to Medical Sciences Universities in Tehran City.
Matrials and Methods: This analytical cross-sectional study was designed and conducted in 2017. Study population consisted of all hospitals affilliated to  Tehran University of Medical Sciences (TUMS), Iran University of Medical Sciences (IUMS) and Shahid Beheshti University of Medical Sciences (SBMU). In this study,  hospital entrance criteria was certified by the Health Tourism Department of MOHME. Data was collected using the health tourism assessment checklist which approved by the MOHME. SPSS version 24 utilized to data analysis using descriptive and Inferential statistics.
Results: The study results revealed that  the overall performance of international patient department was evaluated at a desirable level (87.5 score) in hospitals of Tehran city.  Hospitals had the highest rank of hoteling indices (95/100), in compliance with the regulations and functional indicators gained 87.03 and 82.2 score, respectively.  Also, data analysis highlighted that there was no significant difference between hospitals of TUMS, IUMS and SBMU. The establishment of international patient department had no effect on health tourists attraction.
Conclusion: Considering the purpose and mission of international patient department to facilitate the provision of quality and satisfactory services in health tourists, management and oversight mechanisms for the standards implementation such as patient admission, follow up in the origin country and development of hospital marketing policies in order to attract international patients and increase hospital incomes are recommended.

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