Dr Abdorrahim Afkhamzadeh, Dr Sharmin Fateh Babamiri,
Volume 16, Issue 3 (11-2017)
Abstract
Background: Job stress is a part of physician, nurses and hospital executives lives. Medical is tense basicly and tension affects the quality of life and health of physician. This study aimed to determine the occupational stress and its relates factors among medical residents in Kurdistan University of Medical Sciences.
Materials and Methods: In a cross-sectional study, all of seventy-one medical residents of Kurdistan University of Medical Sciences (first to fourth of residency in 2012) in the field of internal medicine, obstetrics and gynecology, pediatrics and psychiatry were recruited in the study. Data collection was performed using standard questionnaire of job stress, Osipow. In the descriptive analysis, mean, standard deviation (SD) and range were determined for quantitative variables. For hypothesis analysis t-test and chi-square were used.
Results: Mean age and SD was 32.3 ± 3.05 years. Thirty-nine of participants (54.9%) were female and 32 (45.1%) male respectively. Job stress was moderate to severe and low to moderate in 80.3% and 19.7% participants respectively. Average job stress score were almost th same in different scales. But, stress in responsibility subscale was more than the others. Gender, specialty field and all subscales of job stressors had significant relationship with Job stress (P<0.05). But age, marital status and years of residency were not associated with job stress (P>0.05).
Conclusion: As the majority of medical residents experiencie moderate stress, providing interventions in residency training programs management in order to reduce the stress in Kurdistan University of Medical Sciences seems necessary.
Saeid Mahmoudi, Zeinab Gholampour Noghondar , Farhad Habibi Nodeh, Hossein Safari, Parvin Abbasi Borogeni,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Length of stay is one of the most important and practical indices used in hospitals today which represents the performance and efficiency of the hospitals. This study aimed to identify the factors affecting length of stay in hospitals affiliated to Tehran and Iran Universities of Medical Sciences based on Hierarchical Analysis Technique.
Materials and Methods: This descriptive cross-sectional study was conducted in 2013. Study population consisted of 40 participants using purposive sampling method in the two groups including 13 matrons (nursing managers) and 27 supervisors (Clinical and educational) of hospitals affiliated to Tehran and Iran Universities of Medical Sciences. Data collection tool was the paired comparisons questionnaire which was confirmed validity by experts using Lawshe and reliability by Inconsistency Ratio. Data analysis was performed using Expert Choice software version 11.
Results: In general, in the studied hospitals, study results revealed that the "diagnostic, treatment and care methods (treatment efficacy)” with the mean of 21.4% and "admission and discharge in the end days of the week and the days off” with an average of 0.36 were the highest and the lowest priority is given to other factors affecting the length of stay of the patient,respectively.
Conclusion: Efficacy of provided treatment through using equipment, appropriate diagnostic and therapeutic procedures and factors related to hospital manpower were effective on length of stay in quantitative and qualitative dimensions. These important issues need more planning and pay attention by hospital officials.
Dr Hojjat Rahmani, Ghasem Rajabi Vasokolaee , Dr Jalal Saeidpour, Dr Mehdi Rezaei , Dr Somayeh Niakan, Bahman Khosravi ,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Considering the key role of human resource management in health care organizations, assessing human resources and its pathology are essential. Therefore, this study aimed to evaluate human resources pathology in Imam Khomeini Hospital complex in Tehran.
Materials and Methods: The present study was conducted using descriptive-analytical method in 2016. In this research, 342 employees of Imam Khomeini Hospital complex were selected. The data were collected using a standard three-dimension questionnaire, then, descriptive (frequency, percentage, mean, standard deviation) and analytical statistics (Pearson Correlation Coefficient) were used to data analysis.
Results: Study results revealed that the highest and the lowest mean and standard deviation were obtained for the variable of motivation and job satisfaction (3.51 ± 1.02) and improvement methods (2.81 ± 0.84), respectively. Among all studied variables, behavioral (3.29) and contextual (2.91) factors scored the highest and lowest points respectively. Correlation between structural, behavioral and contextual with demographics revealed a statistically significant association with sex.
Conclusion: According to study findings, considering the importance and role in providing the desired services, human resource managers should pay special attention to identify all organizational factors, especially organizational culture, motivation and job satisfaction, employee training, job security and customer orientation.
Rouhangiz Asadi, Dr Masoud Etemadian, Dr Pejman Shadpour, Fatemeh Semnani,
Volume 16, Issue 4 (2-2018)
Abstract
Background: In recent years, Hashemi Nejad Hospital was outsourced or insourced some of their services to private sector or will have decision to do it. Selection and assessment of suppliers in outsourcing of hospital services is a critical issue. In this study, selecting and evaluating suppliers for outsourcing services in hospitals was evaluated.
Materials and Methods: In order to achieve the goal, evaluating and selecting outsourcing service providers with studies and using opinion of the experts and medical experts, consisting of hospital manager, quality manager, HR managers, officials outsourced parts and other experts in this respect which includes 14 criteria. Identified criteria were clustered in three areas of service features, characteristics and criteria for communications suppliers in the supply chain; supplier selection problem is the problem multi-criteria decision. So, criteria were ranked and weighted using the Expert choice 11 software and AHP.
Results: Based on the study results, sub-criteria of the quality of service, management systems, customer care, and information security had greatest impact on the selection of suppliers and sub-criteria, geographic location, flexibility and problem solving had the lowest priority.
Conclusion: C supplier had the highest priority according to the communication criteria and A supplier had the highest priority according to two other criteria. In total, the supplier A had the first priority, supplier B had the second priority and supplier C had the third priority.
Serajeddin Grey, Abolfazl Rouzbeh, Bahman Khosravi, Farhad Habibi Nodeh , Arezo Rahbari, Hosein Safari,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Administrative violations of employees at their workplace create a conflict between individual and organizational goals. Due to the long process of handling these violations, this study aimed to identify and present some suitable solutions in order to reduce delay in the health sector.
Materials and Methods: This study was carried out at three steps. At the first step, causes of delay in handling of administrative violations were extracted along with the proposed solutions using interviews. In second step, Delphi method was applied in order to find out the agreement of experts on the suggested solutions. In third step, practical solutions were prioritized using the analytic hierarchy process.
Results: Overall, 23 out of 39 solutions were certified after consultation with experts running the first round of Delphi using the interview. These solutions were presented to 15 experts using a self-constructed questionnaire and 18 solutions were approved by the experts finally.Solutions were divided into six groups of motivational, organizational, administrative, process, and research group solutions.
Conclusion: Training as the main key to prevent the delay can work effectively at all levels and processes of service delivery. Hiring well-informed and conscious managers at various organizational levels as well as having experienced and mindful research group on administrative violations can speed up the process of handling these violations.
Dr Mohammadjavad Taghipourian , Behrooz Alizade ,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Today, in order to reduce costs along with the realization of superior qualities, assignment of all or part of the responsibility for performing a specific organizational task outside the organization is a great importance. Therefore, this study aimed to assess the role of corporate culture on the quality of working relationships in outsourcing activities at Tehran University of Medical Sciences.
Materials and Methods: This research was a correlational study. The study population consisted of all the staff of the outsourced units of Tehran University of Medical Sciences. Staff who were in contact with outsourced units included 600 individuals. To collect data, a questionnaire based on Zoghbi et al study (2014) was utilized. Two hundred fourteen analyzable questionnaires were collected using multistage cluster sampling method.
Results: Structural simulation results with LISREL software revealed that corporate culture had a positive impact on the quality of working relationships during outsourcing of activities. Hierarchical culture was associated with adverse impacts on disruptions in customer service and orientation. Ethnic culture had a positive effect on both components. The market culture had a positive impact on obstruction and had a negative effect on customer oriented. Temporary culture had no significant impact on both of components.
Conclusion: given that the quality of working relationships between staffs of outsourced units and organizational staffs is of utmost significance for organizational productivity; the interest of managers affiliated to Tehran University of Medical Sciences regarding corporate culture, and also, strengthening hierarchical and ethnical culture is noteworthy to improve customer orientation and reducing disruptions in customer services.
Bita Jafar Yeganeh, Dr Morteza Ghasemi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: This research aimed to investigate the possibility of realizing Magnet hospital attributes and its effect on nurses’ job satisfaction.
Materials and Methods: This applied study was a descriptive and correlational one. The study population consisted of the nurses who worked in Qods hospital in Arak. Nurses of emergency departments, operative rooms and angiography unit due to different implementation of the work were excluded and 275 nurses were selected. Chen, Johananthin and Kramer questionnaires were applied to data collection. Data analysis was conducted by SPSS software.
Results: The study results revealed that the effect of "Magnet Hospital attributes" on "job satisfaction" is equal to 0.567. Autonomy (β = 0.015), policy (β = 0.515), management style (β = 0.295) and professional development (β = 0.103) significantly contributed 56% of the variance of job satisfaction. Per unit increasing in "autonomy", "policy", "leadership style" and " professional development” was added 0.013, 0.427, 0.265 and 0.91 to "job satisfaction”, respectively.
Conclusion: Manager support for professional development has positive impact on nurses’ satisfaction through continuous learning, autonomy in their duties and increased nursing leadership power. Therefore, planning for access to Magnet hospital should be the top priorities of nursing managers.
Dr Ebrahim Jaafaripooyan, Tahere Sharifi, Dr Sara Emamgholi Poor, Dr Mir Saeed Yekani Nejad, Samaneh Esmaeili,
Volume 17, Issue 2 (9-2018)
Abstract
Background: Hospital accreditation is assumed as an effective control mechanism for health systems to improve quality and efficiency. Current study thus, seeks to look into the relationship between hospitals’ accreditation and efficiency
Materials and Methods: In order to measure efficiency, hospital inputs and outputs included the ratio of physician and nurse to bed, mortality and nosocomial infection rate and quality of inpatientservices were used. A sample of 554 hospitalized patients selected using stratified random sampling
method. Data gathering instruments were researcher-developed questionnaire and checklists. DEAP and SPSS software deployed to assess correlation between accreditation rank and technical efficiency
Results: Average hospitals’ technical efficiency score was 0.94 indicating an improvement capacityof %5.1 for hospitals efficiency. The mean quality score was 4.13 out of 5( in the range of 3.9-4.3)There was no correlation between hospitals accreditation rank and their technical efficiency
Conclusion: According to the results, it seems efficiency should be also considered in accreditationmetrics. In addition, for measuring efficiency, performance based inputs and specifically outputs tohave reliable results should be chosen
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 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.
Mahdiyeh Heydari, Dr Leila Doshmangir,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Need to assess the health system performance, various models and frameworks have been developed by different groups and organizations. This study explores health system performance assessment frameworks using the comparative-analytical study.
Materials and Methods: This is a comparative-descriptive study conducted using descriptive-prescriptive method based on comprehensive comparative analysis. The scope of research includes health system frameworks. The study results compared and interpreted based on identified factors in comparative tables.
Results: Overall, 11 frameworks out of 16 ones described, analyzed and compared to each other. Some of the frameworks in addition to providing insight about the health system have focus on assessment of health system performance. Each framework follows especial goals which focus on importance the health systems assessment.
Conclusion: During the time, health system frameworks have changed and developed according to the health systems changes. Developed Frameworks in recent years are more comprehensive than others which have been presented at first. Utilizing these frameworks in order to identify health system goals, assess based on responsibility (organizational actions or outside the organizations) and ways to reach them can be effective. Using the developed frameworks based on their domains and objectives can be considered in health system performance.
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%.
Iman Dehghan, Dr Bakhtiar Ostadi, Dr Saeid Hosseini,
Volume 17, Issue 4 (2-2019)
Abstract
Background: The operating rooms in each health center are one of the most sensitive units in the center, whereas scheduling and scheduling operations are in particular importance and their optimization has a significant effect on the optimization of the whole complex. The scheduling of heart surgery in addition to the limitations of manpower, time, and facilities includes the limitation of the patient's surgical deadline, which is the purpose of the surgical scheduling given this parameter.
Materials and Methods: In this quantitative study, an algorithm containing 3 + 1 function was proposed. This algorithm also addresses uncertainty while monitoring the limitations of available resources and the maximum delay for surgery. In this study, patients categorize to emergency and non-emergency patients which only the scheduling of non-emergency patients is considered. In this study 343 patient was studied.
Results: Based on a six-month period information reviewing from Shahid Rajaie Cardiovascular Center in Tehran, a 11% improvement has been made in respecting the maximum delay for the patient's referral process. The optimization rate is often related to the difference in patient selection based on their deadline for surgery, which in the present algorithm has been a major contributor to the denial of service patients. Another advantage of the proposed algorithm is the dynamic process of the algorithm and appropriate response to the changes.
Conclusion: The longer the length of the queue, the lower the chance of accepting non-emergency patients with the shorter maximum delays.
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.
Dr Hossein Dargahi, Rostam Zalvand,
Volume 18, Issue 1 (5-2019)
Abstract
Background: Physicians' full time attendance is related to increment of many hospitals performance. Regarding the present challenges, this study aimed to analyze this plan using SWOT technique and present TOWS model in Tehran University of Medical Sciences (TUMS).
Materials and Methods: This study was a descriptive-analytical and cross-sectional one conducted during 2016-2017. Based on Cochran formula, 234 full time attending physicians randomly selected using simple randomization method. The research tool was a researcher made SWOT questionnaire which confirmed its content validity and reliability. Collected data was analyzed by SPSS software using SWOT technique and suggested TOWS strategic model.
Results: The most valuable weaknesses of mentioned plan were inappropriate coordination of physicians; lack of compensatory system, and the most important strengths were employment of young physicians and better education for medical students. The most important opportunities and threads of mentioned plan were establishment of competitive work between public and private hospitals and burnout and dispensing of experienced physicians moving to private sector, respectively.
Conclusion: Based on study findings, TOWS model strategies can be suggested for improvement of the plan.
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.
Seyyedeh Safoora Mortazavi, Dr Parvaneh Samouei, Seyyedeh Zohreh Mortazavi, Alireza Moniri,
Volume 18, Issue 3 (10-2019)
Abstract
Background: The intensive care unit is one of the most critical parts of the hospital, where the services provided to patients are of great importance. Because nurses have a high volume of work and should respond to patients at the earliest time, the existence of a curriculum is essential. Therefore, proper planning can reduce their fatigue and dissatisfaction caused by the high volume of work.
Materials and Methods: In this research, all activities performed by nurses in the intensive care unit during different shifts for patients, their timing and their GERT network were drawn. The time of each activity was calculated in 4 optimistic time, most likely time, average time and pessimistic time. Also, the total time of activities that can be done by a nurse for one patient from the beginning to the end of the shift can be calculated based on these four modes and an innovative method was used for planning the nursing activities.
Results: The results showed that the total time spent by nurses is significantly different. Therefore, with the help of the proposed algorithm, the activities were allocated to nurses in a way that it created a time equilibrium and significantly reduced the standard deviation and time domain of assigned activities.
Conclusion: The proposed method showed that it is better to allocate patients' work to nurses instead of allocating the patient to the nurse. This will cause all nurses with a fairly equal workload, which can increase the satisfaction of nurses and increase the quality of service.
Motahareh Payam, Dr Farzad Firouzi Jahantigh,
Volume 18, Issue 3 (10-2019)
Abstract
Background: According to the importance of health and treatment, it is necessary to use suitable models for planning and setting surgery time. In this study, a mathematical model is offered for operational scheduling of surgeries at surgery rooms of hospitals.
Material and Methods: This is an applied study and its data is related to the surgery rooms of Zahedan Al-Zahra eye hospital. Study population was the surgeries performed in March 2016. The mathematical model of scheduling surgeries at the surgery room was optimized in MATLAB2014.
Results: Due to limitations on patient admission capacity in hospital surgery ward, 79 surgeries were called off. In the proposed model, the total waiting time index for performing surgeries was 1547.29, and this index was found to be 1842 without the use of the model. Therefore, the waiting time index was improved by 16%. In accordance with the third purpose (objective) function, the tally of delays for predicted surgery ending time in one month was estimated to be 69.15 hours. The process of each surgery includes four defined activities. The end time of the activities related to each surgery has been examined and it has been optimized according to the existing limitations.
Conclusion: The proposed model can improve the waiting time by 16% and makes it possible to choose the surgical procedures that should be canceled and delayed according to medical priorities.
Dr Ali. Mohammad Mosadeghrad, Dr Parvaneh Esfahani,
Volume 18, Issue 3 (10-2019)
Abstract
Background: Strategic planning is an appropriate strategy for improving hospitals’ performance and increasing managers’ responsiveness and accountability. Iranian hospitals were requested to have mandatory strategic plans due to the accreditation requrements since 2012. As a result, they faced several challenges in formulating and implementing strategic plans. Hence, this study aimed to identify the perquisites of hospital strategic planning.
Materials and Methods: This qualitative study was conducted using semi-structured interviews with 47 managers of teaching, private, military, social security and charity hospitals in 2016. Hospitals were selected purposefully from Tehran province hospitals. Content thematic analysis was used for data analysis using inductive approach.
Results: Justifying the need for strategic planning, using an appropriate strategic planning model, training hospital managers and employees on strategic planning process, providing necessary resources, promoting a collaborative and innovative culture, providing incentives for formulating and implementing strategic plans and managers’ and employees’ commitment and involvement are the main prerequisites of strategic planning in hospitals.
Conclusion: Hospitals managers must commit the strategic planning prerequisites prior to formulating and implementing strategic plans. Otherwise, they will encounter several serious challenges.
