Showing 52 results for Quality
Ali Mohammad Mosadeghrad, Fatemeh Khalaj,
Volume 19, Issue 1 (4-2020)
Abstract
Background and purpose: Electrocautery is a very important tool in surgery. Electrocautery burn is a common side effect of operation surgeries. Quality management is a useful strategy for improving the quality and safety of hospital services. The objective of this study was to examine the impact of quality management on reducing electrocautery burns.
Materials and methods: A participatory action research was conducted in the operating theatre of a hospital in Tehran, Iran, in 2013 and 2014. A quality improvement team was established in the hospital operating theatre. The quality improvement team using an 8-step quality management model, standardized working processes, identified quality goals for the processes and improved them until achieved the quality goals. Data on electrocautery burns was collected before and after the intervention and compared.
Results: Electrocautery burn rate was 0.40% in 2012. A wet patient due to sweating or washing during the surgery, in-appropriate patient position, faulty earth well, faulty anti-static mattress and long usage of electrocautery devices were the main reasons of electrocautery burn injuries. Accordingly an action plan was developed and implemented for preventing and reducing electrocautery burns. Consequently, electrocautery burn rate was reduced to 0.21% and 0.02% in 2013 and 2014. Electrocautery burn was significantly reduced by 95% in two years.
Conclusion: Electrocautery burns can be easily prevented using the quality management strategy. Implementing an appropriate quality management model appropriately in a supportive environment enhances the safety of hospital services.
Fatemeh Khazaei, Hasan Mirza Hosseini, Mostafa Nokani,
Volume 19, Issue 2 (8-2020)
Abstract
Introduction: Hemodialysis is one of the effective therapies in patients with chronic renal failure. Along with increasing life expectancy as a benefit of this treatment; this type of service can threaten the quality of life of recipients. Therefore, the present study was conducted to investigate the effectiveness of emotional schema-based therapy on improving the quality of life of dialysis patients.
Materials and Methods: The current semi-experimental, applied study was designed and implemented as pretest-posttest research with a control group. All outpatients treated with dialysis instrument in medical centres affiliated to Tehran University of Medical Sciences in 2009-2010 were the statistical population of the study and the quality of life questionnaire related to kidney patients used for data collection. After the research team performed the treatment protocol in 8 sessions of 90 minutes in the intervention group, the research data were analyzed using SPSS24.
Results: The results of the study showed that the treatment protocol based on emotional schema therapy influence all aspects of quality of life and increase the mean score compared to the pretest. Also, there is a significant difference between the groups, both in the general dimension and specific dimension of dialysis patient's quality of life.
Conclusion: As the study findings show, it can be stated that emotional schema therapy is effective in improving the quality of life of dialysis patients and can be used as a useful intervention to improve the quality of life of patients.
Ramin Dastab, Farahnaz Farnia, Somayeh Zare,
Volume 19, Issue 3 (11-2020)
Abstract
Background: Quality of life is a mental issue that causes a person to be affected by various factors including self-efficacy. The roadmap in this field is family-centered empowerment, which aims to promote health. The aim of this study was to determine the effect of family-centered empowerment model on quality of life and self-efficacy of kidney transplant patients.
Materials and Method: This study is a randomized controlled clinical trial. 100 kidney transplant patients, who came to Shahid Hasheminejad Hospital, were divided into two groups of control and intervention by initial accidental sampling. Data collection tools were a three-part questionnaire includes of demographic characteristics, quality of life of patients of kidney transplant questionnaire (KTQ-25) and the questionnaire of health empowerment to survey about self-care (SUPPH). These questionnaires were completed by both groups once the study was initiated and another time 1.5 months after intervention. Data were analyzed by SPSS software (version 20), chi-square and T-test.
Results: findings demonstrated that when the study was initiated there was not any significance difference between these two groups in terms of demographic quantitative and qualitative characteristics and mean of quality of life and self-efficacy. In compared with control group, mean of quality of life of intervention group was increased. Statistically, it has a significance difference (0<0.001). Also, in comparison with control group, the score of self-efficacy promoted and it has a significance difference.
Conclusion: Considering the positive effect of family-centered empowerment model on self-efficacy of kidney transplant patients and finally on their quality of life, it is necessary to consider this model with the aim of promoting patients' health.
Sara Karami Parsa, Leila Nazarimanesh, Mahmood Mahmoodi Majd Abadi Farahani,
Volume 19, Issue 3 (11-2020)
Abstract
Background and Purpose: The importance of hospital quality services in order to best utiliz available resources are not unknown to managers. This is especially important in the maternity sector due to the high density of referrals. Implementation of LDR (Labor, Delivery, Recovery) is one of the new approaches to improve delivery services in the country. The purpose of this study was to evaluate the effectiveness of LDR system on quality of delivery services in two selected hospitals of Qom.
Methods and Materials: This is a descriptive-survey study. Data were collected with a cross-sectional approach to compare the quality of service indicators of a hospital with LDR system as a case and a hospital without LDR system as a control group. Data were collected using a standard questionnaire by Poisson sampling and analyzed by SPSS software.
Results: There was no significant difference between the two hospitals except for LDR implementation. There was no significant association between LDR implementation in delivery sector with overall quality of service indicators (3 vs. 2.5) , input, process and output quality indices. However, LDR implementation had a significant effect on some items of these indices (level of significance = 0.05).
Conclusion: According to the research findings, implementation of LDR did not have a significant effect on overall quality of services, but it did affect the subscales of these indices. Therefore, it seems clear that there is a need for proper management policy to control the costs involved in implementing this system.
Ebrahim Jaafari Pooyan, Hojjat Rahmani, Mohammadamin Mirshekari,
Volume 19, Issue 4 (12-2020)
Abstract
Introduction: Identifying the challenges of Quality Improvement Offices (QIOs) not only helps in planning the quality of hospital services and in trying to provide a suitable solution to solve the problems of these offices but also plays an important role in strengthening the offices and increasing the quality of clinical and non-clinical services of hospitals. This study aimed to investigate the challenges of quality improvement offices in hospitals and provide appropriate solutions.
Methods: The present qualitative research was conducted using semi-structured interviews with 40 managers and hospital boards, matrons, quality improvement experts of hospitals and accreditation offices experts of medical universities in Tehran. Content analysis method was used to analyze the data obtained from the interviews. Then, the collected data were analyzed and classified by MAXQDA10 software.
Results: By analyzing the interviews in the field of challenges and solutions, the extracted codes were classified into four areas of management, standards, evaluation and staff. The most codes were related to management with 5 themes and 21 sub-themes. In addition, most of the solutions were related to the field of management.
Conclusion: The findings of the study showed that most of the challenges and solutions were in the field of management. Focusing on this field could be helpful in improving the quality of offices performance.
Leila Hosseini Ghavam Abad, Abbas Vosoogh Moghadam, Rouhollah Zaboli, Mohsen Aarabi,
Volume 19, Issue 4 (12-2020)
Abstract
Background and Aim: Clinical governance is one of the important frameworks for continuous quality improvement and safety in health care systems. Identifying the axes of this approach according to local conditions is one of the important priorities of the health system. The aim of this study was to identify the views of stakeholders on the axes of clinical governance in primary health care based on family physicians in Mazandaran province.
Methods: The present qualitative study was conducted using the conceptual framework analysis method in 2018-2019. The study population were key policy makers of Ministry of Health, Health deputy of the University, the county health network, family physicians association, family physicians, and the parliament research center. Participants were selected using purposeful and snowball sampling methods. Data were collected through semi-structured interviews and were analyzed and coded using MAXQDA 11 software.
Findings: According to the interviewees' views, the research findings were classified into 4 main dimensions: dimensions of clinical governance, requirements and structures, decision-makers and dimensions of quality and safety assessment. 17 sub-themes including community participation, clinical audit, clinical effectiveness, personnel management, training, information use, risk management, guidelines and procedures, promotion of health indicators, equipment and facilities, referral system, financing, policy makers, effectiveness, efficiency, human aspects of services and justice were identified and extracted.
Conclusion: According to the research findings, to facilitate the implementation of clinical governance, solutions such as the existence of appropriate infrastructure, commitment of managers, supportive culture, sufficient knowledge, monitoring and evaluation, appropriate culture building, facilities and equipment and sufficient financial resources are suggested.
Seyed Mohammad Hasan Safi, Mohammad Hossein Sadeghian,
Volume 20, Issue 3 (12-2021)
Abstract
Background:The most important and difficult process in any organization is to create change in the organization because today organizations have to react to changes in the environment.The purpose of this study was to investigate the effect of transformational management on quality of work life of the staff of Shohada-ye Tajrish Hospital in Tehran.
Materials & Methods:The is a descriptive-analytic and cross-sectional study that was conducted in Shohada-ye Tajrish Hospital in Tehran in 2020. Data collection tools were Transformational Management Questionnaire(Bass and Olivier)and Quality of Work Life Questionnaire(Walton 1973). Based on Cochran's formula, 234 employees of Shohada-ye Tajrish Hospital in Tehran were selected as study population.The reliability and validity of the measuring tools were evaluated using Cronbach's alpha coefficient and confirmatory factor analysis. Pearson correlation test and structural equation test were used to analyze the data.
Results:The research findings indicated that there was a positive and significant correlation between transformational management with safe and healthy work environment, growth opportunity and security, fair and adequate pay, employee legalism,social affiliation,social cohesion and integration, development of human capabilities and the general atmosphere of working life. In addition, 92% of the variance in quality of work life was explained by the research model.
Conclusion:Considering the impact of transformational management on the development of human capabilities, senior managers should formulate and implement appropriate programs to improve the quality of work life and provide conditions for employees to enjoy their organization and work.
Sajad Ghorbanizadeh, Fatemeh Tajar, Zahra Asadi Piri, Satar Rezaei, Yaser Mokhayeri, Soraya Nouraei Motlagh,
Volume 20, Issue 3 (12-2021)
Abstract
Introduction: Socio-economic inequalities in the use of dental services are a major challenge to health policies in many countries. This cross-sectional study was conducted to investigate socio-economic inequalities in utilization of dental services in households of Lorestan province and comparing it with neighboring provinces.
Methods: Data required for the study were collected from the household expenditure and income survey (HIES). The study population included 5547 households in the western provinces of the country. Logistic regression method was used to determine the most important factors affecting the use of dental services, and the focus index was used to measure inequality between income groups. Data analysis was performed using Stata software version 14.
Results: The highest and lowest percentages of dental services among households were related to Hamedan (7.02%) and Lorestan (3.19%) provinces, respectively. The results of the focus index showed that the benefits and costs of dental services were concentrated among households with higher socio-economic status. In other words, inequality benefits the rich. Being a female head of household and increased size of the household leads to a decrease in the use of these services. The higher education level of the head of the household and the increase in the number of employed and literate household members showed a positive relationship with the utilization of dental services.
Conclusion: Benefiting from dental services was significantly higher among higher socio-economic groups. These inequalities can be avoided by introducing and implementing targeted policies. Low-income households, lower education levels, and the unemployed should be the focus of health policies to address unmet dental care needs.
Bahareh Hashemi Moghaddam, Mohammad Reza Karimi Alavije, Najima Sadat Kianoosh Fard, Shahin Ebrahimbabaei,
Volume 20, Issue 4 (12-2021)
Abstract
Introduction: The concept of patient satisfaction has become very important in the field of healthcare and the major part of this satisfaction is affected by the quality and variety of hospital hotel services.
The main purpose of this study is to analyzing the effect of quality of non-medical services (hoteling) of hospitals on satisfaction considering the mediating role of satisfaction with health services in Shahid Fayyaz Bakhsh, Shahid Hasheminejad and Masih Daneshvari hospitals.
Method: The type of this study is of applied and descriptive-correlational. The statistical population of this study included 48043 recipients of services in the mentioned hospitals. The sampling method is simple relative random judgment and Krejcie and Morgan table was used to determine the sample size. information collected through a researcher-made questionnaire. In order to analyze the data and test the hypotheses from descriptive and inferential statistics through SPSS22 software and also to check the model fit and confirmatory factor analysis from Lee software. Shannon entropy method was used to measure the importance and weight of the studied variables.
Results: The weight and priority of each of the research variables implied that the views of service recipients in the field of non-medical services of hospitals, services during treatment, cleaning services, welfare services, human resources, buildings and facilities, and patient nutrition were respectively high to low priorities.
Conclusion: Recipients satisfaction of non-medical services was average. Establishing partnership management system and determining their medical priorities and needs might increase their satisfaction .
Hassan Niroomand Sadabad, Ali Vafaee Najar, Elahe Houshmand, Jamshid Jamali, Zahra Keyvanloo, Mahdi Dehnavi,
Volume 21, Issue 4 (1-2023)
Abstract
Background and purpose: Considering the important role of doctors in the implementation of accreditation standards and the necessity of their involvement in this process, this study was conducted in order to identify the views of doctors regarding the challenges of participating in accreditation programs in social security hospitals in Mashhad.
Materials and methods: This study is a cross-sectional descriptive-analytical research that was conducted in two hospitals of the Social Security Organization of Mashhad, Iran. in 2022. The participants were 56 full-time working doctors with at least one year of work experience in the hospital. Data analysis was done using SPSS version 26 software.
Findings: Among the challenges of doctors' participation in accreditation programs , the dimensions of the motivational mechanism (3.96±0.63) , provision of suitable resources for the implementation of accreditation (3.83±0.78), physician empowerment programs (3.78±0.73) and the role of the quality improvement office in attracting doctors' participation (3.75±0.74) were more important from the doctors' point of view, and patients' demands (2.90±0.75) and role ambiguity 2.77±0.96), were less important in their opinion.
Conclusion: Managers should consider that employee motivation and resource allocation are necessary for the effective implementation of the accreditation standard. Empowering doctors in the implementation of accreditation standards as well as the participation of quality improvement offices to interact with doctors and attract their participation are very important factors.
Raziyeh Montazeralfaraj, Sajjad Bahariniya, Sara Jambarsang, Fatemeh Sadat Hashemi,
Volume 21, Issue 4 (1-2023)
Abstract
Introduction and purpose: The main mission of hospitals is to provide quality services for patients. Evaluating the quality of hospital services can lead to the targeted allocation of financial resources to areas that are in worse situation. The aim of the present study was to investigate the quality of services of university hospitals in Yazd province.
Methods: This cross-sectional analytical study was conducted in 2020-2021 in 12 university hospitals of Yazd province. In order to conduct the study, the standard questionnaire of SERVQUAL was used. This questionnaire is made up of two parts, administration and expectations, and each of them contains 28 questions and 6 dimensions. The sampling method was stratified randomly. Data analysis was done in SPSS version 24 software.
Results: 225 patients participated in the study. The majority of patients were over 50 years old (46.7%). The average score of patients' expectations (128.99±8.12) at the high level, the average score of patients' perceptions (107.98±8.62) at the middle level, and the average score of the total quality of hospital services (236.97±12.24) at the high level reported. In both areas of perceptions and expectations, the dimensions of reliability, responsiveness and assurance had a higher mean score and the physical or tangible dimensions, empathy and access had a lower mean score.
Conclusion: The service quality of university hospitals in Yazd province was in a good condition, but the average score of perceptions was lower than the score of expectations. Although there was no deep gap, it is necessary for hospital managers to pay more attention to improving the quality of services.
Behrooz Rahimi, Seyed Mahdi Jalali, Hamed Nazarpour Kashani,
Volume 22, Issue 2 (9-2023)
Abstract
Introduction: Equitable geographical distribution of healthcare system initiatives, aimed at increasing quality and economic efficiency, is a crucial aspect of ensuring access to healthcare services. This study seeks to elucidate the contextual, procedural, and outcome factors of health marketing in Iran, with a focus on enhancing and improving health services.
Methods: This research was conducted using a qualitative approach. The sampling method employed was purposive, resulting in the participation of 51 experts. The study data were analyzed using content analysis.
Findings: The findings of this study have been categorized into conceptual subgroups, including causal conditions, foundational components, strategies, contextual factors, intervening factors, and consequences of implementation.
Conclusion: Adopting an effective health marketing model can create opportunities for service providers to generate sufficient income, thereby motivating them to deliver high-quality services. Attracting ample income, in addition to ensuring service quality for recipients, will also lead to their satisfaction with the healthcare system and contribute to the continuous provision of desirable services.
