Showing 13 results for Health Care
Jafar Sadegh Tabrizi, Saeide Alidoost, Amir Bahrami, Mohamad Asghari Jafarabadi,
Volume 13, Issue 4 (3-2015)
Abstract
Background: Given the importance of quality in health care and meeting the needs of patients, it seems important to measure the quality of services and identify the weaknesses from the patients' perspective. The purpose of this study is to assess the service quality (SQ) of care as perceived by people with Type 2 Diabetes (T2D).
Materials & Methods: A cross-sectional study was conducted among 180 people with Type 2 diabetes in diabetes clinic using convenience sampling method in Tabriz, Iran in 2012. Service quality was calculated using: SQ=10 – (Importance ×Performance) based on importance and performance of non-health aspects from the patients' perspective. Validity and reliability of questionnaire was reviewed and confirmed. Independent sample T-test and ANOVA were used
to investigate relationship between service quality and categorical variables. Data analyzed bySPSS13 software.
Results: The average service quality score was 8.17 of 10. From the participants' perspective, of 12 aspects of service quality, communication and prevention had the highest score for importance. Dignity had the highest score for performance. However, the highest service quality values were for continuity of care, dignity and confidentiality.
Conclusion: overall service quality achieved inadequate quality and there is an opportunity to improve quality of care.
Zahra Vazife, Farshad Tavakoli,
Volume 14, Issue 2 (8-2015)
Abstract
Background: Knowledge management plays an imperative role in the success of organizations. Many factors such as organizational culture affected on knowledge management. Therefore, this study aims at investigating the association between dimensions of organizational culture with knowledge management.
Materials and Methods: A cross-sectional descriptive analytical study was conducted in 2013. Three hundred twenty two employees of three hospitals related to the Zahedan University of Medical Sciences selected through a stratified-randomized sampling. Standard instrument of organizational culture and a self-designed questionnaire of knowledge management were used for data collection. Collected data was analyzed using SPSS version 18 by descriptively and inferential statistics methods.
Results: study results indicated that there was a positive and significant association between organizational culture and knowledge management. Also, results on other objectives pointed out a positive and significant association among dimensions of organizational culture (clan, market, adhocracy) and knowledge management. There was a negative and significant relation between organizational bureaucratic culture and knowledge management.
Conclusion: Organizational culture is one of the most important tools of a successful implementation of knowledge management in organizations. Modifications of organizational culture in health care teaching hospitals of Zahedan University of medical sciences should be set towards establishing knowledge management considering organizational tribe culture and organizational adhocracy culture more than other cultures.
Jafar Sadegh Tabrizi, Yeganeh Partovi, Amir Bahrami, Mohammad Asghari,
Volume 14, Issue 4 (1-2016)
Abstract
Background: Type 2 diabetes is a chronic disease which has incremental prevalence regarding to unhealthy lifestyle. Based on the significant gap between received and standard care in patients with type 2 diabetes, this condition occurred high costs to health system. In order to eliminate this gap, this study aimed at measuring the technical quality of perceived care among patients with type 2 diabetes.
Materials and method: A cross-sectional study was carried out among 180 people with two type of diabetes in diabetes clinic using convenience sampling method. A three part questionnaire includes demographic information, disease statue and the technical quality questions was that the validity and reliability of it was approved. The data were analyzed using SPSS13software.
Results: Total technical quality score was 2.9 which was lower than bench mark 5. The main indices related to diabetic control (HbA1c, blood pressure, LDL) were acceptable regarding Iranian diabetic guideline and they were controlled well.
Conclusion: According to notable gap between existing standards and perceived care in type 2 diabetic patients, there is a good opportunity to promote quality of services.
Jafarsadegh Tabrizi , Saeideh Alidoost, Ahmad Mardi, Mostafa Farshi-Khorsand , Mohammadali Rahmat ,
Volume 15, Issue 3 (8-2016)
Abstract
Background: Lack of financial resources or their poor organization is one of the service delivery challenges and Fraction of dedicated revenues is significant problem in health centers in financial resources management. Hence, this study conducted to investigate causes of dedicated revenue's fraction and strategies to reduce them.
Materials and Methods: This qualitative study was carried out based on phenomenology approach in East Azerbaijan Province in 2014. Data collection methods were Focus Group Discussion (FGD) and semi-structure interview guide based which continued to saturation. their participants were selected using purposeful sampling method. Data were analyzed using content analysis method.
Results: Based on participants' experiences, six themes were extracted for causes of fraction and strategies to reduce them. These themes included causes and strategies related to fractions per capita, insurance fractions, fractions related to sending documents, registration fractions, clients' deductions and fractions related to incomplete deposit of cash incomes. In general, eighteen causes and twenty three strategies were identified in dedicated revenues fractions.
Conclusion: The causes of fractions were related to all stages of changing service process to revenue and insurance obligations in health care centers and strategies and identified interventions emphasize on mentioned fields.
Mohammad Rahim Ramezanian, Hamed Gheibdoust,
Volume 15, Issue 4 (1-2017)
Abstract
Introduction: High quality health care service leads us towards a healthy society. Present paper aimed to use the service quality concept in health care sector based on service quality approach (SERVQUAL) in public hospitals. Methods: In present research a hybrid approach based on Analytic Network Process (ANP) and Fuzzy TOPSIS was used where the former was used for prioritization of healthcare service quality measures and the latter was used to operationalize the hospitals. Questionnaires and ANP and Fuzzy TOPSIS were used for data collection and analysis. Five public hospitals in Rash were evaluated. The time period of the study including data collection was 2014-2015. Results: The service quality criteria comprised of 6 main criteria and 19 sub-criteria in present study. Among five hospitals studied in present research, Rasoul Akram hospital obtained the first rank and other hospitals obtained the other ranks. All criteria and sub-criteria used in present study obtained some rank indicating their importance in the research context. Conclusions: With conducting present research, various criteria and sub-criteria related to service quality (SERVQAL) and their importance were identified and this may contribute to improved performance of health care services
Dr Roghieh Bayrami, Dr Hossein Ebrahimipour, Alireza Rezazadeh,
Volume 16, Issue 2 (7-2017)
Abstract
Background: Pre hospital emergency medical service (EMS) as the first line of emergency care and treatment in the out- of -hospital has a considerable importance in the health care system. Planning on finding about strengths and weaknesses and improve the quality of EMS by exploring the problems of this section has considerable important.This study aimed to explore the challenges of pre hospital emergency medical service in Mashhad.
Materials and methods: A qualitative study was done with 14 personnel working in EMS sites in Mashhad using purposeful sampling. Data was collected by semi structured interview and analyzed using conventional content analysis approach according to Graneheim and Lund man 2004 with ATLAS.ti software.
Results: Three general themes were identified including 1) "challenges in Human resources"( Individual characteristics of human resources and personnel's dissatisfaction 2) "challenges in organization" (Structural challenges, lake of equipment and human resource limitation 3) "socio-cultural challenges"(Environmental-social challenges and cultural challenges) were determined.
Conclusion: personnel's dissatisfaction, structural challenges, human resource limitation, lake of equipment and Environmental-social challenges were the most important challenges in pre-hospital emergency system. Organizational independence , create organizational rows, regulation of laws and administrative regulations reform in relation to the range of services offered by emergency personnel, attention to the facilities and cooperation And the participation of other organizations, such as media and traffic to enhance pre-hospital emergency services at the community level can be effective in reducing the challenges in hospital emergency 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.
Ali Alizadeh Zoeram, Dr Alireza Pooya, Dr Zahra Naji Azimi, Dr Ali Vafaee Najar,
Volume 18, Issue 1 (5-2019)
Abstract
Background: In service organizations such as hospitals, human resources (HR) play a key role in the quality of service delivery. Lack of a systemic attitude in terms of system dynamics, HR planning have been somewhat distant from reality. In order to solve such a problem, this study aimed to modeling the dynamics of human resources capacity management system in healthcare services.
Materials and Methods: This case study is one of the cases at a clinic of Khatam -al-Anbia Eye Hospital of Mashhad which was used to simulate the system dynamics approach. In the implementation process, after modeling and formulating in Vensim software, the model was validated and appropriate policies were identified based on simulation results.
Results: The simulation results revealed a gap existence between service capacity and desired capacity led to a work pressure. Consequently, time per service relative to the standard time per service (0.333 hours equivalent to 20 minutes) as the core of service quality has been reduced (cutting corners of time). To counteract such a situation, appropriate policies were identified during the time in a dynamic manner using sensitivity analysis based on changing patient acceptance rates and human resource changes.
Conclusion: The proposed model provides the status for hospital managers which allows them to manage appropriate human resources in the same conditions with a viewpoint of causal relationships with respect to system dynamics.
Seyed Mostafa Kohestani, Dr Hojjat Rahmani, Dr Sheyda Nourbakhsh, Dr Farhad Habibi, Ghasem Rajabi Vasoukolaei,
Volume 18, Issue 3 (10-2019)
Abstract
Background: Nosocomial Infections (Nis) Are Regarded As The Most Common Complications Of Health Cares. These Infections Affect Patient’s Safety in Developing and Developed Countries
. The Aim Of This Study Was To Epidemiology and Determine the Causes of Nosocomial Infectioin Teaching Hospital of Tehran In A Teaching Hospital In Tehran.
Materials and Methods: This Cross-Sectional, Descriptive And Analytical Study Was Designed In 2019 At A Teaching Hospital Affiliated With Iran University Of Medical Sciences. The Nosocomial Infection Registry Data between 2017 and 2018 Was Used. The SPSS24.0 Software Package Was Used To Analyze Data Into Descriptive
(Frequency, Percentage, Mean and Standard Deviation
( And Analytical
) ANOVA) Statistics.
Result: The Most Frequent Type of Infections Were Urinary Tract (39.76%), Ventilator Associated Events (20.92%), Bloodstream (20.71%), Respectively. Skin and Soft Tissue Infections (0.7%) Had The Lowest Prevalence. The Highest Incidence Of Nosocomial Infection Was In The ICU With 200 Patients And The Lowest Incidence Was In The ENT With 23.1 Patients And The Overall Incidence Of Nosocomial Infections Was 84.9 Patients Per 10,000 Patient-Days.
Conclusion: Designing The Related Interventions To Control Nosocomial Infections, Making Hospital Managers And Staff To Sensitive In Nis Control, Holding Specialized Training Programs, Considering Basic Design Of The Physical Structure Of Hospital Wards, Considering Attitudinal And Motivational Are The Most Effective Ways To Combat Nosocomial Infections.
Simin Shams Javi, Pouran Raeissi, Amir Ashkan Nasiripour,
Volume 19, Issue 2 (8-2020)
Abstract
Background: One of the fundamental changes in the health system of Iran in recent years is the "health system reform plan", that the effects of which should be examined from various dimensions. The purpose of this study is to determining the effect of health system reform plan on health indicators in population covered by Ahvaz University of Medical Sciences.
Materials & Methods: In this descriptive-analytical study, the data of the selected health indicators of Ahvaz University of Medical Sciences in the period before and after the health care system reform plan (from 2012 to 2018) was collected, described and analyzed with SPSS.
Results: The highest rate of change in mortality indices was between 2013 and 2015, orderly in U5MR, IMR & NMR, With the mean difference 13.282, 10.825 & 7.955 (P=0.001, P=0.002 & P=0.004). The highest rate of change in Care Coverage for Children Under-five, is between 2014 and 2015 with mean difference of 11.335 and about the Antenatal Care Coverage, between 2014 and 2017, with mean difference 10.050 (orderly p=0.002 & p>0.001). MMR was not significant.
Conclusion: The time trend analysis on health indicators confirms that the changes in the early years of the reform plan have been a lot, then it has slow down. Most of the change in health indicators is related to years of 2015 and 2016. The findings indicate that the latest health reform plan in Iran has improved the mortality indices (Reduce in NMR, IMR & U5MR), Care Coverage for Children Under-five and Antenatal Care Coverage (6+). Health reform plan has not affected on MMR.
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.
Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 20, Issue 2 (9-2021)
Abstract
Background: The outlook for hospital care is changing rapidly. Supply and demand stimuli in the health service system are changing dramatically. The health department of the Social Security Administration has also been challenged by the growing number of patients. This study was conducted to help this organization with the aim of designing a conceptual causal model of the interaction between supply and demand of health care.
Materials and Methods: This research is a qualitative study that was conducted in 2020. It presented a conceptual model in two steps in the first step, semi-structured interviews were used to extract important factors in the supply and demand of health services in hospitals. In the second step, the system simulation approach was used and the feedback relationships between the patient's routes to the hospital and the provision of medical services were presented.
Results: According to the study hypothesis, the prevalence of disease and budget allocation as an indicator of medical need and expected medical demand, positively affect the number of visits to hospitals of the Social Security Organization. Accordingly, four sub-models of patient flow, health care budget, treatment staff (physician, nurse) and hospital capacity were extracted.
Conclusion: Medical budgets allocated to hospitals to improve medical facilities and increase the number of staff, have created positive expectations among social security insured regarding the use of hospital services. Paying attention to providing sufficient manpower (doctor, nurse) and bed capacity with the budget which is spent for this service are the indicators of improving the quality of services.
Mohaddese Arefi, Farzad Firouzijahantigh,
Volume 22, Issue 3 (12-2023)
Abstract
Background and purpose: The organ transplant network is among the most complex and challenging systems in the healthcare sector. This study presents a three-objective hierarchical location model for kidney transplants, aiming to simultaneously minimize total time and costs while maximizing geographic equity in the supply and demand network for donated kidneys. Various transportation modes within the network are also analyzed.
Materials and Methods: This applied research was conducted over a one-year period in 2022 (1401 in the Iranian calendar) in the province of Sistan and Baluchistan. The proposed mathematical model was implemented in GAMS software and solved using the Torabi-Hosseini method and epsilon constraint technique.
Results: The model recommended establishing candidate locations for organ collection units and transplant centers without the need for air transport equipment. It suggested that only the candidate location number 2 at Zabol Hospital Transplant Center should be equipped with air transport facilities, while the other proposed locations do not require the establishment or use of air emergency services.
Conclusion: The results indicate that the designed kidney transplant network is practical and feasible. Efficient network management ensures that all organ recipients, even those far from the provincial center and in remote areas, have timely access to the necessary facilities and equipment for transplant operations.
