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Showing 14 results for Healthcare

R Baradaran Kazemzadeh , M Sepehri , F Firouzi Jahantigh ,
Volume 12, Issue 4 (3-2014)
Abstract

Background and purpose: Hospital is the largest and most important executive unit of healthcare system therefore, full consideration of how to assess its quality is of particular importance. A question is always raised as how to evaluate the quality of the services. The current study seeks to provide a fuzzy model for assessing the service quality in this healthcare sector. Material and method: The present cross-sectional study was conducted in two hospitals in Zahedan 2012.Via reviewing the related literature, the dimensions and components of service quality assessment were identified. The SERVQUAL questionnaire for hierarchical analyses was designed and the fuzzy AHP (Analytical Hierarchy Process) model was presented. SPSS v 10.0 and Fuzzy TOPSIS Solver 2013 software were used to analyze data. Results: The findings indicated that the most important dimension for estimating the quality of healthcare services was empathy. Responsiveness, assurance, and tangible assets were the last important factors. The hospitals were compared using fuzzy AHP. According to the calculations, the ranking of the hospitals based on their performance was as follows: Imam Ali hospital with 31% compared to Social Security hospital with 29% had a better performance in service quality. Conclusion: The results revealed that hospitals needed to focus more on empathy, expertise and reliability than providing high quality and satisfactory services. By considering their weaknesses, each of these hospitals can enhance service quality and consequently, provide a better service for patients.
Zohreh Kaheh, Dr Ali Husseinzadeh Kashan,
Volume 15, Issue 4 (1-2017)
Abstract

Background: medical centers location is one of the most important problems, which should be considered in different dimensions to improve the services. In this paper, we consider the hierarchical maximum covering problem for bi-level healthcare systems including Clinics and hospitals, by taking the service rates into account. In this problem, the initial objective is minimizing the uncovered demand nodes, and secondary objective is the minimizing the lost demand rate as a measure of potentially patients’ retention in coverage radius.

Methods: In this paper, the serving system in the Tehran heart center hospital is considered for queue analyses. The proposed method is a mathematical optimization model called probabilistic two-stage programming model. To evaluate this model, a number of numerical problems are solved through GAMS software.

Results: according to the results, we have found that the best condition for locating the medical centers is that the clinic are located adjacent to a hospital. Decision making about the location problem by considering the service rate in each healthcare centers, increases the reliability to the result of the optimization model.

Conclusion: The proposed model is able to help the decision makers to attain an optimized decision for locating the medical centers in deprived areas, inspired by the medical centers in areas with similar population. Therefore, if the clinics and hospitals are located by considering the hierarchical mode and their service rates, the patients’ welfare will be enhanced.


Dr Mohammad Javad Naeiji, Fatemeh Gholami,
Volume 15, Issue 4 (1-2017)
Abstract

Background: Although the role of Spirituality has been acknowledged in the social entrepreneurship literature, we know of no research that has empirically investigated relationships between spiritual intelligence and health and care benefactors. Thus, this paper aims to propose and empirically test a theoretical model positing relationships among spiritual intelligence and intentions of hospital-makers benefactors. Materials & Methods: This study is descriptive which is conducted with total number of 164 hospital-makers benefactors, and is tested by path analysis. For measuring spiritual intelligence, three questionnaires distributed between every subject and two of his/her acquaintances. Results: The results suggest that spiritual intelligence and other related variables explained 41 per cent of the variance in the rate of hospital-makers benefactors intentions (R2=0/41) that is a sizable amount in behavioral studies. Results provide strong support for the proposition that social mission and social responsibility fully mediate the positive effect of spiritual intelligence on intentions of hospital-makers benefactor. Conclusion: With existence of opportunities for merely finical investments, hospital-makers benefactors should have high levels of spiritual intelligence to gain motivation for social wealth creation. Policy-makers of health system, to increase charitable activities, should focus on heightening spiritual intelligence in health and care sector.


Dr Rahim Heydari Chianeh , Hojjat Mohamadi Torkamani , Musa Vaezi ,
Volume 16, Issue 3 (11-2017)
Abstract

Background:  Equitable and suitable access of all citizens to the urban public service is one of the primary principles of urban planning, which with the rise of the justice-centered approaches in recent decades has been double care. In the meantime, access to health services as one of the vital public service has greater sensitivity. This research has been performed with aim of identify enjoyed and non-enjoyed regions regarding health care and its distribution assessment applications in Tabriz city.
Materials and Methods: For the access analysis ARC GIS software, specially Network Analysis tool and Williamson and entropy index and has been utilized. Also, considering respective per capita, Tabriz city population needs and the existing deficiencies have been specified.
Results: The study results indicate that %76 of Tabriz city population have optimal access to healthcare facilities. In contrast, in the analysis of access to hospitals %36 of population have optimal access to theme and %64 have Undesirable access. Also, in urban zones analyses unit, based on Williamson index analysis, the index was calculated 0.67 to Tabriz city, which indicates an imbalance in the distribution of health care Facilities in the Tabriz city.
Conclusion: In general, zone 2 has the most balanced distribution of health care facilities and zone 9 is suffering from imbalanced distribution of health care facilities. It is suggested that in order to reduce the inequalities in the enjoyment of health care facilities, proper assessment about to existing facilities and future planning, in terms of Threshold, capacity and access should be conducted.


Minoo Afshani, Dr Hojat Vahdati, Dr Mohammad Hakak, Dr Sayed Najomdin Moosavi ,
Volume 17, Issue 3 (11-2018)
Abstract

Background: Whistleblowing as a control tool should be encouraged in organizations to deter organizational illegal and immoral wrongdoings that finally are harmful to the society. Personality traits of people are influential factors on their intention to disclose the wrongdoings. This study aimed to assess the relationship between four personality traits (internal locus of control, ethical identity, extroversion and responsibility) and employees' intention to whistleblowing among the employees of central department of Mashhad University of Medical Sciences.
Materials and Methods: This cross-sectional study is a descriptive-analytic one. This research conducted on 251 employees of the central department of Mashhad University of Medical Sciences. A researcher-made questionnaire based on previous literature used to collect the data. Analysis of the data processed using the Partial Least Square (PLS) with Smart PLS software.
 Results: Since, the amount of standardized coefficients between independent variables (locus of control, ethical identity, extroversion and responsibility) and whistleblowing intention were statistically significant (P<0.005), all of these independent variables have positive and significant influence on the employees' whistleblowing intention.
Conclusion: Given that individuals with internal locus of control, ethical identity, responsibility and extroversion characteristics cannot be able to ignore the organizational wrongdoings, it is better organizations use employees with these characteristics at more sensitive or critical places, where the possibility of organizational wrongdoing is high, in order to prevent potential harm to the organization and society as a result of wrongdoings.
 
Mohssen Ghanavatinejad, Mahdieh Tavakoli, Dr Mohamadmehdi Sepehri,
Volume 18, Issue 3 (10-2019)
Abstract

Background: with increasing demand for treatment, patients are monitored with help of Internet of Things(IOT). Patient's monitoring devices and technologies include heart rate measurement, blood pressure measurement, blood glucose and other vital signs. The purpose of study is to provide a model of clustering patient physical monitoring gadgets and apps in Healthcare Internet of Things (HIOT) environment using data mining techniques, so based on the needs and characteristics of the user, the more appropriate results of choosing technologies acquired.
Materials and methods: This study is a review and functional since its result. The data includes 6 unique features of 60 selected technologies including function, price, connectivity route, power supply, location and type of use that has been extracted from R&D and advertising sites of technologies and also relevant articles. data analysis method is clustering technique and K-medoids algorithm. to identify the most effective features, random forest algorithm has been used.
Results: the proposed clustering model takes into account 6 as inputs and clusters gadgets and apps in accordance with selected characteristics as the model outputs. clustering problem data is clustered in 4 categories.  Silhouette index is 0.45, which indicates the validity of the model. The type of application and then the price had the greatest impact on clustering.
Conclusion: By this model, patients or users can find the most appropriate technology based on the type of disease and other effective features, such as price. So with accurate physical and momentary monitoring, disease progression decrease and prevention of disease will improve.

Neda Vahedi Nezhad, Farzad Firouzi Jahantigh,
Volume 20, Issue 1 (5-2021)
Abstract

Introduction and purpose: Risk assessment is a necessity in high-risk work environments like hospitals. During epidemics, the need to maintain the health of healthcare staff increases as they are effective people in controlling the spread of the disease. The purpose of this study was to assess the occupational safety of healthcare staff against coronavirus using FMEA in infectious diseases ward of Bu-Ali Hospital in Zahedan.
Methodology: Failure modes were identified using brainstorming technique. After scoring them with S, O and D, they were prioritized by calculated RPN. To improve the traditional FMEA, failure modes were prioritized with weighted FMEA and MCDM techniques. After identifying the critical failure modes, the root causes of them were identified and categorized.  Finally, corrective solutions were provided to handle them.
Results: Three processes including emergency admission, patient visit, and sampling were identified as priority processes. 58 failure modes and their effects were identified in 6 categories. 13 critical failures modes (RPN above 100) equivalent to 22% were identified. Then 42 root causes of them were identified by brainstorming technique and their classifications were done by Eindhoven. Finally, 49 corrective strategies were presented to handle critical risks.
Conclusion: Identifying 58 risks and their effects, identifying and classifying root causes and providing corrective solutions indicate the capability of the FMEA to assess the risk of critical departments such as hospitals. As a result, the FMEA is able to detect risks, reduce their consequences and improve quality. Risk assessment techniques along with the commitment of managers and the renewal of organizational policies can ensure the effectiveness of these activities.

Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 21, Issue 1 (5-2022)
Abstract

Background: The use of simulation models can help elucidate the intuitive behavior of complex health care problems. Today, the complexity of problems goes far beyond our capacity to solve them manually. System simulation is considered as a wise option by approaching structural problems and understanding the complex interactions within the problems and their changes. The purpose of this study is to review the most advanced applications of system dynamics in healthcare.
Materials and methods: This study is a systematic selection of articles that explored the applications of system dynamics in health care in 11 databases between 1999 and 2019. The focus of this research was on articles with the keywords including system dynamics in health care, dynamic health care analysis, continuous health care simulation or dynamic health care simulation.
Results: 79 articles related to system dynamics applications in healthcare were identified in databases. Eighty-five percent of the articles focused on finance, politics, government, regulation, public health, and health care planning. Among the articles, the patient's treatment path, obesity and demand for healthcare workforce were examined.
Conclusion: The tendency to use continuous simulation in healthcare has increased. However, the power of hybrid simulation can take advantage of the inherent strength of the system dynamics overview perspective, and in a hybrid model it can utilize a holistic perspective for managing health care systems. Potential areas with the application of systems dynamics in future research include planning and policy-making in public health decision-making, purchasing quality management, care and risk.

Noushin Kohan, Fatemeh Keshmiri, Roohollah Askari,
Volume 21, Issue 3 (12-2022)
Abstract

Background: It is expected that graduates of healthcare management have the necessary skills to perform various managerial and administrative positions. This study was carried out with the aim of designing and compiling an evaluation framework for students based on educational standards in the internship period.
Materials &Methods: The current study was conducted in four phases: In the first phase, in order to identify the problem and assess the needs, the existing curriculum and topics were examined, as well as the studies conducted in this field. In the second phase, the perspective of the stakeholders was used to complete and modify the initial framework. In the third phase, worksheets for registering internship learning activities were prepared for students and a checklist of educational and learning objectives, personal and management skills, and skills for developing professional qualifications was compiled. Finally, a specialized panel was used to determine the type of formative and final exams.
Results: The problems and challenges of internships can be investigated in 4 areas: inappropriate planning of the course, faculty, group - professors and hospital. In designing the evaluation tool, 9 criteria were taken into consideration. Also, tests designed in a compilation framework were used as formative tests and reasoning tests were used as final tests.
Conclusion: The compiled framework can be used as a valid and comprehensive tool to evaluate the practical competence and capabilities of healthcare management students during the internship period.
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.

 

Saeede Afshari, Shaghayegh Vahdat, Iravan Masoudi Asl, Somayeh Hesam,
Volume 22, Issue 4 (1-2024)
Abstract

Background and purpose: In today’s competitive organizational landscape, the significance of recruiting and developing competent human resources has become paramount. Organizations not only aim to select and attract capable and efficient personnel but also seek to enhance and expand their capabilities. Consequently, the concept of meritocracy has become a key concern for modern organizations. This study aims to investigate the factors influencing succession planning in the leadership of healthcare organizations in Iran.
Methods: This qualitative study was conducted using content analysis in 2020. The statistical population comprised key decision-makers and policymakers in successful and prominent Iranian organizations known for effective succession planning, such as the Islamic Revolutionary Guard Corps (IRGC) and the public banking system. A total of 15 experts were selected through purposive and snowball sampling, with data collection continuing until theoretical saturation was achieved. Data were gathered through structured interviews, and the analysis and coding were performed using MAXQDA 11 software.
Results: The study identified five main themes: alignment of strategic goals and needs analysis, strategic communication and organizational structure, talent identification and empowerment, development and excellence of qualified individuals, and monitoring of succession planning programs. These were further divided into 13 sub-themes.
Conclusion: Organizations and managers should provide comprehensive support and demonstrate commitment to the effective implementation of succession planning programs. This will lead to improved organizational decisions and policies, ensuring that competent and qualified individuals are placed in key positions. Additionally, this approach will enhance work quality, boost employee motivation, reduce resource wastage, and improve career advancement opportunities for staff.
Mehran Lak, Farnaz Vosough, Kianoush Saberi, Shahnaz Sharifi, Hadi Pashapour,
Volume 22, Issue 4 (1-2024)
Abstract

Background and Purpose: Infections related to inadequate healthcare practices can have adverse effects on healthcare systems. This study aims to identify the gap between the current handwashing practices and standard levels by determining the frequency of handwashing among staff at Shahid Modares Hospital in Tehran.
Methods: This descriptive cross-sectional study was conducted in the wards of Shahid Modares Hospital between 2018 and 2019. The tool comprised two parts: job information and hand hygiene practices at different times and specific actions. Observers directly monitored all staff in each shift using a headcount method. Each column represented the hand hygiene compliance score of a specific professional group, allowing simultaneous performance evaluation.
Results: Out of 640 observed instances, 202 involved the use of disinfectants, 255 involved handwashing, 111 involved glove use, and in 71 instances, hand hygiene was not observed. The highest compliance occurred when staff intended to contact the patient's body, while the lowest compliance was observed after performing surgery on the patient.
Conclusion: Given the significant role of nurses in therapeutic interventions, multifaceted training interventions, the drafting of hand hygiene policies, and increasing awareness among department officials should prioritize this group of employees. These measures aim to bring practices closer to desired standards and prevent unwanted consequences.


Asgar Aghaei Hashjin, Ali Nemati, Seyed Mohammad Tabatabaee Jabali, Pouria Farrokhi,
Volume 22, Issue 4 (1-2024)
Abstract

Background and purpose: Iran is ranked among the top ten nations in the world for hosting a large number of migrants and refugees. During the COVID-19 outbreak, refugees and migrants were among the most vulnerable groups. This study aimed to investigate the extent of healthcare service utilization by refugees and migrants during the COVID-19 pandemic in healthcare centers affiliated with Iran University of Medical Sciences
Methods: This quasi-experimental study was conducted in 2021 in Tehran. The research environment included all healthcare networks and general and specialized hospitals. Data were collected through document review and registered information in the Sina system. All provided services were categorized into four groups: primary care, outpatient, emergency, and inpatient services. Data analysis was performed using the Chow test and Interrupted Time Series model with the Wats and Sctest software packages in R version 4.3.0.
Results: The decrease in utilization of outpatient, emergency, and inpatient services by refugees and migrants was significant (P-value < 0.001), whereas the decrease in primary care services was not significant. Additionally, after the onset of COVID-19, only the utilization of inpatient services showed a significant increasing trend (P-value < 0.013).
Conclusion: During the COVID-19 pandemic, the utilization of all healthcare services by refugees and migrants, including primary, outpatient, emergency, and inpatient care, decreased. It is recommended to provide complete insurance coverage for refugees, offer free treatment for impoverished refugees, increase awareness among refugees to encourage greater use of health services, reduce existing social and economic barriers, and facilitate interaction between healthcare providers and refugees.
Mehrak Pourmotahari, Soad Mahfoozpour, Shahram Tofighi, Shaghayegh Vahdat, Irvan Masoudi Asl,
Volume 22, Issue 4 (1-2024)
Abstract

Background and purpose: As health resources face increasing constraints, the use of medical imaging services has risen significantly. On average, diagnostic services account for approximately 10% of total healthcare expenditures, and this figure is steadily increasing. This study aims to identify the causes of irrational utilization of medical imaging services and propose corrective measures.
Methods: This descriptive-survey research was conducted in two phases. In the first phase, a comprehensive literature review was performed using both international and national databases, covering the period from 1990 to November 2021. Relevant studies were identified using specific keywords. In the second phase, a semi-structured questionnaire was developed, and a series of in-depth interviews with experts and professionals were conducted. Data were analyzed using the six-step thematic approach by Braun and Clarke, utilizing MAXQDA software.
Results: A total of 605 studies were initially identified, of which seven met the inclusion criteria after rigorous screening. In the second phase, 12 in-depth interviews were conducted, yielding 65 codes, which were organized into 12 themes. The identified themes included legal issues, conflict of interest, monitoring challenges, poor governance and stewardship, inappropriate policymaking and planning, financial incentives, inadequate service provision infrastructure, health culture, education and continuous training systems, financing and purchasing services, political factors, and inadequate insurance systems. Various strategies for controlling the inappropriate use of diagnostic and therapeutic services were proposed, including policy interventions, monitoring and evaluation, and training.
Conclusion: The irrational use of healthcare services is a significant challenge in many countries. Key contributing factors include incomplete insurance coverage, out-of-pocket payments by patients, defensive medical practices, and gaps in knowledge. Addressing these issues requires targeted interventions and reforms.

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