Showing 9 results for Mission
M Arab, S Fazayeli, M Mohamadpour, V Pirmoazen, M Yousefi,
Volume 8, Issue 3 (2-2010)
Abstract
Background: The admission department as a first point of patients contact with hospital needed special attention. This study has tried to estimate number of needed personnel with work measurement of general functions of admission department.
Material & Methods: This study was a descriptive-analytical and practical research. This study tried to measure real and expected time and determined difficulty degree and skills needed for each task of admission department, then determined total work units and needed personnel in admission department of Children's Medical Center affiliated with Tehran University of medical sciences in 2009.
Results: Total work units in admission department were approximately 10780 units for one month. Counting at least 987 units for every person per month, the number of human resources needed for this unit was 11, while current number of human resources in this department is nine.
Conclusion: Finding of this study show that Children's Medical Center involves with inadequate human resources and multiple pressure due to insufficiency in mentioned department, and tries to promote the technology using in this department and increase the personnel and reset the payment system based on work load
Mohammad Arab, Zahra Eskandari, Abbas Rahimi, Abolghasem Pourreza, Hussein Dargahi,
Volume 9, Issue 1 (9-2010)
Abstract
Background: Most hospitals face with incremental demands, low facilities and readmission of patients as well as dissatisfaction of the clients in regarding to the quality and access of services. Investigating the reasons for readmission and solutions for decreasing the rate of these kinds of admissions can decrease hospital expenditures and improve the efficiency of hospital recourses. By offering high quality standard services and establishing appropriate procedures we can satisfy patients' needs and relieve their pains and discomfort. In this study we are going to evaluate the reasons for patients' readmission in Tehran University of Medical Sciences hospitals
Materials and Method: This is a descriptive and cross- sectional study consisting of 9 hospitals. The samples were consisted of patients who readmitted in hospitals affiliated to Tehran University of Medical Sciences. The required information has been registered in a questionnaire by means of computer, admission forms and index cards. The medical records of 250 patients were collected and analyzed by t test, Fisher Exact Test and Chi Square test.
Result: 17.8% of understudy patients were admitted two times and 80.7% were admitted more than two times in the hospital. Most of these 80.7% of patients were over 60 years old. It was seen a significant relation between patients' age and readmission also occurring infection. In categorizing diseases according to the reason of patients' readmission (23.1% in the second period and 20.2% in the third period) encountered diseases related to body blood system while readmitting in the hospital. The average cost of patients bedridden admitted for the second and third times because of the same reason was 3241532 and 1576593 tomans. There was a significant relationship between readmission and length of stay in both periods. Pursuit of treatment in 101 cases with average cost of 1802757 tomans in second time and 84 cases with average cost of 1205283 tomans in the third period was among the highest costs of readmission causes. Also the highest length of stay was related to surgery unit (9.98 days). The highest average of patients' costs related to surgery unit was 3543854 and 3911168 tomans for second and third periods.
Conclusion: Most of readmissions are among 60 years old patients and the most important reasons for the second and third readmissions are as a result of treatment follow up, adverse effect and illness complication which can be for the reason of incomplete treatment, non compliance of clinical protocols and lacking standard instruments. Results show that readmissions can increase patients' length of stay and additional burden of costs for patients, hospitals and insurance institutes. Therefore we can prevent these unnecessary costs and increase patients' satisfaction by complying clinical protocols, standardizing hospital procedures and instruments, personnel training and using new methods of diagnosis and treatment. The reform in Health care policies and focusing on the health care quality on the side of the administrators also paying more attention to home visits and home care are recommended to this case.
J Fekari, A Ghiasi, M Ezzati, M Pakdaman, A Khalafi,
Volume 9, Issue 3 (2-2011)
Abstract
Background: Assessing applied resources in a hospital as a health system will lead to identify organizational problems in this section and subsequently the necessary actions to resolve them. The aim of this study was to determine measurement of inappropriate admission and hospitalization (ISP: Inappropriateness Patient Stay) and associated reasons.
Materials & Methods: One widely used tools to assess appropriate use of hospital recourse is Appropriateness Evaluation Protocol which include objective criteria related to clinical services provided to the patient. Survey of admission and hospitalization in a cross-sectional and prospective study for 246 patients in the Alinasab hospital affiliated insurance organization carried out in Tabriz.
Results: The total of 7 percent of admissions and 6.2 percent of hospitalized were diagnosed inappropriate manner. There was no significant association between inappropriate admissions and other variables. There was significant relationships between Inappropriate bed days with insurance (P=0/041) and duration of hospital stay (P=0/041). However, there were no association between sex, disease diagnosis and hospital days per week with Inappropriate bed days.
Conclusion: The reasons of inappropriate admission and hospitalization in Iran are similar to other countries. Upgrading strategies to referral system performance, creating standard protocols to evaluate criteria for medical personnel and increasing outpatient diagnostic institutions could be reduce inappropriate admissions and stay of patients.
M Keshavarz, A Akbari Sari, A Rahimi Foroshani, M Arab,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Accreditation is a program that is designed for evaluation of health care organizations and measured processes and structures according to predetermined standards. The purpose of this study is to survey the safety situation and quality of care in selected hospitals of Tehran University of medical sciences based on the Joint Commission International (JCI) standards and determination of their strengths and weaknesses.
Materials and Method: This descriptive, analytical and cross-sectional study was carried out in 5 hospitals. Translated Joint Commission International (JCI) questionnaire checklist with 14 standards was used as the study tool. Data entry and statistical analysis were performed using the SPSS.13 and K Independent Samples tests were used to compare hospitals.
Results: Highest quality and safety of care score belonged to the hospital B (84%) and then to hospitals C (83%), A (72.75%), E (72%) and D (70.5%). Central indices like patient and family rights, quality improvement and patient safety, infection prevention and control standards in the studied hospitals are completely different according to the statistical results.
Conclusion: Study results show that the status of hospitals in terms of safety and quality of care are almost appropriate but in some cases there is a large distance between JCI standards and their current status and the studied hospitals have to make appropriate and related policies in order to plan and implement proper programs to improve their situation in quality and safety of care.
Dr Nader Tavakoli, Milad Amini, Dr Mahsa Mahmodinejad, Mohammad Veisi, Dr Hasan Amiri, Yousef Sadat, Ali Tahmasebi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Assessment of appropriate and inappropriate services offered at the hospital is a very important topic to improve resource allocation. Thus, this study performed to assess inappropriate admission and length of stay to modify extra costs and effective resource management.
Materials and Methods: This study was a descriptive-analytic one which conducted as a cross sectional study in the first half of 2017. The Appropriateness Evaluation Protocol(AEP) was used to collect data. A total of 420 patients hospitalized in Haft Tir and Firoozgar Hospitals were selected using stratified sampling method. collecting data was analyzed using descriptive and analytical statistics by SPSS18.
Result: 391 individuals were admitted appropriately and 29 were classified as inappropriate admission. The rate of inappropriate admission estimated about 7% in the hospitals. female Sex, type of admission, the length of admission and place of patient residence had effect on prediction of inappropriate admission rate (p ≤ 0.05).
Conclusion: Considering the high percentage of inappropriate admission and stay length of patients as well as high costs of health services in these hospitals, the problems can be greatly reduced using proper planning, admissions management between the hospital units.
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%.
Niloufar Amiri Ghale Rashidi, Dr Alireza Namazi Shabestari, Alireza Arab Yarmohammadi, Maryam Mazinani, Sepideh Masoud Sinaki,
Volume 18, Issue 3 (10-2019)
Abstract
Background & Aim: The purpose of this study was to investigate the current organizational culture in Tehran University of Medical Sciences, which is to be considered in order to strengthen organizational culture.
Material & Method: The present study is a descriptive cross-sectional study and an applied research-based survey that was conducted in Tehran University of Medical Sciences in 2019. The sample size was calculated and analyzed using Cochran's formula for 306 people. In this study, Denison's Organizational Culture Questionnaire was used to collect data. Data were analyzed using SPSS software, descriptive statistical methods, one-sample mean and Pearson Correlation Tests.
Results: The average of organizational culture in Tehran University of Medical Sciences, in each component, culture of Involvement (2.29), culture of consistency (2.63), culture of adaptability (2.66) and culture of mission (2.58), Which represented a higher-than-average culture in all aspects of Denison's view.
Conclusion: The organization should do some corrective actions with respect to the components of adaptability (subculture of organizational learning) and Involvement (Capability Development), which has earned a lower score.
Sajjad Moshki, Shaghayegh Vahdat, Somayeh Hesam,
Volume 19, Issue 4 (12-2020)
Abstract
Background: The present study aimed to determine the causes of patients' readmission in hospitals affiliated to Bam University of Medical Sciences in 2019.
Materials & Methods: The current study was a descriptive-analytic study and the study population included patients readmitted in Pasteur Hospital in Bam, Javad Al-Aimeh Hospital in Narmashir, and Ayatollah Hashemi Rafsanjani Hospital in Regan in 2019. The samples consisted of 312 patient records which were chosen randomly. Data were collected by a checklist and were analyzed using SPSS software version 23 and descriptive and analytical tests (Chi-square and one-way analysis of variance).
Results: The results showed that the internal medicine department received 34% of readmissions. The average readmission cost was 17,265,353 Rials. The most common reasons for readmissions were having a new disease (46.2 percent) and recurrence of the former disease (39.8 percent). Findings of inferential statistics revealed no significant relationship between the causes of readmissions and gender (P = 0.566), age (P = 0.065), or costs (P = 0.625), but there was a significant relationship between the causes of readmissions and marital status (P = 0.049) and married people had more readmissions than single people.
Conclusion: It is necessary to pay more attention to readmissions caused by disease recurrence. It is also possible to prevent such readmissions and improve the quality of medical services by standardizing hospital processes and tools, standardizing staff training, and employing new diagnostic and treatment methods.
Yusef Eivazi, Yadollah Hamidi, Ali Akbar Fazaeli,
Volume 20, Issue 1 (5-2021)
Abstract
Introduction: Inappropriate admission and inappropriate hospital days are two undesirable indicators in terms of controlling hospital costs. This study was conducted to determine the rate of inappropriate admission and hospital days and related factors in Shohada Hospital in Kermanshah.
Methods: This is descriptive-analytical study.The statistical population included patients admitted of Kermanshah shohada Hospital in 1397. 245 Inpatient records were selected using Cochran's formula and stratified random sampling. Appropriateness evaluation protocol was used to evaluate the inappropriate admission and inappropriate hospital days. The relationship between age, sex, type of admission, type of ward, type of treatment, coverage of cost hospitalization, place of residence, with rate of inappropriate admissions and inappropriate hospital days was assessed using spss16 software.
Results: 5.7% of admissions and 21.4% of hospital days were inappropriate. Inadequate admission was significantly related to gender, type of surgical or medical treatment, type of hospital ward in chi-square test in contingency tables with 95% confidence. Inappropriate hospital days were related to the type of hospitalization ward in kruskal-Wallis test , type of treatment and place of residence in Mann-Whitney test.
Conclusion: By determining the amount of inappropriate admissions and inappropriate hospital days and related factors for policy makers and managers of hospitals and insurance organizations, it is possible to avoid unnecessary costs without reducing the quality of hospital services.
