Journal of

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Abstract Background: Zone 3 of Zahedan City includes the most deprived areas in province and country. The purpose of this research was assessing the distribution of the health care center (hospitals) and determining the underserved areas based on hospital locating concidering standards and criteria. Materials and Methods: In order to achieve accurate results based on GIS software, spatial and descriptive data using statistics and field observation gathered and connected to database. Besides, AHP Model used to set priorities in locating the optimal urban spaces for building hospitals in the city. Results: Suitable zone with special symbol severance divide from another zones was determine to develop landuse based on dependency to health care centers aimed at providing services in local level . Similarly, two Places recommended constructing health care centers in complete suitable zone. Unsuitable and compeletly Unsouitable zones was determined in zone three of zahedan city in finaly map. Conclusion: study analysis based on urben percapita, population and needed availibilty to health care centers suggests that Zahedan city need two new hospitals setting which has been indexed on final map.

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Background: Deciding on the number of hospital beds is one of the most serious challenges managers face. More hospital beds result in higher running cost although less hospital beds might cause disorder in patients flow.  Minimizing total cost besides maximizing the patients flow in a hospital network, considering the practical limitations is the main objective of this survey.

Materials & Methods: This study had main steps to investigate following: identifying current limitations of changing capacity of each ward, by conducting interview with hospital managers and other personnel of Modares hospital, analyzing cardiac patient flow analysis, simulating current flow, determining practical scenarios and choosing the best among them by mathematical modeling could minimize total cost and maximize patient flow.

Results: 31 practical scenarios have been determined and analyzed by surveying limitations among all existing scenarios. Finally, eight best scenarios had been selected. Results showed that decreasing the number of beds in CCU and increasing the number of beds in Post-CCU can improve patients flow, considering cost limitations.     

Conclusion: A recommended approach in this study can be a general guide for capacity planning with taking practical limitations into consideration. This survey could be useful for the managers who are against the benefits of post CCU  by comparing the patient flow with and without this ward.

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Background: Accreditation is an appropriate strategy for improving the quality, safety and effectiveness of hospital services. Iran national hospital accreditation was initiated as a government and mandatory program in 2012. This study aimed to identify the prerequisites of hospital accreditation implementation in Tehran province hospitals.
 
Materials and Methods: This qualitative study was performed using semi-structured interviews with 72 managers in different level from 15 university, private, military, social security and charity hospitals in 2016. Hospitals were selected purposefully through Tehran province hospitals. Content analysis was used in order to data analysis.
 
Results: Pilot testing of standards before announcing to hospitals for implementation, education and training of hospital managers and employees on accreditation standards, providing required resources, allocating enough time for implementing the standards and providing incentives for implementing standards are the main hospital accreditation prerequisites. Absence of these prerequisites in accreditation implementation resulted in huge challenges for hospital managers and employees.
 
Conclusion: Providing the accreditation prerequisites for hospitals facilitates implementation of hospital accreditation in hospitals which in turn results in quality improvement, safety and hospital services effectiveness.

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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.

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Introduction:The purpose of this study is Investigating the effect of strategic planning on human performance from the perspective of the staff of Shohada Tajrish Hospital in Tehran.
Materials and Methods: This research is applied-practical in terms of purpose and correlational in terms of nature and descriptive method. The statistical population of the present study includes all permanent staff of Shohada Tajrish Hospital. Using simple random sampling method and according to Cochran's formula, 184 people were selected as a statistical sample. In this study, the Strategic Human Resources Management Questionnaire and the Performance Questionnaire were used to collect data. Experts' opinions were used to confirm the validity of the questionnaire and SPSS software was used to assess the reliability. Cronbach's alpha was 0.868 and 0.751. SPSS software and simple linear regression were used to analyze the data.
Results: The results showed that planning, supply, development, performance management, reward and employee relations have a significant effect on the performance of employees of Shohada Tajrish Hospital in Tehran.
Conclusion: Since the results of the research indicate a very strong relationship between strategic human resource management and the performance of the organization in Shohada Tajrish Hospital, it is necessary to pay sufficient attention to human resource management in health centers. It is also necessary to pay special attention to categories such as human education and development, effective interaction and communication with employees, and hiring and hiring.

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Background: The waiting list is a list of selected patients in the surgical queue. If demand exceeds capacity, the waiting list grows rapidly, which may lead to unacceptable waiting for patients, especially those in need of acute medical care. Patients waiting for heart surgery are placed on the waiting list for surgery, and sometimes the waiting time is longer than patients expect. Reducing the waiting time for medical services, including heart surgery, is one of the challenges of the health system. In this regard, the present study was performed by identifying an effective solution to reduce the queue length of patients undergoing cardiac surgery.
 
Materials and Methods: In this article, the process of scheduling open heart surgery at Shahid Rajaei Hospital was reviewed and improved with a discrete event simulation approach in Arena simulation software. After designing the process, the existing bottlenecks leading to the long waiting time of the patients were identified. The waiting time and the number of patients visited were determined as the objective function and the patient flow was improved by presenting improvement scenarios and selecting the best scenario.
 
Results: Simulation results on 66 selected patients in 7 months from October 2020 to May 27, 2021 show that Scenario number 10 has the most improvement in performance criteria but is not applicable in practice. Therefore, due to system limitations, Scenario 2 was selected as the best scenario. Implementing Scenario 2 could reduce the waiting time by 40 percent and increase the number of patients visited by 21 percent.
 
Conclusion: Patient prioritization methods allow patients with higher needs to receive more services than those with lower urgent needs, although they also have longer waiting times for patients with lower urgent needs.

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Background and Purpose: Discharge planning, as a process for the safe transfer of patients, has always been challenged by the interventions of medical social workers. Identifying these challenges prevents disruptions in effective planning. This research aims to explore the challenges faced by medical social workers in discharge planning.
Materials and Methods: This is a qualitative study conducted in Iran in 2023. Data were collected through semi-structured face-to-face and telephone interviews with 16 social workers working in hospitals and were manually analyzed using thematic analysis.
Results: The findings of this study revealed that hospital social workers encounter structural and professional challenges during discharge planning. As a result, themes such as professional isolation, erosive environment, back-breaking costs, inefficient structures, and professional pressures were identified, with the main theme being unattended discharge.
Conclusion: The results indicate that social workers in hospitals are faced with poor cooperation and participation, a lack of facilities and equipment, and socio-economic barriers at the community level. They encounter professional challenges in adhering to professional principles and values and in maintaining the quality of social work services in discharge planning. Given the importance of post-discharge interventions, organizational, structural, and professional reforms at both the micro and macro levels are recommended.

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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.