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Showing 8 results for Mosadegh
Hospitals’ Efficiency in Iran: A Systematic Review and Meta-Analysis of Two Decades of Research
Ali Mohammad Mosadeghrad, Parvaneh Esfahani , Marziyeh Nikafshar,
Volume 11, Issue 3 (9-2017)
Abstract
Background and Aim: Increasing healthcare organizations’ efficiency is a necessity due to the resource scarcity in health sector. The aim of this study was to evaluate hospitals’ efficiency in Iran.
Materials and Methods: This study was conducted using a systematic review and meta-analysis approach to find empirical research papers published on hospital efficiency in Iran between 1997 and 2016. Seven electronic databases and two search engines were searched using appropriate key words. Bibliography section of the retrieved papers and related journals were also searched for papers that were not yet indexed in the data bases. 1563 publications were identified. All retrieved papers were assessed using a checklist before analysis. Finally 91 empirical studies were reviewed.
Results: Data Envelopment Analysis, Pabon Lasso and Stochastic Frontier Analysis methods were mostly used for measuring hospital efficiency respectively. The average efficiency of Iran hospitals varied between 0.584 and 0.998. Hospitals affiliated to Social security organisation were more efficient. In contrast, non teaching public hospitals and charity and private hospitals were less efficient. Number of hospital beds and manpower were the most used input variables and number of outpatients and inpatients patient  and surgical procedures were the most used output variables in Data Envelopment Analysis. Stochastic Frontier Analysis method has more advantage in measuring hospital efficiency compared to Data Envelopment Analysis. 
Conclusion: Iran hospitals suffer from inefficiency. Thus, managers should identify the reasons for hospitals’ ineffeiciency and apply measures for increasing their efficiency and reducing wastage of limited resources.

Challenges of Strategic Planning in Welfare Organization
Ali Mohammad Mosadeghrad, Ahmad Fayaz-Bakhsh, Fataneh Amini,
Volume 11, Issue 5 (1-2018)
Abstract
Background and Aim: Strategic planning has an important role in achieving competitive advantage for nonprofit organizations. However, some strategic plans fail. The present study aimed to investigate challenges of strategic planning in Welfare Organization.
Materials and Methods: A qualitative approach was used for this case study. In-depth semi-structured interviews were conducted with 12 senior and middle managers who were members of the strategic planning committee. Content analysis method was used for data analysis, and 7 themes and 16 sub-themes were identified from the data.
Results: Lack of justification of the strategic planning, the strategic planning model, inappropriate composition of the strategic planning team, the structural and managerial changes of the Welfare Organization, time limitation, insufficient training, and budget constraints were the main challenges of strategic planning in the Welfare Organization. 
Conclusion: If the strategic planning challenges are not managed well, more problems are expected to occure during the implementation of the strategic plan. Senior managers’ commitment, strong management and leadership, participative corporate culture, education and training, staff empowerment, and provision of required resources will facilitate strategic planning implementation in organizations.

Informational Elements Requirements for Managed Care of Diabetic Foot Patients
Reza Safdari, Ensieh Nasli Esfahani, Sharareh Rostam Niakan Kalhori, Mahsa Mosadeghi Nik,
Volume 12, Issue 4 (Oct & Nov 2018)
Abstract
Background and Aim: Diabetic foot ulcer is one of the most painful complications of Diabetes and affects various aspects of a person's life. Therefore, involvement of the patient in self-care can minimize its complications. The purpose of this study was to identify the effective factors in the Diabetic foot self-management for designing a managed-care based app for people with Diabetes who have risk factors for foot ulcers or wound infections.
Materials and Methods: In this cross-sectional study all physicians and nurses employed at ‘Diabetes and Metabolic Diseases Research Center’ of Tehran University of Medical Sciences who had a history of working with Diabetic patients at various levels of Diabetes and foot ulcers participated. The data collection tool was a questionnaire based on the likert scale that made by researchers, which included demographic and clinical information, education and lifestyle management and capabilities of application for self-management in Diabetic foot patients. Finally, descriptive statistics used to analyze the results in SPSS.
Results: After reviewing the rate of experts’ agreement with the components of the survey, all the cases over 51% approval rate were considered as required components. According to the opinion of the physicians respectively capabilities of application, education and lifestyle management and patient information and according to the opinion of the nurses’ education and lifestyle management, patient information and capabilities of application were important respectively.
Conclusion: Beside proper treatment of the disease, self-management strategies can be effective and useful. Effectiveness of the patients’ self-care by acquiring the necessary skills and involvement in self-care might be achievable.

Molecular Analysis of Broad Spectrum Beta-Lactams Resistance Genes TEM, CTX-M and SHV in Escherichia coli Isolates from Traditional Pastry Samples in Yazd
Mohammad Mehdi Soltan Dallal, Mojgan Karimi , Mohammad Kazem Sharifi Yazdi, Hedrosha Molla Aghamirzaei , Mohammad Hossin Mosadegh ,
Volume 13, Issue 2 (Jun & Jul 2019)
Abstract
Background and Aim: The variety of sweets along with significant difference level of hygiene in the production, supplies and high potential contamination of sweets ingredients with Escherichia coli, led to investigate the frequency of broad-spectrum beta lactamase strains of E. coli in sweets and determine the presence of SHV, TEM and CTX-M genes.
Material and methods: In this descriptive cross-sectional study, 150 confectionery samples were collected from traditional confectionery workshops in Yazd. Detection of E. coli strains was carried out by standard biochemical tests and antibiotic susceptibility test was performed using CLSI guidelines. Via combined ESBL disk method on the muller hinton agar medium producing strains were identified. All the ESBL producing strains were evaluated using the PCR test for the existence of SHV, TEM and CTX-M genes.
Results: In 30 isolates, (20%) E.coli was obtained. The results of antibiotic susceptibility test showed that the highest and the lowest antibiotic resistance was related to chloramphenicol l (22 isolates, 73.3%) and Imipenem (8 isolates, 26.6%). The results of the combined disk test was showed that only 9 isolates produced ESBL. The molecular analysis on considered genes indicated that 2, 4 and 3 isolates were positive for presence of TEM, SHV, and CTX-M genes, respectively.
Conclusion: The prevalence of antibiotic-resistant isolates in traditional Yazd sweets in this study highlights the importance of more observing and control measures in the preparation and distribution of sweets.

Hospital Accreditation Surveyors' Evaluation Criteria in Iran
Ebrahim Jaafaripooyan , Ali Mohammad Mosadeghrad , Abbas Salarvand ,
Volume 13, Issue 2 (Jun & Jul 2019)
Abstract
Background and Aim: Hospital accreditation is an external evaluation strategy used to improve the quality and effectiveness of services. Accreditation surveyors are among the important factors affecting the validity of accreditation results. Since the effectiveness of an accreditation system depends on its surveyors, the aim of this study is to identify the evaluation criteria of hospital accreditation surveyors in Iran.
Materials and Methods: This qualitative study was conducted in 2017 based on stakeholders’ views about the hospital accreditation program. Data were collected through semi-structured interviews and analyzed by thematic analysis method. Then the framework was designed and finalized with expert opinion.
Results: Forty-four criteria identified for the evaluation of hospital accreditation surveyors in Iran were classified into six domains: personality, experience, knowledge, attitude, skills, and organizational citizenship behavior. Accreditation surveyors should have an acceptable combination of such criteria.
Conclusion: Evaluation of accreditation surveyors with these criteria will lead to their better performance and ultimately promote the validity of the accreditation results. These criteria also result in a native definition for “accreditation surveyor” that can be used by the directors of accreditation system of hospitals for the management of accreditation surveyors.

Strategic Planning Success Factors in Hospitals: A Qualitative Study
Ali Mohammad Mosadeghrad, Parvaneh Esfahani,
Volume 14, Issue 1 (Apr & May 2020)
Abstract
Background and aim: Strategic planning (SP) is the art and science of strategic analysis of an organization, forecasting changes in an organization’s internal and external environments, setting strategic goals, developing suitable strategies, and allocating optimal resources to achieve competitive advantage. Strategic planning plays an important role in promoting hospital success. However, it has encountered various challenges in Iranian hospitals. This study aimed to identify the critical success factors (CSFs) of the strategic planning process in Iranin hospitals.
Materials and Methods: This qualitative study was performed using semi-structured interviews with 47 members of strategic planning committees of 17 hospitals in Tehran, Iran, in 2016. For data analysis, thematic analysis was used. Overall, 44 CSFs were identified for strategic planning and were grouped into 8 themes and 23 sub-themes. 
Results: Managers’ belief in SP usefulness, SP justification, top managers’ commitment to and involvement in SP, setting up a competent SP team, using an appropriate SP model conducive to hospitals’ structure and culture, promoting teamwork and creativity, empowering employees to involve actively in SP, providing necessary financial and physical resources, and stablishing information management, process management systems, and patient centeredness are key factors in SP success.
Conclusion: The SP success depends on strong leadership and management, coherent planning, conducive organizational culture, organizatioanl learning, and effective management of employees, customers, resources and processes.

Iran hospital accreditation governance: Challenges and solutions
Ali Mohammad Mosadeghrad, Fatemeh Ghazanfari,
Volume 14, Issue 4 (Oct & Nov 2020)
Abstract
Background and Aim: Hospital accreditation is “an external evaluation of a hospital’s structures, processes, outputs and outcomes by an independent professional accreditation body using pre-established optimum standards”. Accreditation is a strategy for ensuring the quality and, safety of hospital services. An accreditation program’s efficacy depends on the validity of its governance, methods, standards, and surveyors. The Iranian hospital accreditation program faces some challenges. This study aimed to identify the governance challenges of the Iranian hospital accreditation program and its solutions.
Materials and Methods: This qualitative study was performed using semi-structured interviews in 2019. Using a pluralistic evaluation approach, 151 policy makers, accreditation surveyors, hospital managers and staffs, and academics from the ministry of health, medical universities, hospitals and health insurance companies were purposively recuited and interviewed. Thematic analysis was used fordata analysis.
Results: Overall, 23 governance challenges were identified and were grouped into seven categories, i.e., organizational structure, organizational communication, policy making, planning, financing, stewardship and evalutation. Lack of independence, inappropriate organizational structure, resource shortage, senior managers’ mobility and turnover, weak internal and external communication, a compulsory accreditation program, insufficient knowledge of hospital accreditation, and lack of evaluation of the hospital accreditation were the main challenges. Establishing an accreditation council with four idependent scientific, accreditation, appeal and performance evaluation committes, piloting the accreditation program, proper planning, cascade education and training, allocating a specific budet for hospital accreditation, getting the ISQua accreditation certificate and public announcement of hospitals’ accreditation results were proposed as solutions to these challenges.
Conclusion: The governance of Iran's hospital accreditation program faces serious challenges. Improving the governance of the accreditation program leads to achieving the desired results.

Reasons for Induced Demand in the Health System: A Scoping Review
Ali Mohammad Mosadeghrad, Parvaneh Isfahani,
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: Induced demand is the provision of healthcare services to patients by the influence of healthcare providers. Induced demand causes excessive use of health services, increases the waiting time for receiving health services, increases the price of health services, increases the costs and reduces the efficiency of the health system. Policymakers and health managers should take measures to reduce induced demand. Hence, they should understand the reasons for induced demand in the health system. Therefore, this research aimed to identify the reasons for induced demand in the health system.
Materials and Methods: This research was carried out using the scoping review method. All published articles and documents about the reasons for induced demand in the health system until June 21, 2023 were searched in nine databases and Google Scholar search engine. Finally, 38 articles were selected and reviewed. The data were analyzed by thematic analysis method and using MAXQDA10 software.
Results: Thirty-eight studies about the reasons of induced demand in the health system were published between 1974 and 2021. The number of researches in this area has been growing since 2011. Overall, 32 reasons for induced demand in the health system were identified and grouped into three categories: macro (health system), meso (health care organization) and micro (provider and receiver of health services). The most frequent reasons for healthcare induced demand in the literature include inappropriate policies, insufficient monitoring, inappropriate payment system, large number of physicians, lack of attention to clinical guidelines, financial motivation of healthcare providers, patient insurance coverage, unreasonable patients’ expectations, inappropriate price of health services, the complexity of the health service and patients’ inadequate medical knowledge.
Conclusion: Induced demand has negative effects on the health system and will lead to an increase in health costs, waste of health resources, a decrease in the efficiency of the health system, and finally, a decrease in people’s access to essential health services. Several factors at different levels of the health system lead to induced demand for health services. Therefore, interventions should be systematically applied at three levels of the health system, healthcare organizations, and providers and recipients of health services to prevent and reduce healthcare induced demand.
 

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