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Showing 27 results for Performance
Saeed Nateghi, Ali Ganjali Khan Hakemi, Soheila Damiri, Samira Raoofi, Elham Haghshenas, Sara Akhavan Rezayat, Shamsi Ekhtiyar, , Maryam Radin Manesh,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Effective monitoring and evaluation of human resources in countries require an agreed set of indicators and measurement tools. Due to the existence of different payment mechanisms, this study aimed to identify performance evaluation indicators in hospitals affiliated with the Tehran University of Medical Sciences.
Materials and Methods: A qualitative phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, purposive sampling, and participation of 23 members of the Senior executives and financial team of hospitals affiliated to Tehran University of Medical Sciences and analyzed by content analysis method using MAXQDA-10 software.
Results: Twenty-three experts participated in this research, 78.2% were men and 21.7% were women, and a total of 526 final codes were identified and according to the balanced scorecard management tool in 4 main themes of finance, customers, internal processes, and growth and Development. Also 8 sub-themes of resource efficiency with 86%, medical tourism with 52%, professional ethics with 65%, satisfaction with 78%, accreditation with 48%, diagnosis and treatment with 78%, education with 56% and The research was categorized with 78%.
Conclusion: The provision of optimal medical services requires managers to be aware of the performance of subordinate personnel, which makes it possible to choose the appropriate criteria, develop performance evaluation systems and conduct correct evaluation, informing Doctors regarding the indicators considered for more accurate evaluation are among the suggestions that can be a solution to the existing problems. Another important point considering the limited available resources is the role of doctors in the field of health tourism to which attention will lead to an increase in financial resources.
Materials and Methods: A qualitative phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, purposive sampling, and participation of 23 members of the Senior executives and financial team of hospitals affiliated to Tehran University of Medical Sciences and analyzed by content analysis method using MAXQDA-10 software.
Results: Twenty-three experts participated in this research, 78.2% were men and 21.7% were women, and a total of 526 final codes were identified and according to the balanced scorecard management tool in 4 main themes of finance, customers, internal processes, and growth and Development. Also 8 sub-themes of resource efficiency with 86%, medical tourism with 52%, professional ethics with 65%, satisfaction with 78%, accreditation with 48%, diagnosis and treatment with 78%, education with 56% and The research was categorized with 78%.
Conclusion: The provision of optimal medical services requires managers to be aware of the performance of subordinate personnel, which makes it possible to choose the appropriate criteria, develop performance evaluation systems and conduct correct evaluation, informing Doctors regarding the indicators considered for more accurate evaluation are among the suggestions that can be a solution to the existing problems. Another important point considering the limited available resources is the role of doctors in the field of health tourism to which attention will lead to an increase in financial resources.
Mohammad Jalali, Ehsan Zarei, Ali Maher, Soheila Khodakarim,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: With the outbreak of the COVID-19 pandemic, the performance of hospitals were affected, and changes were made in the utilization of hospital services. Analyzing hospital performance data during the COVID-19 pandemic can provide insights into service utilization patterns and care outcomes for managers and policymakers. This study was conducted to investigate the impact of COVID-19 on selected outcome indicators in the hospitals of Shahid Beheshti University of Medical Sciences, Tehran.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.
Mahdi Hadi, Ali Jahan, Lila Najafi, Mohamad Ali Shariat,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Parallel to the progress of services, organizational complexity levels in health care centers (HCCs) have increased. The influential factors in this regard include the variety of services, the non-uniformity of the centers’ management conditions, and the rising expectations from the health system. Therefore, considering many factors influenced and effective, improvement of health services requires development of a systematic approach to evaluate their efficiency and management system. The aim of this study was to develop a balanced scorecard (BSC) model suitable for HCCs using a hybrid approach that combines the Fuzzy Delphi and DNAP techniques.
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives.
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives.
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.
Zohre Abbaszade Molaei, Aeen Mohammadi, Manijeh Hooshmandja,
Volume 18, Issue 5 (11-2024)
Volume 18, Issue 5 (11-2024)
Abstract
Background and Aim: With the advancement of information technology in the new century, changes are experienced in all aspects of life. One of the reflections of these changes in education is conducting exams electronically instead of paper-and-pencil examinations. The success of virtual education is not achievable without considering the students’ viewpoints towards it. This study aimed to investigate the attitude and performance of students in online exams and their relationship with academic achievement.
Materials and Methods: This research is a mixed-method study (qualitative-quantitative). First, all related articles published, between 2000 to 2022, were extracted from ERIC, PubMed, ScienceDirect databases, and the Google Scholar search engine. Then, the attitude and performance questionnaire was designed and validated based on the literature review results. All BSc and MSc. nursing and midwifery students of Sarivar Nassibeh School filled out the questionnaire. Two hundred and five questionnaires were analyzed with SPSS using descriptive (mean and standard deviation) and inferential (t-test) statistics.
Results: Based on a content analysis of 15 selected articles, the extracted components were structured into 12 items. A preliminary questionnaire was designed with 28 questions across these 12 extracted components. Face validity was assessed using expert opinions, and necessary revisions were made. Both the Content Validity Index (CVI) and Content Validity Ratio (CVR) coefficients were employed for content validity. The final questionnaire comprised 22 items using a five-point Likert scale, ranging from strongly agree (score 5) to strongly disagree (score 1), with an internal consistency of 0.69. Exploratory factor analysis revealed that the questionnaire has six factors: “validity and accuracy”, “technical problems”, “types of questions and announcing the results”, “technique and simplicity”, “motivation and anxiety”, and “speed and error recording” that explain 60.88 percent of the total variance. Correlation results indicated no relationship between students’ attitudes and performance toward electronic examinations and academic achievement (r = 0.055, P-value = 0.432). There was a significant difference between male and female groups, BSc. and MSc. nursing and midwifery students, and semester of study.
Conclusion: The tool for measuring students’ attitudes and performance towards electronic exams has acceptable validity and reliability. This tool can be used to assess online exams and improvement plans.
Materials and Methods: This research is a mixed-method study (qualitative-quantitative). First, all related articles published, between 2000 to 2022, were extracted from ERIC, PubMed, ScienceDirect databases, and the Google Scholar search engine. Then, the attitude and performance questionnaire was designed and validated based on the literature review results. All BSc and MSc. nursing and midwifery students of Sarivar Nassibeh School filled out the questionnaire. Two hundred and five questionnaires were analyzed with SPSS using descriptive (mean and standard deviation) and inferential (t-test) statistics.
Results: Based on a content analysis of 15 selected articles, the extracted components were structured into 12 items. A preliminary questionnaire was designed with 28 questions across these 12 extracted components. Face validity was assessed using expert opinions, and necessary revisions were made. Both the Content Validity Index (CVI) and Content Validity Ratio (CVR) coefficients were employed for content validity. The final questionnaire comprised 22 items using a five-point Likert scale, ranging from strongly agree (score 5) to strongly disagree (score 1), with an internal consistency of 0.69. Exploratory factor analysis revealed that the questionnaire has six factors: “validity and accuracy”, “technical problems”, “types of questions and announcing the results”, “technique and simplicity”, “motivation and anxiety”, and “speed and error recording” that explain 60.88 percent of the total variance. Correlation results indicated no relationship between students’ attitudes and performance toward electronic examinations and academic achievement (r = 0.055, P-value = 0.432). There was a significant difference between male and female groups, BSc. and MSc. nursing and midwifery students, and semester of study.
Conclusion: The tool for measuring students’ attitudes and performance towards electronic exams has acceptable validity and reliability. This tool can be used to assess online exams and improvement plans.
Mojtaba Salimi Bani, Mehdi Ghassabi Chorsi, Roghayeh Ershad Sarabi,
Volume 18, Issue 6 (2-2025)
Volume 18, Issue 6 (2-2025)
Abstract
Background and Aim: Malaria is one of the health challenges in many countries worldwide. Iran is among the countries that have prioritized a malaria elimination program, aiming to interrupt local transmission of the disease by 2025. Health workeres (community health workers) play an important role in primary healthcare for identifying, controlling, and preventing malaria. Keeping their knowledge and skills up-to-date through continuous training can be effective in the success of this program. Virtual training is a modern educational method that facilitates such training courses. This study aimed to investigate the impact of virtual retraining courses on the knowledge, attitude, and performance of konarak health workers in implementing the malaria elimination program in 2022.
Materials and Methods: This research was a quasi-experimental study with a single-group pre-test and post-test design. The population included 69 individuals who were enrolled using a census method. Initially, a pre-test was conducted to assess the baseline level of knowledge, attitude, and performance of participants regarding malaria elimination strategies. Then, the educational intervention was delivered virtually, followed by a post-test to evaluate the outcomes. The educational content was provided in eight 45-minute sessions by an instructor from the Health worker Training Center using the Sky Room platform. Data collection was performed using a researcher-made questionnaire. Content validity of the questionnaire was confirmed, and its reliability was assessed in a pilot study prior to the training by the responsible expert; the Cronbach’s alpha coefficient of the questionnaire items was calculated at an acceptable level (r=0.83). Data were analyzed using SPSS software and paired t-tests.
Results: Out of 69 participants, 40 (58%) were male and 29 (42%) female. Comparison of pre-test and post-test results showed that the mean scores of knowledge, attitude, and performance of health workeres increased by 1.05, 1.2, and 1.17 units respectively after the training, and these differences were statistically significant (P=0.000).
Conclusion: Based on the results, considering the advantages of virtual training such as easy access, lower cost, and wide coverage, this method is recommended as a strategy for educational programs for healthcare staff.
Materials and Methods: This research was a quasi-experimental study with a single-group pre-test and post-test design. The population included 69 individuals who were enrolled using a census method. Initially, a pre-test was conducted to assess the baseline level of knowledge, attitude, and performance of participants regarding malaria elimination strategies. Then, the educational intervention was delivered virtually, followed by a post-test to evaluate the outcomes. The educational content was provided in eight 45-minute sessions by an instructor from the Health worker Training Center using the Sky Room platform. Data collection was performed using a researcher-made questionnaire. Content validity of the questionnaire was confirmed, and its reliability was assessed in a pilot study prior to the training by the responsible expert; the Cronbach’s alpha coefficient of the questionnaire items was calculated at an acceptable level (r=0.83). Data were analyzed using SPSS software and paired t-tests.
Results: Out of 69 participants, 40 (58%) were male and 29 (42%) female. Comparison of pre-test and post-test results showed that the mean scores of knowledge, attitude, and performance of health workeres increased by 1.05, 1.2, and 1.17 units respectively after the training, and these differences were statistically significant (P=0.000).
Conclusion: Based on the results, considering the advantages of virtual training such as easy access, lower cost, and wide coverage, this method is recommended as a strategy for educational programs for healthcare staff.
Roya Rajaee, Marziyeh Najafi, Nasrin Donyaee, Masoumeh Vaziri Seta, Hojjat Rahmani, Ghasem Rajabi, Mahsa Akbari,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: Budgeting in the health system plays a crucial role in enhancing the quality of healthcare services, increasing equitable access to health care, and reducing costs. Financial decision-making based on scientific data and evidence can improve the efficiency of the health system and ensure equity in resource allocation. This study aimed to examine the scientific status and trends of published literature on budgeting methods in the health system using bibliometric analysis to assist policymakers in making better financial decisions.
Materials and Methods: This study is a bibliometric review with a descriptive–analytical approach, analyzing 222 scientific documents indexed in Scopus between 1974 and 2024. Data were analyzed using Excel, Bibexcel, VOSviewer, and Gephi software to map the knowledge structure, co-word relationships, and international collaborations in this field.
Results: The United States (30%), Taiwan (15%), and Canada (10%) were the leading contributors to scientific output in this field. Journal articles comprised nearly 90% of all publications. The most frequent keywords were “budget,” “health care cost,” and “financial management,” reflecting a strong emphasis on cost control and resource management. Three main budgeting approaches were identified: performance-based, traditional (historical), and needs-based. Traditional budgeting remains dominant in developing countries, particularly where information infrastructure and managerial capacity are limited. International collaboration involved 18 countries, with the strongest cooperation observed between the United States and Taiwan.
Conclusion: Improving the health budgeting system requires strengthening information systems, training managers, and enhancing international scientific collaboration. Resource allocation based on scientific data and bibliometric insights can optimize resource distribution and enhance equity in access to health services. Such measures would lead to greater health system efficiency and more comprehensive financial decision-making.
Materials and Methods: This study is a bibliometric review with a descriptive–analytical approach, analyzing 222 scientific documents indexed in Scopus between 1974 and 2024. Data were analyzed using Excel, Bibexcel, VOSviewer, and Gephi software to map the knowledge structure, co-word relationships, and international collaborations in this field.
Results: The United States (30%), Taiwan (15%), and Canada (10%) were the leading contributors to scientific output in this field. Journal articles comprised nearly 90% of all publications. The most frequent keywords were “budget,” “health care cost,” and “financial management,” reflecting a strong emphasis on cost control and resource management. Three main budgeting approaches were identified: performance-based, traditional (historical), and needs-based. Traditional budgeting remains dominant in developing countries, particularly where information infrastructure and managerial capacity are limited. International collaboration involved 18 countries, with the strongest cooperation observed between the United States and Taiwan.
Conclusion: Improving the health budgeting system requires strengthening information systems, training managers, and enhancing international scientific collaboration. Resource allocation based on scientific data and bibliometric insights can optimize resource distribution and enhance equity in access to health services. Such measures would lead to greater health system efficiency and more comprehensive financial decision-making.
Creating a Management Dashboard for the Oncology Ward to Monitor Health Data of Children with Cancer
Saber Yazdani Damavandi, Tayebeh Baniasadi, Mohammad Ali Molavi, Farid Khorrami,
Volume 19, Issue 5 (12-2025)
Volume 19, Issue 5 (12-2025)
Abstract
Background and Aim: Cancer has been recognized as the second leading cause of child mortality in recent years. Due to the increasing amount of healthcare data for cancer patients, healthcare providers need a tool to monitor patients for immediate intervention. An intelligent and dynamic information management dashboard is capable of compiling and displaying data using charts and tables. In the present study, a management dashboard was designed for the oncology department of a children’s hospital, and its usability was evaluated.
Materials and Methods: This developmental–applied research was conducted in 2024 at the Educational, Medical, and Research Center for Children in Bandar Abbas. In order to create a management dashboard for the pediatric oncology department, three stages were carried out. In the first stage, all necessary content to be displayed on the dashboard was extracted based on a review of literature and documents from the oncology department of Bandar Abbas Children’s Hospital. This content was then validated by experts using the Delphi method in two rounds. In the second stage, a prototype of dashboard for the oncology ward was designed using Power BI Desktop software. Finally, its usability was evaluated using a SUS questionnaire by 20 users. The data were analyzed using descriptive statistics with SPSS software.
Results: Following the screening of 3,435 initial records and a review of 22 articles alongside 38 patient files, a preliminary set of 104 managerial and 67 clinical indicators was extracted. These indicators were validated through a tworound Delphi process with 12 experts, resulting in the final selection of 105 managerial and 71 clinical indicators for dashboard inclusion. Based on this validated set, a tenpage managerial dashboard was developed to present key performance metrics. Usability assessment using the System Usability Scale (SUS) yielded a mean score of 75.87, which, according to the Bangor scale, is classified as “acceptable” and corresponds to a grade of “excellent.” User feedback informed subsequent refinements to the dashboard’s data visualizations and interface. In summary, the developed dashboard represents an effective and userfriendly tool for monitoring and managing information within a pediatric oncology department.
Conclusion: The pediatric oncology management dashboard facilitates the integration and summarization of essential data for healthcare providers, thereby assisting them in making timely diagnoses and interventions for children with cancer. Additionally, the present dashboard demonstrates appropriate usability, which enhances users’ understanding of health information and leads to more accurate decision-making.
Materials and Methods: This developmental–applied research was conducted in 2024 at the Educational, Medical, and Research Center for Children in Bandar Abbas. In order to create a management dashboard for the pediatric oncology department, three stages were carried out. In the first stage, all necessary content to be displayed on the dashboard was extracted based on a review of literature and documents from the oncology department of Bandar Abbas Children’s Hospital. This content was then validated by experts using the Delphi method in two rounds. In the second stage, a prototype of dashboard for the oncology ward was designed using Power BI Desktop software. Finally, its usability was evaluated using a SUS questionnaire by 20 users. The data were analyzed using descriptive statistics with SPSS software.
Results: Following the screening of 3,435 initial records and a review of 22 articles alongside 38 patient files, a preliminary set of 104 managerial and 67 clinical indicators was extracted. These indicators were validated through a tworound Delphi process with 12 experts, resulting in the final selection of 105 managerial and 71 clinical indicators for dashboard inclusion. Based on this validated set, a tenpage managerial dashboard was developed to present key performance metrics. Usability assessment using the System Usability Scale (SUS) yielded a mean score of 75.87, which, according to the Bangor scale, is classified as “acceptable” and corresponds to a grade of “excellent.” User feedback informed subsequent refinements to the dashboard’s data visualizations and interface. In summary, the developed dashboard represents an effective and userfriendly tool for monitoring and managing information within a pediatric oncology department.
Conclusion: The pediatric oncology management dashboard facilitates the integration and summarization of essential data for healthcare providers, thereby assisting them in making timely diagnoses and interventions for children with cancer. Additionally, the present dashboard demonstrates appropriate usability, which enhances users’ understanding of health information and leads to more accurate decision-making.
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