Ahmad Joneidi Jafari , Ebrahim Sahebdel , Asghar Hajipour , Mihan Jafari Javid , Seyed Mohammad Mireskandari , Kasra Karvandian , Afshin Jafarzadeh , Shahram Samadi ,
Volume 71, Issue 11 (2-2014)
Abstract
Background: Surgeons and anesthesiologists working in orthopedic operating theatres are exposed to significant noise pollution due to the use of powered instruments. This may carry a risk of noise-induced hearing loss. The present study was designed to quantify the noise pollution experienced by anesthesiologists at Imam Khomeini Hospital which is one of the largest Iranian hospitals.
Methods: Prior to beginning of any operation a sound level meter was worn by the anesthesiologist at the level of chest pocket. Basal sound level was recorded. All changes in the sound level of 25 operation rooms and two related pass ways were recorded and the mean sound level along with maximum sound level were noted. These data were analyzed by SPSS version 17. For comparing the mean values, the One way ANOVA and Post-Hoc analysis was used. Noise exposures were compared with occupational health guidelines.
Results: Our comparative data showed that orthopedic operation room had the highest level of noise, indicating that orthopedic operation room is significantly suffered by the most types of noise with the P value of 0.002. This is contrast to the sound levels at the other operation rooms which were at same range and were not significantly different. Comparison of the maximum sound level between these 27 places showed that orthopedic and one of general surgery room had top two maximum sound levels.
Conclusion: Overall total noise dose during all types of surgeries was measured as twice of permitted dose and also orthopedic and general operation rooms experience brief periods of noise exposure in excess.
Ali Mohammad Mosadeghrad , Mahnaz Afshari ,
Volume 75, Issue 10 (1-2018)
Abstract
Background: Hospitals are dealing with unlimited demands and limited resources. Hospital managers should use appropriate strategies to improve quality of services, enhance patients’ satisfaction and increase financial resources. This study aimed to examine the impact of quality management.
Methods: A participatory action research was used for the intervention on income of operating theatre in Vali-e-Asr Hospital in Tehran University of Medical Sciences, between March and September 2014. A quality improvement team was established and improved operational processes of the operating theatre department of the hospital using Mosadeghrad’s ten-step quality management model. The quality improvement team standardized processes, identified goals for the processes and improved them until achieved the goals. Accordingly, an action plan was developed and implemented for increasing the income of the operating theatre department. Income data of the operating theatre department were obtained for a 6-month period in 2014, and were compared with a control 6-month period in 2013.
Results: Implementing quality management increased the number of surgeries by 14.96 percent, decreased cancelled surgeries by 14.6 percent and reduced bill deductions imposed by health insurance companies by 44.9 percent. As a result, the operation theatre department income has increased by 68.8 percent (P=0.028). Some of solutions used for increasing the income were as standardizing and improving working processes, removing unnecessary activities, empowering staff; increasing department’s working hours, on time visit of patients by doctors and surgeons, reducing surgery cancellations, increasing number of patients, reducing deductions applied by the health insurance companies and training staff and patients.
Conclusion: Implementing an appropriate quality management model appropriately helps improve quality of services and enhance hospital departments’ income.
