Yasaman Ketabi; Saeedeh Ketabi
Volume 12, Issue 6 , December 2016, , Pages 762-769
Abstract
Introduction: It is clear that if the discharge process takes less time and the patient leaves the hospital bed earlier, the length of hospitalization, and consequently, the waiting time for admission decreases. Therefore, the method of use of treatment facilities is somewhat improved. The hospital discharge ...
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Introduction: It is clear that if the discharge process takes less time and the patient leaves the hospital bed earlier, the length of hospitalization, and consequently, the waiting time for admission decreases. Therefore, the method of use of treatment facilities is somewhat improved. The hospital discharge process, from when the discharge authorization is issued until the patient leaves the hospital, is a bottleneck in hospital procedures. The aim of this study was to reduce the waiting time for patient discharge from hospitals in Alzahra Hospital in Isfahan, Iran. Methods: This was an empirical and descriptive-analytical research in which the data collected in the summer of 2010 was analyzed using the queueing network model. The required data consisted of the time of starting and ending each activity related to the discharge process, from 10:15 am on 10 selected days (related to 200 patients). The collected data were recorded in the related table. The required parameters for the stochastic distribution were estimated by the mean of the collected times. Statistical distribution of duration between discharge and different services were analyzed using Kolmogorov-Smirnov test in SPSS software. Evaluation of services provided in the discharge process, areas of improvement in procedures, and reduction of time spent on different procedures was conducted through analysis of the related queueing network. Results: The analysis of the discharge process procedures showed that the main factors affecting average waiting time were patients’ financial problems, unnecessary activities, and delay in writing the medical record abstract and insurance confirmation. Conclusion: Using the queuing network model, scenarios on improving the discharge process and reducing the waiting time are proposed, which are applicable in many other hospitals.
Hadi Balouei Jamkhaneh; Saeedeh Ketabi; Mehdi Pourmostafa khoshkerodi
Volume 10, Issue 7 , December 2014, , Pages 901-911
Abstract
Introduction: The most important aspect of management is service quality and the first strategy in the world can be considered as customer service oriented. This study attempts to clarify the factors affecting the quality of health services using a combination approach of Fuzzy AHP - TOPSIS to rank teaching ...
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Introduction: The most important aspect of management is service quality and the first strategy in the world can be considered as customer service oriented. This study attempts to clarify the factors affecting the quality of health services using a combination approach of Fuzzy AHP - TOPSIS to rank teaching hospitals of Mazandaran University of Medical Sciences. Methods: According to purpose of this research the method was applied and descriptive survey. The population of research was teaching hospitals of Mazandaran University of Medical Sciences and four teaching hospital of Mazandaran University of Medical Sciences were selected with non-random sampling method And a standard questionnaire by a team of experts has been completed. At first according to fuzzy hierarchical analysis, the importance of service quality standards was defined and by the TOPSIS method the hospitals were ranked. Results were analyzed using Excel software. Results: Research findings suggest that the Hospital C, Hospital B, Hospital A and hospitals D were ranked in order of the first quarter. Conclusion: Results from this study for managers will be very instrumental. Its place in society can properly recognize and apply strategies to maintain or improve it. Keywords: Quality of Health Care; Analytical Hierarchy Process; Hospital, Teaching
Ali Mahabadi; Saeideh Ketabi; Sayed Mojtaba Sajadi
Volume 11, Issue 7 , December 2014, , Pages 1016-1025
Abstract
Introduction: In the new age, human health is at risk more than any other time. Hospitals play an important role in restoring health to the people. The emergency department provides the patients who are damaged in an accident or their illness has worsened suddenly with emergency medical care and diagnostic ...
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Introduction: In the new age, human health is at risk more than any other time. Hospitals play an important role in restoring health to the people. The emergency department provides the patients who are damaged in an accident or their illness has worsened suddenly with emergency medical care and diagnostic services. In the emergency department every single second counts. The proper management of the patients waiting time requires identifying the parameters which affect increasing the waiting interval and “lean management” is one of the tools for identifying these parameters and optimizing the process of serving patients. This study aimed to investigate the parameters which affect the patients waiting time in emergency department of orthopedic services in Ayatollah Kashani hospital with the lean management approach. Methods: This study was a descriptive and mining survey. Population survey consisted of patients in the emergency department of Ayatollah Kashani hospital for orthopedic services in the summer. In order to create a simulation model, the required data have collected from 60 patients entered for orthopedic services in the last week of June and the first week of July (The sample size was determined according to a formula). The data collected by some forms and was processed using “EASY FIT” software. Data collection forms were collected by the researchers was designed and its validity was confirmed by professors and experts concerned. Containing these forms include patient arrival time, start time and the end of the orthopedic service. Then the value stream map was drawn on the basis of lean management principles. On the next step the existing waste was identified and some approaches for eliminating the waste were suggested. Finally the model simulated by “SIMUL8” software and the influence of the applied approaches on the average time of the patient presence was investigated. Results: Regarding to different kinds of waste in orthopedic services, the total waste identified was 30 and 16 approaches were suggested to eliminate them. The output result of applying the approaches 4(Embed a closed operating rooms (stock)), 5 (implementation of (5s)) and 14 (using single minute exchange of die technique (SMED)) in order to receive services, orthopedics average patient stay of 139 minutes to 118, 121 and 131 declined .simultaneous implementation of the three strategies to implement the results showed that the average time a patient in the emergency 139 minutes to 95 minutes reduced. Conclusion: The results show we can eliminate a lot of waste in the process of providing orthopedic services with low costs. In order to do that, we should use scientific methods such as lean management techniques to improve the processes. To achieve the objective mentioned above the decision makers and health managers should be familiar with these techniques and provide practical methods in the field of health and medical care. Key Words: Emergency Service, Hospital; Orthopedics; Computer Simulation.
Mansoureh Pourmiri; Saeedeh Ketabi
Volume 10, Issue 3 , September 2013
Abstract
Introduction: Evaluation of performance is fundamental essentially in the facing and coping with changes and continues improvement activities. University also is not an exception with critical task of training human resources for required community and occupation. Each of the evaluation of performance ...
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Introduction: Evaluation of performance is fundamental essentially in the facing and coping with changes and continues improvement activities. University also is not an exception with critical task of training human resources for required community and occupation. Each of the evaluation of performance models is instrumental which can give various data which are needed for decision-makers. Methods: This article used mathematical model BCC (Banker-Charnes-Cooper) output oriented DEA (Data envelopment analysis) and used LINGO software for evaluation of performance in non-clinical educational departments in Isfahan University of Medical Sciences, Iran. In this model, the main indicators of performance were considered as input variables i.e. number of students and number of faculties and also output variables i.e. number of graduates and faculty research activities. Results: The results showed that of 13 educational departments, 6 departments were efficient and 7 departments were inefficient. The references department was also identified. Conclusion: Inefficient educational departments are able to increase their output levels with pattern of efficient performance. Thus, it is recommended to increase their output based on the reference patterns. Keywords: Performance Assessment; Data Envelopment Analysis; University Department
Sima Ajami; Saeedeh Ketabi
Volume 9, Issue 5 , November and December 2012, , Pages 697-710
Abstract
Introduction: Medical Records Department (MRD) is important for evaluating, planning andprioritizing health care services. The major aim of this study was to evaluate the performance ofthe MRDs of hospitals using multi-criteria decision-making approach in the selected hospitals ofIsfahan city, Iran.Methods: ...
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Introduction: Medical Records Department (MRD) is important for evaluating, planning andprioritizing health care services. The major aim of this study was to evaluate the performance ofthe MRDs of hospitals using multi-criteria decision-making approach in the selected hospitals ofIsfahan city, Iran.Methods: This was an analytical and cross-sectional study that was conducted in spring 2008 inIsfahan, Iran. The study population consisted of the MRD of Al-Zahra, Kashani and Khorshidhospitals in Isfahan. Data were collected through brainstorming technique. Expert Choicesoftware was used to analyze the data.Results: The results showed that relative weight of archiving unit had the higher degree ofimportance than others in terms of information management. However, in terms of customeraspect, relative weight of admission unit had the higher degree of importance than others.Relative weight of medical records departments in Al-Zahra, Kashani and Khorshid hospitals inIsfahan were 0.394, 0.342 and 0.264, respectively.Conclusion: It is necessary for managers to allocate and prioritize resources according toMultiple Criteria Decision Making (MCDM) ranking at every units of the MRD.
Elaheh Azad; Saeedeh Ketabi; Iraj Soltani; Majid Bagherzade
Volume 8, Issue 7 , January and February 2012, , Pages 938-947
Abstract
Introduction: Hospitals are considered as the most important resource consuming units in health sector. They are also one of the main organizations providing health services. Hence, paying full attention to the efficiency of different wards of a hospital is of great importance. The aim of this study ...
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Introduction: Hospitals are considered as the most important resource consuming units in health sector. They are also one of the main organizations providing health services. Hence, paying full attention to the efficiency of different wards of a hospital is of great importance. The aim of this study was to analyze the efficiency of different wards of Shariati Hospital, Isfahan, Iran, by the use of Data Envelopment Analysis (DEA). Methods: This study evaluated and analyzed the efficiency of clinical wards of Shariati Hospital (15 wards) in 2010 using DEA. For this purpose, input-oriented model of DEA based on variable return to scale was applied. Two inputs, i.e. number of beds and personnel, and three outputs, i.e. inpatient bed occupancy ratio, performance and activity of ward were considered. To analyze the data, "DEA-Solver" was used. Results: The results obtained from DEA showed that different wards of Shariati Hospital had at least an 8% capacity for increasing efficiency without any increased costs. In other words, the existence of surplus production was clear in the hospital. Conclusion: In the process of study, efficient and inefficient wards have been recognized. Out of 15 wards, 7 wards were efficient and the others were inefficient. For inefficient wards, reference sets were appointed based on a combination of efficient units and some suggestions for reallocating the resources to these wards.
Ali Attafar; Saeedeh Ketabi; Zahra Momeni Noorabadi
Volume 8, Issue 8 , January 2012, , Pages 1112-1121
Abstract
Introduction: In the present knowledge-oriented era, potential capabilities of individuals need to be used and innovation and creativity should be created. Self-management is a set of strategies that an individual applies in order to improve and influence his behavior. It plays a significant role as ...
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Introduction: In the present knowledge-oriented era, potential capabilities of individuals need to be used and innovation and creativity should be created. Self-management is a set of strategies that an individual applies in order to improve and influence his behavior. It plays a significant role as a hidden capital in establishing a suitable environment for creating innovation. The purpose of this paper was to study the role of self-management strategies on innovation level of students of management in Isfahan University, Isfahan, Iran.Methods: This descriptive survey study used a verified researcher-made questionnaire with formal validity and reliability coefficient of 0.91 to collect data. The statistical population consisted of management students in Isfahan University during 2009-2010. The required number of participants was calculated as 196 students who were selected by simple random sampling method. Based on available literature, a model was designed to evaluate the role of self-management strategies on innovation level among the students of management. This model was then tested by LISREL software.Results: Self-management strategies, particularly behavioral strategies, had a significant effect on students' innovation level. In addition, students' internal focus, as a hidden variable, had a great effect on their innovation level. Moreover, level of education affected students' innovation level, i.e. PhD students were more innovative than other students due to the skills and experiences they acquired during their course of study. The amounts of fit indexes in the studied model showed the suitability of the model.Conclusion: Practical commitment to self-management system creates a different attitude toward ersonal values through a professional approach and self guidance and can thus facilitate creativity and innovation in students.
Samira Nikoukar; Saeedeh ketabi; Elham Moazam
Volume 7, Issue 0 , December 2011
Abstract
Introduction: The purpose of this research was to evaluate the Performance of the hospitals’ managers affiliated to Medical University of Isfahan by Data Envelopment Analysis (DEA) method. Also since some attributes of performance are qualitative, Analytical Hierarchy Process (AHP) method was used ...
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Introduction: The purpose of this research was to evaluate the Performance of the hospitals’ managers affiliated to Medical University of Isfahan by Data Envelopment Analysis (DEA) method. Also since some attributes of performance are qualitative, Analytical Hierarchy Process (AHP) method was used also to quantify the data.Methods: This research was practical in purpose and descriptive-analytic in method. The research population was 29 hospitals’ managers affiliated to Medical University of Isfahan University in 2008.Primary data collected from the existed documents in care deputy of medical University of Isfahan. Data analysis has been done by DEA & AHP methods using Expert Choice and DEA-Excel Solver software.Results: In this research the efficient managers are determined along with their return to scale (RTS). The variable returns to scale and output oriented model of DEA has been applied in the research. And also the optimal situation compared by in this situation, that showed the most variation between these situations was about ratio of revenue to cost. The efficiency, Optimal Multipliers and slacks are determined.Conclusion: In this research the efficient managers and their score were determined. Between 29 managers 15 managers was determined as efficient ones. RTS for more managers are decreasing or constant. Indicators such as Lack of hard work indices, the number of expert resources and number of resources were treated as inputs. Indicators such as performance form Score, bed occupancy, last time payments and ratio of revenue to cost were selected as the output.Keywords: Performance Assessment; Data Interpretation, Statistical; Administrators; Hospitals.
Reza Salehzadeh; Saeedeh Ketabi
Volume 8, Issue 4 , September and October 2011
Abstract
Introduction: Due to increased costs of health sector, much effort has been done to compare the performance of hospitals and measure their efficiency in recent years. The purpose of this study was to evaluate the relative efficiency of public and private hospitals in Qom during 2007 using data envelopment ...
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Introduction: Due to increased costs of health sector, much effort has been done to compare the performance of hospitals and measure their efficiency in recent years. The purpose of this study was to evaluate the relative efficiency of public and private hospitals in Qom during 2007 using data envelopment analysis (DEA) approach. Methods: This was an applied and analytic study. The study population included all the 8 hospitals in Qom. There was no need to assess the validity and reliability since real data and performance statistics of hospitals were used. Input variables in this study were number of general practitioners, specialist physicians, and paramedical staff, as well as number of active beds. Output variables included number of inpatients and outpatients admitted. First, input variables weighted by analytical hierarchy process (AHP) and reduced to two variables, namely number of physicians and number of active beds. Then, input-oriented CCR (constant returns to scale (CRS)) and BCC (variable returns to scale (VRS)) were used to assess the performance of Qom hospitals in 2007. After determining inefficient hospitals, efficient hospitals were ranked using Anderson-Peterson (AP) model. Expert Choice, Win4Deap and DEA-Master were used to perform the calculations. Results: CCR model indicated 3 hospitals as efficient and five hospitals as inefficient. The final ranking of hospitals based on this model was 1. Zahra; 2. Fatemi; 3. Izadi; 4. Vali-e-Asr; 5.Masoomeh; 6. Nekooyi; 7. Kamkar; and 8. Golpaygani. However, based on BCC model, four hospitals were efficient and four were inefficient. The final ranking was 1. Zahra; 2. Vali-e-Asr; 3. Izadi; 4. Fatemi; 5. Masoomeh; 6. Nekooyi; 7. Kamkar; and 8. Golpaygani. Conclusion: Most hospitals are not efficient. The performance of inefficient hospitals can be improved following the patterns used by reference hospitals and also by better financial and human resources management. Keywords: Hospitals; Analysis; Data Interpretation, Statistical; Performance Assessment.
Maryam Yaghoubi; Saeed Karimi; Saeedeh Ketabi; Marzieh Javadi
Volume 8, Issue 3 , July and August 2011
Abstract
Introduction: Length of stay is one of the most important and most practical indices used in hospitals today and presents the performance and efficiency of the hospitals. On the other hand, hierarchical analysis technique, one of the group decision making techniques, is utilized to determine priorities. ...
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Introduction: Length of stay is one of the most important and most practical indices used in hospitals today and presents the performance and efficiency of the hospitals. On the other hand, hierarchical analysis technique, one of the group decision making techniques, is utilized to determine priorities. Therefore, this study was conducted to identify the factors affecting length of stay in Alzahra Hospital based on hierarchical analysis technique. Methods: This descriptive cross-sectional survey included the management, chief, educational supervisor, and also nursing and ward managers of Alzahra Hospital in Isfahan during 2009. All the subjects were selected by census sampling method. Data collection tool was the paired comparisons questionnaire. Data analysis was done by Expert Choice software. Results: Generally, patient's underlying disease (0.245), availability of beds (0.203), being discharged before holidays (0.657), coordination between paraclinical and treatment units (0.294), health personnel's awareness (0.241), performing various graphies in the hospital (0.286), and nurses' sympathy with the patients (0.517) were the most effective factors on length of stay. Conclusion: Identifying the factors effective in shortening the length of stay is one of the main responsibilities of hospital managers. Factors related to patient visit, coordination with other sectors and patient characteristics are the most important and need more planning and attention from hospital officials. Keywords: Length of Stay; Analyic Hierarchy Process; Presonnel, Hospital.
Sima Ajami; Saeedeh Ketabi
Volume 5, Issue 1 , March 2008
Abstract
Abstract Introduction: The hospital discharge process is a basic bottleneck in hospital management. Improved discharge process is the main strategy that covers many hospital activities. Discharge process is the last patient's contact with hospital system. Therefore, it is the most important stage affecting ...
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Abstract Introduction: The hospital discharge process is a basic bottleneck in hospital management. Improved discharge process is the main strategy that covers many hospital activities. Discharge process is the last patient's contact with hospital system. Therefore, it is the most important stage affecting patient's satisfaction. If this process takes long, not only it makes patients dissatisfied but it also will not be beneficial for the hospital. The main objective was determining average waiting time of patient discharge process at Beheshti Hospital in Esfahan, Iran in the spring of 2006. Methods: This study was case study in which data were collected by questionnaires, observation and forms. The statistical population was all personnel involved in discharge process and patients discharged throughout the spring of 2006. To analyze data SPSS and Win QSB (Windows Quantative Systems for Business) were used. Results: According to the personnel's views, the main factors affecting average waiting time were patients' financial problems and un-accessibility of interns to complete the summery sheets. The longest patient's waiting time for discharge was 345 minutes and the least was 35 minutes. Average time for patients in discharge process was 197 (±65) minutes. Conclusion: Discharge planning is a routine feature of health systems in many countries. Hospital information system should be implemented at least between wards, Para-clinics stations, accounting and cashier station. It causes many stages in manual patients' discharge process will be omitted. Keywords: Hospitals; Patient Discharge; Time
Saeedeh Ketabi; Javad Monzavibarzaki
Volume 3, Issue 2 , September 2006, , Pages 83-91
Abstract
Introduction: Most of Iran’s health budget goes to hospitals as the largest care providing unit in the community. More than 60% of hospital resources are allocated for staffing. One of the problems facing hospitals especially in critical and sensitive parts such as in emergency room is appropriate ...
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Introduction: Most of Iran’s health budget goes to hospitals as the largest care providing unit in the community. More than 60% of hospital resources are allocated for staffing. One of the problems facing hospitals especially in critical and sensitive parts such as in emergency room is appropriate staffing. This research was designed to investigate and improve nursing staffing and human resource planning at the emergency room of Chamran Hospital using Linear programming as a method of Operational Research.
Methods: This descriptive-analytical study used a checklist for data collection. Study population included patients and nursing staff of emergency room during the months of November and December 2006 and January 2007. After estimating the average number of patients and the average time required for nursing care to each category of emergency patients, the number of nurses needed for each hospital shift was calculated using Wine Windows Quantitative Systems for Business (QSB) program.
Results: According to the findings, for more appropriate patient care, Chamran hospital emergency room needs at least 28 nurses per shift.
Conclusion: Various models of Operational Research such as linear programming are practical for estimating the appropriate staffing at various parts of a hospital.
Keywords: Nurses; Hospital Programming; Medical Emergencies; Scientific Management
