Amir Ashkan Nasiripour; Mohammad Ali Afshar Kazemi; Ahmad Reza Izadi
Volume 9, Issue 7 , December 2012
Abstract
Introduction: Balanced scorecard is one of the most successful and widely used models of performance assessment in healthcare organizations, especially in hospitals. The model is a framework for designing a set of performance measures for organization strategies. The study was conducted aiming ...
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Introduction: Balanced scorecard is one of the most successful and widely used models of performance assessment in healthcare organizations, especially in hospitals. The model is a framework for designing a set of performance measures for organization strategies. The study was conducted aiming to yield a performance assessment model for Iranian social security hospitals with balanced scorecard approach. Methods: In this adaptive and descriptive research, 11 theory and practical models of balanced scorecard with successful experiences were studied. A model for Iranian social security hospitals was designed. A questionnaire was designed as a data collection tool. It was validated using expert's survey in Delphimethod. Reliability coefficient for this questionnaire was relatively high (Cronbach's alpha = 0.94). Independent t-test was used to identify significance of expert responses. Results: The mean score of experts opinion about the proposed model was 4.02 (out of 5) for mission statement and 4.5 for continuous improvement in healthcare quality and safety policy, 4.66 for optimization of current resources and facilities utilization, 4.66 for team working for satisfying ourpatients/clients policy, and 4.32 for responsible for environment and employee health and safety policy. The mean score was 11.66 for clinical perspective, and 11.5 for patient perspective, 11.66 for internal processes perspective, 10.78 for financial perspective and 11.46 for employee growth perspective. Totally, 27 measures were designed for these perspectives one of which was excluded. Conclusion: The model can be implemented in one or all the social security hospitals and also can be used for comparing the performance of the hospitals. Because of the dynamic nature of the balanced scorecard, the model is a flexible framework that could be adjusted by local situations based on differences in targets.
Ahmad Reza Izadi; Jahangir Drikvand; Ali Ebrazeh
Volume 9, Issue 6 , March 2012, , Pages 895-907
Abstract
Introduction: Health care organizations, especially hospitals, must focus on patient safety as their mainstrategy. Cultural change is the most important challenge that they are faced with in creating a safesystem. The present article aims to improve the patient safety culture with an assessment of the ...
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Introduction: Health care organizations, especially hospitals, must focus on patient safety as their mainstrategy. Cultural change is the most important challenge that they are faced with in creating a safesystem. The present article aims to improve the patient safety culture with an assessment of the safety inFatemeh Zahra Hospital, Najafabad, Iran.Methods: This descriptive and cross-sectional research was conducted in 2010. Patient’s safety culturewas measured using the Persian adaptation of the Hospital Survey on Patient Safety Culture. This surveywas validated by the opinion of 15 experts. The reliability of the questionnaire was determined byCronbach’s alpha and was 0.846. The questionnaire was sent to all medical employees of Fatemeh ZahraHospital. Data were analyzed with t-test and one-way ANOVA by SPSS Software. A P-value of less than0.05 was considered as statistically significant, and 95% confidence interval was calculated.Results: Overall, 196 of the 350 individuals responded to the surveys. The overall response rate was 56%.Supervisor expectations and actions gained 76% of all scores, teamwork within hospital units 75%,organizational learning 73%, feedback and communication about error 70%, transitions 69%,communication openness 68%, management support 65%, teamwork across units 62%, non-punitiveresponse to error 54%, and staffing gained 48%. 64% of all employees had no reports of error. The meanpatient safety score was 3.36 (out of 5). According to t-test results, there was no significance differencebetween patient safety scores in direct and indirect contacts with patient (P = 0.373). Moreover, accordingto the results of ANOVA, there was a significant difference between the scores of the maternitydepartment and midwifes, and other wards and employees (P < 0.000). There was no significant differencebetween the patient safety culture scores of employees of different wards, work experience in the ward(their current place of work), work experience in the hospital, and type of contact with patients (P < 0.05).Conclusion: Although the total score of patient safety culture was acceptable, non-punitive response toerror, staffing, teamwork across units, and management support are in need of immediate intervention.The hospital can improve the patient safety culture by planning and taking action in these areas.
