Rouhollah Ghaedamini Asadabadi; Ahmad Amerieon; Shahram Tofighi; Fatemeh Azizian; Azam Fayazi
Volume 9, Issue 4 , September and October 2012, , Pages 479-489
Abstract
Introduction: One of the types of hospital management information systems is decision supportinformation system (DSIS). This system uses decision-making models and databases forpreparing specific information to support their semi-structured or unstructured decisions. Thepresent study aimed to design ...
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Introduction: One of the types of hospital management information systems is decision supportinformation system (DSIS). This system uses decision-making models and databases forpreparing specific information to support their semi-structured or unstructured decisions. Thepresent study aimed to design a decision DSIS model for Board of Trustees of Ayatollah KashaniHospital, Shahrekord, Iran.Methods: This exploratory and modeling study was performed in 2010 and conducted in Board ofTrustees Ayatollah Kashani Hospital in Shahrekord. The study population consisted of 30 Board ofDirectors and hospital administrators. Data collection was performed through a researcher-made42-item questionnaire with approved validity and reliability (85%) by the expert professors used forinterviewing and observation. The data were analyzed using principles of systems analysis andmanagement and, mathematical analysis and also operations research technique.Results: Complete information about identifying the organizational environment, informationarchitecture diagrams, the decision-making pattern of Board of Directors and the hospitalauthorities, the mathematical models and other decision-making models were achieved and theDSIS model was designed for Board of Trustees of Ayatollah Kashani Hospital, Shahrekord, Iran.Conclusion: Hospital information architecture diagram did not have much difference comparedwith the other conducted studies; however, using DSIS model and its output through theoperations research techniques, mathematical patterns and other appropriate patterns wouldresulted in decisions that the hospital’s board might make and support them.
Shirin Abbassi; Nahid Tavakoli; Mohammad Moslehi
Volume 9, Issue 4 , September and October 2012, , Pages 502-512
Abstract
Introduction: Recently, the accreditation program has been used increasingly by an emphasis onpatient safety. In Iran, efforts have been made to establish the accreditation program. In 2011, itreplaced previous standards of traditional evaluation system. As the impact of accreditation planneed internal ...
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Introduction: Recently, the accreditation program has been used increasingly by an emphasis onpatient safety. In Iran, efforts have been made to establish the accreditation program. In 2011, itreplaced previous standards of traditional evaluation system. As the impact of accreditation planneed internal self assessment against minimal standards, this study aimed to survey the readinessof selected hospitals in Isfahan based on the functional model of Joint Commission onAccreditation.Methods: This cross-sectional descriptive study was conducted on four hospitals in Isfahan, Iran.Data was collected using 13 checklists based on the functional model of Joint CommissionInternational Accreditation. The checklists were verified by the Iranian Ministry of Health. Datawas collected via observations and interviews with hospital representatives in qualitymanagement. All statistical analyses were performed using SPSS.Results: The readiness of the selected hospitals in Isfahan was 64% regarding patient-basedstandards and 66% for facility-based standards. In general, the studied hospitals had adequatereadiness for implementation of accreditation standards.Conclusion: As the study population has ISO 9000 certification, it is possible to replace oldmethods of process, outcome, and structure evaluation with new standards. Accordingly, patientrights have to be considered by health care employers in Isfahan.
Marzieh Javadi; Hamid Ganji; Ahmadreza Reiesi; Maryam Yaghoobi; Parvin , Hematian
Volume 9, Issue 4 , September and October 2012, , Pages 539-547
Abstract
Introduction: In today’s world, organizations are attempting to achieve advantages andcompetitive results. Understanding mutual interactions between organizations and using modernmanagement techniques as well as modern management tools might have an influential effect onobtaining optimal organizational ...
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Introduction: In today’s world, organizations are attempting to achieve advantages andcompetitive results. Understanding mutual interactions between organizations and using modernmanagement techniques as well as modern management tools might have an influential effect onobtaining optimal organizational results. Nowadays, one of the competitive advantages is applyingthe excellence models. The present study aimed to evaluate the improvable areas in Al-ZahraHospital, (Isfahan, Iran) using EFQM (European foundation for quality management) model.Methods: This was an applied, cross-sectional descriptive study. Data collection was performedusing EFQM questionnaire through census method. Thirty-nine managers were involved in all thelevels (junior, senior and operational management) of this study.Results: The results showed the Al-Zahra Hospital obtained total score of 502.78 (out of 1000scores). The obtained score was 259.60 in enablers area and 243.08 in results area. Each of the nineEFQM-criteria score and percentages were as the following: Leadership 52 scores (52%) policy andstrategy 43 (54%), human resources 42 (47%), resources and companies 50 (56%) and processes 70(50.6%) for the enablers area. In the results area customer satisfaction score was 97 (48.8%), staffsatisfaction 31.5 (35%), society results 30.7 (51%) and key performance results was 83.6 (55.7%).Conclusion: Implementation of the self-evaluation model in this hospital led to identification ofstrengths and areas in need of improvement. Out of enabler and results criteria, staff andcostumer satisfaction were with lowest scores, respectively; which are considered as the areaswith improvement prioritization. Therefore, further attention is required for improving thesemodification criteria in hospitals.
Abdolmahdi Rajaei; Morteza Nouraei,; Loghman Dehghan Nayyeri
Volume 9, Issue 4 , September and October 2012, , Pages 580-593
Abstract
One of the most important institutions of a city is hospital as it is directly involved with life of thecitizens. This review article aimed to study the circumstance of establishing newer hospitals inIsfahan city, Iran, which was started in late Qajar Dynasty era with a pause during theconstitutional ...
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One of the most important institutions of a city is hospital as it is directly involved with life of thecitizens. This review article aimed to study the circumstance of establishing newer hospitals inIsfahan city, Iran, which was started in late Qajar Dynasty era with a pause during theconstitutional era and was extended to Reza Shah Pahlavi in its modern form. The mainreferences for this study were the reports of local newspapers and press. It is obvious that thesetypes of resources would shed light on the real healthcare situation dominated on the life of thecitizens. This is partly due to the official reports which may not contain the real city dweller'sopinions. On the other hand, the audience cycle of the newspapers that covered the majority ofthe ordinary people's views seems more advantageous rather than merely referring to thebureaucratic documents and reports by the administrative authorities view. This article will alsoshow that since the constitutional era, 1906 to 1941, six hospitals have been established inIsfahan, either by local government or non-governmental charities (municipalities and religiousdelegations). The role of the governmental authority in this regard was mainly suport andencouragement. The urban renewal system, enhanced health situation in the reign of Reza ShahPahlavi and the partnership between private sectors, semi-private sectors and government causedto meet demand for hospitals in Isfahan during that period.
Saeed Karimi; Yousef Masoodian; Maryam Yaghoubi; Mohsen Hosseini; Jamil Sadeghifar
Volume 9, Issue 6 , March 2012, , Pages 780-785
Abstract
Introduction: One of the most important indices of effectiveness and delivery quality of sanitary andmedical services is patient satisfaction with hospital services. It is necessary that hospitals pay attention topatient's needs and ensure their satisfaction. Therefore the current study was conducted ...
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Introduction: One of the most important indices of effectiveness and delivery quality of sanitary andmedical services is patient satisfaction with hospital services. It is necessary that hospitals pay attention topatient's needs and ensure their satisfaction. Therefore the current study was conducted with the aim ofidentifying the level of patient satisfaction with hospital services delivered from the time of theiradmission to their release in educational hospitals of Isfahan, Iran.Methods: The present investigation is a descriptive and cross-sectional study conducted in the fall andwinter of 2009. The statistical population consisted of 196 patients referring to educational hospitals ofIsfahan. Simple random sampling method was used. The data collection tool was a researcher-madequestionnaire consisting of 66 questions on 5 areas. Content validity of the study tool was approved byprofessionals, and its reliability was approved by calculating Cronbach’s alpha (α = 0.87). Data wasanalyzed by SPSS software using chi-square test, Kruskal-Wallis test, and ANOVA.Results: The average score of patient satisfaction with outpatient admission was 15.5%, clinic physician27.9%, hospitalization admission 15.9%, nursing services 33%, hospitalization physician 38.6%, public andwelfare services 55.2%, hospitalization section 42.1%, and financial-administration section was 14.3%. Nosignificant correlation was observed between demographic characteristics and satisfaction score.Conclusion: The results showed that overall level of patient satisfaction with hospital services was low.Therefore, it is necessary to pay attention to activities and performance of different units of hospitals,identify factors causing dissatisfaction, and direct efforts towards eliminating the shortages andempowering the strengths. It is also necessary to plan for delivering higher quality services, securingfinancial benefits of the health section, and recognizing and amending some hospital procedures,especially admission and release procedures.
Hossein Ghalavand; Roghayeh Eskrootchi; Mohammadreza Alibeyk
Volume 9, Issue 6 , March 2012, , Pages 814-821
Abstract
Introduction: Many criteria are involved in the assessment of websites. The importance of these criteriadiffers depending on their various subject areas. The purpose of this study was to identify the importanceof assessment criteria of health websites based on the opinions of hospital librarians.Methods: ...
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Introduction: Many criteria are involved in the assessment of websites. The importance of these criteriadiffers depending on their various subject areas. The purpose of this study was to identify the importanceof assessment criteria of health websites based on the opinions of hospital librarians.Methods: This descriptive study was conducted in 2011. After face and content validity of the researcherconstructed questionnaire (based on the likert scale) were evaluated, its reliability was determined byCronbach’s alpha coefficient (0.98). The questionnaire was distributed between all librarians of 30hospital libraries affiliated with Tehran University of Medical Sciences and Shahid Beheshti University.53 questionnaires were collected. Data analysis was done using descriptive statistics (mean, median,mode, and standard deviation) in SPSS for Windows (version 19).Results: Of the information quality criteria, accuracy had of the highest degree of importance (4.56), andprice and response time had the lowest degree of importance (2.52). Moreover, in the external indicatorsgroup author credentials had the highest mean (4.73), and accessibility and advertising policy had thelowest mean of importance (2.20).Conclusion: Based on librarian’s opinions, the evaluation criteria of websites’ content information qualityare of greater importance than their external indicators.
Hamid Sepehrdoust; Elham Rajabi
Volume 9, Issue 6 , March 2012, , Pages 887-894
Abstract
Introduction: Iran's social security organization provides hospital services through direct treatmentsystem (hospitals owned by the organization) and indirect treatment system (purchasing of hospitalservices and other health care services from other providers). The current research aims to assess technicalperformance ...
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Introduction: Iran's social security organization provides hospital services through direct treatmentsystem (hospitals owned by the organization) and indirect treatment system (purchasing of hospitalservices and other health care services from other providers). The current research aims to assess technicalperformance and determine the relationship between activity size and efficiency level of social securityhospitals in Iran.Methods: This descriptive-analytical study was performed on 65 active social security hospitals that wereselected for Data Envelopment Analysis during the period of 2007–2009. In order to measure the technicalefficiency of hospitals the input-output model and data envelopment analysis (DEA) were used.Furthermore, statistical tests were used to study the significance of the effect of activity scale on theefficiency level of the hospitals.Results: About 28.5% of small scale social security hospitals and 16.2% of large scale social securityhospitals were found to be working with full efficiency. Statistical analysis showed a significant differencebetween the mean efficiency of small scale and large scale hospitals (Sig. = 0.029).Conclusion: It is expected that, through improvement of managerial techniques in efficient input use, themanagerial inefficiency level be reduced by 6%, and a 5% increment be achieved in the output servicesscale of hospitals through the efficient use of existing resources.
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.
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.
Farzaneh Hatampour; Mohammad Hossein Yarmohammadian; Nahid Tavakoli; Asadolah Shams
Volume 8, Issue 6 , January and February 2012, , Pages 762-765
Abstract
Introduction: Today, many organizations attempt to fully develop in gradual evolution of their processes. PCMM is one of the models which focus on improving organizational human capabilities. This model is applied to continually increase people's ability to attract, develop, motivate, ...
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Introduction: Today, many organizations attempt to fully develop in gradual evolution of their processes. PCMM is one of the models which focus on improving organizational human capabilities. This model is applied to continually increase people's ability to attract, develop, motivate, organize and retain the skills. In this study, PCMM was used to investigate organizational maturity needs in medical record departments of Isfahan public hospitals and to determine strengths, weaknesses, skills and capabilities of their staff members. Methods: This was an applied, cross-sectional study in which data was collected by questionnaires. The questionnaires were given to the staff of Isfahan public hospitals to investigate PCMM model needs at levels 1 and 2. The questionnaire has been extracted from the PCMM model and its validity and reliability have been approved by Cronbach's alpha (α = 0.96). The collected data was analyzed by SPSS using descriptive statistics. Results: Our findings showed that the mean score of skills and capabilities of medical record staff in governmental hospitals was 35 (out of 56). Medical record staff of hospital number 10 had the maximum maturity in level 2 of PCMM model (mean score = 55). Hospitals number 1 and 4 had minimum maturity in level 2 of PCMM model (mean score = 24). There was no significant relation between organizational maturity and the characteristics of medical record staff. Conclusion: PCMM model application would lead the staff and managers to pay increased attention to identifying the weaknesses of current activities and practices to improve and develop the onging processes.
Hassan Jafari; Mohammad Reza Maleki; Hossein Safari; Rahim Khodayari Zarnaq
Volume 8, Issue 8 , January 2012, , Pages 1017-1024
Abstract
Introduction: A new kind of leadership, called spiritual leadership, emphasizes on serving to others, general attitude toward work, personal development, and collaborative decision making. Spiritual leadership has been developed based on the philosophy of servant leadership and includes staff participation ...
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Introduction: A new kind of leadership, called spiritual leadership, emphasizes on serving to others, general attitude toward work, personal development, and collaborative decision making. Spiritual leadership has been developed based on the philosophy of servant leadership and includes staff participation and empowerment. This research aimed to survey the relationship between spiritual leadership and its seven dimensions on the quality of work life among the staff members of Hasheminejad Hospital, Tehran, Iran.Methods: This descriptive, applied research was carried out on 111 staff members ofHasheminejad Hospital in 2010. Data was collected by Fry's spiritual leadership survey and quality of work life questionnaire of Casio model. Data was analyzed by descriptive statistics and Spearman test in SPSS.Results: There were significant and positive correlations between spiritual leadership and its seven dimensions (vision, altruistic love, hope, meaning, membership, organizational commitment, and performance feedback) and quality of work life among the staff of Hasheminejad Hospital.Conclusion: Spiritual leadership provides supporting backgrounds for staff and helps them meet the organizational goals by pursuing their aims and needs through using their potentials.
Mohammad Hossein Yarmohamadian; Raheleh Samooie; Rahim Khodayari Zarnagh; Ali Ayoobian; Hossein Bagherian Mahmoodabadi
Volume 8, Issue 8 , January 2012, , Pages 1122-1128
Abstract
Introduction: Agility means ability to respond and react quickly and successfully toenvironmental changes. Agility is an important factor for hospital effectiveness. Agility in ahospital indicates the hospital's responsiveness when faced with internal and external changes. Ifhospitals are designed to ...
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Introduction: Agility means ability to respond and react quickly and successfully toenvironmental changes. Agility is an important factor for hospital effectiveness. Agility in ahospital indicates the hospital's responsiveness when faced with internal and external changes. Ifhospitals are designed to be agile, they should have the ability to compete with other hospitalsand provide appropriate services to their patients. This study compared agility in public andprivate hospitals in Isfahan, Iran in 2009.Methods: This descriptive, analytical, cross-sectional study was conducted in 2009. The studypopulation included the executives of administrative and financial sectors, health sector, andparaclinics, as well as supervisors in Khorshid, Chamran, Khanevadeh and Sina Hospitals. A totalnumber of 130 individuals (calculated according to Cochran formula) were selected from the fourmentioned hospitals. Data collection tool was the 42-item Likert-scale questionnaire of agility.The maximum and minimum scores of the questionnaire were 168 and zero, respectively. Thequestionnaire was valid and reliable based on the experts in the field and a Cronbach's alpha of0.96, respectively. Data was analyzed by descriptive and inferential statistical methods in SPSS16 .Results: Mean agility scores public and private hospitals were 103.7 and 113.9, respectively.Although a significant difference was observed between mean agility scores of selected hospitalsin Isfahan (P < 0.0001), public and private hospitals were not significantly different in terms ofagility (P > 0.05).Conclusion: Agility in both public and private hospitals was higher than moderate. In order toimprove agility in hospitals, using strategies and solutions such as flexible organizationalstructure, outsourcing of supplies and services, professional development of staff and preparationto face the environmental changes are required.
Behzad Karami Matin; Seyed Mohammad Saeid Ahmadi; Hossein Babapour; Elahe Miri; Mohammad Aram Khalesi; Amin Karami Matin
Volume 8, Issue 8 , January 2012, , Pages 1235-1242
Abstract
Introduction: Nowadays, many organizations such as hospitals have realized that utilization of quality management models and systems is the best way for them to compete, survive and develop. Therefore, 5S (sorting, straightening, systematic cleaning, standardizing, and sustaining) model ...
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Introduction: Nowadays, many organizations such as hospitals have realized that utilization of quality management models and systems is the best way for them to compete, survive and develop. Therefore, 5S (sorting, straightening, systematic cleaning, standardizing, and sustaining) model was implemented in three units of Imam Reza Hospital (Kermanshah, Iran) including medical records, nutrition, and surgery. The present study evaluated the effects of the model on various units offering hospital services. Methods: This quasi-experimental study included all the staff members of medical records, nutrition, and surgery wards (81 persons) in Imam Reza Hospital before and after an intervention in 2010. The pretest was conducted by standard 5S checklists and patients satisfaction measurement questionnaire whose validity and reliability were confirmed. The staff members were then educated, 5S model was implemented in the three mentioned units, and the required changes were applied during two months. Afterwards, the same tools were used again to perform the posttest. The results obtained before and after the implementation of 5S model were presented by descriptive tables and diagrams. They were analyzed by analytical statistics including paired-t and Wilcoxon tests in SPSS15. Results: Findings of this study showed establishing 5S model to be effective on performance and service quality improvement in the three mentioned units. In other words staff and patients satisfaction rates changed significantly after 5S model in all 3 units. The organizational 5S model (sorting, straightening, and systematic cleaning (S1-S3, respectively)) made desirable changes in the nutrition (S1: P < 0.001; S2: P < 0.001; and S3: P < 0.011), medical records (S1: P = 0.001; S2: P < 0.001; and S3: P = 0.009), and surgery (S1: P = 0.001; S2: P = 0.003; S3: P = 0.033) units. Conclusion: Overall, 5S model could improve service quality in the studied units. This finding supports the success of 5S model in industrial parts. Therefore, the model is suggested to be employed in all hospital parts and medical care provider units.
