فهرست مطالب nasrin sharbafchi-zadeh

 The spread and epidemic of COVID-19, as a new disease, challenged many health achievements. In hospitals, as the center of crisis management activities, it is very important to develop a crisis preparedness plan. In this study, the response-readiness of Khorram Abad hospitals in the crisis of COVID-19 was discussed.

 This study is a descriptive and applied research that was conducted cross-sectionally in the summer of 1400 in two stages. In the first stage, the condition of 3 Khorram Abad University Hospitals was based on a checklist WHO-EMRO evaluation of the hospital's response readiness to deal with the covid disease was done. The data were analyzed after being recorded in Excel. Based on the obtained results, the weak points of each hospital were extracted and examined through the management panel and individual interviews, and finally implementation solutions were presented.

 Hospital "A" is relatively prepared in terms of human resources, rapid identification and infection control; Hospital "B" was relatively prepared in the fields of continuity of services, rapid identification, isolation and management of patients; Hospital "C" was also relatively prepared in the fields of information, human resources, rapid identification and infection control; They were fully prepared in other areas. Two hospitals "B and C" are at the level of full readiness and hospital "A" is at the border of full readiness and the overall level of readiness with 81% was estimated at the optimal level.

 Considering the optimal preparation of Khorram Abad hospitals in dealing with the crisis of the COVID-19 epidemic, it is necessary to train and allocate sufficient manpower to face future crises, and allocate budget to the program. Crisis preparedness, standard supply chain design and evaluation of crisis management programs should be given more attention.

Palliative care should be a top priority in public health and disease management programs. This study aimed to compare the palliative care services in selected countries and provide a framework for Iran.

This study was conducted with a descriptive and comparative approach in 2019. Data were collected through literature review of the databases of the relevant organizations in the selected countries.

Findings suggest that the United Kingdom and the United States are leading countries in palliative care and provide comprehensive services to end stage Ill patients. Turkey has also made significant progress in palliative care and has covered a large population in recent years. In Iran, many services required for end stage patients have not yet been implemented or the centers for providing these services are very limited. Experts in palliative care also believe that in Iran, less attention has been paid to the organization of such centers than the United Kingdom, the United States, and Turkey.

Based on the results of this study, it is suggested to benchmark the experiences of leading countries and initiatives and proceedings of the developing countries, considering organizational structure, financing and support services, supervision of services, interdisciplinary teams, patient care need assessment, training and recruitment as a framework for Iran.

Infectious diseases in the pandemic stage have significant life-threatening, psychological and social effects. Identifying the characteristics associated with peoplechr('39')s cooperation in self-care leads to greater immunity for themselves and others. Therefore, this study was conducted to predict the self-care of the Iranian people according to their individual and social characteristics in face of the Covid-19 pandemic.

A survey study was conducted on 1056 adults aged 18 and over in different provinces of Iran through a form of answering online researcher-made questions (n=40, α=0.9) in social networks in four days. This paper studies the level of self-care of people against Covid 19 pandemic which was conducted with the support of Isfahan University of Medical Sciences in April 2016. Data were analyzed using Student t-test and variance. Moreover, "decision tree technique" was used to identify communication patterns.

The findings showed that the average self-care score in women, the most educated, married women, women aged 41 to 55, housewives and some other occupations was very high. However, the average self-care score of single men with a diploma was average. In general, the mean score of womenchr('39')s self-care was higher than men (P<0.0001) and the educated were more than the less educated literate (P=0.007). There was no significant difference between the self-care scores of the respondents in terms of their marital status and employment.

The results showed that the average scores of self-care in women, more educated people, married women, women in the age group of 41 to 55 years, housewives and some other occupations were reported to be very high; While the average self-care score reported in single men with a diploma was average. Overall, the mean score of self-care reported in women was higher than men (P<0.0001) and people with doctoral education reported more self-care than illiterate people (P=0.007). Besides, there was no significant difference between the self-care scores of the respondents in terms of their marital status (single and married) and their employment status (employed and non-employed).

As a control tool, performance evaluation has always been a concern for managers. Hence, the present study aimed to apply a balanced scorecard approach to assess the performance of educational hospitals in Khorramabad before and after the development of the health system (2013 and 2017).

This descriptive-comparative study was conducted in 2013 and 2017 using a balanced scorecard model. The statistical population included all educational hospitals in Khorramabad. The performance of every hospital was examined based on the dimensions and indicators of the study using SPSS-22 software.

There were significant differences between the performance of the educational hospitals of Khorramabad in terms of customer orientation and internal processes before and after the implementation of health system reform (p<0.05). Nevertheless, there were no significant distinctions between the hospitals with regard to growth, learning and financial issues (p> 0/05).

The results of this study indicated that two dimensions of the balanced scorecard approach were improved following the implementation of health care reform plan in Khorramabad educational hispitals

The hoteling quality improvement package of the Health Reform Plan has provided Health Ministry managers with an unprecedented opportunity to optimize the hoteling services. This study investigated the managers’ view on the challenges and opportunities of this package.

This qualitative study with phenomenology approach was done on 15 hospital managers and staff managers of Isfahan University of Medical Sciences selected through purposeful sampling. Data were collected through semi-structured interviews with the average time of 25 minutes. All interviews were analyzed using the thematic content analysis approach and MAXQDA10 software.

The identified challenges were classified in 6 main codes and 24 sub-codes. The main codes contained: financial, managerial and planning, monitoring and evaluation, legal cases, equipment/ facilities and buildings. The Identified opportunities were classified in 4 main codes and 10 sub-codes with main codes containing main advantages of hoteling, patient satisfaction, management and process opportunities and structural and infrastructural opportunities.

To reduce the challenges of hoteling package and reinforcement of the opportunities, some strategies should be considered by the health system policymakers such as the equitable allocation of budget resources, training managers and more supervision to avoid the waste of resources, continuity of resources and resource allocation based on the real needs, budget allocation and expenditure according to the guidelines.

Unpleasant incidents are one of the biggest problems in health system and error reporting system is an efficient way to improve patient’s safety. Therefore, this study was conducted with the purpose of assess reporting error system in one of the pediatric hospitals in Tehran and finally a proposed model for health centers was presented.
This was qualitative study. The procedures of study included four phases such as identifying status of selected hospitals in the error management system, identifying the status of error reporting systems in selected countries, identifying the features, requirements and benefits of setting up an error reporting system and develop a proposed model for health centers. Triangular method was used to collect information and descriptive content analysis and consensus opinion was used to analyze the data.
Demographic, cultural, organizational, legal-regulatory and financial factors have been introduced as the main barriers of error reporting in the respective hospital. Structural and process criteria should be strengthened to establish a desired reporting system. The process of incidents detection, incidents drawing, incident analysis, review and share errors, implementing solutions and monitoring and evaluation are recommended to design an error reporting system.
The competitive key to manage medical’s error successfully is to establish a voluntary reporting system, commitment of senior managers, change the culture of blame and removing barriers of reporting errors. So, healthcare system needs to provide an error reporting system with learning and proactive approach to improve quality of services and safety of infrastructure.

To develop and implement more effective programs of health care delivery to prevent and control diabetes, Iran has developed and implemented the urban phase of the specialized care program for diabetic’s patients. Deeply understanding theviews and experiences of various stakeholders in this program can assist policy makers to identify the program’s strengths and weaknesses and enable them to develop action plans. Hence, the present study aimed to evaluate the planning and establishing ofthis program from the perspective of providers. A qualitative study was applied using documents review and face‑to‑face semi‑structured interviews with the program leads and relevant executive managers of the local medical universities. Thematic analysis was used to analyze the data. Three main themes and nine subthemes were explored, including program planning (the content and the strengths, weaknesses, and corrective measures), implementation (executive mechanisms at the university level, establishment of referral system, collaboration between deputies of health and treatment, information dissemination mechanisms, satisfaction measurement and strengths, weaknesses and corrective measures), and result (implementation results). The urban phase of the specialized care program for diabetic’s patients has been a good base to improve continuity of care, which emphasizes on controlling and prevention of occurrence or progression of chronic complications of diabetes. This model can also be used for better management of other chronicdisease. However, there are still issues that should be considered and improved such as allocation of guaranteed resources, more trained health professionals, and more evidence based guidelines and protocols, better collaboration among medical universities’ deputies, clearer payment system for program evaluation and better information management system.