فهرست مطالب

Evidence Based Health Policy, Management and Economics - Volume:1 Issue: 3, 2017
  • Volume:1 Issue: 3, 2017
  • تاریخ انتشار: 1396/07/05
  • تعداد عناوین: 9
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  • Sara Emamgholipour * Pages 128-130
  • Adel Eftekhari, Samaneh Mirzaei, Somayeh Azimpour, Azita Taher * Pages 131-141
    Background
    Failure Mode Effects Analysis (FMEA) is an analytical method for risk assessment that seeks to identify and rank as far as possible the potential risks within the scope of risk assessment, as well as the causes and effects associated with it. Considering the classification of the Intensive Care Unit (ICU) as one of the high-risk wards, this ward of Ziaee Hospital- Ardakan is studied to identify, prioritize and evaluate errors, and present and implement proposed measures to reduce or eliminate possible errors.
    Methods
    This is a quasi-experimental study of interventional type. The present study is a quantitative, qualitative combination of inductive and applied method and evaluates and analyzes the states and effects of the error using FMEA method in the form of a before-after study. Studies of this research were carried out during the period of January 26 to December, 2016 on the processes of the intensive care unit of Ziaee Hospital in Ardakan. The information collection is based on FMEA standard worksheet and formation of FMEA team.
    Results
    Re-evaluate the risk priority number (RPN) after performing corrective measures showed that the priority score of all common errors was decreased in the ward. The results of this study indicated that out of 26 identified clinical errors, 10 first error modes were selected for further study. Selected error modes accounted for the highest error rate. This was related to the non-usage of routine disinfectants in hand washing with a score of 504, and the lowest score was related to the failure of the nurse to identify alarm type with a score of 240.
    Conclusion
    We can reduce as much as possible the severity of injuries by re-measuring the priority score and making effective control and corrective measures by identifying the errors and methods of reducing these errors in the intended ward or in any other ward in the organization.
    Keywords: FMEA, Risk Assessment, Intensive Care Unit
  • Ahmadreza Raeisi, Marzieh Javadi, Reza Mohamadnezhad* Pages 142-150
    Background
    The need for training throughout the whole occupational life time of a personnel is crucial. As educational needs of all personnel in hospitals are not the same, planning for holding in-service training courses is complex and sensitive, which in some cases causes incidence of challenges and different taste in training. Understanding these challenges and offering solutions to them are really important.
    Methods
    This research was a qualitative study, conducted through a phenomenological approach, for which structured interviews were used to collect data. A total of 10 training supervisors, training volunteers, and administrators of clinical sections, who had been chosen through a targeted method were interviewed. The average duration of interviews was 35 minutes, and their analysis was done through content analysis method.
    Results
    In this research, five primary codes and fifteen secondary codes were obtained. The primary codes comprised support by managers, financial supply, need assessment, time period, and program content.
    Conclusion
    Based on this research, holding in-service training is faced with serious challenges due to different training needs of the hospital personnel and medical team, which are categorized into five groups of support by managers, program need assessment, program time period, program financial support, and educational content. It appears that solving such challenges requires collaboration between the three major decision-maker pillars, i.e. vice-chancellor for treatment, hospital, and universities of medical sciences.
    Keywords: Educational Hospital, In-Service Training, Qualitative Research, Nurses
  • Javad Qodoosinejad, Amin Daemi, Mohammad Saadati, Rouhollah Yaghoubi Pages 151-157
    Background
    Hospitals are the largest and most costly operating units of health systems, and their share of current government expenditures in the healthcare sector is between 50 and 80 percent. The hospital efficiency is more indicative of the proper function of the resources devoted to it. The aim of this study was to evaluate the efficiency of hospitals in Tabriz by using the Pabon Lasso model.
    Methods
    This is a descriptive study that investigated the efficiency of Tabriz hospitals during 2009-2013. All hospitals of Tabriz were entered by census. Data (bed occupancy rate, bed turnover and patient length of stay) were collected in summer 2014 and charts were plotted using SPSS19 software.
    Results
    The mean of Pabon Lasso's three indices of efficiency in 5 years (excluding psychiatric beds) was 67.6% for bed occupancy rate, 104.3 times bed turnover, and 2.48 days average patient length of stay. The coefficient of bed occupancy increased by 3% over 5 years, the bed turnover index increased by 8 times and the average length of stay decreased by 0.17 day. On average, 25.2% of hospitals were in Region 1, 23.5% in Region 2, 26.1% in Region 3 and 25.2% in Region 4 of Pabon Lasso Diagram.
    Conclusion
    The presence of 26% of hospitals in the region of Pabon Lasso Diagram shows the effective efficiency of hospitals which is not an acceptable statistics for hospitals and requires the intervention of health practitioners and policymakers.
    Keywords: Pabon Lasso, Efficiency, Hospital
  • Mohammad Ranjbar, Mehdi Ahmadinejad, Shiva Sheikholeslami * Pages 158-165
    Background
    Patients’ complaints show dissatisfaction from the services received in hospital and gaps in health care service providing system. The present research was conducted with the aim of determining patients’ complaints and the effective factors in Shahid Bahonar Hospital of Kerman in 2015.
    Methods
    This research is cross-sectional with descriptive-analytical approach and studied all the recorded complaints in Shahid Bahonar Hospital of Kerman in 2015. Data was collected using form as census from 155 recorded complaints from office of complaints in accountability unit in 2015. Data was analyzed after extraction by SPSS22 software, descriptive statistics, and chi-square test.
    Results
    Complaints of 155 people with 174 subjects were recorded. The maximum complaints were for clinical sector (54.2%). Each non-receiving desirable services and improper communication was the most proposed subject. Frequency of complaints based on team and doctors was 31.6% and administrative-support team was 30.5% as the maximum frequency. The most popular complaint subject for men was non-receiving timely, conscious, and desirable services with 23.87% frequency, and for women was improper communication and confrontation with 17.41% frequency. The efficient evidences based on relationship between genders and age weren’t found among subjects.
    Conclusion
    One hundred and fifty five complaints were recorded in Shahid Bahonar Hospital of Kerman in 2015. The reason for patients’ complaints was non-receiving desirable services, improper communication, defect in facilities and amenities, ignorance to cares and costs. The most frequent factor was non-receiving timely, conscious, and desirable services. Therefore, it is suggested that senior managers of this center should formulate a proper operational program to promote medical services. Moreover, a permanent follow up of mangers to increase number of approved beds and facilities for patient admission and treatment will reduce the amount of complaints.
    Keywords: Complaint, Patient, Hospital
  • Ali Molaiy Eil Zolh, Elham Shah Bahrami *, Mohammad Nasiri Pages 166-177
    Introduction
    Social capital as a network of communication and mutual trust in the organization plays a crucial role in the production and creation of knowledge. Therefore, the present study aims to investigate the effect of social capital on knowledge management processes in Mazandaran University of Medical Sciences.
    Methods
    This is a descriptive-analytical study conducted on a cross-sectional basis in 2016. The statistical population of the study comprised all the staff (faculty and administrative members) of this university (N = 230). The questionnaires were distributed among them and 183 questionnaires were collected. The data were collected via the Social Capital Questionnaire (17 questions) and Lawson Knowledge Management Questionnaire (24 questions). Data were analyzed using statistical tests (t), path coefficients (β), SPSS22 software and structural equation technique using SMART PLS software.
    Results
    The results of t-test statistics (0.60, 0.61, 0.60, 0.61, 0.59 and 0.41) and path coefficients of β (7.32, 21.76, 21.6, 6.7, 14.49, and 2.9), respectively showed that social capital positively and significantly affect knowledge management processes (knowledge creation, knowledge absorption, knowledge organization, knowledge storage, knowledge dissemination, and knowledge utilization).
    Conclusion
    The officials of such social institutions are recommended to identify, improve and strengthen social capital and its dimensions in order to enhance the knowledge management processes and provide them with a sustainable competitive advantage compared with other universities.
    Keywords: Social Capital, Knowledge Management, Knowledge Management Processes
  • Mohammad Kamali, Shabnam Asadollahi *, Mahnaz Afshari, Hosein Mobaraki, Nasrin Sherbaf Pages 178-185
    Introduction
    Since disabled persons and their families are those who refer to wellbeing organization, staff of such organization requires special education to provide essential capabilities in them. On the other hand, such educations should increase job satisfaction of staff leading to the increasing commitment. The current research aims to find the relation between organizational learning and organizational commitment of staff in wellbeing organization of Yazd province.
    Methods
    This is an analytical-descriptive research and the statistical population is all staff of wellbeing organization of Yazd province (74 persons). Sampling was done by census in 2015. To gather information, Nifa organizational learning questionnaire and Allen & Mayer's organizational commitment questionnaire were used and each includes 24 items. Data were analyzed using SPSS18 software, t-test, ANOVA, Pearson correlation and linear regression tests in significance level of P-value
    Results
    Participants were 34 men (46%) and 40 women (54%). 66% of respondents had bachelor and 35.1% had work experience between 11 and 15 years. There was no significant difference between organizational commitment, organizational learning and gender. There was no significant relation between age and other research variables except for normative commitment. There was a linear significant relation and positive and direct correlation between components of organizational commitment including affective commitment, continuous commitment and normative commitment (P-value
    Conclusion
    there was a positive and direct relation between organizational learning and organizational commitment of staff. Organizational commitment and organizational learning were averagely low in the organization. Therefore, managers of wellbeing organization should identify educational requirements of staff and offer opportunities to meet such needs and to promote abilities, skills, loyalty and commitment of staff to the organization.
    Keywords: Organizational Learning, Organizational Commitment, Wellbeing Organization
  • Mina Baniasad *, Hamidreza Horry Pages 186-192
    Background
    When trying to estimate demand elasticity, it is important to first obtain an appropriate estimation of the demand function. One of the best methods for estimating the demand for healthcare services that is part of the household cost is the use of the almost ideal demand system (AIDS). The purpose of this study was to making better decisions when estimating the demand elasticity for healthcare services.
    Methods
    This research is a descriptive-analytic study. The statistical population of this study is the Iranian population for the years 1990 to 2011. The required data were collected from the Central Bank of the Islamic Republic of Iran. In this research, the demand for healthcare services was estimated using the AIDS model by the method of estimating seemingly unrelated regressions (SUR).
    Results
    According to the estimates, the income elasticity for the demand of healthcare services in the household budget is slightly larger than one and the self-priced elasticity is close to one and the cross elasticity between the change in house prices and the share of healthcare services is a negative value and close to zero and the cross elasticity between food prices and the share of healthcare services is positive and near zero and the cross elasticity between clothing prices and the share of health care services in the household budget is zero.
    Conclusion
    Since the income elasticity of demand for healthcare services is greater than one, it is necessary for the government to increase the share of health care budget so that low-income groups can use these services. Furthermore, the price elasticity of healthcare services is one; therefore, a steady rise in the price of health care services cannot lead to a sharp decline in using these services for households.
    Keywords: Demand for Healthcare Services, Price Elasticity of Demand, Income Elasticity of Demand, Almost Ideal Demand System
  • Morteza Arab-Zozani, Saeed Husseini Barghazan* Pages 193-197
    Despite noticeable progresses and visible changes in health system of Iran, there are many shortages and gaps which make this system far away from ideal. In order to solve these problems and to visit goals set by the government a plan was launched to reform the health system in May 2014. These reforms encompassed seven sub-plans: decreasing in-patient's out-of -pocket (OOP) payments, supporting physicians to stay in deprived areas to improve healthcare services quality, planning presence of physicians in public hospitals to improve quality of their services, improving public hospital’s clinic visits quality, upgrading hoteling care quality in public hospitals, financial protecting of non-treatable diseases and special needs, as well as promoting natural childbirth. This manuscript reflects opinions of an expert dealing with this reform. On the one hand, there have been noticeable changes and achievements in this realm, such as 8.5 to 37 % reduction in in-patient OOP payment, coverage of 10.2 million people under national health insurance, and many other significant short-term achievements. On the other hand, instability of financial resources, irregularity of plans, weakness of the private health sector, and costs of reform's implementation are main disadvantage of reforms. Reform's designers are now working on payment systems of the providers to solve problems that arose as consequences of reforms and formulate structures to ensure about stability of financial resources even in future governments.
    Keywords: Health Reform, Policy Making, Reforms Agenda, Iran