نشریه مدیریت سلامت
پیاپی 79 (بهار 1399)

Patient safety culture is an important factor in reducing hospital's adverse event and improving patient safety. The aim of this study was to evaluate the relationship between patient safety culture and adverse events in hospitals of Hamadan city.

The present study was a descriptive-analytical study which was performed in hospitals of Hamadan in 2018. The study population consisted of nurses working in hospitals. The patient safety culture questionnaire and adverse event checklist were used for data collection. Questionnaires were completed by 650 nurses. Multiple logistic regression was used to examine the relationship between the variables.

The highest mean score of patient safety culture was related to the dimension of organizational learning, and the lowest score was for exchange and transfer of information. 35.4 percent of nurses said they had seen at least one patient fall in the past year (the least adverse event). Moreover, 51.9 percent of nurses stated that at least one pressure ulcer, or a complaint by a patient or his/her family had happened at their workplace in the past year (the most adverse event). Finally, the mean score of the patient safety culture had a significant relationship with the incidence of adverse events.

This study confirms the patient safety culture as a predictor of adverse events. Hence, health officials and hospital administrators should provide prerequisites for promoting patient safety culture and reducing adverse events through different strategies, such as encouraging erse events reporting as well as holding nurse training courses.

Today, managers in the field of health and care, especially in hospitals, need to address not only the internal issues but also the social and environmental issues of their decisions and actions to improve financial performance and increase productivity. The purpose of this study was to improve the financial performance of hospitals through social responsibility future study.

The method of this research was applied in terms of purpose, and according to the research methodology, it was a mix of quantitative and qualitative methodology consisting of phenomenology, content analysis, and future study. In the first step, phenomenological methods and interviews with experts were used to extract hospital financial performance indicators. In the second step, the content analysis method and systematic review on selected articles, dimensions, and indicators of social responsibility were extracted. Finally, as for the future study, the variables related to social responsibility were extracted through fuzzy delphi technique and analyzed using structural-interpretive model.

In the first step, 16 financial performance indicators were extracted. In the second step, the results of this phase showed the extraction of 35 proponents and four dimensions of economic, social, employee, and environmental social responsibility. In the last step, 20 variables related to social responsibility were extracted using the structural-interpretive model. The power of penetration and the degree of the dependence of the variables were determined.

The research results showed that all the variables associated with social responsibility had a great deal of influence and instability powers. That is, any change that occurs on them affects both them as well as other variables. Since the main purpose of public hospitals is to provide quality services to all segments of society and satisfy them, Therefore, considering all dimensions and components of social responsibility increases productivity and consequently improves the financial performance of hospitals.

Today, health tourism is one of the growing sectors of the tourism industry in the world. Health tourism as a source of income and job creation can be an approach to national economic development. Therefore, the aim of this study was to identify the factors related to creating a competitive advantage in the tourism business in the field of health.

This descriptive analytical study was conducted cross-sectionally in 2019. The Target population of this study includes activists and business owners of Mazandaran tourism industry. A questionnaire was used to collect data. Experts were used to measure the validity of the questionnaire. Two hundred copies were distributed, out of which 165 questionnaires were completed and returned. The reliability of the data collection tool was confirmed by Cronbach's alpha and composite reliability. Data analysis used structural equation method and Smart PLS software.

The results showed that the socio-cultural situation with a path coefficient of 0.96 had a significant effect on creating a competitive advantage in health tourism in Mazandaran province. Having welfare، access to accommodation, recreational facilities, and skilled manpower with a route coefficient of 0.95 and 0.85 were in the next ranks, respectively.

While identifying the exact list of socio-cultural and historical capabilities of the province and introducing the welfare complexes and service-treatment centers, the trustees of the organizations should provide the necessary preparations for attracting health tourists. Furthermore, ways to identify facilities for tourists should be facilitated. Also, by training and employing skilled labor, the health tourism business will be strengthened.

Investigating the impact of sanctions on the health of ordinary people of sanctioned countries has sparked challenging issues. According to the theoretical foundations, health is affected by the economic, social, environmental, and therapeutic variables. The present study investigated the effect of sanctions on the health of people in all provinces of Iran.

This descriptive, analytical and longitudinal study was conducted for the period of 2009 to 2016. The study population includes all provinces Iran and the used variables include control, economic, social, therapeutic and environmental variables such as provincial gross domestic product, education status, urbanization, therapeutic inputs and dummy variable of sanction. Data analysis was run through spatial panel model using Stata software.

Comparing the applied interruptions in the model showed that the negative effect of sanctions occurred in the second year. Investigations showed that the mortality elasticity into the treatment variable of a number of doctors was four percent. The government's development budget had a negative impact on health after two years. The coefficient of the unemployment variable was +0.0235. The estimate for urbanization rate was not significant.

The impact of sanctions on the public health was not significant in the first year as well as the following year and its effect in the second year was negative and positive in the third year. Therefore, according to the results of the current study, in order to reduce the costs of sanctions, it is necessary to consider the appropriate planning to improve the socio-economic conditions, such as the unemployment rate. Also, development projects and health policies should be done with caution, because its improper implementation has a negative impact on health.

One of the important requirements of health care systems in providing quality and safe services is developing appropriate strategies, effective implementation of these strategies, and controlling the results of the implementation. The design and implementation of a strategic control system ensures that the organization's performance in relation to the strategic management steps is correct. The purpose of this study was to identify and explore factors related to strategic control in the hospital systems.

This analytical study was conducted in 2016 on 425 experts from the Strategic Planning Committee of educational hospitals affiliated to Tehran and Iran University of Medical Sciences and experts in the field of strategic planning. Data were collected using a researcher-made questionnaire. Data analysis was performed based on exploratory factor analysis with SPSS 21 software. Data were collected using a researcher-made questionnaire. Data analysis was conducted based on exploratory factor analysis using the SPSS software version 21.

Results of the exploratory factor analysis showed that factors related to strategic control in the hospital system were five independent factors including infrastructure and external support (variance percentage 13.3), vision clarification and strategy and conversion to action (variance percentage 12.2), sharing and establishing data and knowledge flow (variance percentage 10.3), planning and setting goals (variance percentage 9.2), and strategic learning and feedback (variance percentage 7.5).

The results of the study showed that the strategic control questionnaire used in this study could be useful as a tool for assessing the accuracy of designing, implementation, monitoring, and evaluation of strategies in the hospital systems.

Today, the provision of medical services to international patients around the world has received widespread attention. This opportunity is being applied to increase GDP and raise quality standards for health care services in centers. In Iran, one of the government programs is the expansion of medical tourism. The purpose of the present study is to Design a technological Entrepreneurship-Based medical Tourism Model in Iran.

The present research is applied-developmental research in terms of its purpose. Due to implementation, it is a Quantitative covered in correlational type. Throughout the first step, to identify the indicators of technological entrepreneurship- based Medical tourism, fuzzy Delphi method was used and in second step, Quantitative -Descriptive-method was applied (Factor-analysis method to practice as well as hierarchical method for grading).

Indicators of Structural Factors with Score 0.382, professional factors with score 0.250, management factors with Score 0.160, Staff Support with Score 0.101, External Factors with Score 0.064, and Inter-Organizational Interaction with Score 0.043 are in the most Priority, respectively.

The results showed that six major indices and 26 sub-indices were introduced as the most significant indices of Entrepreneurship Based Medical Tourism. Applying the mentioned indices is effective in developing and expanding medical tourism industry and can provide supports to the managers and policy makers of the industry.

Social responsibility is a concept in which organizations pay particular attention to environmental and social issues in its business processes. The purpose of this study was to investigate social responsibility dimensions in public hospitals affiliated to Mashhad University of Medical Sciences in 2019.

In this cross-sectional and analytical study, social responsibility and its dimensions in 13 public university hospitals of Mashhad were examined using a questionnaire based on 273 samples of staff and customers. Data were analyzed using descriptive statistics (frequency, mean, and standard deviation) using SPSS software version 11.

The highest mean score (2.40) was related to leadership and internal processes, and the lowest mean score (1.83) was related to workplace dimension. The other average scores from highest to lowest were: environmental dimension (2.08), market dimension (2.01), and community and country dimension (1.92). Overall, the social responsibility of the hospitals under study was significantly different from the mean level of 2 (2/05), and considering the positive t-statistic for comparing a sample, it can be concluded that social responsibility was significantly higher than the average level (p-value ≤ 0.05)

Improving the employment status of employees as the most important social capital is very important, which had the lowest score in this study. According to the results of the research, the existence of discrimination and work shifts reduced the satisfaction in this dimension. Lack of employee awareness has been the most important reason for the decrease, which can be promoted by increasing the awareness of employees in this dimension.

Nowadays, green human resources management is one of the new approaches which isconsidered in all organizational and managerial fields. The health sector needs green human resources management to improve service quality more than other fields. Thus, the purpose of this research was to present a green human resources management model in the health sector.

The research method was a qualitative grounded theory, and the participants were28 health-related people in Isfahan in 1398. They were selected through the purposive sampling method, and in-depth semi-structured interviews were used for them. In order to analyze the data, open, axial, and selective codings were utilized.

Data analysis led to identifying the following items: 51 preliminary concepts, 16 central themes of structural context (software and hardware), attitude to health, health-oriented policy, social responsibility, cooperative culture, for-profit actors, managerial view of health, materialistic and meta-materialistic requirements, lifelong learning, competition opening, investment, health-oriented associations, employee empowerment, crises management, and the formation of health-oriented governance which formed the central theme of the research, i.e. "Green Human Resources Development as Sustainable Health Development". Moreover, in order to validate the findings, the analysis process was rereviewed and the opinions of five experts outside the research were used. Finally, all the main themes were incorporated into the paradigmmodel of Strauss and Corbin.

Given the views of the experts, it can be concluded that using green human resources management is implementable in the health sector. In addition, serious attention must be paid to its different aspects such as employee empowerment, hardware and software platforms, various investments, and specialized personnel.