نشریه مدیریت سلامت
پیاپی 80 (تابستان 1399)

Asthma is uncontrolled in more than half of asthma patients due to inadequate and incorrect management. The main reasons for inadequate management are non-adherence, inadequate knowledge of a general practitioner about patientchr('39')s clinical condition, and not following asthma management guidelines The purpose of this study was to develop a conceptual model for the asthma management system in primary care

In this study, according to the guideline of the Global Initiative for Asthma, workflows for the management of asthma were extracted. Then, the conceptual model of the system was developed with unified modeling language and evaluated by an expert panel, including five asthma and allergy specialists, three informatics specialists and two health information management experts who were selected through non-probability sampling method. Data collection tools were the discussion framework with open-ended questions that reached a collective agreement after discussion on the conceptual model. The collective agreements were applied simultaneously to the diagrams of the conceptual model.

The conceptual model was developed and evaluated in 10 diagrams, including business use-case, use-case, activities, sequences and class diagrams. The diagrams were reported after evaluation. The business use-case shows the main use-case, and the use-case diagrams show the more detailed use-case which is used for the system. The activity diagram shows how the patient was admitted, visited, and managed. The sequence diagram and the class diagram also present the order of asthma management operation, the objects required by the asthma management, and how they are related, respectively.

Given the validity of the conceptual model by asthma and allergy specialists together with informatics and health information management, it can be expected that the current conceptual model will significantly help to design and implement efficient systems that meet the needs of users.

Hospital administrators have always faced the challenge of providing the best possible health services in a resource-limited environment. The patient flow throughout the hospital is affected by lack of the capacities that can lead to bed-blocking among the hospital units. In this research, the patient flow in the hospital is modeled as an open queueing network with blocking. Then, the hospital capacity planning is implemented to reduce the blocking using a simulation-based optimization approach in such a way that the total cost will not exceed from the accessible budget.

This research is an applied research in terms of purpose, which is a descriptive-survey research in terms of data collection method. The data were collected during the first six months of the year 1396 in the selected hospital of Lorestan province. The research process is a combination of the bi-objective mathematical modeling and discrete-event simulation.

By analyzing the simulation results of the current situation, 43 scenarios were proposed to improve patient flow in the hospital units. Then, nine Pareto-optimal scenarios were determined by using the mathematical model on the simulation results of the proposed scenarios.

In order to facilitate the selection of the optimal scenario by hospital administrators, the Pareto-optimal scenarios were classified and analyzed in two categories. The integration of the simulation model with the proposed mathematical model can lead to developing a practical approach for capacity planning and improvement of patient flow which can be used by other hospitals.

Health centers around the world are facing significant pressures to increase productivity. Therefore, in order to improve the quality of services and to create competitive advantages in these centers, we need to implement lean principles. The purpose of this study was to identify and prioritize the key factors affecting the implementation of lean thinking in the field of health services.

This research is a kind of applied-descriptive study that was conducted in 2019. The data collection procedure included a questionnaire, articles, as well as interviewing experts. The study population included 15 managers, specialists, and experts in the field of health in five medical centers in Isfahan. After reviewing the literature, 16 factors influencing the implementation of lean thinking in the field of health services were identified and the most important ones were screened using the fuzzy Delphi method. Then, using the DEMATEL technique, the internal relationships between these factors were investigated and the most important ones were identified and prioritized using the Analytic Network Process.

The results indicated that "active leadership", "infrastructure of health centers", "staff resilience", "clear goals", "investing money and time", " staff participation", "step-by-step approach", "training", "monitoring and executing audits" and "paying attention to the concept of team" are respectively the most important factors for the successful implementation of lean thinking in health services.

In an effort to achieve success in implementing a pure system, health care organizations must strengthen leadership, provide the necessary infrastructure, and ensure adequate resource allocation. Management already needs to have clear goals in advancing projects. In addition, a step-by-step approach as an important way to improve project implementation can help to accurately understand the process of implementing pure principles.

Health tourism is a new form of marketing in the tourism industry which has been growing in recent years, health tourism is done to improve the health of people and to take them out of their place of residence.the aim if this article is presenting Health Tourism Model with emphasis on word of mouth advertising in health centers.

This study purpose is applied and in terms of collecting data is non-experimental and descriptive data. The researcher has attempted to identify the factors affecting the concept of health tourism by emphasizing the role of word of mouth advertising by qualitative method and using interviewing with twenty managers of Health Tourism Center, and academic experts and finaly data analyzed and presented by phenomenological approach

The researcher then analyzes the data through open, axial, selective coding of the final results of his research into a model, with six main dimensions, including market attractiveness, strategy, service diversification, internal conditions, word of mouth advertising, health tourism, and Thirty-three sub-dimensions have been presented.

According to the results, it can be said that decision makers can collect and categorize the factors influencing health tourism concept.

Economic constraints have made it difficult to provide health care facilities. Therefore, improving the performance management of employees in organizations is a very important issue, so this study was conducted to investigate the workload in the field of family health in health centers.

The present research is descriptive and cross-sectional conducted using combined methods (qualitative and quantitative). The study population included all activities of the family health unit of Savadkouh health centers. Interview and observation methods were used to identify activities and other qualitative parts, and Excel 2007 software was used to facilitate the above steps.

The total standard time for all activities in the study scope was 2107 working units. Clientschr('39') information registration activity in the Sib system with 482 work units had the highest, and the activity of referring a mother or child with developmental problems to the doctor with 0.3 work units had the lowest workload. The total number of work units calculated for the family health unit was less than the minimum required.

The findings of our study showed that the number of employees in the family health units was more than the required number, and there was a high unemployment rate. Every organization needs indicators or models such as the model presented in this research to improve its performance level in order to reduce the waste of resources and improve the efficiency of the relevant organization.

Health centers must can adapt quickly to catastrophic events, such as natural and human disasters. One way to face various disasters in health centers is to increase resilience. This study tries to identify the affecting factors on hospital resilience and the relationship between them, to design a comprehensive model of hospital resilience in the face of COVID-19 disease.

First, the affecting factors on hospital resilience were identified using a research background study. Then, through an interpretive structural modeling (ISM) technique, a relationship model among the identified factors was obtained. The conceptual model obtained from ISM was goodness of fit by using the Smart PLS3 software. For this purpose, a questionnaire containing 33 questions was administered to 80 managers, experts, and staff of Yazd training hospitals.

The results identified 8 general affecting factors on hospital resilience. The eight factors identified in this study were structured at 4 general levels by ISM. The initial level of the model consisted of "stability" and "communication system and information technology" factors. Also, the results of model goodness of fit confirmed the relationships formed by ISM.

The results of this study can be used by health managers for the countrychr('39')s hospitals resilience in the face of natural disasters and unforeseen accidents.

Drug supply chain management is recognized as one of the main factors influencing the performance of the health sector. The aim of this study was to prioritize factors affecting sustainable drug supply chain management in pharmacies of teaching hospitals affiliated to Iran University of Medical Sciences.

This applied, cross-sectional study was performed by using Delphi and fuzzy Demetel methods. To identify the factors affecting the management of sustainable drug supply chain in the pharmacies in question, a questionnaire was designed based on the supply-chain operation reference model and was distributed among experts to collect their opinions. The sampling method was purposeful. In the next step, fuzzy Delphi method was used to identify the main factors and then, fuzzy Dimatel method was applied to determine and rank the Cause and Effect actors.

According to the findings, 23 factors were identified in five dimensions(reliability,accountability, flexibility, costs and asset management). The factors consisted of 6 exogenous and 17 endogenous factors, 10 of which were Cause factors and 7 were Effect factors.

The most important factors identified in the present study were related to asset management and the highest number of factors were pertinent to accountability, indicating the poor response of the management system of the studied pharmacies. Therefore, addressing these two dimensions is more recommended in the management of pharmacies.