Journal of Health Management and Informatics
Volume:7 Issue: 3, Jul 2020

This study aimed to assess the role of nurses in the Covid-19 pandemic and the way a nurse can help the health system in this regard.  

This is a qualitative research using content analysis in 2020. The aim of this study was to elucidate the key role of nurses in the COVID-19 epidemic and the determinants of a professional nurse during an epidemic/pandemic crisis using virtual expert panels consisting of experts in the field of nursing, health care management, and psychology. Data were analyzed using the thematic analysis approach.

The findings show that nurses in the coronavirus pandemic can have 4 main duties such as professional, spiritual and mental, health economics, and social roles. According to the present framework, the health economics, social and mental and spiritual roles together can determine and affect the nurses’ professional role. These professional nurses can be able to provide necessary cares during COVID-19 pandemic.     

In the crises like COVID-19 pandemic in which medical sciences alone cannot treat or alleviate the condition, as seen worldwide, among professional, spiritual and mental, health economics, and social roles, the spiritual and mental role may be the most important part a nurse can play.

Accreditation is one of the standard assessment systems in hospitals used for its importance, efficiency, and critical role in improving health care services. According to the statistics, one of the primary accreditation axes is the management and leadership axis. Considering the close relationship between management and clinical issues in hospitals. This study aims to evaluate the realization of the management and leadership unit in Shiraz hospitals.   The research population in this applied field study includes 33 public and private hospitals in Shiraz (i.e., charitable, military, and affiliated hospitals). According to the Ministry of Health's announced checklist, all data was gathered from the hospital accreditation program during 2017 (the latest overall accreditation) completed by trained assessors. The accreditation certificate was issued. All data regarding Shiraz hospitals were collected from the accreditation portfolio of hospitals after obtaining the necessary permits. Data was analyzed in inferential levels using SPSS25 software. The study results demonstrated that the average percentage of realization of the sub-axes of the governing team, executive management team, quality improvement, error management, disaster risk, and human resources management in public hospitals were higher than those of private and affiliated ones. The average percentage of realization of the sub-axes of supply and accommodation management and food management increased in private hospitals than those of the public ones. The results showed that the average achievement percentage of six sub-axes was higher in public hospitals than the private and affiliated ones. Therefore, it reveals that public hospitals have paid more attention to infrastructural issues while working on the leadership axis than the other hospital types. The higher achievement percentage is necessary to deliver better service to patients. The public hospitals manifested a better performance in meeting the standards of this axis. The study conducted on these criteria showed that infrastructural issues had been paid more attention while being developed. Meanwhile, it is also required to pay more attention to the promotion of the processes as well as infrastructural matters to improve the level of safety and the services provided to patients

Identifying the causes of nursing errors based on the nurses' lived experience.

Nursing errors have adverse consequences,including risk of health,death and disability,prolonging treatment period,increasing treatment costs,and increasing disrespect for nursing system and treatment centers.

This research was performed qualitatively through a descriptive phenomenological method.Samples were selected from nurses of hospitals with the highest nursing errors reported.Purposive sampling was carried out in accordance with the benchmark and continued until saturation of information with ten people.Data gathering tool was an individual,in-depth,semi-structured interview;accuracy and robustness of data were confirmed by the standards of Lincoln and Guba (1985).The results were analyzed by Colaizzi method.

The causes of nursing errors were classified into 7 clusters and 18 categories.Main clusters extracted included organizational,task,interpersonal,hardware,environment, individual, and diagnostic causes.

Nursing errors cannot be simply attributed to agency; the structure and context also contribute to it.There are suggestions for controlling and addressing the causes of error. This paper shows that nurses' experiences are an important source for identifying the causes of error;many factors that may not seem to affect nursing errors have been identified as an influencing factor which can reduce the incidence of nursing errors if understood by administrators and supervisors.

The costs of the eye care services are considered as one of the most important obstacles to timely diagnosis and treatment of eye disorders, but there is  little evidence about patients’ cost for receiving these services. This paper aimed to investigate the costs paid by patients for eye care services in Tehran hospitals. 346 patients referring to ophthalmology wards of Tehran's educational hospitals were selected throughconvenient sampling method. The data were extracted through researcher-made checklist and investigating the hospital bills in 2017. Then, they were analyzed using descriptive statistics methods, as well as Mann-Whitney and Kruskal Wallis tests in SPSS 21. The share ofhospital bills, informal payments like bought & brought goods, and non-medical costs were 32.8%, 1.85%, and 66.06%, from the total cost paid by patients, respectively. Further, 10.24%, 83.1%, and 6.85% of medical costs were paid by patients, insurance organizations, and government, respectively. Age (p=0.008), type of basic insurance (p=0.000), and the type of the treated disorder (p=0.000) affected the patients' medical costs. On the other hand, the level of income (p=0.001) and place of residence (p=0.001) variables caused significant differences in the total costs paid by patients. The patients’ out-of-pocket payments for ophthalmology services are evaluated as reasonable. Nevertheless, a large share of the total costs paid by patients was non-medical ones. Improving equity in geographical access to ophthalmology services across regions of the country can reduce non-medical costs and increase the possibility of benefiting from the needed ophthalmology services for all population.

The purpose of the Electronic Healthcare Record is to improve the service quality by reducing medical errors, prevention, monitoring, diagnosis, prioritization, treatment, follow-up, provision of effective ways to communicate and share information between health care providers, and better health information. While benefiting  EHCR, physicians just like to practice medicine. These changes have created a new level of complexity that makes physicians feel frustrated and dissatisfied with medical practice. Therefore, one of the factors that affect EHCR is the physician's authority, which  affects the acceptance or non-acceptance of EHCR. The present study aimed to investigate the effect of using electronic health records on physicians’ authority. Qualitative data collection was performed by a semi-structured interview with eight physicians, three specialists and four psychologists. The data collected show the users’ perceptions of the impact of EHCR on the physicians' careers. All participants experienced the use of EHR in the health care system. A total of three dimensions were identified to assess the impact of the perceived threat of professional independence on the physician’s acceptance of EHCR, increased managers’ control, loss of professional privacy and professional authority, data trust, and security. When technology negatively affects the job roles, professional status, and independence, resistance is more likely to occur. The results of the study show that the design and implementation of EHCR should be in a way that does not threaten the autonomy of physicians. If the electronic health record system is designed and implemented without regard to the issue of autonomy, it will be nothing but a "cookbook" for doctors, and they will not welcome it.

A management information system (MIS) can have a great effect on the effectiveness and efficiency of management in different centers. Various conceptual models are used for designing, implementing, and evaluating this system. The Soft Systems Methodology (SSM) is one of those models in which the underlying and effective factors of an MIS are identified, evaluated and clarified, making it possible to design, implement, apply and evaluate the system by using different techniques and the opinions of different experts and managers and reaching a consensus among different attitudes. In this model, the designer and all stakeholders participate in the system; identify the needs, expectations, possibilities, and problems; and offer step-by-step solutions to implement the MIS.  The purpose of this study was to investigate the possibility of using the conceptual model of soft systems method to design and implement information management system in incubators of medical universities. This is a practical descriptive study conducted during the period 2017-2019. This study showed a significant difference in all selected indices (P-Value <0.05). It seems that all the indicators have been improved and the implementation of a comprehensive management information system has had a positive effect on their improvement, but there is no significant difference in the index of increasing creative work efficiency (P-Value> 0.05).  It was concluded that, among the conceptual models, the SSM can be used as an appropriate model for implementing an MIS, and the system developed in this project is efficient enough to be used in the management of the incubator.

The health systems around the world are facing significant pressure to control the costs and improve the health services delivered. A method to address this challenge is to express the potential savings and inefficiencies of hospitals. The hospitals should provide health care services with the acceptable quality and minimum cost. For this purpose, managers should have accurate information about the cost of the services they provide.

This is a cross-sectional retrospective study  carried out based on the data of financial year of 2017-2018. In this study, the cost structure of Shafa Hospital was analyzed and its unit cost of the final activity centers was calculated using top-down approach.

The total cost of the hospital in the studied period was US$ 29752539.1. The highest and lowest cost share was related to human resources and energy consumption (64.33% and 0.48%, respectively). The human resources, medicines, and consumables account for over 96% of the cost of the final clinical activity centers. The unit cost of the final activity centers varies so that among admission wards the unit cost of ICU is the highest (US$372.45) and the daily bed cost in the neurology ward is the lowest (US$118.9).

Clarification of the hospital cost structure can provide a comprehensive analysis of hospital costs for decision making and policy making. The unit cost of the final activity centers also provides insights into the hospital cost management planning.