مجله مدیریت بهداشت و درمان
سال دوازدهم شماره 4 (پیاپی 42، زمستان 1400)

Today, the issue of development is considered by many countries and one of the basic requirements for achieving balanced development is the issue of good governance. Therefore, the present study was conducted to evaluate good governance in terms of quality, effectiveness and responsibility in the health system.

This study was a comparative study. In this process, the study of the governance of the health system in the organizational dimensions of quality, effectiveness and responsibility was conducted in seven selected countries of the world and Iran. Data were described, interpreted and analyzed after collection. In order to find articles and information documents in Persian and English databases, reputable sites of the World Health Organization were searched.

The results of the study of selected countries and Iran showed that all countries to improve the quality and effectiveness of services, have paid special attention to electronic systems and information technology, in terms of responsibility, the results showed that In Singapore, Turkey and Iran, the multiplicity of responsibilities of the Ministry of Health is an obstacle to the performance of their core tasks.

The current model of governance of the health system of Iran and developing countries with similar health systems creates challenges in achieving the goals of the health system. The development of an integrated model of the health system and the development of comprehensive system standards for the evaluation and accreditation of health services are proposed for the governance of the health system of these countries.

The issue of security is very important from the perspective of ensuring the safety of hospital staff and patients. In this study, we have tried to study security in hospitals from three aspects (physical security, social security and information security) and identify the leading challenges.

This study was conducted in two stages: qualitative-case and quantitative and with field-survey method. In the qualitative section, using targeted sampling method and snowball method, 14 experts in this field (managers and security officials of hospitals) were identified among the statistical population and interviewed in a semi-structured interview. Using the findings of the previous stage in the quantitative stage, a closed questionnaire with a 5-point Likert scale was designed and random sampling method was used to determine the statistical sample. The statistical population of this stage was 35 people. The obtained data were analyzed using descriptive statistics and SPSS software.

By designing the questionnaire, it was found that the existence of emergency response equipment and the safety of sensitive paper documents in the field of physical security, physical protection training for security guards and physical violence for nurses in the field of social security, antivirus updates, hospital entry and exit control, Restricting network access and storing cameras had the greatest impact on information security in the hospital.

Creating the necessary infrastructure to provide a physical security system and equipping the surveillance network can be effective in maintaining physical, social and information security.

In this study, the effect of human resource information systems on employee innovation capacity with the mediating role of human resource management functions and employee creativity has been investigated. Human resource information systems are a set of tools that enable managers to achieve the goals of the organization by implementing the functions and tasks of human resource management and using the human resources of the organization and determine the extent to which the goals are achieved. This is a descriptive-causal study and its statistical population is all Iranian companies in the sixth Iran Pharma exhibition in 1400. In this study, by presenting a conceptual model and proposing related hypotheses in the study population, the opinions of 194 employees of pharmaceutical companies were examined and the data collected by Smart-PLS software were analyzed. Based on the results of this study, human resource information systems had a positive (β=0.511) and significant (t=7.449) effect on the innovation capacity of employees in pharmaceutical companies. In addition, the variables of human resource management functions and employee creativity with an impact factor of 0.209 and 0.085, respectively, play a mediating role in the relationship between human resource information systems and employee innovation capacity. The results showed that the use of human resource information systems improves the innovation capacity of employees in these companies. In addition, the mediating role of human resource management functions and employee creativity in the relationship between the use of human resource information systems and staff innovation capacity was also confirmed.

Due to the importance of blood as a vital element in the health system, in this study, the blood supply chain is modeled at three levels of donors, banks (blood centers) and hospitals in the form of a multi-objective model to minimize total costs, total delivery time of blood units and non-estimated demand of hospitals in each period.

The present study is applied in terms of purpose and descriptive and quantitative in terms of method. The data needed to implement the real problem in 2021 have been collected by through the regional office of the Tehran blood transfusion organization along with the Negareh system. Due to the Np-hard nature of the problem, the proposed model is solved using three algorithms of GA, NSGA-II and MOPSO in GAMS software.

In the proposed model, matching the blood type in meeting demand; blood type delivery and allocation system in laboratories and blood banks, blood wasting in laboratory, transfer of products between demand centers, sensitive and determinative parameters of the model such as; demand, blood donation and delivery time of blood products between network components are considered indefinitely. The findings show that the MOPSO algorithm has a better performance in problems 3, 7, 10 and 12 for the QM index, but generally, based on running times and their average, the NSGA-II algorithm is better.

Based on the results, the proposed model leads to a reduction in total costs, total delivery time of blood units and unapproved demand of hospitals.

Counterfeit drugs kill many people in the world every year. With the introduction of blockchain technology in the drug supply chain, the basic problem of this system, which is the existence of counterfeit drugs, will be solved. The purpose of this study is to investigate and identify the effective indicators in the use of blockchain technology in the drug supply chain.

In this paper, the meta synthesis method has been used to investigate and identify the effective indicators in the use of blockchain in the drug supply chain. meta synthesis is a qualitative research method. The data collection tool is library studies and research background research. In this regard, first 7770 original articles were found, of which, after reviewing the relevant titles, 102 articles remained and the rest were deleted. In the next step, by reviewing the abstracts of articles, 6 articles were deleted and 96 articles remained. Finally, 89 articles were selected by reviewing the content of the remaining articles. Validity and reliability were checked and finally, the data were entered in Excel software and the average percentage of blockchain indexes in the drug supply chain was calculated by the elites.

Using selected articles and experts' opinions, the following six main effective indicators were obtained. Smart contract, simplification of international transactions, identification, supply chain coordination, tracking and prevention of fraud in the pharmaceutical industry, permanent and secure storage of information, and balancing the pricing process and reducing costs.

At present, this technology is the best option for use in the drug supply chain due to the benefits of drug traceability, transparency, permanent and secure storage of information, elimination of intermediaries, cost reduction and unchangeable information.

In recent years, the country's health system has faced numerous problems that have caused dissatisfaction among the people. The Ministry of Health launched the Health System Transformation Plan with the aim of protecting people from health costs, improving quality, and increasing access to health care. The aim of this study is to investigate the effect of health system transformation plan on the time of providing emergency services in Hazrat Rasoul Hospital.  

The statistical population of this study included all patients referred to the emergency department during the years 1391 to 1395. In order to investigate the effect of the design on the time of emergency treatment, interrupted time series analysis and Stata software have been used has been used. This method allows us to show the short and long-term plan for the duration of service.

The research of this study showed that the implementation of the transformation plan in the short-term does not have any impact on the waiting time but in the long-term significantly (P<0.01) has reduced the waiting time for the visit, the first treatment, preparation of the test result, receiving the test result by the doctor, receiving the final test result, receiving the ECG result, receiving the ECG result by the doctor and Receiving the final result of the ECG in Hazrat Rasool Akram Hospital.

Findings of this study can be useful in managing the waiting time of patients to receive services after the implementation of the health system transformation plan.

Cultural competence, which is the ability to respond to cultural diversity within health care systems. The aim of this article was to identify the factors affecting the cultural competence of physicians and nurses of government organizations in the health sector of Iran.

To analyze the research literature, the Meta-synthesis method was used, then using the opinions of 10 organizational experts with a questionnaire, the two-stage Delphi method was used to finalize the model.

In the first phase, with a systematic review of 198 documents, which after refinement reached 32 and by reviewing these studies, we obtained 7 effective indicators and 26 sub-indicators affecting cultural competence, which in a questionnaire of 10 experts In the first round, the Kendall coefficient is ./512  It was obtained by removing a factor that had less credibility from the experts' point of view, as well as correcting 3 other factors, and finally in the second round of Delphi, the number ./704 It was found that it indicates the high validity of these indicators.

Indicators of cultural diversity, cultural attitude, cultural desire, cultural humility, humanistic competence, educational readiness and organizational support are the seven final indicators. The application of the extracted model of cultural competence in public health can be a tool for Assessing and prioritizing the cultural competence of medical staff in the public sector of Iran and its results should be the basis for taking managerial measures for organizational reform and improvement.