Journal of Health Management and Informatics
Volume:9 Issue: 2, Jun 2022

Health systems have been exposed to innumerable challenges by COVID-19.The present study aimed to detect nursing challenges during the COVID-19 pandemic. This qualitative study was conducted in 2021; 26 subjects were selected using thepurposive sampling method and interviewed. Data saturation was reached after analyzing thedata collected from 26 semi-structured interviews. The collected data were analyzed using thecontent analysis approach with MAXQDA software version 10. Three main themes and some subthemes were extracted: “Managerial challenges,”“Educational challenges,” and “Individual challenges”. Some managerial challengesencompassed the following subthemes: lack of adequate workforce and equipment, nontimelypayment of claims, and employment of non-specialist personnel instead of nurses.Educational challenges encompassed the following subthemes: virtual training, lack oftraining, lack of training on commitment to the profession, lack of training to work inparticular wards and training in dealing with critical patients. Furthermore, some individual’schallenges contained the following subthemes: decreased job motivation, fear of illness,stress, and anxiety. An analysis of the themes and subthemes in this study indicated that there weremanagerial, educational, and individual nursing challenges during the COVID-19 pandemic.It is, therefore, recommended that policymakers and senior managers of the health systemformulate and implement programs at the micro- and macro-levels to address the detectedchallenges.

Substance use disorder has led to various psychosocial and health-relatedproblems worldwide. The solution for reducing negative consequences associated withsubstance use is Methadone maintenance treatment (MMT). This study aims to design amanagement model in the centers for substance use disorder treatment in Shiraz, Fars, 2019. This qualitative research is a grounded theory (GT) study using Strauss and Corbin’sstrategy for data collection. We used a theoretical approach of sampling and interviewed 21staff members of MMT centers. Data analysis was simultaneously done with data collection. After analyzing all the interviews, we defined treatment challenges as the central issuein MMT centers. Also, we determined causal conditions, context, and intervening conditions.Causal conditions include weakness in supervision, insufficient training, technicians’weaknesses, and underestimation of the importance of prevention. Poor teamwork, lack ofmotivation, and inappropriate personnel competency were among the interventional factors.We found that contextual factors were due to inefficient public policies, limitations in issuingnew licenses for new centers, and insufficient income centers. At last, we extracted the initialperformance management model. To sum up, people who apply for work in MMT centers must take specificpsychological tests before recruitment. To increase efficiency, MMT centers need financialand economic support. Developing more MMT centers and, at the same time, expandingrecovery programs such as social aid, psychotherapy, and medical care will help build ahealthy environment and encourage the abusers to return to everyday life.

One of the most complex decision-making problems for managers is evaluatingthe performance of hospitals using various criteria. To do this, we first divided the indicators into four categories using the BalancedScorecard (BCS) and then analyze the indicators using the Data Envelopment Analysis(FDEA) method. First, all the relationships between the four perspectives were obtainedusing the DEMATEL method and this network structure was used to create the DEA networkmodel. Satisfactory performance evaluation indicators have been selected by reviewing theliterature and opinions of hospital managers and physicians with real practical experiencesin medical professional ethics. Then, the causality between the four BSC perspectives as wellas the relative weights between the evaluation indicators were determined using test anddecision evaluation (DEMATEL), respectively. The average efficiency of medical professional ethics based on the results ofgrowth and training stage was 84.73% , internal process stage 92.09%, capital stage 100%,and financial stage 95.81%, based on the designed model of an input and output. The stepswere obtained. The results were below the overall performance evaluation of the hospitals.General performance of hospitals (DMU) No. 1, 3, 5, 8, 12, 13, 17, 21, 22, 23, 24, 25, 27, 28,29, 30, 31, 32, 33, 35, 36, and 37 were obtained 100%, and 2 hospitals were 92.9% efficient, 4hospitals 91.5%, 6 hospitals 58.4%, 7 hospitals 67.1%, 9 hospitals 95.1%, 10 hospitals 98.4%,11 hospitals 98.4%, 13 hospitals 92.6%, 14 hospitals 85.1%, 15 hospitals 88.8%, 16 hospitals94%, 18 hospitals 87.2%, 19 hospitals 86.3%, and 20 of them were 98/6% efficient. This study used the non-financial approach of medical ethics to evaluate theperformance of hospitals; it can be said that the method and type of perspective used arecompletely new.

The quality of care consists of several factors, one of the most important ofwhich is patient safety. Nursing error, which is an unintentional error, affects the safety andquality of patient care. This study aimed to determine the relationship between patient safetyculture, work environment index, and medication errors. This is a cross-sectional study in which 300 nurses were enrolled using stratifiedproportional sampling. The standard questionnaires of patient safety culture, workenvironment index, and self-made medication error were used to collect data. Data analysiswas performed using Mann-Whitney, Kruskal-Wallis, and Spearman tests through SPSSsoftware version 22. The mean scores of nurse work environment, patient safety culture, and medicationerror were 74.41±15.6, 144.94±14.82, and 38.96±6.04, respectively. A good relationshipbetween physician and nurse, sufficient number of nurses, and good patient safety culturewere directly related to reduction of medication errors. The results of this study indicated that the high level of patient safety culture andimprovement of the work environment of nurses can reduce medication errors. Therefore, byholding classes, workshops, and briefing programs, health managers can promote the patientsafety culture in hospitals.

Patient safety is one of the priorities in all care systems in the world. Unsafecare can cause harm to patients and increase the mortality and morbidity rate. Establishing anerror reporting system is one of the initial steps toward improvement in the quality of care inprimary health care. The aim of this study was to set and validate the first electronic reportingsystem for primary care in Bandar Abbas, Iran. To design and create an electronic error reporting system, we designed a datacollection form and validated it by the experts; then, the tool was designed and revalidated tocapture the errors and design automatic report forms. Finally, the modifications were madein the software. The software had been implemented in selected comprehensive health centersin Bandar Abbas for 8 months. The registry is designed to include two main sections, including general informationon medical errors (demographic information, type of event, error severity, error occurrencelocation, pre-error training, preventable error, causes of error, error identification source,and error detection time) and classification of medical errors (care errors, vaccination errors,environmental and occupational health errors, laboratory errors, and imaging errors). Managing medical errors successfully needs the establishment of a voluntaryreporting system and addressing barriers to reporting errors. This innovative error registrysystem of primary care was created to collect, analyze, and disseminate information about thefrequency, types, and causes of medical errors in primary health care.

Health Sector Evolution Plan (HSEP) is regarded as one of the most dominantreforms in the health system in Iran. This study aimed to review the agenda setting of Outof-Pocket Payment (OOP) reduction in HSEP plan by using the multiple streams Kingdon’smodel. This is a qualitative study conducted through ten semi-structured interviews.Sampling was purposeful and continued until reaching data saturation based on snowballsampling method. To formulate a theoretical structure and review the potential explanations,we used the framework analysis. A higher proportion of growth in OOP expenditures and catastrophic health costsamong Iranian population in the years 2002-2012 was identified as the Problem stream.Emphasis on establishing an equitable financing system to reduce the problems of gettingaccess to health services based on population health needs led to the Policy stream whichhas been considerably supported by the Islamic Consultative Assembly and Iran Ministry ofHealth and Medical Education. Such supports were made possible by approving the budgetin 2014 and allocating appropriate resources (Political stream). By examining the method of setting the policy of OOP reduction as agenda, wecan make a precise analysis of the basis of this policy, and by emphasizing these three streamsin order to introduce corrective policies, we can improved it, if necessary.

 Based on predictions by the World Tourism Organization, the future of the world economy and international trade market will be dominated by the tourism industry, especially between 2020 and 2030.  Medical tourism, as a fast-growing and accelerating industry, will be a major contribution to the future of the tourism industry. This study was conducted with the aim of morphological analysis of the factors and key uncertainties affecting medical tourism in Yazd, Iran.

 The present study identified the key factors and uncertainties of medical tourism in Yazd using a mixture of qualitative and quantitative methods. The research sample included 24 experts selected using purposive sampling method. The data collection instruments were interview and a questionnaire. Qualitative content analysis and morphological analysis were used to analyze the data through SPSS21.

 After analyzing the interviews, 19 themes for capacities and 23 themes for obstacles were extracted. Then, 41 factors, prioritized based on two criteria of importance and uncertainty, were identified using Likert scale. In the second stage, 9 out of 41 factors that had more uncertainty and served as drivers were determined by experts.

 According to the results, it is recommended that a comprehensive medical tourism Plan should be prepared for Yazd province based on the drivers identified in this study and introduce the medical tourism capacities in Yazd to the target countries.

The health care system is one of the most complex systems in the industry. The processes of this system include a set of activities such as; prevention, diagnosis, treatment, and rehabilitation of their clients. To simplify, facilitate and provide high-quality healthcare services, it is recommended that the current processes are drawn and then its challenges and bottlenecks such as long waiting times for services, increased costs and customer dissatisfaction in dealing with them identified and analyzed. Using process mining and its methods in the health system is one of the practical and affordable ways to analyze, modify, and improve processes. Therefore, it seems that due to the numerous capabilities of the process mining in the health system, its implementation can lead to improved healthcare quality, increased service, reduced waste, and time and resources wasted, and ultimately increased patient and therapist satisfaction. In this regard, the use of the mining process in the hospital information system (HIS) as a modern and suggested approach