فهرست مطالب

Journal of Health Management and Informatics
Volume:5 Issue: 4, Oct 2018

  • تاریخ انتشار: 1397/07/25
  • تعداد عناوین: 5
|
  • Fariba Askari, Nahid Maleki, Saghooni, Eisa Nazar, Zahra Hadizadeh Talasaz, Ali Vafaee Najar * Pages 119-124
    Introduction
    Reducing maternal and neonatal mortality requires improved care quality; the aim of this study was to determine various dimensions of the quality of services in maternity wards in Iran from the patient’s perspective.
    Methods
    In this cross-sectional study which was conducted from April to October 2017, 363 patients were selected from maternity wards of five hospitals affiliated to Mashhad University of Medical Sciences by convenience sampling method. Data collection tools consisted of the SERVUSE (Service Usability questionnaire), including 51 items in 6 dimensions of services quality; its validity and reliability were determined in previous studies. Data analysis was performed using SPSS, version 20. The analysis was performed using descriptive and inferential statistical methods including Wilcoxon, Kruskal Wallis and Mann-Whitney tests. The significance level in all the tests was considered 5%.
    Results
    The total mean scores of the patients’ expectation and perception were 19.10±2.14 and 15.11±4.25, respectively. The highest expectation and perception were related to the usability dimension, and the lowest expectation and perception were related to reliability dimension. The differences between the median score of perception and expectation for all dimensions and total median score of perceptions and expectations were statistically significant (P<0.05, using Wilcoxon test). There were no statistically significant differences in the median score of the gap between the patient’s expectations and perceptions at the levels of demographic variables (P>0.05, using Mann-Whitney and Kruskal Wallis tests).
    Conclusion
    It seems that the service quality of maternity ward of hospitals was approximately unsatisfactory from the patients’ perspective, and they had high expectations in maternity wards of hospitals. Since maternity service quality is critically important, improvement of quality requires management, concordant participation, and efforts of the hospital and staff at all levels of the medical facilities and convenience.
    Keywords: Hospital, Maternity, SERVUSE model, Quality, Iran
  • Zahra Ghanavatinejad, Mehrdad Askarian, Charles John Palenik, Nahid Hatam *, Payam Farhadi, Haleh Ghaem Pages 125-136
    Introduction
    Hospitals are complex organizations faced with continuous fundamental changes complicated by expertise diversity. The aim of this study was to investigate the factors influencing hospital employees’ resistance to change.
    Methods
    This cross-sectional study included 510 employees working in hospitals affiliated to Shiraz University of Medical Sciences; they were selected using stratified random sampling. Data were collected through a questionnaire. A structural equation modeling technique using LISREL Version 8.8 tested the hypotheses and conceptual model.
    Results
    Results indicated that dispositional resistance to change and involvement with change directly affected the employees’ resistance to change. Perceived benefits of change to involvement in change were significant (T-values >1.96) and the hypotheses related to these paths were accepted. Perceived benefits of change indirectly affected the employees’ resistance to change by influencing involvement. Dispositional resistance to change and involvement in change (mediator variables) were estimated 0.89, 0.03, and 0.47, respectively.
    Conclusion
    The study results indicated that hospital managers should encourage the employees to actively participate in their change program by strengthening perception of the benefits. This could help reduce the employees’ resistance.
    Keywords: Change, Resistance, Benefits, Involvement, Hospitals, Employees, Management
  • Gholam Reza Jamali, Payam Farhadi *, Elham Behbudi Pages 137-144
    Introduction
    Proper management of health systems requires the use of a suitable decision making logic. Simulation is a good tool for accurate and evidence-based decision making. The main objective of this study was to developing a simulation model to minimize the waiting time of patients in the cardiac subspecality clinic of Kowsar Hospital.
    Methods
    This is a cross-sectional study. The statistical population consisted of 576 patients, referring to Kowsar cardiac clinic in the morning and afternoon shifts. Data collection was conducted according to a designed timetable form. Scenarios were defined to receive the best answer. These scenarios were as follows: scenario A: decrease of the average of the service time; scenario B: increase of the mean time between the two entries; and scenario C: decrease of the service time and increase of the time between two entries. ARENA software was used to simulate and review the scenarios and General Algebraic Modeling System (GAMS) softwarewas used to obtain a definite answer.
    Results
    Simulation results showed that in scenario A the mean time spent in the system was 85.55 minutes in the morning and 77.05 minutes in the evening shifts. In scenario B, the average time spent in the system was 65.95 minutes in the morning and 79.63 in the evening shifts. In scenario C, the mean time spent in the system was 73.90 minutes in the morning and 61.17 minutes in the evening shifts. The result of the final model showed that the average time spent in the system was 97.33 min in the morning and 86.85 min in the evening.
    Conclusion
    According to the results obtained from the use of the definitive and simulated models, it was found that the simulation model, due to its probability, faces a percentage of error. Comparison of the definitive and simulated models revealed that the best scenario to the definitive answer was scenario B (increasing the mean time between the two logs).
    Keywords: Clinic, Waiting time, Queuing theory, Simulation
  • Zahra Kavosi, Habibollah Ranaei Kordshouli *, Maryam Zare Saadabadi, Azime Ghorbanian Pages 145-151
    Introduction
    Identification of the factors related to the employee’s job stress is very important in any organization, so in this study we investigated these factors by meta-analysis.
    Methods
    In this study, we searched the terms “job-related stress”, “employees’ job stress” and found 637 articles among seven English and five Farsi databases. After reviewing and screening these articles, sixty-three articles were finally selected. The selection criteria were based on the surveys which had investigated the correlation between job-related stress and other variables; also, just the variables that were investigated in more than four studies were included in this meta-analysis. The meta-analysis was calculated based on the correlation coefficients integrated with job-related stress and sample size by Stata 11 software, using Rosenthal-Robin method.
    Results
    The meta-analysis results suggested that seven variables had a significant relationship with the employees’ job-related stress (P<0.001). By increasing the workload, role conflict, role ambiguity, work-family conflicts, and total working hours per week increased the employees’ job stress, and conversely increased job satisfaction decreased the employees’ job stress; also, women were more exposed to job stress.
    Conclusion
    Organizations should pay more attention to time management training; the staff benefits from these skills and can use them in their business affairs and organize large volumes of work and work-family conflicts in order to reduce the impact of these stressors to a large extent. Also, description of the tasks that the employee is only obliged to carry out should be established.
    Keywords: Occupational stress, Job stress, Organization, Meta-analysis
  • Babak Behzadi *, Abdul Khaleq Keshavarzai, Mohammad Hossein Pour Pages 152-156
    Introduction
    There are different problem-solving courts for prosecuting medical offences due to the broadness of healthcare sector as well as the variety of offences in this sector. One of these courts in Iran is the Commission of Ta’zir Offences which prosecutes specific offences in this domain. Due to the implementation of National HealthCare Reform Program since the second half of May 2013, this study was carried out to compare the prevalence of Ta’zir medical offences in Shiraz University of Medical Sciences before and after the implementation of this program.
    Methods
    This was an applied, cross-sectional study. The sample size of the study included all cases related to medical offences argued in the cases of Commission number 11 in the Department of Governmental Discretionary Punishment of Shiraz University of Medical Sciences during two periods: before(15/2/2012 -15/2/2013) and after the implementation of Healthcare Reform Program (15/2/2015-15/2/2016). A designed form was used to collect data in which the medical cases available in the Department of Governmental Discretionary Punishment were recorded. Data were analyzed, using descriptive and inferential statistics including Paired-Samples T-Test. SPSS version 16 was used to analyze the data and the significance level was considered 0.05.
    Results
    The results showed that the total number of Ta’zir medical offences was 169 before the Healthcare Reform Program and increased to 431 cases after the Healthcare Reform Program. Employment of medical and paramedical professionals who had no legal work permit before the implementation of Healthcare Reform Program was significantly (P<0.05( different from that after its implementation ) Mean:2.5- Std-Deviation: 3.28-P=0.02 (and also additional patient fees (Mean: 0.91- Std-Deviation: 19.56-P=0.02).
    Conclusion
    It is recommended that the Iranian Ministry of Health and Medical Education should increase monitoring the physicians’ performance after the implementation of Healthcare Reform Program to prevent the violations of patients’ rights.
    Keywords: Violation of laws, Punishment, Healthcare reforms, Treatment, Iran