امین قاسم بگلو

Nurses play a crucial role as one of the primary pillars of the healthcare system. The training of proficient nursing staff incurs significant costs for the healthcare system, and their departure leads to irreparable harm across various sectors of their home country. The purpose of this study was to determine and prioritize the factors affecting the migration of nurses based on the opinions of hospital managers.

This quantitative study utilized hierarchical analysis through Expert Choice software to examine the perspectives of nursing managers from selected hospitals in Tehran, employing a census approach with a 95% participation rate.

Out of 57 participants, the psychological factor emerged as the most influential, with a weight value of 0.746. Within the realm of psychological factors related to the country of origin, the absence of spiritual and psychological support in the workplace, with a weighted value of 0.458, was singled out as the primary cause. Gender discrimination within the country of origin, carrying a weighted value of 0.193, was highlighted as the foremost individual factor. Moreover, environmental factors in the destination country, with a weight value of 0.765, outweighed those in the country of origin.

Upon analysis of the data, psychological factors were identified as the top priority, followed by economic considerations. Thus, policymakers and managers are urged to implement innovative strategies, recognizing the importance of addressing both psychological well-being and economic stability.

Turnover of nurses creates great problems in providing services to and the quality of care regarding patients. Organizational commitment and compatibility between personal and organizational values of nurses reduces turnover intention in nurses. The current research was conducted with the aim of investigating the relationship between organizational commitment and turnover intention, considering the mediating role of personal and organizational values.

In this descriptive study, the statistical population included nurses working in the hospitals of Tehran Islamic Azad University of Medical Sciences in 2023. 250 people were selected by simple random sampling method and responded to the questionnaires of  Kim et al.'s turnover intention, Allen and Meyer's organizational commitment, Scroggins' person-organization fit, and demographic questionnaires. . In order to analyze data, Pearson's correlation coefficient, bootstrap method, and Sobel's test were used in structural equation modeling with Amos software.

The results of path analysis showed that the direct effect of organizational commitment on personal and organizational value and turnover intention was significant, and the direct effect of personal and organizational values on turnover intention was also significant. Moreover, the indirect effect of organizational commitment on turnover intention was confirmed through the mediation of personal and organizational values.

The findings of the current research show the mediating effect of personal and organizational values on the relationship between the turnover intention and organizational commitment. It is suggested that nursing managers try to formulate intervention strategies to improve organizational commitment and compatibility of personal and organizational values of nurses.

The rapid growth of technology, demographic changes, increasing patients’ demand, and changes in the nature of diseases, increased competition among hospitals and healthcare providers, and constraints in budget allocation necessitate adopting a novel approach to the management of medical centers based on international standards.

This qualitative study was conducted in two stages by a content analysis approach in the year 2022 in teaching hospitals affiliated with the Islamic Azad University nationwide. The statistical population in the first stage included all studies addressing various aspects of the factors affecting the optimal management of hospitals. In the second stage, it included 10 executive managers of hospitals purposively selected as experts until reaching data saturation. The validity and reliability of the interviews were confirmed using the Lincoln and Guba methods. The data analysis method involved a comprehensive review of studies to identify factors affecting the optimal management of hospitals and a contractual content analysis to identify, analyze, and report themes.

In the first stage, a comprehensive review of studies was conducted, encompassing a total of 96 research papers, including 36 in Persian and 60 in English. Following the examination of the titles and abstracts of these research papers and aligning them with the predefined inclusion and exclusion criteria, a total of 18 studies were selected for final analysis, comprising 11 in Persian and 7 in English. After identifying the factors affecting the optimal management of hospitals, three main dimensions were extracted, including strategic planning (12 components), reengineering (8 components), and supply chain engineering (14 components) for the optimal management of hospitals affiliated with the Islamic Azad University using the content analysis method.

Managers should implement each of the identified components of strategic planning, reengineering, and supply chain engineering for the optimal management of hospitals in line with the hospitals’ structure. By examining the excellence and efficiency of hospitals over time, as well as evaluating the trends of each of them, they should take steps towards adopting reform policies and their experiences should be utilized in other hospitals.

Nursing is one of the most important occupations that play a key role in the treatment and improvement of patients. High work load and psychological problems can significantly reduce the quality of services and endanger the lives of patients and the health of the nurses. The study aimed to determine the relationship between the workload of nurses and their performance in the intensive care units (ICUs) of teaching hospitals in Tehran, Iran in 2017. This descriptive and correlational research was conducted on nurses of teaching hospitals in Tehran, Including Sina, Imam Khomeini and Shariati hospitals. In total, 188 out of 371 nurses were selected based on the Cochran Formula. Subjects completed the questionnaires of workload and performance of nurses. Data analysis was performed in SPSS version 20 using stepwise regression. In this study, 75% of nurses assessed their performance to be favorable. According to the results of the stepwise regression, the subscale of workload was able to predict 39% of the performance of nurses. According to the results of the study, there was a reverse relationship between occupational performance and workload of nurses since the increased workload of nurses working in ICUs reduced their performance.

One of the objectives of each system is cost of management and costing to help the organizations to provide high quality goods and services at a competitive environment. The present study was done to computing of cost price of hospital services at the NICU section of according to activity-based costing (ABC) method. This is a cross-sectional study. The costing of hospitalization was calculated based on activity at the Bent-Al-Hodi hospital of Bojnourd in 2015. The data was collected by observation, interview and review of documents and records. Data were analyzes according to activity-based costing (ABC) method using the Excel software. In this study the costing of provided services by the NICU section was 37/292/952/569 Rials, equivalent to 13.6% out of the total of costs of hospital. 76.45%, 1.44%, 21.24% and 0.87% of the costing were related to staff compensation, materials and consumables, indirect overhead and expenses direct overhead respectively. The cost of one-day hospital bed occupied by a patient was calculated about 8,609,905 Rials The Majority of the costs of the NICU service is consist of the costing of staff services charge. Hence, optimal use of resources and staffs help to increasing productivity and more services as well. Usage of the proper consumption patterns in equipment and materials can have a huge impact on decreasing of the cost price.

Hospitals need performance evaluation systems for development and competition in order to evaluate the effectiveness and efficiency of their plans, processes and human resources. The objective of this research is to design an evaluation system at hospitals through the use of the Balanced Scorecard. Methods and Materials: In this comparative study, the selected countries consisted of Australia, USA, Canada and New Zealand, and 34 public hospitals of Iran which were applying strategic planning. Performance evaluations were examined in terms of 6 aspects including mission, vision, strategies, perspectives, objectives and measures. A pattern was designed for performance evaluation of public hospitals in Iran and was validated using experts’ survey of DELFI method. All countries had mission and vision as important aspects of their performance evaluation model while health effectiveness promotion was the most important strategy. High quality health services, resource development, innovation and guaranty in continuous services were other strategies. Perspectives of Balanced Scorecard included customer, internal processes, learning and development of staff and financial affairs. All of the countries had objectives and measures for each of the perspectives. Iranian hospitals had mission, vision, strategies and objectives but for them perspectives had not been defined and measures were not congruent with strategies and objectives. In the model, 4 perspectives were determined to describe hospital strategies and to use competition benefits as well. Applying measures of 4 perspectives including "Patients and Community", "Internal process and Productivity", "Growth and innovation" and "financial aspects" to doevaluation of Iranian public hospitals collates their performance, improves productivity of their resources and enhances patients and community satisfaction.