فهرست مطالب نیوشا شهیدی صادقی

Considering the necessity of learning from past experiences and continuous improvement in order to prepare development plans, the present study examines the challenges and strategies to implement health-related provisions in the first to sixth development plans. The current research was conducted in the form of a scoping review. Studies published in English and Persian 2000 until the end of November 2021 were reviewed. The search was done in the databases (SID, Magiran, Ensani.Ir, Irandoc, Web of Science, Scopus, Google Scholar, Pubmed) and related journals. 262 studies were obtained, after removing unrelated, duplicate studies and quality assessment, finally articles were selected for final analysis. CASP checklist was used to evaluate the quality. Conventional content analysis approach with Max-QDA 12 was used for data analysis. 262 studies were obtained, finally 16 articles were selected and analyzed. Challenges and solutions related to implementing the health sector development plans of the Islamic Republic of Iran in seven main dimensions including: the program development approach; Policy makers and executives; Execution and implementation of the program, program development, program monitoring challenges; Content of the program; and Lack of following the principles of planning and 51 sub dimensions were extracted that the lack of a clear definition of the concepts of development and development planning; Non-compliance of program provisions with general policies; Lack of meaningful and developmental supervision; Multiple goals and priorities were among challenges. Also, the corresponding solutions of each challenge based on the review of studies included 47 sub dimensions that the correct implementation of the principles of coherent planning, definition of appropriate indicators, mechanisms for gathering information, evaluation of the program, political support, creating a unified understanding between stakeholders, adapting the design of executive programs to infrastructure and moving to mixed programs were among the solutions. Human-centered approaches to development place a lot of value on health and believe that unless an efficient health system governs the society, societies and nations cannot achieve their economic and social goals. Therefore, discussions and planning in this area are very important; Therefore, the identified challenges resulting from this study and the solutions to overcome them can help to formulate, implement and finally evaluate the future development plans.

Similar to many countries, Iran is committed to achieving universal health coverage. As such several laws have been approved regarding rehabilitation services. Examining these laws shows that there are many legal challenges in the functions of the health system including procurement, financing, resource production, service delivery and accountability, and service quality. Also, the problems of governance in Iran include unbalanced policies and laws, irresponsible intervention, weak all-round supervision, lack of thoughtful and compassionate management, and inconsistency within and between departments. In addition, rehabilitation financing in Iran is unbalanced. In the third chapter of the law of the sixth development plan, the challenges and problems of supportive institutions, especially the lack of credit and coverage gaps were brought into attention. It was emphasized that the needs cannot be met with direct support approaches. Contrary to many countries that have specific laws for recording and analyzing information for disabled people, Iran is in its initial stages of forming a database for them. Furthermore, the comprehensive law on the protection of the rights of the disabled in 2013 is not a right-oriented law emphasizing the recognition, and does not guarantee their rights equal to ordinary people; instead, it has a welfare perspective on the issue. The presence of government organizations such as Ministry of Cooperatives, Labor and Social Welfare, and the National Welfare Organization has caused the law to become a support-economic with the dominant discourse of rehabilitation instead of empowering disabled people and becoming a budget-oriented law.

the present study evaluated the implementation of legal materials related to health in the Sixth Development Plan.

The present study was a triangulation combined study in 2022. The first stage was carried out with the aim of identifying the measures including documentary analysis, using the data collection form, and the data collected by the research team were refined separately and using contract content analysis. In the second stage, the evaluation indicators including the review of documents and the data collection form, the calculated indicators were sent in the form of a researcher-made questionnaire, and using experts meeting through the discussion framework. The third stage was conducted with using questionnaire approved and completed by three groups including the apparatus and its affiliated units, foreign experts and supervising experts.

Based on the findings, 122 indicators were used separately for legal clauses. The highest distribution of foreign experts’ scores was in percentages of less than 25 and 26 to 50, and this distribution was largely similar for observer experts. On average, the rate of progress of the verdicts was 49%, foreign experts 43% and the opinion of the apparatus with a large difference of 87%. About 60% of the opinion of the supervising experts and evaluators were similar. The focus of foreign experts has been more on outcome indicators. About 43% of the 122 indicators were part of the support document or quantitative indicators with the documents provided by the executive body.

Reviewing and evaluating the progress of development plans, depending on their generalities and details, can include very small to large indicators. Also, the use of three groups of evaluators, the use of different sources to enumerate the indicators, relying on official documents such as supporting documents and monitoring devices, as well as presenting the progress of program implementation separately for each of the legal materials are other strengths of this research.

This study was conducted via a systematic review of causes and solutions to reduce insurance deductions of hospitals in Iran. This study was conducted via a systematic review. The researchers reviewed studies that investigated the causes or solutions to hospital deductions or both of them up to 2017, based on keywords that included deductible, hospital, bill of insurance, and hospital records through databases, search engines, and related journals. The extracted data form for each article was completed and finally, the data were categorized, summarized, and analyzed. In the initial search, 114 articles were found. After reviewing the inclusion and exclusion criteria, 21 articles were analyzed. The main categories of the reasons for deductions were comprised of 15 areas that were classified into the two main areas of documentation flaws during the provision of services and the difficulties with the preparation, adjustment, and sending documents. Analyzing the articles for the reduction of deductions showed that these solutions were classified into 9 main areas of reforming the planning, training, monitoring, reforming the registration process, governance issues, reforming the documentation process, reforming the structure, complying with the rules of the insurance organization, and modifying the process. Computational errors, lack of hospital supervision, and errors related to the date and time of the documents constituted the main causes of deductions, and the reform of planning, education, and supervision were among the most important suggested ways to reduce deductions. Reviewing professionally related papers showed that specialist doctors and nurses are professionals who are more involved in making deductions. In terms of the type of offered services, the surgery, paraclinical services, and the drug were at the top of the reasons for deductions. The hospitals affiliated to the Ministry of Health, which are faced with the problem of inadequate hospital revenues, as well as chief executives, can benefit from the results of this study to understand the financial performance of these centers.

Training competent and capable human resources in order to meet community needs is one of the most important challenges of higher education. This research aimed to revise the curriculum of the Master of Science (MSc) level in health services management in order to meet the needs of health sector.

This study was carried out using quantitative-qualitative method. The first stage was conducted in a comparative manner, while in the second stage, structured interviews were conducted with a sample population selected through non-probability quota sampling. The data of the first and second stages were analyzed using Bereday model and content analysis, respectively, with the help of SPSS software.

According to comparative study, similarities and differences of 24 universities from 15 countries were extracted and compared with Iran. Then, stakeholders were identified at three organizational levels. In addition to changing the titles of some major courses, 25 specialized courses and 28 optional courses were categorized in eight priorities according to their importance and necessity. 63.2% of the stakeholders did not agree the current career opportunities; while 73.3% agreed the professionalization. Finally, very influential factor, influential factors, and factors in need of improvement were identified.

The results of the comparative study indicate that in most cases, there are significant differences between the studied areas in Iran with world-renowned universities. Change in the specialized courses due to the adoption of similar disciplines, attention to optional courses in order to specialize and create tendencies, and apprenticeships and internships are emphasized as the opportunities to turn knowledge into skills. Separation of specialist training, and classification of education according to the occupation and educational level were among suggested methods for improvement.

Implementation of clinical governance (CG), as a strategy for improving the quality, safety and effectiveness of health services, has encountered challenges in Iranian hospitals. This study aimed to identify barriers to clinical governance implementation in Tehran hospitals, Tehran, Iran. This descriptive cross-sectional study was carried out in 92 hospitals in Tehran that had implemented CG in 2014. Data were gathered using a researcher-made questionnaire assessing the human resource, managerial, cultural, procedural and structural barriers of CG. Data analysis was performed through SPSS software (version 20) and using descriptive and inferential statistics. The mean score of CG implementation barriers in Tehran hospitals was 3.36 out of 5. Human resource (mean score: 3.69) and cultural barriers (mean score: 3.02) were the most and least barriers of CG implementation respectively. Simultaneous implementation of accreditation, lack of a continuous improvement culture, staff insufficient motivation, CG bureaucracy and lack of time had respectively the most negative effects on CG implementation. Commitment and participation of senior managers, staff and doctors were low in CG and indeed had a significant relationship with the CG managerial barriers in hospitals. Tehran hospitals encounter many barriers in implementing CG. Policy makers should consider the structure and culture of the hospitals and staff organizational maturity to develop an appropriate CG model. Besides, hospital managers should address the existing barriers and create an appropriate organizational structure and culture to facilitate CG successful implementation.

Successful implementation of clinical governance improves the quality and safety of healthcare services and enhances the accountability of managers and employees. This study aimed to examine the success of clinical governance implementation in Tehran hospitals.
A valid and reliable questionnaire was used for the aim of this study. 144 questionnaires were distributed among the hospital managers. Data analysis was performed using SPSS software and descriptive and analytical statistics.
92 questionnaires were returned and analyzed. Clinical governance implementation was moderately successful in Tehran hospitals (the mean score of 2.82 out of 5). The most and least success were achieved in patient involvement and clinical audit respectively. Managers and employees’ commitment in implementing clinical governance was assessed as moderate. The involvement of about 70 percent of physicians was less than average. There was a statistical meaningful correlation between managers’ commitment and clinical governance success.
Implementation of clinical governance in Tehran city hospitals was not successful. Using an appropriate model for implementing clinical governance, management and leadership commitment, clinical staff involvement and information and process management are necessary for successful implementation of clinical governance.

Manpower is the most important input in any organization. Unfortunately, despite the importance of this issue in organizations such as hospitals, few studies have addressed this topic. The aim of this study was to determine the correlation between trust and organizational identification and characteristics of the nursing practice environment and their dimensions in Tehran City hospitals. In this descriptive-correlational study, 200 of nurses from nursing management categories according to Morgan table and simple random selection method were participated. Data were collected by "Trust and Closure Audit Questionnaire created by Learning Center" and “Measuring organizational traits of hospitals: The revised Nursing Work Index". The validity of the instruments were measured by content validity and reliability was assessed by Cronbach's alpha of 0.90. Data was analyzed by SPSS/20. The proportion of high-level (2.51) trust and organizational identification and characteristics of the nursing practice environment is at the lower level (2.30). Trust and organizational identification and characteristics of the nursing practice environment and all of its dimensions (P<0.05, r=0.474) except the employment relationship (P>0.05, r=-0.020) have a direct linear relationship. Moreover, characteristics of the nursing practice environment and trust and organizational identification and all of its dimensions (P<0/05, r=0.474) have a direct linear relationship. Trust and organizational identification and characteristics of the nursing practice environment, also characteristics of the nursing practice environment and trust and organizational identification and all of its dimensions have a direct correlation. The hospital managers can improve performance and ultimately a positive step in improving the quality of nursing care and safety, by the promotion of trust and organizational identification and characteristics of the nursing practice environment.

Pre-hospital emergency medical services may have an effective role in the survival rate and prevention of serious injuries to patients and victims. On the other hand، increased length of stay can lead to an increase in hospital and patient costs while prolonging the recovery and rehabilitation time. This study aimed to investigate the relationship between pre-hospital care and hospital length stay in patients with acute myocardial infarction in Hazrate Rasool Hospital.

The population of this retrospective analytical cohort study constituted the patients diagnosed with Acute Myocardial Infarction hospitalized at Hazrate Rasool Hospital in Tehran in 2009. These patients were diagnosed during the first six month of 2009 and were ultimately discharged alive. The sample was the same as the study population. Data analysis was done by means of SPSS version 16، non-parametric Mann-Whitney، and Kruskal-Wallis tests.

The findings showed that 88% of the patients were transferred to the hospital with ambulance and had already received pre-hospital services. The average length of stay in the hospital was found to be 17. 6 days (SD = 4. 05). There were no significant differences in length of stay for the two groups of patients; those taken to hospital by ambulance and those who were not. However، a significant difference was observed between patients with various age groups. Moreover، the length of stay in patients with different insurance coverage was statistically significant. (P ≤0. 05)

According to the findings، although the means of transportation of the patients as well as pre-hospital services seem to have no impact on the length of stay in hospital، they may، however، affect other consequences such as improvement in overall health of the patient، reduction of injuries، pain، etc. which may not lead to a reduction in hospital stay. It seems that in studies examining factors affecting length of stay in hospitals، researchers should have systemic and holistic views on these factors in order to obtain a realistic contribution of each factor in increasing or decreasing the length of stay.