جستجوی مقالات مرتبط با کلیدواژه « کیفیت مراقبت های بهداشتی » در نشریات گروه « پزشکی »

Prerequisite for the success of service organizations is the provision of superior services.  Hospitals play an important role in providing medical services and the opinions of the clients determine the quality of the services provided. The purpose of this article is to identify and rank the quality of services provided based on SERVQUAL model in selected wards of Ali Ibn Abitaleb Hospital in Zahedan.

Using the results of Ahmadi and medical research and library and field studies, 5 criteria (SERVQUAL's Five Model) and 22 sub-criterions were collected. By collecting data by distributing this questionnaire among the patients (patients and companions) in four departments of CCU, men's surgery, pediatrics 1 and internal medicine 1. Sampling method was random and using Morgan's table, 100 people were selected. The ranking criteria were ranked by Shanon's entropy weighting method and the service quality of the departments was ranked by ARAS multi-criteria decision-making method.

The research findings show the inequality in the quality of services provided between the four selected departments, so that the CCU, men's surgery, pediatrics and internal medicine ranked first to fourth, respectively. The framework presented in this research can be used as a criterion for evaluating the performance and improving the quality of services in hospitals.

According to the results of this study, hospital managers can improve the quality of services and ultimately patient satisfaction by using medical facilities and equipment, increasing staff and treatment staff, increasing the number of rooms with low beds and increasing welfare facilities and increasing the number of physicians in different shifts.

Due to the high mortality of patients admitted to the intensive care unit, the provision of high quality nursing care, especially for patients admitted to these wards, is of great importance, so the quality of death and dying in these wards is necessary. The aim of this study was to determine the quality of dying and death from the perspective of nurses working in intensive care units.

The present study was performed cross-sectional in the teaching hospitals of Kurdistan University of Medical Sciences. The research samples in this cross-sectional study were 105 nurses working in intensive care units who were selected by census. Data collection tools included two sections: demographic information, Quality of Dying and Death Questionnaire (QODD).

The results of the present study showed that the mean and standard deviation of the quality of dying and death variable were 37.15±13.47 and below the mean. Among the items related to the quality of death, the highest average was related to receiving appropriate sedation during the stay in the intensive care unit (5.80±2.41) and being touched or hugged by loved ones (4.90±2.78) and the lowest average quality of care was related to having a spiritual ceremony before the patient's death (2.12±2.59) and having one or more visits to a religious or spiritual counselor (2.24±2.66). There was a statistically significant relationship between the quality of dying and death and the history of passing training courses related to dying and death (P=0.03).

It is recommended to hold training courses related to quality dying and death care criteria for personnel working in intensive care units, as well as to evaluate the quality of mortality care from the perspective of the families of patients admitted to the intensive care unit.

The Comprehensive Child Development Center was established in 2012 in the center of Isfahan province to rapidly identify and intervene in the developmental problems of children. The aim of this study was to evaluate the implementation of this program.

This was a descriptive-analytical study conducted based on the framework for evaluating public health programs established by the Center for Disease Control and Prevention of United States of America with regard to evaluation of infrastructure, process and outcome. The infrastructure’s checklist included an area of land, equipment, workforce and equipment completed with presence of researcher at the center. Process and outcome evaluation was performed for 127 registered children during 2019. A satisfaction questionnaire was completed in person or remotely by parents of 144 children referred to the center in 2019 and 2020. Data were analyzed using descriptive statistics and independent t-test, and one-way ANOVA was carried out through SPSS 16 software.

The overall compliance of infrastructure with standards was 75.42%, with the highest compliance related to the equipment and the lowest related to the specialized workforce. The degree of compliance of the process compared with the standard one varied in different dimensions. 6.30 % of the children were cured and 76.38 % quit treatment. The most common reasons for treatment discontinuation were lack of appointment (29.53 %) and long distance (18.12 %). The overall satisfaction score was 83.90 ± 14.08. The satisfaction of the parents who completed the questionnaire in person was higher than those who completed the questionnaire remotely.

The results of this study revealed that the rate of complete cure is low and the rate of treatment discontinuation is high, whose main reasons were the lack of appointment to admit children with developmental disorders and long distance. It is suggested that, in order to solve the problem, the Ministry of Health establish more centers and provide the required workforce.

The willingness to pay is criteria criterion for measuring the patientschr('39') interest to continue their relationship with health centers. The main purpose of this study was to determine the effect of service quality and informing system of hospitals on the patientchr('39')s willingness to pay with mediating role of patient satisfaction.

This is an applied survey. The statistical population of this study consisted of all patients referring to Imam Khomeini Hospital in Sarab City during the first six months of 2019. Random sampling method was applied and 390 questionnaires were distributed among the patients. Data gathering tools included researcher made questionnaire with confirmed validity and reliability. Experts’ opinion and confirmatory factor analysis were used to confirm the validity. Cronbachchr('39')s alpha method and combined reliability coefficient were used for reliability. Data were analyzed using structural equation modeling (SEM) test by partial least squares method. To analyze the data, SPSS 20 and Smart PLS 3 software were used.

Among the distributed questionnaires, 300 ones were completed and returned. According to the descriptive statistics, mean score of service quality, hospital information system, patient satisfaction, and willingness to pay were 2.98, 2.81, 3.44, and 2.67, respectively. The results obtained from the inferential analysis showed that the quality of services had a significant effect on patients’ satisfaction and willingness to pay. Moreover, the information system had a significant effect on patients’ satisfaction and patientschr('39') satisfaction had a significant effect on the willingness to pay. The impact of the information system on the willingness to pay was not confirmed.

  Based on the findings, changes in the quality of hospital informing system and service quality with the mediating role of patients’ satisfaction affected their willingness to pay.

Quality of care from the perspective of patients is increasingly considered an important component of comprehensive chronic disease management and as instrument that use for evaluation of quality. This study aimed to assess of quality of delivered care among patients with rheumatoid arthritis based on a model of Comprehensive Quality Measurement in Health care (CQMH). A cross-sectional study was conducted with 170 people with rheumatoid arthritis who were received care from specialist clinics of Isfahan University of medical sciences in 2013. Validity of The study questionnaires were reviewed and confirmed by 8 specialist in rheumatology and research and there reliability was confirmed according to Cronbach''s alpha index (Service Quality (SQ); α = 0. 721، Technical Quality (TQ); α = 0. 766، Costumer Quality (CQ); α = 0. 803). Final scores for each dimension were referred on a 0-100 scale with high values indicating better quality. Data analyzed using the SPSS-19 statistical package. Independent Samples Test، ANOVA Tests were conducted to compare CQ، SQ، TQ and QI score between categorical variables. The average Quality Index was 72. 70 of a 0-100 scale and average SQ، TQ، CQ score were 79. 09، 68. 54، and 70. 25 respectively. For CQ only 19. 8% of participations staying the course of action even under stress and financial constraints، there was a significant gap between what Rheumatoid Arthritis (RA) care they received and what was recommended in the guideline for TQ and the concept of service quality was poorly developed in many cases، specifically «availability of support group» that was the lowest scores. According to the present study quality of care the patient’s perspective was low، thus its need to pay attention to patient partnership and empowering them to manage their condition. Also there are need to Promote compliance and establish association of rheumatology patients.

Given the importance of quality in health care and meeting the needs of patients, it seems important to measure the quality of services and identify the weaknesses from the patient's perspective. The purpose of this study is to assess the service quality (SQ) of care as perceived by people with Type 2 Diabetes (T2D). A cross-sectional study was conducted among 180 people with Type 2 diabetes in diabetes clinic using convenience sampling method in Tabriz, Iran in 2012. Service quality was calculated using: SQ=10 – (Importance ×Performance) based on importance and performance of non-health aspects from the patient's perspective. Validity and reliability of questionnaire was reviewed and confirmed. Independent sample T-test and ANOVA were used to investigate relationship between service quality and categorical variables. Data analyzed bySPSS13 software. The average service quality score was 8.17 of 10. From the participant's perspective, of 12 aspects of service quality, communication and prevention had the highest score for importance. Dignity had the highest score for performance. However, the highest service quality values were for continuity of care, dignity and confidentiality. overall service quality achieved inadequate quality and there is an opportunity to improve quality of care.

The family physician system is among the most fundamental developments of Iran's health system in the recent years and customer’s satisfaction should be considered in the design of the system. This study aimed to investigate the customer's satisfaction from family physician services in the rural health centers related to Sabzevar University of Medical Sciences- 2012. In this descriptive cross-sectional study, 266 individuals of rural customers in Sabzevar were selected using clustered random sampling method. Data were gathered using a Questionnaire and then were analyzed by descriptive statistics and SPSS 11. Excellent satisfaction from family physician services was as the following: 40.2% good, 15.8% moderate, and 0.4% weak. Excellent satisfaction was observed in Khoshab, Rodab, and Davarzan respectively (40.2%, 30.1%, and 29.7%).There was no statistical significant relationship between satisfactions and demographic factors. All in all, the family physician in Sabzevar has been successful and with modification of some defects based on feedback from the recipients of services, satisfaction will be even higher.

The most important aspect of management is service quality and the first strategy in the world can be considered as customer service oriented. This study attempts to clarify the factors affecting the quality of health services using a combination approach of Fuzzy AHP - TOPSIS to rank teaching hospitals of Mazandaran University of Medical Sciences. According to purpose of this research the method was applied and descriptive survey. The population of research was teaching hospitals of Mazandaran University of Medical Sciences and four teaching hospital of Mazandaran University of Medical Sciences were selected with non-random sampling method And a standard questionnaire by a team of experts has been completed. At first according to fuzzy hierarchical analysis، the importance of service quality standards was defined and by the TOPSIS method the hospitals were ranked. Results were analyzed using Excel software. Research findings suggest that the Hospital C، Hospital B، Hospital A and hospitals D were ranked in order of the first quarter. Results from this study for managers will be very instrumental. Its place in society can properly recognize and apply strategies to maintain or improve it.

One of the criteria in the evaluation of hospitals، medical institutions and the practice of dentistry in recent years is evaluation of services quality. This study aimed to analyze and prioritize the factors affecting the quality of dental services from customers perspective. The Method of the study was descriptive- analytical based on combination of the fuzzy hierarchical analysis process and Kano. The population of the study were patients of dentistry centers in Isfahan in 1391. Thus، 490 patients were selected randomized. Data collection tools was included Kano questionnaire and was Analytical Hierarchy Process. Analysis of data was Based on fuzzy methods using SPSS software and Excel. Data analysis using the Kano model shows that the standards of professional competence، behavior of the dentist and pain control are required criteria and time of the treatment، environment and climate، Easy accessible location، waiting for treatment، punctuality and service fees are one-dimensional criteria and finally dentist''s reputation، clinics route and layout and parking facilities are attractive criteria. Also findings indicate that using FAHP dimensions indicate that from the customer perspective of the dental services، respectively required dimension (with amount of 0. 4641)، one-dimensional (with amount of 0. 3346)، and attractive (with amount of 0. 2013) the priorities are more important. Dental care centers managers، with using a combination of Kano and Fuzzy Analytical Hierarchy Process will be able to identify factors that affecting the quality of dental services and have program for strengthen and reform of weaknesses in this section

Nowadays, organizations perform segmentation of their customers in order to maximize profits and minimize costs. However, in addition to segmentation, an optimal combination of the customers, i.e. the number of the customers or their percentage, is required to be specified in order to invest on development of products and services. In this study, by maximizing the customers’ satisfaction, we measured the optimal combination of the clients. Therefore, this study aimed to identify a method of deciding on the optimal combination of the customers based on the Kano Model and ideal programming. In terms of objectives, this study was developmental and applied; with regard to data collection time, it was a cross-sectional survey; and in terms of nature of the data, the study was a qualitative and descriptive investigation. Based on literature review concerning costumers’ satisfaction, logical frameworks for maximizing customers’ satisfaction in addition to the hierarchical dimensions of the quality of services were evaluated. In order to maximize the customers’ satisfaction, an ideal programming model has been used. The proposed model indicated the maximization of the customers’ satisfaction in which the hierarchical dimensions of the quality of services have been considered based on Kano model. Furthermore, the dimensions of the quality of services constitute the constraints of the model of which the decision-making variables coefficients have been calculated through the Kano standard questionnaire and customers’ satisfaction maximization. A standard questionnaire was designed and completed by the participants in the cardiology clinic of Al-Zahra Hospital, Isfahan, Iran. The study subjects (n = 196) were randomly selected among the patients who had referred to the above mentioned clinic during August and November 2010. Validity and reliability of the questionnaires were evaluated using content validity and Cronbach’s alpha coefficient. WinQSB (windows for qualitative system for business) software was used to analyze the data. The findings indicated that the proposed approach is able to specify the optimal combination of the patients. Thirty-four percent of the patients suffered from myocardial infarction (MI) and 66 percent were patients with valvular heart disease. In general, the findings of the present study were effectiveness in customers’ segmentation, planning to provide appropriate services compatible with different customers’ needs and increased positive outcomes by hospital.

To promote the processes of providing medical services, patient's rights and establishing uniformity in treatment policy, the evaluation quality indexes were communicated to all general hospitals in 2002. This study evaluates the implementation of managed care guideline before their communication as evaluation quality indexes of hospitals and their relationship with communication and quality degree of conducted services. This study was an analytical study based on information in the records of patients, before and after the communication of managed care guideline. The statistical population including the records of patients who underwent surgery or had delivered in the pilot hospitals affiliated to Golestan University of Medical Sciences in 2002 and 2007, Iran. The sample included 792 cases which were selected by stratified method. Data collected using three types of checklists and a standard information form communicated by the Ministry of Health. Obtained data analyzed by SPSS16 software and χ2 test. The preoperative assessment guideline was performed in 5.1% and 32.1% of evaluated documents in 2002 and 2007, respectively (P < 0.001). The prophylactic antibiotic guideline was performed in 31.6% and 44.9% of documents in 2002 and 2007, respectively (P < 0.001). The pain relief guideline was fully performed in 77.8% and 85.1% of documents in 2002 and 2007, respectively (P = 0.001). Cesarean section ratio to total deliveries in investigated hospitals were 49% in 2002 and decreased significantly to 42% in 2007 (P < 0.001). Most cesarean indication belongs to repeated cesarean section indication. Generally, in all investigated indexes there were positive and significant relation between establishing of Evaluation quality indexes and services quality. Implementation of managed care guideline led to improvement of quality in medical services. Establishing of guarantees and continuous rechecking regarding the quality assessment communications, could improve the quality of services in the future.

Health care organizations have begun applying six sigma methods into their operations. On the other hand, the difficulty of using indicators to compare health care providers in a meaningful way has led to an increased focus on using information about “adverse events”- that is, events that should not happen in a hospital - as a measure of quality. This information is required to perform Six Sigma methods.By nesting the Lean flow methodology within the six sigma methodology, a synergy can be attained that provides results that are much more significant than the results of the individual approaches. When Lean is added to six sigma, slow processes are challenged and replaced with more streamlined workflowsAdditionally, the data gathered during Lean Flow implementation helps identify the highest–impact six sigma opportunities. When six sigma is added to Lean flow, a much-needed structure is provided that makes it easier to consistently achieve optimum flow.Organizations that use a combination of Lean and six sigma (Lean-sigma) methods incorporate a testing phase during the fourth step of DMAIC cycle (improve). In this step, teams create solutions, develop tests of change, learn from the test, improve the change, and then test again, eventually finding the best - fit solution. By the time a solution is ready to be implemented, it has undergone many tests of change and has a greater chance of acceptance.The Charleston area medical center used six sigma methodology to evaluate and improve its rate of colon and vascular surgical site infections.