The Impact of Strategic Planning on Job Satisfaction among Hospital Staff: a case study

Background & Objectives: Hospital staff's job satisfaction has a significant role in improving the quality of hospital productivity. This study aimed to examine the impact of strategic planning on hospital staff's job satisfaction. Methods: This participatory action research was carried out in a selected private hospital in Isfahan/ Iran during 2012-2014. The hospital strategic plan, with a goal for improving job satisfaction was designed and implemented. Employees’ job satisfaction was measured before and after implementing the strategic plan through 9-item Job Satisfaction Questionnaire. Data were analyzed through SPSS22 software package. Results: The rate of subjects' job satisfaction in 2012 was approximately 58.6%. The highest satisfaction rate was found for the nature of job and job and coworkers' needs and the lowest was obtained for salary, job promotion, work conditions and job security. Employees’ job satisfaction increased to 64.7% in 2014 (10.1% improvement). Employees’ tendency for job quit decreased by 61.4% (from 42.2% in 2012 to 16.3% in 2014). Strategic plan had the most impact on dimensions of job promotion, management and supervision, coworkers and salary. Conclusion: Adequate designing and implementation of a strategic plan can improve job satisfaction of employees and reduces their tendency for job quit. Key¬words: Strategic planning, Employees, Job satisfaction, Hospital, Case study ¬Citation: Mosadeghrad AM, Ebneshahidi A, Abdolmohammadi N. The Impact of Strategic Planning on Job Satisfaction among Hospital Staff: a case study. Journal of Health Based Research 2017; 3(2): 99-114

E-Commerce Audit Judgment Expertise: Does Expertise in System Change Management and Information Technology Auditing Mediate E-Commerce Audit Judgment Expertise?

A global survey of 203 E-commerce auditors was conducted to investigate the perceptions about the potential determinants of expertise in E-commerce audits. We hypothesize and find evidence indicating that information technology and communication expertise are positively related to expertise in E-commerce audit judgment. We also find that system change management expertise and information technology audit expertise mediate this relationship.E-commerce Audit Judgment, IT Audit, Structural Equations Modeling

E-Commerce Audit Judgment Expertise: Does Expertise in System Change Management and Information Technology Auditing Mediate E-Commerce Audit Judgment Expertise?

A global survey of 203 E-commerce auditors was conducted to investigate the perceptions about the potential determinants of expertise in E-commerce audits. We hypothesize and find evidence indicating that information technology and communication expertise are positively related to expertise in E-commerce audit judgment. We also find that system change management expertise and information technology audit expertise mediate this relationship

Are Corporate Codes of Ethics and Risk Assessment by Internal Auditors Associated with Sustainability Audits by Internal Auditors?

An increasing number of organizations engage in sustainability reporting to the public. However, assurance of this disclosure is relatively new. In this study we investigate corporate codes of ethics and risk assessment by internal auditors as correlates of organizations’ engaging their internal audit functions (IAFs) in sustainability audits. Using data from a large sample of chief audit executives (CAEs) we find significant and positive associations between code of conduct and risk assessment and sustainability audits by IAFs. Also, we find positive and significant association between industry (environmentally sensitive vs. others), CAE experience, and CAE major (accounting vs. others) and sustainability audits by IAFs. Other control variables (organization size, CAE grad/undergrad degrees, and CAEcpe do not indicate significance in their association with sustainability audits by IAFs. These results have implications for design of sustainability reporting by various organizations and assurance of such reporting by internal auditors

The Impact of Strategic Planning on Patient Satisfaction: a case study

Background & Objectives: Patient satisfaction is a key hospital quality and effectiveness indicator. Strategic planning is necessary for hospitals to respond to the rapidly changing internal and external environments, to provide quality services, to maximize revenues and to minimize costs. This study aimed to examine the impact of strategic planning on patient satisfaction in a hospital. Methods: A participatory action research was conducted in a private hospital during the period 2012-2014. Hospital strategic plan was developed and implemented. A goal for enhancing patients’ satisfaction was determined in the strategic plan. Structural, procedural and cultural interventions were applied to improve patient satisfaction. Patient satisfaction was measured before and after implementing the strategic plan via a valid and reliable questionnaire. Data was analyzed using the SPSS software. Results: The quality of inpatient services and outpatient services were increased 6% and 8.6% respectively. Accordingly, inpatient satisfaction has increased from 77.4% in 2012 to 83.8% in 2014 (a growth of 8.3%). Out patient satisfaction has increased from 71.6% to 88.8% (a growth of 24%) during the same time period. Outpatients’ waiting time has declined by 33%. Improving quality of services and patient satisfaction enhanced inpatients’ and outpatients’ loyalty by 20% and 87% respectively. Conclusion: Developing an appropriate strategic plan, promoting a collaborative and cooperative culture, empowering employees, expanding organizational resources and implementing the strategic plan appropriately improve patient satisfaction and enhance their loyalty. Keywords: Strategic planning, Inpatients satisfaction, Outpatients satisfaction, Private hospital, case study, Participatory action research Citation: Mosadeghrad AM, Ebneshahidi A, Abdolmohammadi N. The Impact of Strategic Planning on Patient Satisfaction: a case study. Journal of Health Based Research 2018; 4(1): 13-29

Earnings Management Priorities of Private Family Firms

We compare earnings management priorities of private family and private non-family firms. Our study is made possible by the availability of a new and unique database on family relationships between CEOs, board members and owners of private Norwegian firms. We hypothesize and find that compared with private non-family firms, private family firms are likely to manage earnings downward. However, we also find that highly leveraged private family firms make more income increasing accounting choices than highly leveraged private non-family firms. Finally, we document that CEOs representing controlling families promote earnings management, and independent board members somewhat mitigate it. We note that research on the relationship between financial reporting quality and family governance is quite limited. We contribute to this emerging literature

The Impact of Strategic Planning on Hospital Efficiency: A Case Study

Background & Objectives: It is necessary to utilize hospital scare resources to meet patients’ unlimited needs. Hospital managers should pay more attention to efficiency. This study aimed to examine the impact of strategic planning on hospital efficiency in 2012-2014. Methods: A participatory action research was used in this study. The hospital strategic plan was formulated and implemented. There was a goal and objectives for increasing hospital productivity and efficiency in the strategic plan. Hospital efficiency was measured before and after implementing the strategic plan using bed occupancy (BO), patients’ average length of stay (LOS) in the hospital, bed turnover (BT) and bed turnover interval (BTI) indicators. Data was analyzed using the SPSS software. Results: The hospital BO and BT rates were increased by 16.7% and 25% respectively in 2014 compared to 2011. The average LOS and BTI rates swere reduced by 7.5% and 57% respectively during the same period. The case hospital’s BO and BT rates were respectively 3.2% and 79.8% higher than the average of all Iranian general hospitals’ BO and BT rates. Patient LOS and hospital BTI rate in the case hospital were 57% and 54% lower than the average of these indicators among the country’s general hospitals. Conclusion: Developing an appropriate strategic plan and implementing it properly help to improve hospital efficiency. Adopting and adapting industrial management theories and models could enhance hospitals’ performance. Hospital managers should be trained properly in strategic planning formulation and implementation. Key¬words: Strategic planning, Efficiency, Private hospital, Participative action research. Citation: Mosadeghrad AM, Ebneshahidi A, Abdolmohammadi N. The Impact of Strategic Planning on Hospital Efficiency: A Case Study. Journal of Health Based Research 2018; 4(3): 317-34. [In Persian

Hydrogen Peroxide Preconditioning Promotes Protective Effects of Umbilical Cord Vein Mesenchymal Stem Cells in Experimental Pulmonary Fibrosis

Purpose Idiopathic pulmonary fibrosis (IPF) is a progressive lung disorder with few available treatments. Mesenchymal stem cell therapy (MSCT), an innovative approach, has high therapeutic potential when used to treat IPF. According to recent data, preconditioning of MSCs can improve their therapeutic effects. Our research focuses on investigating the anti-inflammatory and antifibrotic effects of H2O2-preconditioned MSCs (p-MSCs) on mice with bleomycin-induced pulmonary fibrosis (PF). Methods Eight-week-old male C57BL/6 mice were induced with PF by intratracheal (IT) instillation of bleomycin (4 U/kg). Human umbilical cord vein-derived MSCs (hUCV-MSCs) were isolated and exposed to a sub-lethal concentration (15 pM for 24 h) of H2O2 in vitro. One week following the injection of bleomycin, MSCs or p-MSCs were injected (IT) into the experimental PF. The survival rate and weight of mice were recorded, and 14 days after MSCs injection, all mice were sacrificed. Lung tissue was removed from these mice to examine the myeloperoxidase (MPO) activity, histopathological changes (hematoxylin-eosin and Masson\u27s trichrome) and expression of transforming growth factor beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) through immunohistochemistry (IHC) staining. Results Compared to the PF+MSC group, p-MSCs transplantation results in significantly decreased connective tissue () and collagen deposition. Additionally, it is determined that lung tissue in the PF+pMSC group has increased alveolar space () and diminished expression of TGF-β1 and α-SMA. Conclusion The results demonstrate that MSCT using p-MSCs decreases inflammatory and fibrotic factors in bleomycin-induced PF, while also able to increase the therapeutic potency of MSCT in IPF

Effect of Hypoxia Preconditioned Adipose-Derived Mesenchymal Stem Cell Conditioned Medium on Cerulein-Induced Acute Pancreatitis in Mice

Purpose: Acute pancreatitis (AP) is an inflammatory disorder distinguished by tissue injury and inflammation of the pancreas. Using paracrine potential of mesenchymal stem cells (MSCs) provides a useful clinical approach in treating inflammatory diseases. We investigated the therapeutic effects of adipose-derived MSC conditioned medium (CM) and hypoxia preconditioned adipose-derived MSC conditioned medium (HCM) in cerulein-induced AP in mice. Methods: AP was induced in C57BL/6 mice by intraperitoneal injection of cerulein (75 μg/ kg/h × 7 times). One hour following the last injection of cerulein, mice were treated with intraperitoneal injection of CM and HCM (500 µL/mice/30 min × 3 times). Twelve hours following the treatment, serum levels of amylase and lipase were measured. In addition, pancreas pathological changes, immunohistochemical examinations for evaluation of IL-6 expression and pancreatic myeloperoxidase (MPO) enzyme activity were analyzed. Results: The in vitro results of the morphological, differentiation and immunophenotyping analyses confirmed that hypoxia preconditioned MSCs (HP-MSCs) conserve MSCs characteristics after preconditioning. However, HP-MSCs significantly expressed high mRNA level of hypoxia inducible factor 1-α and higher level of total protein. The in vivo findings of the current study showed that CM and HCM significantly reduced the amylase & lipase activity, the severity of pancreas tissue injury and the expression of IL-6 and MPO enzyme activity compared with the AP group. However, no significant difference between CM and HCM groups was demonstrated. Conclusion: Use of CM and HCM can attenuate cerulein-induced AP and decrease inflammation in the pancreas tissue in AP mice

Remdesivir associated sinus bradycardia in patients with COVID-19: A prospective longitudinal study

Background: Remdesivir is effective against SARS-Cov-2 with little evidence of its adverse effect on the cardiac system. The aim of the present study is investigating the incidence of bradycardia in COVID-19 patients treated with Remdesivir.Methods: This prospective longitudinal study was conducted in a tertiary center on COVID-19 patients for Remdesivir therapy. The objectives were to investigate the incidence of sinus bradycardia, and also the association between their demographics, underlying diseases, and the disease severity with developing bradycardia in COVID-19 patients treated with Remdesivir.Results: Of 177 patients, 44% were male. The mean (±standard deviation) age of patients was 49.79 ± 15.16 years old. Also, 33% were hospitalized due to more severe symptoms. Oxygen support was required for all hospitalized subjects. A total of 40% of the patients had comorbidities, with the most common comorbidity being hypertension. The overall incidence of bradycardia (heart rate<60 bpm) in patients receiving Remdesivir was 27%, of whom 70% had extreme bradycardia (heart rate <50 bpm). There was also a statistically significant reduction in heart rate after five doses of Remdesivir compared to the baseline heart rates. In the multivariable model, none of the covariates including age above 60 years, female sex, CRP>50 mg/L, O2 saturation<90%, underlying cardiovascular disease, hypertension and diabetes mellitus, and beta-blockers were associated with Remdesivir-induced bradycardia. No association was found between the COVID-19 severity indicators and bradycardia.Conclusion: As sinus bradycardia is a prevalent adverse cardiac effect of Remdesivir, it is recommended that all COVID-19 patients receiving Remdesivir, be evaluated for heart rate based on examination; and in the case of bradyarrhythmia, cardiac monitoring should be performed during administration to prevent adverse drug reactions