Challenges in the Optimal Management of Human Resources in Hospitals: A Qualitative Study

Introduction: Optimal management of human resources is considered as a basic and most fundamental principle of management of the health services because manpower is the most important organizational resources. The aim of this study was to identify the challenges in the optimal management of human resources in hospitals. Method: This qualitative study was conducted in hospitals affiliated to Tehran University of Medical Sciences and all experts who had sufficient knowledge of the human resources management programs were included. Nineteen participants were selected using non-probability purposive sampling. Data were collected through semi-structured interviews. Qualitative content analysis was used to analyze the data. Results: Three major themes emerged: organizational, motivational, and knowledge-related factors. Organizational factors included lack of up-to-date job descriptions, staff recruitment through university and hospital constraints in the selection of employees, lack of the culture of team working and process attitudes, incomplete establishment of occupational health and safety, and deficiencies in the evaluation system. Motivational factors included absence of a performance-based pay system, lack of communication between evaluation and incentive systems, and lack of motivation and confidence of the staff in solving problems. Knowledge-related factors included old human resources and resistance to change, lack of knowledge, and non-learner hospital environment. Conclusion: Clear job description, implementation of dynamic organizational culture, safe environmental conditions, performance-based pay system, and directing hospitals towards becoming learning organizations play an important role in reducing the challenges of human resources management. Keywords: Challenge, Management, Human resources, Hospita

Spiritual health in cancer patients at OMID hospital affiliated with Mashhad University of Medical Sciences -2012

For downloading the full-text of this article please click here.Background and Objectives: Due to high prevalence of cancer and its destructive impact on spiritual health of patients, this study aim to investigate Spiritual health in cancer patients at OMID hospital affiliated with Mashhad University of Medical Sciences, 2012. Materials and Methods: In this descriptive cross-sectional study, the study population was 106 cancer patients referred to hospital. Paloutzian-Ellison questionnaire (1982) and convenience sampling were used to collect data which were analyzed using SPSS 16.Results: The mean scores of spiritual health, religious health and existential health were 97±1.2, 52.1±6.4 and 44.8±8.4 respectively .There was not statistical significant relationship between Spiritual health and  demographic factors. Conclusion: Spiritual health in cancer patients was intermediate. Promotion of spiritual health in diseases such as cancer that it is effective on the body, mind and spirit be taken into consideration specifically, because the Promotion of spiritual health leads to physical and mental health promotion. Keywords: Cancer, Spiritual health, HospitalFor downloading the full-text of this article please click here

Health System Responsiveness: A Case Study of General Hospitals in Iran

Background : Considering patients’ needs and expectations in the process of healthcare delivery improves the quality of services. This study aimed to investigate the responsiveness of general public and private hospitals in Mashhad, Iran. Methods : In this cross-sectional and explanatory study, hospitalized patients (with at least 2 days of stay) in general private and public hospitals in Mashhad were investigated. In total 425 patients (259 from private and 166 from public hospitals) were selected using a stratified and simple random sampling. Standard responsiveness questionnaire was used as the data collection tool. Data were analysed using descriptive statistics, independent t-tests and ANOVA by SPSS 16 at a significance level of 0.05. Results : Access to the social support during hospitalization as well as confidentiality of the patient’s information achieved the highest score (3.21±0.73) while the patient participation in decision-making process of treatment received the least score (2.34±1.24). Among the research population 1.6%, 4.1%, 17.6%, 63.3% and 13.2% commented on the responsiveness level as very low, low, moderate, good, and excellent, respectively. There was no significant difference between the overall responsiveness scores of public and private hospitals ( P ≥0.05). Conclusion : The hospitals have enough potential to improve various aspects of their responsiveness. We suggest a number of measures can help improve the non-clinical aspects of care. These include: using educational courses to improve the knowledge and attitudes of medical and nonmedical staff, changing the resource allocation method, and using quality tools such as reengineering to modify the healthcare delivery processes

Challenges of Establishing Clinical Governance in the Field of Patient Education: A Qualitative Study

Introduction: Clinical governance is a framework in which service provider organizations are accountable for continuous improvement of responsive quality and protect high service standards by creating an environment where clinical service excellence is flourished. The purpose of this study was to explore challenges of establishing clinical governance in the field of patient education. Methods: This qualitative study was conducted in four teaching hospitals of Tehran University of Medical Sciences and the population consisted of experts involved in the clinical governance program. Sixteen participants were selected using non probability purposive sampling and known cases. Data were collected through semi-structured interviews which were recorded, transcribed and analyzed after informed consent was obtained. Qualitative content analysis was used to analyze the data. Results: Two major themes were emerged: “organization-related and patient-related factors”. Cultural factors included “poor teamwork culture, nurses’ lack of motivation to train patients, unvalued education, lack of time and high workload, shortage of personnel, lack of clear guidelines for education, overtime processes, managers’ neglect of education”. Patient-related factors, included “patients’ unawareness of their legal rights, public predicament and lack of cooperation from patients, patients’ illiteracy and low literacy, low motivation, cultural diversity of patients and difficulty to communicate with them”. Conclusion: Informing patients of their rights to receive comprehensive education and informing caregivers of such rights are the manifestation of patient-orientation concept and could pave the way to remove the challenges of clinical governance program

Health System Responsiveness: A Case Study of General Hospitals in Iran

Background: Considering patients’ needs and expectations in the process of healthcare delivery improves the quality of services. This study aimed to investigate the responsiveness of general public and private hospitals in Mashhad, Iran. Methods: In this cross-sectional and explanatory study, hospitalized patients (with at least 2 days of stay) in general private and public hospitals in Mashhad were investigated. In total 425 patients (259 from private and 166 from public hospitals) were selected using a stratified and simple random sampling. Standard responsiveness questionnaire was used as the data collection tool. Data were analysed using descriptive statistics, independent t-tests and ANOVA by SPSS 16 at a significance level of 0.05. Results: Access to the social support during hospitalization as well as confidentiality of the patient’s information achieved the highest score (3.21±0.73) while the patient participation in decision-making process of treatment received the least score (2.34±1.24). Among the research population 1.6%, 4.1%, 17.6%, 63.3% and 13.2% commented on the responsiveness level as very low, low, moderate, good, and excellent, respectively. There was no significant difference between the overall responsiveness scores of public and private hospitals ( P ≥0.05). Conclusion: The hospitals have enough potential to improve various aspects of their responsiveness. We suggest a number of measures can help improve the non-clinical aspects of care. These include: using educational courses to improve the knowledge and attitudes of medical and nonmedical staff, changing the resource allocation method, and using quality tools such as reengineering to modify the healthcare delivery processes

بررسی سلامت معنوي در بيماران مبتلا به سرطان در بیمارستان امید مشهد-1391

Background and Objectives: Due to high prevalence of cancer and its destructive impact on spiritual health of patients, this study aim to investigate Spiritual health in cancer patients at OMID hospital affiliated with Mashhad University of Medical Sciences, 2012.  Materials and Methods: In this descriptive cross-sectional study, the study population was 106 cancer patients referred to hospital. Paloutzian-Ellison questionnaire (1982) and convenience sampling were used to collect data which were analyzed using SPSS 16. Results: The mean scores of spiritual health, religious health and existential health were 97±1.2, 52.1±6.4 and 44.8±8.4 respectively .There was not statistical significant relationship between Spiritual health and  demographic factors.  Conclusion: Spiritual health in cancer patients was intermediate. Promotion of spiritual health in diseases such as cancer that it is effective on the body, mind and spirit be taken into consideration specifically, because the Promotion of spiritual health leads to physical and mental health promotion.سابقه و اهداف: به علت طبيعت تهديد کننده‌ی سرطان، تشخيص اين بيماري سبب مي‌شود که نيازهاي معنوي بيماران به‌طور چشمگيري افزايش يابد. اين مطالعه با هدف بررسي سلامت معنوي بيماران مبتلا به سرطان در بیمارستان امید مشهد انجام گرفته است. مواد و روش­ ها: این مطالعه‌ی توصیفی- تحلیلی در سال 1391 در بیمارستان امید مشهد انجام گرفته است. جامعه‌ی پژوهش، شامل 106 نفر از بیماران سرطانی بستري در بیمارستان امید است. ابزار گردآوري داده‌ها، پرسش‌نامه‌ی پالوتزين- اليسون (سال 1982) بوده است و داده‌ها به روش نمونه‌گيري آسان (در دسترس)‌ و به صورت ميداني گردآوري شد. برای تحلیل داده‌ها از آمار توصیفی، آزمون همبستگي (سطح معني‌داري 05/0) و نرم افزار SPSS نسخه‌ی 16 استفاده شد. يافته­ ها: میانگین کل نمره‌ی سلامت معنوی بیماران  2/1 ± 97 و میانگین نمره‌ی سلامت مذهبی و وجودی آن‌ها به ترتیب 4/6 ± 1/52 و  4/8± 8/44 بود. بین سلامت معنوی بیماران با سن، مدت ابتلا به سرطان، سطح تحصیلات و وضعیت تأهل، ارتباط آماری معنی‌داری مشاهده نشد. نتیجه­ گیري: نتیجه‌ی این مطالعه نشان داد، بسیاری از بیماران مبتلا به سرطان سلامت معنوی متوسطی داشتند. توصیه می‌شود ارتقای سلامت معنوی در بیماری هایی همچون سرطان که بر جسم، روان و روح افراد تأثیرگذار است، به صورت خاص مورد توجه قرار گیرد، چرا که ارتقای سلامت معنوی بهبود سلامت جسمی و روحی بیمار را در پی خواهد داشت. واژگان کلیدي: سلامت معنوی، سرطان، بیمارستا

A Study on the Frequency and the Reasons for Cancellation of Surgical Operations in Khatam Hospital (Mashhad, Iran) in 2013

Introduction: Operations cancellation at the last minute is one of the main reasons of inefficiency and waste of resources in Hospitals. This study aims to investigate the reasons and the frequency of operations cancellations in Khatam-al-Anbia Eye Hospital (Mashhad-Iran) in 2013. Materials and Methods:In this descriptive and cross-sectional study, all canceled scheduled operations in 2013 in Khatam-al-Anbiya Eye Hospital were investigated and the data were recorded in a checklist. Study variables included: 1) the number of planned operations, 2) the number of canceled operations, 3) age, 4) gender and 5) the reason of operation cancellation. Data were analyzed using descriptive statistics and SPSS16. Results: Of 16512 operations scheduled during 2013, 329 cases (1.99 percent) were canceled. The reason of cancellation was not mentioned in (28.6 percent) of cases. Other reasons of operations cancellation included, in the order of importance, high-risk underlying disease (22.5%),  medical advice ignorance  from the patient's behalf (10.6%), change in clinical status (7.9%), prolongation of previous operations (7%), patient’s dissatisfaction (5.8%), Patients' incomplete Nil Per Os (NPO) time (5.5%), inadequate equipment (4.6%), lack of lab tests and consultations (2.7%), diagnosis change (2.4%), surgeon's absence (1.8%), and incomplete admission documents (0.6%). Conclusion: In a high percentage of canceled cases, the reasons of operation cancellations had not been mentioned in the patient’s file. A significant portion of theses cancellations can be attributed to the patients' incomplete cooperation.  Cancellations can be significantly reduced through providing the patient with enough instructions and explanations

Artificial Intelligence in Cancer Care: From Diagnosis to Prevention and Beyond

<p>Artificial Intelligence (AI) has made significant strides in revolutionizing cancer care, encompassing various aspects from diagnosis to prevention and beyond. With its ability to analyze vast amounts of data, recognize patterns, and make accurate predictions, AI has emerged as a powerful tool in the fight against cancer. This article explores the applications of AI in cancer care, highlighting its role in diagnosis, treatment decision-making, prevention, and ongoing management. In the realm of cancer diagnosis, AI has demonstrated remarkable potential. By processing patient data, including medical imaging, pathology reports, and genetic profiles, AI algorithms can assist in early detection and accurate diagnosis. Image recognition algorithms can analyze radiological images, such as mammograms or CT scans, to detect subtle abnormalities and assist radiologists in identifying potential tumors. AI can also aid pathologists in analyzing tissue samples, leading to more precise and efficient cancer diagnoses. AI's impact extends beyond diagnosis into treatment decision-making. The integration of AI algorithms with clinical data allows for personalized treatment approaches. By analyzing patient characteristics, disease stage, genetic markers, and treatment outcomes, AI can provide valuable insights to oncologists, aiding in treatment planning and predicting response to specific therapies. This can lead to more targeted and effective treatment strategies, improving patient outcomes and reducing unnecessary treatments and side effects. Furthermore, AI plays a crucial role in cancer prevention. By analyzing genetic and environmental risk factors, AI algorithms can identify individuals at higher risk of developing certain cancers. This enables targeted screening programs and early interventions, allowing for timely detection and prevention of cancer. Additionally, AI can analyze population-level data to identify trends and patterns, contributing to the development of public health strategies for cancer prevention and control. AI's involvement in cancer care goes beyond diagnosis and treatment, encompassing ongoing management and survivorship. AI-powered systems can monitor treatment response, track disease progression, and detect recurrence at an early stage. By continuously analyzing patient data, including imaging, laboratory results, and clinical assessments, AI algorithms can provide real-time insights, facilitating timely interventions and adjustments to treatment plans. This proactive approach to disease management improves patient outcomes and enhances quality of life.</p&gt