Organizational Pathology in Staff Department of Shiraz University of Medical Sciences based on Three-branch Model

Introduction: Pathology of organizations is one of the most key actions that make the university officials aware of the strengths, weaknesses, opportunities and challenges of an organization and allows these officials to take the right actions accordingly. Therefore, this study examined the pathology of human resources in staff departments of Shiraz University of Medical Sciences. Methods: This was a cross-sectional study. Two hundred employees participated in this study. Random sampling was used and the data were collected by an organizational pathology questionnaire based on the three branch model. Data analyzed by SPSS software. Results: The results showed that behavioral factors (mean = 2.73) and contextual factors (mean= 3.34) had the highest and the lowest impacts on human resources malfunction in Shiraz University of Medical Sciences. Among subsets of structural factors, the payment system (average rank of 2.5, mean=2.21±0.72 and p-value ≤0.001), behavioral factors, and job security (mean rank = 2.03, mean=2.28±0.93 and p-value ≤0.001) and among subsets of contextual factors, customer-orientation (mean rank= 1.31, mean=3.07±0.70 and p-value 0.19) had the most impact on organizational pathology in this university. Conclusion: Considering that the behavioral factors had the greatest impact to the damages, it seems that the university has to adopt programs and policies in terms of creating appropriate organizational culture, increasing motivation and job satisfaction, adopting effective leadership, providing opportunities for training and development of employees and improving job security for the staff. Indeed, it is worth mentioning that solving some of these issues is beyond the powers of the executive organs, so solving these types of problems at macro-organizational level in the country is of vital importance

Evaluation of Prescription Appropriateness of CT Scan for Low Back Pain in Shiraz’s Referral Trauma Hospital Using RAND Appropriateness Method

Introduction: This study aims to identify the appropriateness of CT Scan prescriptions for Lumbar Spine using the RAND Appropriateness Method in Shiraz University of Medical Sciences (SUMS). Methods: A total of 281 patients referred to the hospitals affiliated with Shiraz University of Medical Sciences were selected as sample of the study in 2016. The scenarios derived through the RAND Appropriateness Method were compared with medical records of these patients by educated physicians. Results: Out of 281 cases of lumbar spine MRI prescriptions, 57.7% were appropriate, 32.7 % were uncertain, and 9.6 % were considered to be appropriate. In addition, some related factors to appropriateness of prescriptions were identified. Conclusions: Clinical guidelines developed using RAND Appropriateness Method can be an appropriate instrument for policy makers, health care providers, and health insurance companies in order to reduce inappropriate cares and quality improvement, especially in developing countries. It is recommended that appropriateness of prescriptions will be considered as the criteria for payment and reimbursement to prescribers. In this way, inappropriate cares may be reduced

Exploring measures to control road traffic injuries in Iran: key informants points of view

Background: Injuries and fatalities from road traffic Injuries are global public health concerns, and a major problem in the Iran. This study aimed to explore strategies to control road traffic Injuries (RTI) in Iran. Methods: We conducted a qualitative study to explore possible ways to reduce the occurrence of road traffic Injuries in Iran in 2016. Interviewees were purposively sampled from various sectors due to multidisciplinary nature of RTIs. Participants were mainly representatives from the police, Ministry of Road, Municipal, emergency services and Minis-try of Health. Besides, public health authorities, researchers, and university professors were interviewed. We con-ducted in-depth interviews using generic guides. Data was analyzed using MAXQDA 10 software. Through content analysis, we interpreted core themes relevant to the accomplishment of our study objectives. Results: Themes that emerged from our study include; road traffic management, governance, education, improving accident database, enforcement, driving license restrictions, and construction of pedestrian overpass. Conclusion: This study revealed key informants’ views regarding available and affordable solutions to reduce RTIs in Iran. Many applicable strategies are identified in the control of RTIs in Iran. Although some solutions such as highway construction and/or expanding rail transportation have been suggested as effective measures for reducing accident, but they are costly and may not be fully applied in developing countries like Iran

Exploring Measures to Control Road Traffic Injuries in Iran: Key Informants Points of View

Background: Injuries and fatalities from road traffic Injuries are global public health concerns, and a major problem in the Iran. This study aimed to explore strategies to control road traffic Injuries (RTI) in Iran. Methods: We conducted a qualitative study to explore possible ways to reduce the occurrence of road traffic Injuries in Iran in 2016. Interviewees were purposively sampled from various sectors due to multidisciplinary nature of RTIs. Participants were mainly representatives from the police, Ministry of Road, Municipal, emergency services and Minis-try of Health. Besides, public health authorities, researchers, and university professors were interviewed. We con-ducted in-depth interviews using generic guides. Data was analyzed using MAXQDA 10 software. Through content analysis, we interpreted core themes relevant to the accomplishment of our study objectives. Results: Themes that emerged from our study include; road traffic management, governance, education, improving accident database, enforcement, driving license restrictions, and construction of pedestrian overpass. Conclusion: This study revealed key informants’ views regarding available and affordable solutions to reduce RTIs in Iran. Many applicable strategies are identified in the control of RTIs in Iran. Although some solutions such as highway construction and/or expanding rail transportation have been suggested as effective measures for reducing accident, but they are costly and may not be fully applied in developing countries like Iran

The Relationship between Management Styles and Change and Innovation Skills of Administrators in Teaching Hospitals of Shiraz University of Medical Sciences

Background: With regard to novel plans in the health sector, including “Health Sector Evolution” and changes of hospitals’ issues, change and innovation skills are considered essential for hospital administrators. This study aimed to determine the relationship between management style and change and innovation skills of administrators in Teaching Hospitals of Shiraz University of Medical Sciences in 2009. Methods: This was a cross-sectional and descriptive-analytical survey. Study samples were 9 managers and 135 headquarter staff of hospitals affiliated to Shiraz University of Medical Sciences. Data were collected using the management style questionnaire of Rensis Likert and questionnaire of change and innovation skills. Data were analyzed through SPSS16 and using descriptive statistics (frequency, percentage and mean) and analytical statistics (t-test and ANOVA .( Results: Most hospital administrators of Shiraz University of Medical Sciences had consultative management style. The majority of headquarter staff were in the age group of 20-40 years. There was a significant relationship between change and innovation skills of hospital administrators and their management styles (P<0.001). Conclusion: It seems that in order to implement the change and innovation plans in hospitals, implementing a successful participatory management style is very effective, because with honest participation, the organizational goals will be more achievable. Keywords: Management style, change and innovation skills, hospital administrators, headquarter staf

Informal Payments in Healthcare: A Case Study of Kerman Province in Iran

Background: Informal payments for health care, which are common in many countries, can have negative effects on health care access, equity and health status as they lead people to forgo or delay seeking care, or to sell assets to pay for care. Many countries are putting reforms in place with the aim of reducing informal payments. In order to be successful, such policies should be informed by the underlying causes of such payments. This study attempts to explore why, how, and in what ways informal payments occur. Methods: We conducted face-to-face interviews with a purposeful sample of 45 participants, including patients, healthcare providers and officials, in Kerman province in Iran, in 2010. The research participants were asked about the nature of informal payments, the reasons behind both asking and making those payments. We analysed the data using content analysis. Results: We found that people make informal payments for several reasons, namely cultural, quality- related and legal. Providers ask for informal payments because of tariffs, structural and moral reasons, and to demonstrate their competence. Informal payments were found to be more prevalent for complex procedures and are usually asked for directly. Conclusion: Informal payments are present in Iran’s health system as in other countries. What makes Iran’s condition slightly different from other countries is the peculiarity of reasons behind asking informal payments and the disadvantages associated with these kinds of payments. Iran could overcome this dilemma by precise investigation of the reasons to inform appropriate policy formulation. Some policies such as raising salaries, justifying the tariffs and cost-sharing, defining a benefits package of services, and improving accountability and transparency in the health system could be taken by the government to alleviate the proble

Prevention and control of health care–associated infections in Iran: A qualitative study to explore challenges and barriers

Background: Globally, the health and economic burden posed by health care–associated infections (HAIs) remains wide and severe. To curb the burden associated with HAIs, countries, including Iran, aim at HAI prevention and control. This study explores the challenges faced by the Iranian health system in addressing the issues associated with the prevention and control of HAIs. Methods: A qualitative research method was adopted in exploring the phenomenon. We used the purposive sampling approach in reaching 24 key informants at the national and subnational levels. The thematic framework analysis was conducted for analyzing the interviews. Results: Five main themes emerged from our study demonstrating the obstacles toward the prevention and control of HAIs. They include governance and stewardship, resources, safety culture, monitoring and surveillance systems, and inappropriate prescription of antibiotics. Conclusions: Strengthening of reporting and surveillance systems for HAIs coupled with proper governance and stewardship are crucial in order to improve the health and safety of patients. However, the availability of resources, through an intersectoral approach, is essential to achieve sustained output. © 2016 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control an

Investigating the effective factors on patients' escape from one of the public hospitals in Bushehr city in 2017-2018: A descriptive, cross-sectional study

چکیده زمینه و هدف: خروج از بیمارستان بدون اطلاع پزشک و پرسنل یا به عبارتی فرار از بیمارستان، یکی از چالش های&nbsp; بزگ نظام سلامت محسوب می شود چرا که می تواند باعث ایجاد هزینه های اقتصادی برای سیستم و زیان جانی برای بیمار گردد . هدف از این مطالعه بررسی عوامل موثر در فرار بیماران و بار مالی ناشی از آن&nbsp; در یکی از بیمارستان های عمومی شهر بوشهر می‌باشد. مواد و روش‌ها: این پژوهش یک مطالعه توصیفی- مقطعی است که در یکی از بیمارستان‌های شهر بوشهر انجام گرفته است. در این مطالعه، اطلاعات بیماران با روش سرشماری و با استفاده از یک چک لیست &nbsp;استخراج گردیده است. این چک لیست حاوی سئوالات دموگرافیک، بالینی و اقتصادی می‌باشد. تحلیل داده ها از آمار توصیفی در محیط&nbsp; نرم افزار spss &nbsp;نسخه 25 &nbsp;بهره گرفته شد. یافته‌ها: بنابر نتایج حاصل از آنالیزهای آماری نرخ فرار از بیمارستان0018/0 برآورد می‌شود. یعنی به طور میانگین، هر ماه 6 نفر از بیماران فرار کرده‌اند. زیان مالی وارد شده به بیمارستان شهدای خلیج فارس بوشهر بابت فرار بیماران در سالهای 1396 و 1397 بالغ بر ده میلیارد ریال بوده است که سهم بیمارانی که بیمه داشتند در آن بیشتر از افراد فاقد بیمه بوده است. نتیجه گیری: نرخ فرار در بیمارستان مورد پژوهش کم بود. با این حال به دلیل این که فرار علاوه بر زیان مالی قابل توجهی که به بیمارستان ها وارد می‌کند می‌تواند مشکلاتی را برای خود بیماران، خانواده‌‌‌‌هایشان و نیز جامعه ایجاد کند، لازم است تلاش ها در جهت کاهش وقوع این معضل توسط مدیران&nbsp; به کار گرفته شود. &nbsp;Background and Aims: Absconding from hospitals presents big challenges to the health care systems, with consequences such as delay and incomplete treatment process. Also it may result in increased personal workload and the cost burden of health system. The aim of this study was to determine absconding rate and its driving factors in a public hospital in Bushehr city in 2017-2018. Materials and Methods: The present descriptive cross-sectional study was conducted in a general hospital in Bushehr. During the study, patients' information was extracted by a checklist from their medical records between 20 March 2017 and 1 March 2018 using census method. Ethical criteria such as confidentiality of patients' names and the hospital under study were observed. Results: Absconding rate was found to be 0.18 percentage. The highest number of escapes was noticed in emergency wards (137 and 92%), meaning that in average 6 persons have escaped each month. Mean age of the patients was 29.02 and they stayed 2.07 days in the hospital. The highest frequency of escape was observed in male patients and in singles which occurred in night shift. About 72%&nbsp; (117) of patients did not have health insurance, but 88% of&nbsp; unpaid amount was belonged to insured persons. The total amount of damages was estimated to be 1,411,950,080 Rials. The average cost per patient was also appraised to be 9,540,203 Rials. Conclusion: Despite the low escape rate at the studied hospital, the property damage was significant. Installation of gates and controlling the entry and exit of patients, coupled with increasing the number of physical protection staff and insurance offices, as well as reforming the clearance process and insurance laws are proposed to reduce the occurrence of this problem

Clinical Risk Factors for Early-Onset Sepsis in Neonates: An International Delphi Study

Background: Despite growing evidence, there is still uncertainty about potentially modifiable risk factors for neonatal early-onset sepsis (EOS). This study aimed to identify potential clinical risk factors for EOS based on a literature review and expert opinions. Methods: A literature search was conducted in PubMed (MEDLINE), Cochrane, Embase, and Scopus databases. Articles in English, published up to May 2021, on clinical risk factors for neonatal EOS were included. Initially, a questionnaire on risk factors for EOS was developed and validated. The fuzzy Delphi method (FDM) was used to formulate the final version of the questionnaire. The validity of the risk factors was assessed using the Chi square test. P<0.05 was considered statistically significant. Results: In the review phase, 30 risk factors were approved by two neonatologists and included in the FDM phase. In total, 25 risk factors met the consensus criteria and entered the validation phase. During the observational study, 114 neonates (31 with and 83 without EOS) were evaluated for two months. The results of the Chi square test showed that cesarean section was not a significant risk factor for EOS (P=0.862). The need for mechanical ventilation and feed intolerance was observed in about 70% of neonates with EOS, and therefore considered significant risk factors for EOS (P<0.001). Finally, 26 potential clinical risk factors were determined. Conclusion: Neonatal-related risk factors for EOS were birth weight, one-min Apgar score, and prematurity. Maternal-related risk factors were gestational age and urinary tract infection. Delivery-related risk factors were premature rupture of membranes, chorioamnionitis, and intrapartum fever

Does a socially well integrated university have anything to do with faculty retention? A study on Kerman University of Medical Sciences-2011

Purpose – The purpose of this paper is to measure the relationship between organizational social capital and retention of faculty members in Kerman University of Medical Sciences in 2011. Design/methodology/approach – Using a stratified multistage sampling, 120 faculty members were recruited to fill the questionnaire. Findings – There were a direct and positive bilateral (r¼0.65) relationship between social capital and retention of faculty members. Originality/value – The university officials and policy makers need to pay closer attention to some issues such as providing welfare facilities, salary and wages, benefits, interests and appreciation for faculty members. Keywords Socia