A critique of the hospital services provision in Iran after implementing Health Sector Evolution Plan: A case report

Background and aims: Public sector in Iran is responsible for providing whole primary health care and approximately 85 of the second and third level services. Following the previous programs, and in order to improve health system performance, Iranian Ministry of Health and Medical Education launched Health Sector Evolution Plan of Iran (HSEP) in 2014 aimed to reduce patients’ cost, improve quality, and provide equal access for all. Methods: We examined the achievement of these objectives through reporting a case and comparing current and past situation. The data related to the case were collected by interview and surveying patient documents. Published articles were considered as a base to compare some indices before and after the plan. Results: Our case was a Ph.D. student who sought out health care for his wound treatment. Total treatment expenses were 195 and many medical supplies were used. Waiting time and visit length were calculated 345 minutes and 1 minute, respectively. Paying an amount of money equivalent to almost 57 of his salary and too long waiting time to receiving short visit are in contrast to the primary objectives of HSEP and show no improvement in these indices compared with prior to the plan. Conclusion: With regard to increasing financial resources through HSEP (70) compared with the same time before HSEP, it is necessary to manage these funds properly to achieve objectives more effective and efficient than the current ones

Knowledge, Attitudes, and Practice towards Occupational Health and Safety among Nursing Students in Gaza Strip, Palestine

Health and safety in the workplace are critical components in healthcare institutions. Unsafe working conditions are among the causes of poor  quality of care and burnout. This study aims to assess the knowledge, attitudes, and practice of occupational health and safety among nursing  students at Al-Israa University. Methods: In this cross-sectional study, a structured online questionnaire was distributed from March to May 2021. Of the 350 eligible students, 219  students answered the questionnaire (Response rate=62.6). Data were analyzed using the statistical software IBM-SPSS version 22. Descriptive  statistic, Independent- samples T-Test, and ANOVA tests were used. Results: The majority of participants were female (81.7%) and studying in a diploma program. 21% of nursing students have experienced a needle  stick injury. The mean scores for knowledge, attitudes, and practice were (M±SD:78.2% ±12.9, M±SD:80.6% ±7.1, and M±SD:81.2% ±7.6) respectively.  In terms of knowledge, attitudes, and practice the mean scores were statistically significant between nursing students who attended a safety  precautions course and those who didn not (P-value <.05). In terms of attitudes, the mean scores were statistically significant between diploma and  bachelor students (P-value =.026).In terms of practice, the means scores were statistically significant between males and females (P-value =.017),  nursing students who had experience with needle sticks and those who didn’t (P-value =.015). Conclusion: The authors recommend that clinical  training departments and universities continue to offer occupational health and safety courses and training for health science students. Since the  training had a positive impact on the students' practices.&nbsp

Leadership and management competencies for hospital managers: a systematic review and best-fit framework synthesis

Objective: Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method. Methods: A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework. Results: Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism. Conclusion: This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context

Experiences of critical care nurses fighting againstCOVID‐19: A qualitative phenomenological study

Aim: This study sought to describe the experiences of critical care nurses caring for patients infected by coronavirus disease 2019 (COVID‐19). Design: A qualitative phenomenological design was used. Methods: We enrolled 15 nurses who provided care for patients infected by COVID‐19 purposively and through snowballing, using a phenomenological approach in critical care units of Iran's public hospitals between May and June 2020. The semi‐structured interviews were carried out either via face‐to‐face or telephone and were analyzed using the 7‐step method of Colaizzi. Results: The experiences of nurses caring for patients infected with COVID‐19 were categorized into four challenges, including psychological (eight subthemes), organizational (six subthemes), social (six subthemes), and professional (five subthemes). In general, based on the current classification, there seems to be a mixture of positive and negative effects on the psychological, social, and professional challenges and the negative effect only on the organizational challenges. Conclusions: Positive and negative emotions and experiences have coexisted for the critical care nurses since the COVID‐19 outbreak. Emotional support and psychological counseling play an important role in maintaining nurses' optimal mental health during the COVID‐19 crisis. Adequate protective equipment, financial and nonfinancial supports, effective communication, training and hiring of staff, and appropriate work shifts are also required to reduce nurses' negative experiences when providing care for the affected individuals

Perceived risk of infection and death from COVID-19 among community members of low- and middle-income countries: A cross-sectional study [version 1; peer review: awaiting peer review]

Background: Risk perceptions of coronavirus disease 2019 (COVID-19) are considered important as they impact community health behaviors. The aim of this study was to determine the perceived risk of infection and death due to COVID-19 and to assess the factors associated with such risk perceptions among community members in low- and middle-income countries (LMICs) in Africa, Asia, and South America. Methods: An online cross-sectional study was conducted in 10 LMICs in Africa, Asia, and South America from February to May 2021. A questionnaire was utilized to assess the perceived risk of infection and death from COVID-19 and its plausible determinants. A logistic regression model was used to identify the factors associated with such risk perceptions. Results: A total of 1,646 responses were included in the analysis of the perceived risk of becoming infected and dying from COVID-19. Our data suggested that 36.4% of participants had a high perceived risk of COVID-19 infection, while only 22.4% had a perceived risk of dying from COVID-19. Being a woman, working in healthcare-related sectors, contracting pulmonary disease, knowing people in the immediate social environment who are or have been infected with COVID-19, as well as seeing or reading about individuals infected with COVID-19 on social media or TV were all associated with a higher perceived risk of becoming infected with COVID-19. In addition, being a woman, elderly, having heart disease and pulmonary disease, knowing people in the immediate social environment who are or have been infected with COVID-19, and seeing or reading about individuals infected with COVID-19 on social media or TV had a higher perceived risk of dying from COVID-19. Conclusions: The perceived risk of infection and death due to COVID-19 are relatively low among respondents; this suggests the need to conduct health campaigns to disseminate knowledge and information on the ongoing pandemic

Guidance for management competency identification and development in the health context: a systematic scoping review

Abstract Background Using management competency-based frameworks to guide developing and delivering training and formal education to managers has been increasingly recognized as a key strategy in building management capacity. Hence, interest in identifying and confirming the competency requirements in various contexts have been witnessed. Therefore, learnings from how competency studies were designed and conducted, how competencies were identified, and strategies in ensuring success in competency identification are of great value to researchers planning and conducting competency studies in their own country. Methods A scoping review was conducted guided by the Arksey and O’Malley framework and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). All papers that published empirical studies aiming at identifying and assessing manager’s competencies at the peer-reviewed journals were identified from Web of sciences, PubMed, Scopus and Emerald Management between 2000 and 2021. In order to maximize learning, studies focusing on health and non-health sectors are all included. Results In total, 186 studies were included in the review including slightly more than half of the studies conducted in health sector (54.5%). 60% of the studies focused on mid to senior level managers. Surveys and Interviews were the two most commonly used methods either solely or as part of the mix-method in the studies. Half of the studies used mixed methods approach (51.1%). Large proportion of the papers failed to include all information that is necessary to contribute to learning and improvement in future study design. Based on the results of the scoping review a four steps framework was developed that can guide designing and implementing management competency studies in specific country vs. sector context and to ensure benefits of the studies are maximised. Conclusion The review confirmed the increasing trend in investing in management competency studies and that the management competency identification and development process varied substantially, in the choice of methods and processes. The identification of missing information in majority of the published studies calls for the development of more rigorous guidelines for the peer-review process of journal publications. The proposed framework of improving the quality and impact of the future management competency study provides clear guidance to management competency identification and development that promotes the functional alignment of methods and strategies with intended uses and contexts

The Relationship between Organizational Justice and Turnover Intention: A Survey on Hospital Nurses

Introduction: High organizational justice and its factors are associated with reduced turnover intention. Therefore, in this study, we aimed to examine the relationship between organizational justice and turnover intention among hospital nurses. Materials and Methods: This descriptive, analytical study was conducted on 135 nurses working in Labafi Nejad Hospital in Tehran, Iran, 2015. The data were collected using Beugre's (1998) questionnaire of organizational justice questionnaire. To analyze the data, Pearson’s correlation and ANOVA tests were performed using SPSS, version 20. Results: Mean organizational justice and turnover intention scores were 68.85±7.67 and 47.8±12.47, respectively. Among the different types of organizational justice, the highest mean score was pertinent to interactional justice (75.24±16.68). A significant inverse correlation was observed between turnover intention and organizational justice (r=-0.36), interactional justice (r=-0.38), and procedural justice (r=-0.36), while no association was noted between turnover intention and systemic and distributive types of justice. Furthermore, there was no link between demographic variables, organizational justice, and turnover intention. Conclusion: Considering the prominent role of organizational justice in personnel’s intention to leave their job, and given high costs of recruiting and training new staff, managers should pay especial attention to promoting justice and employees’ satisfaction and enhancing stability in their organizations by reinforcing positive attitudes in the employees

Association between managers’ Competency and Technical Efficiency in General Hospitals in Iran

Introduction: Inefficient management of hospitals leads to the substantial waste of resources. Therefore, hospital efficiency has recently been a major concern among researchers. The present study aimed to evaluate the association of the management competency and technical efficiency in the general hospitals of Tehran, Iran. Materials and Methods: This descriptive-analytical, cross-sectional study was conducted in 28 general hospitals in Tehran, Iran in 2015. In the first step, a survey was performed among 224 managers at different levels in the hospitals using a researcher-made management competency self-assessment questionnaire. In the second step, technical efficiency in the selected hospitals was measured by the Data Envelopment Analysis (DEA). Data analysis was performed using SPSS, Enterprise Management Software (EMS), and Deap1, 2. Results:The average of competency was relatively high among the hospitals managers. However, more than half of the hospital performances were observed to be inefficient. Moreover, the results indicated that the competency of hospital managers was significantly correlated with their field of education, participation in training courses, and managerial experience. Also, a significant, direct association was observed between the competency of managers and technical efficiency in the studied hospitals. Conclusion: According to the results, although the level of technical efficiency was favorable in the studied hospitals, the hospital managers with high competency should further develop and improve their performance and efficiency in these hospitals

Hospital nurses' job security and turnover intention and factors contributing to their turnover intention: A cross-Sectional study

Background: Job security is a critical factor behind quality care delivery. However, it is still unclear whether job security is related to turnover intention among Iranian nurses. Objectives: This study aimed to determine job security and turnover intention and also factors behind turnover intention among hospital nurses who worked in Tehran, Iran. Methods: This cross-sectional study was conducted from April to November 2015 in three public and three private tertiary hospitals in Tehran, Iran. A quota sample of hospital nurses was recruited and a researcher-made questionnaire was used for data collection. The data were analyzed through the Chi-square and the independent-sample t-tests, the one-way analysis of variance, Pearson correlation analysis, and multivariate logistic regression analysis. Results: The mean score of job security was 3.10 ± 0.38 (from a possible range of 1-5). Around 22.6 of nurses reported low job security. Job security among nurses in private hospitals was significantly greater than those in public hospitals (P = 0.001). Moreover, 32.7 of nurses reported that they will leave their profession if they find another job opportunity. Factors behind nurses' turnover intention were work experience (odds ratio OR = 1.30; confidence interval CI: 1.117-2.742), organizational justice (OR = 0.516; CI: 0.522-0.785), job prospect and stability (OR = 0.533; CI: 0.299-0.948), relationships with managers and colleagues (OR = 0.401; CI: 0.409-0.927), and work environment (OR = 0.414; CI: 0.227-0.856). Conclusions: Hospital managers need to develop and adopt effective policies to promote nurses' job security and reduce their turnover intention through improving their job satisfaction and working conditions, providing fair compensations, enhancing supportive nursing management, promoting job prospect and stability, and facilitating competence-based career advancement