Identifying factors affecting about outsourcing in paraclinical services: a systematic review of literature

Objective: Outsourcing refers to the transfer of services or functions to an outsider supplier, which controls them through a contract or cooperative. The main problem of senior managers in health organizations is determining the services which should be outsourced. The present study seeks to identify the factors that affect decision about outsourcing.Methods: We systematically searched relevant databases including Pub Med, Scopus, Science Direct and Web of Science databases using terms “Outsourcing AND Decision Making OR Policy AND health OR hospital OR health care OR health services OR healthcare”. Studies were identified and screened in accordance with the preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) published in English or Farsi, determining factors that affect making decision about outsourcing a health organization services.Results: The search retrieved (2585) citation of which 14 studies were eligible. Across the eligible articles,10 overarching themes including 40subthemes that affectdecision maker to outsource a service or not, emerged.Conclusions: Results of this study offer evidence for a comprehensive approach todesign and implement a strategic planthat can be used as guidance for policy makers, micro and macro healthcare authorities and managers, and other stakeholders in this area to select and apply the best strategies to make outsourcing in the best possible way.Keywords: Outsourcing, Health Services, Effective factors, Health Organizatio

Assessment of hospital management and surge capacity in disasters

Background: Hospital administrators play a key role in the effective management of surge capacity in disasters, but there is little information available about the characteristics required to manage this. Objectives: In this study, we aimed to identify characteristics of hospital administrators that are important in the effective management of surge capacity in disasters. Materials and Methods: This was a qualitative study. Semi-structured purposive interviews were conducted with 28 hospital administrators who had experience working in surge situations in hospitals during disasters. Framework analysis was used to analyze the data. Results: Three themes and 12 subthemes were identified. The themes were as follows: 1) crisis managerial characteristics, 2) personal characteristics, and 3) specific requirements. Conclusions: In this study, some characteristics that had a positive impact on the success of a manager in a hospital surge situation were identified. These characteristics ought to be taken into account when appointing hospital administrators and designing training programs for hospital administrators with the aim of being better prepared to face disasters. Copyright © 2016, Trauma Monthly

Ranking the effective factors in attracting health tourists in Tehran: Application of multi-criteria decision-making model

Health tourism is rapidly emerging as a symbol of international trade in health care. The present study was aimed to identify and prioritize the effective factors in attracting health tourists in Tehran province by multi-criteria decision-making model. The present study is a descriptive research which was carried out in a cross-sectional method in 2016 in two stages. In the first stage, the factors affecting the attraction of health tourism were identified with reviewing the studies. And in the second stage, the identified effective factors were ranked, which was carried out using the Analytic Hierarchy Process. In order to collect the required data, a paired comparison questionnaire was employed. The reliability of questionnaire was confirmed according to the inconsistency rate which was 0.02. Expert Choice 11.0 was employed to analyze and weight the factors. After the factors were weighted, they were prioritized based on their assigned weights. The results of the present study showed that all of the participants believed that quality with a weight of 0.223, patient-centered areas with a weight of 0.106, and appropriate time with a weight of 0.100 were ranked first to third. According to the results of the present study, it can be concluded that quality of the delivered services is the most important criteria in absorbing health tourists in the province and even in the country. © 2016 Hosein Shabaninejad et al

Developing a practical toolkit for evaluating hospital preparedness for surge capacity in disasters

Hospitals play a key role in providing health care services for a surge of disaster victims. For better planning in this area, it is necessary to have a toolkit for evaluating hospital preparedness for surge capacity. This study was aimed to design an elementary toolkit for evaluating hospital preparedness for surge capacity in disasters, based on the experts' viewpoints. This study consisted of four stages. In the first stage, in order to design an initial toolkit, an expert panel was held. The second stage was done to verify the initial toolkit. In the third stage, the components of the toolkit were weighed and in the fourth stage, at first the components of the toolkit were scored and then, a system for ranking the rate of hospital's preparedness for surge capacity was developed. In both the second and the third stage, Delphi method was used. In this study, a toolkit was developed which consisted of 64 components in five categories and 13 sub-categories. Among 64 components, 33 components were weighed as critical, 18 as core and 13 as advanced components. Also, it was determined that each component could earn a score between 0 and 5. Finally, a system with five levels was presented for ranking the rate of hospital's preparedness for surge capacity in disasters. The toolkit presented in this study can be used for evaluating hospital preparedness for surge capacity in disasters, as well as a guide for better planning and management in this regard. © 2018 Elsevier Lt

Multi-messenger Observations of a Binary Neutron Star Merger

International audienceOn 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of $\sim 1.7\,{\rm{s}}$ with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg(2) at a luminosity distance of ${40}_{-8}^{+8}$ Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 $\,{M}_{\odot }$. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at $\sim 40\,{\rm{Mpc}}$) less than 11 hours after the merger by the One-Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ∼10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position $\sim 9$ and $\sim 16$ days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC 4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta