Determination of Gap in Accreditation Standards Establishment Process Using Zachman Framework at a Health-Educational Hospital

Background: Accreditation is usually a voluntary plan supported by a non-governmental institution and trained evaluators that examine the competency of organizations providing health service according to pre-specified performance standards. Objectives: The current study aimed to determine the degree of establishment of accreditation standards using logical framework of Zachman. Methods: This descriptive research was conducted during year 2015. The population of the study included people involved in the establishment of accreditation standards. Sampling was conducted in the form of complete enumeration according to 36 standards of accreditation. The instrument used for data collection was the “Logical framework of Zachman”. Columns of framework consisted of people involved in conducting the work (Who), the purpose of the work (Why), strategy of the work (What), work time (When), and sub-system of doing work (Where) and way of doing work (How), and rows of framework included the view of hospital chief, director/assistants of hospital, officials and personnel. Test chi-square was used to compare between accreditation standards text and studied hospital gap. Descriptive statistical method was used for variables. Results: People involved in doing work and sub-systems of doing work at the hospital were consistent with specified accreditation standards. In 27% of the standards, time interval of doing work in the hospital was not conducted according to accreditation standards. In terms of way of doing work, 25% of standards had not been established, and 26% of them had been established incompletely. During interviews, it was found that 59% of personnel of purpose of doing work, and 94% of them are not informed about the strategy of doing work, according to accreditation standards in the hospital. Conclusions: Uncertainties in the accreditation standards in dimensions of purpose, people involved, strategy and time interval of doing work, respectively, led to a lack of understanding the intention of author/developers of standards by personnel. As a result, this led to lack of complete establishment of accreditation standards in the studied hospital. Keywords: Accreditation, Establishment, Gap, Hospitals, Tehra

Comparative study on availability of health services among Zanjan, Qazvin, Alborz provinces using service availability and readiness assessment model

Background: The realization of fair access to health services is one of the essential goals of health systems. The regular monitoring of access is often consider as a weak component in many countries around the world. Objective: This study aimed to compare the availability of health services in Qazvin, Zanjan and Alborz provinces using service availability and readiness assessment model (SARA). Methods: This cross-sectional study was performed in Qazvin, Zanjan and Alborz provinces in 2012. The questionnaire using components available in the SARA reference book has been prepared and further localized for our country. This questionnaire contains three main components including infrastructure, core health personnel and service utilization. The data is obtained from the ministry of health and statistics center of Iran. Findings: Availability of health service in Qazvin, Zanjan and Alborz province showed favorable situation (115, 167 and 59% respectively), infrastructure (383, 264 and 163% respectively), core health personnel (307, 223 and 96% respectively) and the outpatient utilization (24, 18 and 14% respectively) and in patient utilization (108, 44 and 72% respectively) in compare to SARA model. Conclusion: The results showed that the availability of health services in Zanjan is more qualificated than Qazvin and Alborz, so that Qazvin and Alborz should allocate more costs to provision of health services in both provinces. Keywords: Health services accessibility, Supply and distribution, Health manpowe

Relationship between Communication Skills in Headnurses and Self-Efficacy in nurses in the Educational Hospitals of Sanandaj

Abstract Background: Providing convenience and comfort for patients is a nursing duty which is affected by different stressors. Therefore, Lack of attention to the communication skills of head nurses can cause increased stress in the workplace and has an adverse effect on the self-efficiency of nurses. This study aimed to determine the relationship between communication skills of head nurses and self-efficacy of nurses in the educational hospitals of Sanandaj. Methods: This Analytical Cross Sectional study was conducted in 2015 on 51 head nurses and 153 nurses in different wards of Sanandaj teaching hospitals (Besat, Tohid and Qods hospitals). Samples were selected through census for headnurses and random for nurses. Queendom Communication Skills Inventory and Sherer's self-efficacy questionnaire were used to collect the data. Finally, collected data were analyzed using SPSS version 22 by descriptive statistics and appropriate tests like independent t-test, one way ANOVA, Tukey test, and Pearson correlation coefficient. Results: Most head nurses were women, aged 30 to 54 years. They were married and had a bachelor’s degree in nursing. Communication skills, including the ability to receive and send messages, emotional control, listening, insight into the communication process in studied head nurses were higher than the average value (average value=3) and communication skills combined with the certainty which was less than the average value. There was no significant relationship between age, sex, education level, work experience, and communication skills of head nurses. Conclusion: There was a statistically significant relationship between communication skills of head nurses and self-efficacy of nurses. Therefore, the self-efficacy of nurses increased with the increasing communication skills of head nurses in the clinical activities. It led to job satisfaction and motivate the nurses to work in their current duty station and prevented job quitting. Keywords: communication skills, supervisor, nurse, educational hospita

Comparative study on Availability of Health Services among Zanjan, Qazvin, Alborz provinces using SARA Model

Background: The Realization of Fair Access to Health Services Is One of the Essential Goals of Health Systems. The Regular Monitoring of Access Is often Considered as a Weak Component in Many Countries Around the World. Objective: This Study Aims to Compare the Availability of Health Services in Zanjan, Qazvin and Alborz Provinces Using the Service Availability and Readiness Assessment Model (SARA). Materials And Methods: This Cross-Sectional Study Was Performed in Qazvin, Zanjan and Alborz Provinces Due to Demographic and Geographic Similarities that Provinces Studies Had Found for These Regions in 1391. The Questionnaire Using Components Available in the Service Availability and Readiness Assessment Reference Book Has Been Prepared and Further Localized for Our Country. This Questionnaire Contains Three Main Components Including Infrastructure, Core Health Personnel, and Service Utilization. The Data is Obtained from the Ministry of Health and Statistics Center of Iran, and Analyzed by Microsoft Excell 2010. Results: Availability of Health Service in Zanjan, Qazvin and Alborz Province Showed Favorable Situation(115,167 and 59 Percent Respectively). Infrastructure (383, 264 and 163 Percent Respectively), Core Health Personnel (307, 223 and 96% Respectively) and the Outpatient Utilization (Respectively 24, 18 and 14 Percent) and Inpatient Utilization (108,44 and 72 Percent Respectively) in Compare to SARA Model. Conclusion: The results Showed That the Availability of Health Services in Zanjan is More qualificated than Qazvin and Alborz, so that Qazvin and Alborz should allocate more costs to provision of health services in both province

مقایسه استقرار حاکمیت بالینی در بیمارستان های دارای سیستم مدیریت کیفیت ایزو 9001 و فاقد آن در کشور در سال 91

زمینه و هدف: تاكيد بر كيفيّت در اقتصاد جهاني امروز, كليد دستيابي به شايستگي در عمليّات و فعاليّت ها مي‌باشد. افزايش كيفيّت، منجر به افزايش بهره وري و منافع وابسته به آن, مي‌گردد. این مطالعه با هدف مقایسه فرایند استقرار فرایند حاکمیت بالینی در بیمارستان دارای گواهینامه ISO9001 و بیمارستان های فاقد آن در استان های منتخب در سال های 91 انجام شد. مواد و روش ها: این مطالعه به صورت توصیفی – تحلیلی انجام شده است. نمرات اخذ شده توسط بیمارستان ها در هر محور در چهار دسته قابل بهبود،‌ متوسط، خوب وخيلي خوب تقسیم بندی شده است که به ترتيب مبين احراز كمتر از 50درصد نمره، بين 50تا70درصد، 70تا 85درصد وبالاتر از 85درصد نمره مي باشد. یافته ها : در این مطالعه تعداد 112 بیمارستان مورد بررسی قرار گرفتند . که تعداد 33 بیمارستان های دارای ایزو و 70 بیمارستان فاقد ایزو بوده اند. در این مطالعه هیچ رابطه معنی داری بین پیاده سازی سیستم مدیریت کیفیت ایزو و محورهای حاکمیت بالینی یافت نشد. نتیجه گیری: با توجه به اهمیت وجود یک مدل مناسب جهت ارزیابی عملکرد و بالا بردن کیفیت خدمات، در این مطالعه رابطه معنی داری بین پیاده سازی ایزو و موفقیت در اجرای حاکمیت بالینی در بیمارستان ها یافت نشد و بین محور مدیریت و رهبری با سه محور آموزش و مدیریت کارکنان، ایمنی بیمار و استفاده از اطلاعات رابطه مستقیم و معنی دار وجود دارد و همچنین بین محور آموزش و مدیریت کارکنان با تمامی محورهای مورد مطالعه رابطه مستقیم و معنی دار وجود دارد و همچنین بین محور ایمنی بیمار و استفاده از اطلاعات نیز ارتباط مستقیم و معنی دار وجود دارد، لذا توصیه میشود که مطالعات بیشتری در این زمینه انجام شود

Evaluation of the Performance of Selected Social Security Hospitals Using the PATH Model in 2016

Abstract Background and aim: Evaluation of the performance of hospitals of the Social Security Organization in multiple dimensions in improving the quality of services provided by these hospitals and community health is of great importance. The purpose was to evaluate the performance of social security hospitals using (PATH) in 2016. Material and Method: The present study was descriptive-survey and applied in terms of its purpose. The research tool was a questionnaire for determining the weight of elements of the evaluation model and the information form of the hospital indicators. The statistical sample in the Weighting component of the evaluation model was 13 experts in the performance assessment of the hospital and in the performance evaluation section of eight hospitals of the Social Security Organization. Data were analyzed using descriptive statistics, AHP and Topsis approach, and using Excel and Expert Choice software. Results: According to AHP, the priority of PATH performance evaluation criteria in the hospitals of the organization was 1- Safety, 2- Patient-centredness, 3-clinical effectiveness, 4- Reponsive governance, 5- Staff and 6- Efficiency .According to the findings of a comparison of the existing performance assessment of hospitals in the social security organization with the PATH model, only 20% of the PATH approach indicators are evaluated in the current method, and beyond these four indicators assessed in the current assessment method It is related to the clinical performance and clinical efficacy of hospital functioning, and therefore the current methodology does not comprehensively evaluate all aspects of hospital performance and addresses the dimensions of patient safety, patient morbidity, accountability and senior staffing with high priority dimensions The social security organization has not paid any attention. According to Tapisis, the performance of hospitalized hospitals in order of better performance is: 1- Imam Hossein Hospital, Zanjan 2- Fayazbakhsh Hospital, 3- Lavasani Hospital, 4- Hazrat Masoumeh Hospital, 5- Gorazi Hospital, 6- Shariat Razavi Hospital, 7 Ali nasab Hospital and Shahriyar Social Security Hospital and Conclusion: The PATH pattern is an evaluation system that reflects the key interests of the hospital, patients, employees and stakeholders and Social security administrators can use this approach to compare the performance of the hospital and its ranking from different perspectives And in the long run, by defining the necessary improvement measures, improves the performance of supervised hospitals and, as a result, promoting community health. Key Words: Hospital Performance Evaluation, PATH Mode