The impact of quality management on reducing canceled elective operations: a participatory action research

Background and Aims: Surgery operations cancellation causes problems in operation theatre planning and results in hospital inefficiency as well as resource wastage. In addition, it causes stress for both patients and their relatives.This study aimed to examine the impact of quality management on surgery operations cancellation in Vali-e-asr hospital’s operating theatre department (Tehran) in 2014-2015.Materials and Methods: In this participatory action research, the reasons for surgery operations cancellation were identified using a checklist. These reasons were assessed and an action plan was developed for cancellation reduction. The plan was implemented using the action research cycle. SPSS software (version 22) was used for data analysis. Ethical issues such as respect for patients and staff and the confidentiality of information were all considered.Results: Patients failing to turn up, lack of ICU beds availability, and prolonged previous surgeries were the most common causes of surgery operations cancellation. Surgery operations were increased by 15 percent and surgery operations cancellation was reduced by 14.6 percent through the implementation of quality management strategy. Standardization of processes, proper planning, using HIS based operation list, recruiting more staff and giving more information to patients helped reducing the surgery operations cancellation.Conclusion: Formation of quality improvement team, using an appropriate quality management model and its appropriate implementation can help enhance hospital departments’ productivity and reduce surgery operations cancellation.Keywords: Quality management, surgery operations cancellation, hospital, action researc

تأثیر مدیریت کیفیت بر کاهش موارد لغو اعمال جراحی: یک مطالعه اقدام پژوهی مشارکتی

Background and Aims: Surgery operations cancellation causes problems in operation theatre planning and results in hospital inefficiency as well as resource wastage. In addition, it causes stress for both patients and their relatives.This study aimed to examine the impact of quality management on surgery operations cancellation in Vali-e-asr hospital’s operating theatre department (Tehran) in 2014-2015.Materials and Methods: In this participatory action research, the reasons for surgery operations cancellation were identified using a checklist. These reasons were assessed and an action plan was developed for cancellation reduction. The plan was implemented using the action research cycle. SPSS software (version 22) was used for data analysis. Ethical issues such as respect for patients and staff and the confidentiality of information were all considered.Results: Patients failing to turn up, lack of ICU beds availability, and prolonged previous surgeries were the most common causes of surgery operations cancellation. Surgery operations were increased by 15 percent and surgery operations cancellation was reduced by 14.6 percent through the implementation of quality management strategy. Standardization of processes, proper planning, using HIS based operation list, recruiting more staff and giving more information to patients helped reducing the surgery operations cancellation.Conclusion: Formation of quality improvement team, using an appropriate quality management model and its appropriate implementation can help enhance hospital departments’ productivity and reduce surgery operations cancellation.چکیدهزمینه و هدف: لغو اعمال جراحی یی از دلال عدم کارای بخش اعمال جراحی بیمارستانها است که علاوه بر اجاد اختلال در برنامهرزی،ک ییییمنجر به اضطراب بیمار و همراهان وی میشود. ان پژوهش با هدف بررسی تأثیر مد رت کیفیت بر کاهش موارد لغو اعمال جراحی در یین.بیمارستان ولیعصر  تهران در شش ماهه اول سال 1393 انجام شد مواد و روشها: ان پژوهش از نظر هدف کاربردی و از نوع اقدامپژوهی مشارکتی است. با استفاده از ک مدل مد یرت کیفیت، فراندهای یییییو راش 22 استفاده شد. SPSS کاری بخش به منظور کاهش لغو اعمال جراحی استاندارد و ارتقا افتند. برای تحلیل داده ها از نرم افزاریییدر کلیه مراحل پژوهش موازن اخلاقی از جمله احترام به کارکنان و بیماران و محرمانه تلقی کردن اطلاعات شخصی افراد شرکت کننده دری.پژوهش رعات شدی یافتهها: عدم مراجعه بیمار، نبودن تخت ICU، تشخیص در هنگام مشاوره و ... از دلال عمده لغو اعمال جراحی در ان بیمارستان بود. اجرای ییی مدل مد رت کیفیت منجر به افزاش 15 درصدی تعداد اعمال جراحی و کاهش 14/6 درصدی لغو اعمال جراحی شد. از اقدامات انجام شده ییی برای رفع ا کاهش لغو اعمال جراحی میتوان به تهیه پروتل آماده سازی بیماران برای جراحی در اتاق عمل، پیگیری به موقع انجام و زت ک یییپزش ان و تهیه پروت ل درخواست مشاورههای درمانی برای بیماران وآموزش بیمار و کارکنان بود.کک نتیجهگیری: تشیل تیم بهبود کیفیت، ب ارگیری ک مدل مناسب مد رت کیفیت و اجرای درست آن میتواند در کاهش موارد لغواعمال جراحی بیماران موثر باشد. &nbsp

The Relationship between Stress Coping Styles and Pain Perception in MS Patients during the Coronavirus Outbreak: The Mediation Role of Resilience

Background and Aim:The present study aimed to investigate the relationship between stress coping styles and pain perception of MS patients during the coronavirus outbreak with the mediating role of resilience. The coronavirus outbreak and its rapid global spread have created unprecedented challenges for health care systems, and patients with MS were no exception to these problems. Materials and Methods:The research method was correlational using the path analysis method. The statistical population included all patients with relapsing-remitting multiple sclerosis (MS) referred to the MS Research Center of SINA Hospital in Tehran in 2020-2021. A total of 300 people were selected as the research sample through the purposive sampling method. The results were analyzed using path analysis with Amos software. Results:The results showed a negative and significant relationship between stress coping styles and pain perception of MS patients during the coronavirus outbreak. The results showed that resilience had a moderating role in the relationship between stress coping styles and pain perception of patients with MS during the coronavirus outbreak (P<0.01). Conclusion:Resilience regulates pain management and perception in MS patients by moderating and reducing tension. Therefore, it seems that it can reduce the pain perception during the coronavirus outbreak by reducing and adjusting coping styles against stress related to COVID-19. Instead of directly confronting the source of stress and dealing with its various aspects by ignoring and considering the issue unimportant, patients can significantly reduce their anxiety

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A novel risk management model in the Scrum and extreme programming hybrid methodology

Risk management in software development has always been one of the necessities of software project management. The logical nature of software projects and products has caused several challenges and risks in these projects. On the other hand, with the emergence of Agile methodologies, especially Scrum, and extreme programming (XP) methodologies, in recent years, this issue has become more serious. This is mainly because emphasizing limited documentation in these methodologies has caused these methods to pay little attention to some aspects of project management, particularly risk management. Concentrating on this challenge, the current study has proposed a risk management model in the hybrid methodology, combining Scrum and XP. Using this model in a case study shows this model's success in achieving risk management purposes. The results of this study indicate an appropriate reduction in the number of reworks, change requests, identified risks, and occurred risks. Moreover, the number of eliminated risks and team productivity have increased

The Impact of Quality Management on Job Satisfaction of Operating Theatre Department Employees of Valiasr Hospital in Tehran: A Participatory Action Research

Introduction: Employees’ job satisfaction has a significant effect on providing high quality services to patients. The aim of this study was to examine the impact of quality management on job satisfaction of Operating Theatre Department employees of Valiasr Hospital in Tehran in 2014. Methods: This participatory action research was performed on employees of Operating Theatre Department of Valiasr Hospital in Tehran in the first six months of 2014. Employees’ job satisfaction was measured using a reliable questionnaire and the causes of employees’ dissatisfaction were determined. Then, the employees’ working processes and job satisfaction were improved using a ten-step quality management model provided by Mesdagh Rad. Employees’ job satisfaction was statistically compared before and after the quality management intervention using SPSS 18. Results: Employees’ job satisfaction was 51.2 percent. High work pressure, compressed shift schedule, high job stress, lack of organizational justice, reward system, and inappropriate encouragement, and lack of attention to the employees’ needs, especially on the night shift, were the main causes of employees’ dissatisfaction. Employees’ satisfaction after intervention was 59.2 percent. The results showed that quality management improved employees’ satisfaction by 15.6 percent. Employees’ job satisfaction before and after the intervention was significantly different (P=0.000). Quality management principles such as management commitment, employees’ empowerment, teamwork, trust and cooperation, effective communication, continuous training and learning, customer focus, and continuous quality improvement have positive effect on employees’ job satisfaction. Conclusion: Implementing an appropriate quality management model enhances job satisfaction of hospitals employees. Key­words: Quality Management, Continuous Quality Improvement, Job Satisfaction, Hospital, Action Research Citation: Mosadeghrad AM, Afshari M. The Impact of Quality Management on Job Satisfaction of Operating Theatre Department Employees of Valiasr Hospital in Tehran: A Participatory Action Research. Journal of Health Based Research 2016; 2(2): 147-158

The impact of quality management on income of operating theatre in a hospital: brief report

Background: Hospitals are dealing with unlimited demands and limited resources. Hospital managers should use appropriate strategies to improve quality of services, enhance patients’ satisfaction and increase financial resources. This study aimed to examine the impact of quality management. Methods: A participatory action research was used for the intervention on income of operating theatre in Vali-e-Asr Hospital in Tehran University of Medical Sciences, between March and September 2014. A quality improvement team was established and improved operational processes of the operating theatre department of the hospital using Mosadeghrad’s ten-step quality management model. The quality improvement team standardized processes, identified goals for the processes and improved them until achieved the goals. Accordingly, an action plan was developed and implemented for increasing the income of the operating theatre department. Income data of the operating theatre department were obtained for a 6-month period in 2014, and were compared with a control 6-month period in 2013. Results: Implementing quality management increased the number of surgeries by 14.96 percent, decreased cancelled surgeries by 14.6 percent and reduced bill deductions imposed by health insurance companies by 44.9 percent. As a result, the operation theatre department income has increased by 68.8 percent (P=0.028). Some of solutions used for increasing the income were as standardizing and improving working processes, removing unnecessary activities, empowering staff; increasing department’s working hours, on time visit of patients by doctors and surgeons, reducing surgery cancellations, increasing number of patients, reducing deductions applied by the health insurance companies and training staff and patients. Conclusion: Implementing an appropriate quality management model appropriately helps improve quality of services and enhance hospital departments’ income

Acute Datura Stramonium poisoning in East of Iran - a case series

Objectives: Datura Stramonium (DS) is a common weed along roadsides, in cornfields and pastures and in waste areas. It belongs to the family Solanaceae and its toxic components are tropane belladonna alkaloids. It has been used voluntarily by teenagers for its hallucinogenic effect. The plant is named in Iran as Tatoore. Symptoms and signs of acute D. Stramonium poisoning usually are similar to anticholinergic syndrome. This study is done in order to clarify the status of this poisoning in our region. Materials and Methods: This study is a case series on all patients admitted to Imam Reza Hospital, Mashhad, Iran, with acute D. Stramonium poisoning between 2008 and 2011. We observed their symptoms, signs, routine laboratory test results and treatment used to control their symptoms. Results: There were 19 patients included in our study. Children were poisoned more commonly than teenagers and poisoning in adults was rare. All of the children ingested the plant accidentally. The most presenting symptom was irritability and the most common sign was sinus tachycardia. There was not any presentation of seizure or coma. Most of the symptoms were controlled by parenteral benzodiazepines and there were no need to use of cholinergic agents such as physostigmine. Conclusion: Our study showed most of D. Stramonium poisoned population in our region are children. We suggest decreasing accessibility to the plant in order to decrease the incidence of its poisoning.

Impact of unemployment on health in Iran: A scoping review of 15 years of research

Background & Objective: One of the social determinants of physical and mental health is unemployment. This has a harmful effect even when the social class, poverty, age, and history of previous illnesses are also controlled. The purpose of this study was to review the evidence of the unemployment on the health of Iranian society. Materials & Methods: This study was conducted using a scoping review to find empirical research papers published on the impact of unemployment on health in Iran from 2003 to 2018. Seven electronic databases and two search engines were searched using appropriate keywords. Bibliography section of the retrieved papers and related journals were also searched for papers that were not yet indexed in the databases. 1063 publications were identified. All retrieved papers were assessed using a valid checklist before analysis. Finally, 56 empirical studies were reviewed using MAXQDA software. Results: About 39.3 percent of articles was published in Persian on impact of unemployment on health, which 70% of them have been written since 2011. Most of the studies were conducted in Tehran, Esfahan and Eastern Azerbaijan provinces. In this study, four main themes were psychological hazards, physical dilemmas, family problems, and socioeconomic risks. Conclusion: Unemployment has the greatest impact on the dependent variable of multidimensional poverty (health). Therefore, attention to professional and occupational policies, the establishment of social welfare systems and taxation can help to expand employment and increasing the share of GDP to implement labor market programs is essential. Efforts to raise employment should be prioritized

The impact of health transformation plan on health services fees: brief report

Background: Tariff setting in healthcare is an important control knob affecting the quality, access and cost of services. As part of Iran Health Transformation Plan (HTP) in 2014, the relative value of health care and services was increased to motivate healthcare providers to deliver high quality services. This study aimed to examine the impact of HTP on health services tariffs. Methods: This descriptive and cross-sectional study used the data from California Tariff Book (2013 edition) and the new relative value book (2016 edition). The weighted average of the relative value of the anesthetic and surgical services in both books was calculated and compared. Results: The California book and the new relative value book had 5281 and 3448 service codes respectively in 13 major medical specialties (34.7 percent reduction of service codes in the new tariff book). Overall, 64985.9 K and 125133.6 K were considered in the California book and the new relative value book (92.6% growth). The California book and the new relative value book considered 25,976 K and 22,307 K for anesthesia services, respectively in those 13 medical specialties (14.1% reduction). The HTP has increased the relative value of healthcare services tariff by 1.9 times in average. Conclusion: The HTP has doubled the tariff of healthcare services. A rise in the relative value of healthcare services has incurred financial burden on Iranian public health insurance companies and made it difficult to finance health system of the country. A sustainable health financing system should be developed as well a change should be applied in provider payment system to control the cost and increase the health system efficiency