QUALITY OF SERVICES IN REHABILITATION CENTERS FROM THE PATIENTS' PERSPECTIVE, USING THE IMPORTANCE-PERFORMANCE ANALYSIS IN AHVAZ, 2015

Quality of service is a key factor in the success of health care organizations, including the rehabilitation centers. Nowadays, rehabilitation centers are faced with many challenges in the quality of service and there are many differences between patients' expectations and perceptions of the service quality received at these centers. So, this study aimed to determine the quality of services in rehabilitation centers from the patients' perspective in Ahvaz using the importance - performance analysis (IPA). In this analytical-descriptive study, the study population was all patients who referred to the five selected rehabilitation centers in Ahvaz in 2015. In this study, 110 patients were selected as samples by a random sampling method. Using a standard 22- item SERVQUAL questionnaire, the quality of service provided in the centers in 5 dimensions of two parts "importance" and "performance was investigated. Data were analyzed using the SPSS and Excel software. All dimensions of service quality in the centers studied, were in the first area of the importance- performance matrix, namely at optimal levels. A significant difference was seen between scores of the importance and performance of the dimensions of the quality of service at the centers studied (p=0. 001). The highest (-0.75) and the lowest (-0.49) gap was estimated for the dimensions of "tangibility" and "empathy", respectively. Services offered in any of the dimensions were not beyond the expectations of clients and still there is much possibility for improving the process. Keywords: Quality of service; Importance-Performance Analysis (IPA); Rehabilitation center

Comparison of Standard and Percutaneous Tracheostomy Complications in Shariati Hospital in Iran

Background: Tracheostomy is a procedure which aims at better managing patients’ airway. It can be done using two methods: standard and percutaneous. The percutaneous method is a favorable choice for critically illpatients because it is a less invasive procedure. This study compares the short-term complications of these two methods (during 7 days after the procedure).Methods: This study was a cross-sectional research performed on 50 ICU patients in need of tracheostomy.The patients were divided into two groups of percutaneous procedure (15 patients) and standard procedure(35 patients). The complications were registered in questionnaires and the data were analyzed using SPSS software (χ² test and t-test).Results: The two groups had no significant difference in age, sex, and vital signs. Average duration of the procedure was 24.4 minutes in the standard procedure (10-45 minutes) and 26.78 minutes (5-70 minutes) in the percutaneous procedure, and there was no significant difference between two groups (P = 0.814). Average bleeding during 7 days after the procedure was 44 cc (10-150 cc) in standard procedure and 24.7 cc (10-50 cc) in the percutaneous procedure, and the difference was significant (P = 0.012). The other variables were not significantly different in two groups.Conclusions: There was no difference in short-term complications between percutaneous and standard tracheostomy method should be selected considering other important factors

Multi-objective inventory routing problem: A stochastic model to consider profit, service level and green criteria

International audienceThe Inventory Routing Problem has been mainly studied in recent decades under an economic performance perspective. In this paper, we develop a multi-objective mathematical framework for the IRP to link: (i) the economic performance, (ii) the achieved server level in terms of shortage and delivery delays and (iii) the environmental footprint. The framework developed addresses the uncertainty by considering fuzzy distributions for certain problem inputs, such as the demand and the transportation costs. We show the negative impact on the economic performance when service level targets are exogenously chosen without coordination with the logistics components (inventory and distribution). (C) 2017 Elsevier Ltd. All rights reserved

Inventory Routing Problem for Perishable Products by Considering Customer Satisfaction and Green Criteria

International audienceThis paper presents a new model for Inventory Routing Problem (IRP) considering simultaneously economic criteria, customer satisfaction level and environmental aspect for perishable products with expiration date. For this consideration, a multi-objective mathematical model has been developed. The first objective focuses on traditional inventory and distribution costs as well as recycling cost of perished products. The second objective concerns in customer satisfaction by minimization of three criteria, such as the number of delays (deliver after time windows), the quantity of backordered, and the frequency of backorders. The third objective considers Greenhouse Gas (GHG) emission, produced by different IRP activities. The proposed model is also enabled to investigate the possibility of using diesel and electrical vehicles in urban transportation. In order to cope with complexity of proposed model, Non-dominated Sorting Genetic Algorithm-II (NSGA-II) is tuned and applied. Finally, sensitivity analysis is performed to investigate the effects of variation of customer satisfaction and green aspects in economic side

Inventory Routing Problem for Perishable Products by Considering Customer Satisfaction and Green Criteria

International audienceThis paper presents a new model for Inventory Routing Problem (IRP) considering simultaneously economic criteria, customer satisfaction level and environmental aspect for perishable products with expiration date. For this consideration, a multi-objective mathematical model has been developed. The first objective focuses on traditional inventory and distribution costs as well as recycling cost of perished products. The second objective concerns in customer satisfaction by minimization of three criteria, such as the number of delays (deliver after time windows), the quantity of backordered, and the frequency of backorders. The third objective considers Greenhouse Gas (GHG) emission, produced by different IRP activities. The proposed model is also enabled to investigate the possibility of using diesel and electrical vehicles in urban transportation. In order to cope with complexity of proposed model, Non-dominated Sorting Genetic Algorithm-II (NSGA-II) is tuned and applied. Finally, sensitivity analysis is performed to investigate the effects of variation of customer satisfaction and green aspects in economic side

Inventory Routing Problem for Perishable Products by Considering Social Issue

International audienceInventory Routing Problem (IRP) for perishable products is one of the complex subjects in IRPs. Moreover, considering other criteria and constraints, such as respecting time window, managing the amount of expired products, fuel consumption and environment and social criteria bring this problem more complex. This paper presents a new model considering economic and social aspects in IRPs. We study the effect of speed of vehicle in distribution of perishable products in IRPs. This consideration allows to reduce delivery time, impacting several economic criteria, but increase driver injury (risk of accident for driver), considerate in this model as social issues. In order to find a tradeoff between these issues, a new bi-objective mathematical model has been proposed. First objective focuses on traditional cost of inventory and distribution as well as age and price strategy, backorder cost and discount. Second objective function concerns in minimization of driver injury (social issue), calculated by considering the speed of vehicle in different existing paths between retailers. In fact, quicker path allows to decrease some costs but increase accident risk. It is noteworthy that other economic and social criteria can also add to proposed model. Finally, sensitivity analysis are performed to investigate the importance of each objective function as well as the effect of variation of inventory holding cost against profit and driver injury

Sustainable Inventory Routing Problem for Perishable Products by Considering Reverse Logistic

International audienceManaging the expiration date of perishable products, gathering the expired products, pollution and cost of recycling the expired products and etc. brings complexity in considering the perishable products in Inventory/Routing Problem (IRP). Moreover, taking into account other criteria such as environmental criteria, social criteria, fuel consumption, respecting time windows and etc. apply more complexity in the IRPs. On the other hand, increase of pollution and pressure of social communities force the managers to pay attention to environmental and social issues. This paper proposes a new bi-objective mathematical model concerning economic, social and environmental issues in distribution of perishable products with specified expiration date in IRPs. First objective focuses on traditional costs of inventory and distribution as well as age and price strategy. Second objective function concerns in maximization of social issues calculated by considering rate of vehicle accident as well as number of expired products. Moreoer. in order to reduction complexity of proposed model, vehicle noise emission as another social issue as well as some environmental criteria have been taken into account as constraint. Since, expired products have direct effect in environmental side and should be recycled, concept of reverse logistic is also applied for gathering the expired products from retailer and return back to supplier. In order to solve the model and reach compromise solution the Torabi-Hassini method is applied. Finally sensitivity analysis is performed to investigate effects of variation of social issues in economic side of proposed problem. (C) 2016, IFAC(International Federation of Automatic Control) Hosting by Elsevier Ltd. All right reserved

Inventory Routing Problem for Perishable Products by Considering Social Issue

International audienceInventory Routing Problem (IRP) for perishable products is one of the complex subjects in IRPs. Moreover, considering other criteria and constraints, such as respecting time window, managing the amount of expired products, fuel consumption and environment and social criteria bring this problem more complex. This paper presents a new model considering economic and social aspects in IRPs. We study the effect of speed of vehicle in distribution of perishable products in IRPs. This consideration allows to reduce delivery time, impacting several economic criteria, but increase driver injury (risk of accident for driver), considerate in this model as social issues. In order to find a tradeoff between these issues, a new bi-objective mathematical model has been proposed. First objective focuses on traditional cost of inventory and distribution as well as age and price strategy, backorder cost and discount. Second objective function concerns in minimization of driver injury (social issue), calculated by considering the speed of vehicle in different existing paths between retailers. In fact, quicker path allows to decrease some costs but increase accident risk. It is noteworthy that other economic and social criteria can also add to proposed model. Finally, sensitivity analysis are performed to investigate the importance of each objective function as well as the effect of variation of inventory holding cost against profit and driver injury

Explaining the Effect of Tourist's Perceived Risks on the Desire to Revisit the Tourism Destination with Mediating Role of Tourism Destination Image

Tourism destination image plays a significant role in the choice of destination. On the other hand, tourist perceived risk is an important factor influencing his/her image of tourism services. Therefore, the present article aims to provide a model for better explaining the impact of tourist perceived risks on the desire to revisit the tourism destination with the mediating role the mental image of the tourism destination image. The statistical population of the study consisted of those foreign tourists who traveled to Isfahan city in November 2015. A sample of 300 people was selected from this population by simple random sampling. To collect data, a questionnaire containing 38 questions was designed. Then, descriptive and inferential statistics were used to examine the research data and test the hypotheses. According to the findings, tourist perceived risk was classified into four groups of political, economic, hygiene and socio-cultural risks. Also, the mental image of the tourist destination can be divided into three dimensions: affective, cognitive, and conative. Furthermore, the research findings showed that perceived political, health, economic and socio-cultural risks have a significant effect on the desire to revisit the destination of tourism with the mediating role of the affective, cognitive, and conative image of the tourist destinatio

Simultaneous coordination of capacity building and price decisions in a decentralized supply chain

International audienceAbstract