Assessing performance of Guilan university hospitals (2012)

Background: Performance assessment could provide information to control and monitor of the current status and activities in hospitals. Objective: To assess the performance of hospitals affiliated with Guilan University of Medical Sciences in 2012. Methods: This cross-sectional study covered all the 22 public hospitals in the Guilan province, with 3760 registered beds. Using standard data-gathering form, verified by the Iranian Ministry of Health, performance indicators of 22 hospitals were recorded from the Statistical Services Center at Guilan University of Medical Sciences. Bed Occupancy Rate, Average Length of Stay and Bed Turnover Ratio were calculated and Pabon Lasso chart was drawn using SPSS statistics 17.0. Findings: On average, the Bed Turnover Ratio (time/year), Bed Occupancy Rate (%) and Average Length of Stay (day) were 78 times per year, 60% and 3.70 days, respectively. Based on the Pabon Lasso chart, 27 percentage hospitals were located in zone 1, 23 percentage hospitals in zone 2, 36 percentage hospitals in zone 3 and 14 percentage hospitals in zone 4. Conclusion: The performance of the hospitals was in a moderate level. Keywords: Hospital, Performance Assessment, Bed Occupancy, Bed Turnover, Length of Sta

Application of Balanced Scorecard (BSC) in Evaluating the Performance of Health Care Providers: A Review

Background: As a comprehensive approach to assessing the performance of hospitals, Balanced Scorecard methodology is a tool to transform the organization's mission into concrete measurable objectives, activities and performance. Methodology: The present study is a systematic review conducted via searching in different sites, such as: Magiran, Irandoc, Google Scholar, Iranmedex. Several studies on the balanced scorecard have been done in different organization. In this study, we chose the articles aiming to assess the health care and hospital using BSC. Then their subjects were compared with the present study, and then the related studies were briefly mentioned. Finding: Based on the results of studies in this area, the main purpose of using the balanced scorecard can be used in studies such as the ability to update the strategy, the establishment of the strategy throughout the organization, coordination unit and individual goals of the strategy, linking strategic objectives to long-term goals and annual budget through performance measures, assessment of performance for learning and improvement strategies. Results: The results of this study showed that combining models is a way for assessing function and increasing the satisfaction and commitment. And the balanced scorecard is recommended as a model that can help increase efficiency and better evaluation of the performance

The effects of the health reform plan on the performance indicators of hospitals affiliated with Qazvin University of Medical Sciences, Iran, 2014

BACKGROUND: One of the significant goals of healthcare delivery organizations is to promote people’s health and provide high quality care. In this regard, health reform plan was designed in Iran. Therefore, the present study aimed to evaluate the performance of teaching hospitals after running of health system reform plan in Iran.METHODS: This retrospective-descriptive study was carried out in 4 hospitals (Avicenna, Velayat, Rajaee, and Qhods) affiliated with Qazvin University of Medical Sciences, Qazvin, Iran, in 2014. Data collection tool was the checklist of standard indicators of Iranian Ministry of Health, because the checklist is standard to measure hospitals’ performance. In this study, 19 indicators (performance indicators, personnel indicators, and financial indicators) were investigated. To fill out the indicators checklist, the statistics unit of Ministry of Health was used according to the reports of two consecutive years of 2013 and 2014. The collected data were analyzed using Excel software.RESULTS: In general, out of the 7 performance indicators that were investigated in the hospitals, increase was observed in four, and decrease was seen in three items. Out of the six personnel indicators, all of the hospitals experienced a rise; and out of the six financial indicators, four items increased and two decreased.CONCLUSION: The results of this study indicated that after one year of implementing health reform plan, the mentioned health care system experienced a remarkable progress in the hospitals. Providing the necessary infrastructures can help better conduction of the plan and promotion of the mentioned indicators by removing or decreasing the effect of some barriers

Nurses’ understanding of evidence-based practice: Identification of barriers to utilization of research in teaching hospitals

BACKGROUND: In medical organizations, utilizing evidence-based practice (EBP) helps nurses and patients make the best decision in health care in certain clinical settings. Hence, recognizing its educational barriers is so important.METHODS: The present study was a descriptive-analytical research that was conducted using a cross-sectional design in 6 teaching hospitals of Qazvin City, Iran, in 2014. The study sample consisted of 260 nurses. Based on the number of the nurses working in each hospital, the study sample was chosen by a stratified random method. Two questionnaires were employed to collect the required data. The first questionnaire was Evidence-Based Practice Questionnaire (EBPQ) that evaluates nurses’ understanding of EBP. The second questionnaire was related to measuring the barriers to utilization of research by the nurses that was developed by Funk et al. For analyzing the collected data, frequency distribution tables, analysis of variance (ANOVA), and linear regression coefficient were used.RESULTS: The total mean of EBP among the nurses was at a level above average. The subscales of knowledge/skill (3.74) and attitude (3.87) had a lower average compared to the subscale of practice (4.14). The total mean of the barriers was 3.07. According to the results of the present study, organization and adopter had the highest and lowest means, respectively.CONCLUSION: Identifying the barriers that affect effective EBP implementation can help nurses achieve their goals by removing these obstacles, building the necessary infrastructure, and providing human, physical, and financial resources

A lump in throat: Qualitative study on hospitalization-related experiences among the parents of children with cancer

BACKGROUND: As the second leading cause of death, cancer is among the most stressful life events. It affects not only the afflicted patients, but also their families. Hospitalization of children with cancer faces their parents with many challenges and problems. This study was made to explore the hospitalization-related experiences among the parents of children with cancer. METHODS: This qualitative phenomenological study was made in 2015–2016 in the hematology and oncology care unit of a teaching hospital located in Qazvin, Iran. Sampling was done purposefully and was ended once data saturation was achieved. Consequently, fifteen parents of children with cancer were recruited. Semi-structured interviews were held for data collection. The data were analyzed through the seven-step hermeneutic data analysis process proposed by Diekelmann and Ironside (1998). RESULTS: Two main categories were extracted from the data which included “the shadow of government administration” and “the role of support systems”. The former refers mainly to accommodations in hospital settings and the process of clinical care delivery, while the latter points to the parents’ psychological experiences of presence in hospital settings. These themes came under the overarching main theme of “lump in throat: the suffering of the parents of children with cancer”. CONCLUSION: Study findings reveal that parents’ experiences of hospitalization greatly depend on their perceptions of the environmental conditions of hospital settings. Moreover, the findings showed that negative hospitalization-related experiences could lead to many adverse consequences for patients, families, and healthcare providers

The effects of the health reform plan on the performance indicators of hospitals affiliated with Qazvin University of Medical Sciences, Iran, 2014

BACKGROUND: One of the significant goals of healthcare delivery organizations is to promote people’s health and provide high quality care. In this regard, health reform plan was designed in Iran. Therefore, the present study aimed to evaluate the performance of teaching hospitals after running of health system reform plan in Iran. METHODS: This retrospective-descriptive study was carried out in 4 hospitals (Avicenna, Velayat, Rajaee, and Qhods) affiliated with Qazvin University of Medical Sciences, Qazvin, Iran, in 2014. Data collection tool was the checklist of standard indicators of Iranian Ministry of Health, because the checklist is standard to measure hospitals’ performance. In this study, 19 indicators (performance indicators, personnel indicators, and financial indicators) were investigated. To fill out the indicators checklist, the statistics unit of Ministry of Health was used according to the reports of two consecutive years of 2013 and 2014. The collected data were analyzed using Excel software. RESULTS: In general, out of the 7 performance indicators that were investigated in the hospitals, increase was observed in four, and decrease was seen in three items. Out of the six personnel indicators, all of the hospitals experienced a rise; and out of the six financial indicators, four items increased and two decreased. CONCLUSION: The results of this study indicated that after one year of implementing health reform plan, the mentioned health care system experienced a remarkable progress in the hospitals. Providing the necessary infrastructures can help better conduction of the plan and promotion of the mentioned indicators by removing or decreasing the effect of some barriers

Effect of workload on quality of work life among staff of the teaching hospitals of Shahid Beheshti University of Medical Sciences (2014)

Background: Quality of work life is the reaction of employees to their work specially the individual results at work and mental health that affects their personal experience and work results. Objective: The aim of this study was to determine the effect of workload on quality of work life in staff of the teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran. Methods: This analytical study was conducted in 530 staff of four hospitals affiliated to the Shahid Beheshti University of Medical Sciences that were selected by Cochrane sampling method during 2014. The measurement tools were demographic questionnaire, Walton's quality of work life questionnaire (including 32 questions and eight dimensions), and the NASA TLX workload scale. Data were analyzed using Pearson’s correlation coefficient. Findings: The mean scores of quality of work life and workload were 48.21±13.34 and 64.70±11.44, respectively. There was negative significant correlation between workload and quality of work life (r= -0.0161). Conclusion: With regards to the results, it seems that high workload is one of the most important factors of reduced quality of work life that can be reduced through proper organization and planning. Keywords: Quality of life, Workload, Hospital

Disaster Risk Assessment in Educational Hospitals of Qazvin Based on WHO Pattern in 2015

Introduction: In addition to damaging communities and infrastructures, unexpected disasters affect service provider centers as well. Structural, non-structural, and functional components of hospitals could be affected when hazards or disasters occur, and they may be unable to admit casualties, have their own personnel and patients killed or injured, have their property destroyed. In such as case, they would increase the burden of death resulting from the disaster. Therefore, in this study, hospital safety was reviewed in two hospitals in Qazvin in 2015. Methods: This cross-sectional descriptive study was conducted on two of the Rajaee and Velayat Hospitals in Qazvin. The tools used to assess for the hospitals’ risk of experiencing a disaster were observation, interviews, and a checklist of hospital disaster risk assessment provided by the World Health Organization (WHO), including 5 sections and 145 indices for the safety assessment of hospitals. To determine the general weight, three main parts of the questionnaire, i.e., functional safety, non-structural safety, and structural safety, were given weights of 0.2, 0.3, and 0.5, respectively, according to the original version of the indices. Each index was scored as 0, 1, and 2 based on the low, medium, and high scores. The safety scores that were obtained were categorized in three groups, i.e., low safety (≤ 34%), medium safety (34-66%), and high safety (> 66%). The data were analyzed using Excel 2007 software. Results: Functional, structural, and non-structural safety scores were evaluated as 60.20% (medium safety), 67.61% (high safety), and 76.16% (high safety), respectively. General preparedness of the hospitals we studied were 71.90%, a high safety level. This high preparedness was related to the indices of availability of medicines, equipment, water supply, and other resources required in emergency conditions (85%), and the lowest preparedness was related to contingency plans of medical operations (19%). Conclusion: The preparedness of the two hospitals in the study was evaluated as being high. Considering the history of disasters in this Province, it would be effective to retrofit hospitals and compile written plans for administrative measures at the time of disasters. These measures must be consistent, and there should be safe installation of risky office and medical equipment

Preparedness of Iranian Hospitals Against Disasters

Context: Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition: The present study was a simple review article, which was conducted via searching different sites, such as:Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness.The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results: Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions: Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals. Keywords: Disasters, Risk Assessment, Hospital Preparedness, Iranian Hospital