Designing a model of drug quality assurance for Iran

Objective: To take up the project for designing a Drug Quality Assurance Model (GMP) for Iran. Methodology: It is a descriptive and comparative study. GMP models from USA, EU, Australia and Iran, and WHO, ICH and PIC/S were selected for the comparative study. Internet sites and scientific journals were used for data collection. The comparative study determined the primary proposed model. Then, based on Delphi technique, the primary model was evaluated by experts and eventually the final model was designed, for application in Iran. Results: The comparative study and feedbacks of experts determined the final proposed model for pharmaceutical quality assurance (GMP) for Iran, which consisted of two parts. The first part included thirteen chapters consisting sixty-two major titles. The second part consisted of sixteen annexes. Conclusion: Establishment of standards of the final model of GMP in the drug industry could lead to the improvement of quality of national manufactured drugs, hence, promoting the population health levels

Designing the maternal and child health services package based on comparative study of developed countries models

Introduction: Community women�s health is more vulnerable than men due to various reasons, in addition to biological characteristics; it is influenced by cultural, social, economic and political factors. Nowadays,managing maternal health development is one of the World Health Organization priorities.This study was performed with aim to improve maternal and child health service package in Iran by providing variables derived from a comparative study conducted in selected developed countries. Methods: In thiscomparative study, the studied countries(Singapore, Australia, England and Japan) wereselectedby comparingmaternal-child healthindicators from different continentsusing cluster sampling and with studying of their maternal and child health service package through referring to valid health documents, important variablesanddimensions were identified, and based on itand designed comparative tables, the conclusion was made. Results: Free sportsandtraining classeswiththe husbands� presence, extensive maternal network emergency as specialized and boarding, varietyof vehicles fortransportto emergency centers,emotional supportpackages, home visit and delivery, newbornsfreesurgical facilitiesandcare, pregnant womenscreeningfacilitiesfor free, guideline booklet and unifiedrecording of servicesin allcountrycenters are the factorsidentified in successfulmaternal-child health servicespackage. Conclusion: The role ofsome identified factors such as home visit and deliveryis loworabsent in Iran health service package. Implementation ofthesuggested factors canplay an important rolein promotingmaternal-child healthindicators inIran. � 2016, Mashhad University of Medical Sciences. All rights reserved

Designing a model for hospital services globalization in Iran

BACKGROUND AND OBJECTIVE: Globalization and planning for global thinking and institutions' activity that could work and act out of national limit are important actions which should be taken in Iran. Globalization is a progressive power in health index promotion. This aim of this study was to design a model for globalization of hospital services in Iran in order to promote the participation in patient attraction for diagnostic and medical services in hospitals from different countries in 2009. METHODS: This descriptive- comparative and cross sectional study was performed on some selected countries such as United States of America, England, India, Thailand and Malaysia. The hospital's information related to selected countries was marketing mechanism, equipment and hospital's facilities. The original model prepared based on data gathering form. This model was tested using Delphi technique and obtained data were analyzed and then the final model was introduced. FINDINGS: The results of studies in selected countries showed that developed countries like America and England have strong basis of management structure, knowledge, modern and complex technology. India, Thailand and Malaysia because of their success to present hospital services on the international level and successful marketing in this connection and arrived the developed countries technologies in previous decade have been able to have effective part presented international services. The designed model in this research, in attention to basis obtained has presented according to Iran qualifications. CONCLUSION: According to the results of this study, with utilization of possibilities and capacities in Iran, the proposed model can greatly contribute to globalization of hospital services

A model for priority setting of health technology assessment: The experience of AHP-TOPSIS combination approach

Background: In recent times, the use of health technologies in the diagnosis and treatment of diseases experienced considerable and accelerated growth. The goal of the present study was to describe the designated pilot MCDM (Multiple Criteria Decision Making) model for priority setting of health technology assessment in Iran. Methods: Relevant articles were sought and retrieved from the most appropriate medical databases, including the Cochrane Library, PubMed and Scopus via three separate search strategies, using MESH and free text until March, 2015. Retrieved criteria were questioned from health technology assessment experts in two rounds and the relative weight for valid criteria was finally obtained from paired wise comparison method. After extraction of relative weights based on the aforementioned procedure, TOPSIS (The Technique for Order of Preference by Similarity to Ideal Solution) priority setting model was designed. The stated model was applied for assessing three technologies (adenosine, tissue plasminogen activator and mechanical thrombectomy) which were available for projects call of Iranian health technology assessment department in order to determine applicability of the model for practical purpose. Results: Nine criteria, including efficiency/effectiveness, safety, population size, vulnerable population size, availability of alternative technologies, cost effectiveness in other countries, budget impact, financial protection, quality of evidence, were extracted by the Iranian health technology assessment experts. The relative weights of these criteria were as follows 0.12, 0.2, 0.06, 0.08, 0.08, 0.13, 0.08, 0.09, and 0.15, respectively. Finally TOPSIS pilot model was designed by three health technologies and nine criteria relative weights. Results showed that, the applicability of the stated model was suitable and as the pilot testing, tissue plasminogen activator was the first priority, adenosine was second and mechanical thrombectomy was third for performing health technology assessment by the Iranian ministry of health and medical education. Conclusion: According to the results of this study, this model with nine effective criteria and their relative weights and in combination with TOPSIS approach could be used with suitable applicability by health technology assessment department in deputy of curative affairs and food and drug organization for determination of research priorities in health technology assessment. © 2016 Mobinizadeh et al

A comparative study on community-based disaster management in selected countries and designing a model for Iran

Purpose: Iran is located among the top disaster-prone countries in the world and, therefore, disaster management is considered to be one of the most important issues in this country. One of the existing and worldwide approaches for managing disasters is the so-called community-based disaster management (CBDM). Community participation means that people's contribution in the disaster management cycle can be started from the basic steps of a process and ends in the achievement and institutionalization in the community. The purpose of this paper is to make a comparative study on the CBDM in various selected countries in order to design a model for Iran. Design/methodology/approach: A descriptive-comparative study was undertaken through a methodology including six steps in which a few countries have been chosen based on their contribution to issues such as policy making, planning, coordination, and control and organizing of disasters as well as their experience in disaster management and access to related information. Findings: The results of the study show that, in order to achieve a successful disaster management, there is a need for the participation of the community in various disaster management lifecycles. However, it is evident that the type of contribution may differ according to the characteristics of each specific country. Practical implications: By using the CDBM, it is hoped that, with updating and implementing this model, the government's capability enhances in order to encounter disasters more effectively in the future. Originality/value: On the basis of these findings, a model was designed to use CDBM in Iran. The issue most emphasized by this model is the presence and contribution of community at the local level in villages and neighborhoods in a city. © Emerald Group Publishing Limited

Performance evaluation of medical record department of specialized-teaching hospitals of Iran Medical science University

Background: With respect to the importance of medical record as a useful tool for supervision, assessment, and planning in order to improve our system facilities, the present study was carried out to evaluate the performance of medical record department of specialized-teaching hospitals of Iran Medical Science University in 1380.Materials and methods: It was a descriptive study. Data were gathered via checklist through face-to-face interview. Performance evaluation was achieved in 4 different categories reception, coding, statistics, and archiving, each with 8-9 indices. Results: Total performance of the medical record department was 55.4. Coding and statistics units have the best (64.2) and the worst (50) scoring. The least index of reception and coding units was the presence of a guideline (20). Shaheed Heshemi Nejad and Shaheed Navab Safavi had the best and worst performance, respectively (70.5 vs. 48.8).Conclusion : The overall performance of the evaluated hospitals was good. Preparing specific guidelines, staffing and employing graduates of medical records, implementation of continuous and regualra training courses, design of suitable software package, allocation of budget, space and equipment may improve medical record department performanc

Application of Schemeer's stakeholder analysis to design an accreditation model in iranian hospitals

Background and Aim: Quality in health services is a level of health services provided to individuals and communities which increases the likelihood of the desired health outcomes and is in accordance with the day's professional knowledge. The world's health systems, design and implement miscellaneous regulators including periodical and continuous accreditations of hospitals through governance patterns and tools. To guarantee the quality of such tools, it is necessary to always benefit from the stakeholders' analytical skills, i.e., analytical understanding of individuals and organizations that have an efficient role in the process of hospital reforms so as to get effective and accurate information. The present study was designed and implemented with the aim of identifying This applied study was implemented through a "descriptive-comparative" method based on Kammi Schmeer's 8-step model of stakeholder analysis within 4 executive design phases with the multistage participation and survey of 29 domestic experts working on various technical and executive (line and staff) levels relevant to the country's accreditation systems of public and private hospitals. Results: Contrary to expectations, the analytical composition of the stakeholders in the "evaluation pattern of Iranian public and private hospitals" was not limited to the participation of only two ministries and health insurance organizations. The application of the selected model led to the identification of 17 groups of stakeholders in the order of importance at all levels of the Iranian health system. This could guarantee the universal coverage of services at regional, provincial, and national levels in case of their effective operational partnerships in both "absolute and conditional" states. Conclusion: The Kammi Schmeer's model recommended by the World Health Organization used in this research could provide a suitable scientific identification tool and administrative support for an indigenous design and deployment of an accreditation model of public and private hospitals in Iran. Obviously, only in case of the effective structural and/or operational interactions of all organizations, ministries, institutions, and Non- Governmental Organizations (NGOs), the realization of the multi-sectoral goals of the country's health care system can be expected from the proposed analytical composition

Factors affecting the quality of hospital hotel services from the patients and their companions� point of view: A national study in Iran

Background: The hospitality design of a hospital is a complex process that depends on careful planning, systematic thinking, and consideration of various factors. This study aimed to determine the viewpoints of patients and their relatives on factors affecting hospital hotel services in Iran in 2015. The results of this study can be used to design a suitable model for the assessment and improvement of hospitality service quality. Materials and Methods: In this cross-sectional descriptive study, 10 hospitals of Iran were included. The subjects of the study included 480 patients and their companions from different internal and surgical wards. Simple random sampling method was performed at the hospitals, where patients were selected through stratified sampling based on hospital wards, and in each ward, through systematic sampling based on the bed numbers. A researcher-made questionnaire was used as the study tool which was developed through reviewing the literature and opinions of experts. Its internal reliability was determined based on Cronbach�s alpha coefficient (α =0.85). Results: In reviewing the eleven aspects of hospital hotel services regarding the patients� and their companions� viewpoint, services related to all aspects, whether human, economic, operational, personnel identification, safety, health care services, physical, clinical welfare, cultural, patient guidance, or public welfare services, received mean scores of higher than three (out of five). Conclusion: The present study showed that in the patients� and their companions� viewpoint, factors affecting hospital hotel services in the country are very important. The tool used in this study can be a criterion for assessing the status of the hotel services of the country�s major hospitals, so accordingly, the assessment and improvement of the existing conditions can be possible. © 2016 Journal of Research in Medical Sciences

Application of Schemeer's stakeholder analysis to design an accreditation model in iranian hospitals

Background and Aim: Quality in health services is a level of health services provided to individuals and communities which increases the likelihood of the desired health outcomes and is in accordance with the day's professional knowledge. The world's health systems, design and implement miscellaneous regulators including periodical and continuous accreditations of hospitals through governance patterns and tools. To guarantee the quality of such tools, it is necessary to always benefit from the stakeholders' analytical skills, i.e., analytical understanding of individuals and organizations that have an efficient role in the process of hospital reforms so as to get effective and accurate information. The present study was designed and implemented with the aim of identifying This applied study was implemented through a "descriptive-comparative" method based on Kammi Schmeer's 8-step model of stakeholder analysis within 4 executive design phases with the multistage participation and survey of 29 domestic experts working on various technical and executive (line and staff) levels relevant to the country's accreditation systems of public and private hospitals. Results: Contrary to expectations, the analytical composition of the stakeholders in the "evaluation pattern of Iranian public and private hospitals" was not limited to the participation of only two ministries and health insurance organizations. The application of the selected model led to the identification of 17 groups of stakeholders in the order of importance at all levels of the Iranian health system. This could guarantee the universal coverage of services at regional, provincial, and national levels in case of their effective operational partnerships in both "absolute and conditional" states. Conclusion: The Kammi Schmeer's model recommended by the World Health Organization used in this research could provide a suitable scientific identification tool and administrative support for an indigenous design and deployment of an accreditation model of public and private hospitals in Iran. Obviously, only in case of the effective structural and/or operational interactions of all organizations, ministries, institutions, and Non- Governmental Organizations (NGOs), the realization of the multi-sectoral goals of the country's health care system can be expected from the proposed analytical composition