Performance of Tunisian Public Hospitals: A Comparative Assessment Using the Pabón Lasso Model
Moheddine
Younsi
Unit of Research in Development Economics (URDE), Faculty of Economics and Management of Sfax, Tunisia
author
text
article
2014
eng
Background and Objectives: Constant monitoring of healthcare organizations’ performance is an integral part of informed health policy-making. Several hospital performance assessment methods have been proposed in the literature. Pabon Lasso Model offers a fast and convenient method for comparative evaluation of hospital performance. This study aimed to evaluate the relative performance of hospitals in Tunisia, using Pabon Lasso Model. Methods: A cross-sectional descriptive study was conducted during 2011-2012 to measure the hospitals performance in Tunisia. A sample of 40 public hospitals was surveyed. The assessed hospital performance indicators included Bed Occupation Rate (BOR), Bed Turnover Ratio (BTR), Average Length of Stay (ASL). The relevant data were collected using a standard forms approved by the Tunisian Ministry of Health. For each hospital the data were extracted from the Hospital Information Systems. The data were plotted on Pabon Lasso diagram and the performance of each hospital was analyzed by visual inspection. The data were summarized using descriptive statistical methods. Findings: Average values of 62.3, 58.1% and 3.8 days, was observed for the BTR, BOR, and ALS, respectively. While nineteen hospitals (47.5%) were located in zone 1 of the Pabón Lasso diagram, three (7.5%) were located in zone 2, eleven (27.5%) in zone 3, and seven (17.5%) in zone 4. In addition, 50% of the studied hospitals had low performance in terms of either bed occupancy rate or bed turnover ratio or both. Conclusions: This study ranked the surveyed hospitals of Tunisia with respect to their overall performance and reveals the relative strength and weakness of each hospital. The speed and convenience of Pabon Lasso measurement method facilitate constant monitoring of overall hospital performance. Moreover, large-scale application of this method, can offer an overall view of the health system performance, which could be used by policy-makers in future plantings.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
159
166
https://ijhr.iums.ac.ir/article_7708_2edd0b22fb47c2c4374741e7c5c8f961.pdf
Quality of Angiography Services as Perceived by the Cardiovascular Diseases Patient
Jafar-Sadegh
Tabrizi
Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
Morteza
Ghojazadeh
Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
Saber
Azami-Aghdash
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
Amin
Daemi
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
author
Roya
Hassanzadeh
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
author
text
article
2014
eng
Background and Objectives: Angiography remains as the gold standard for the diagnosis of cardiovascular diseases (CVD). The aim of this study was to assess the quality of angiography services in Shahid Madani Hospital, Tabriz, Iran. Methods: A cross-sectional study was conducted in 2013 in Shahid Madani Hospital. A sample of 203 CVD patients who had received angiography services was surveyed. Data was collected using valid and reliable questionnaire with 42 items related to 12 aspects of service quality. Total score service quality was derived by combining the scores of Performance and Importance as perceived by the patients. Scores > 8 was considered as ‘High’, 6-8 as ‘Moderate’, and Findings: A moderate overall score of 7.00 was given to the angiography services quality. While continuity, communication, and autonomy gained high scores, choice of provider, prompt attention, and quality of basic amenities, and confidentiality scored moderately, and support groups, dignity, safety, and prevention received low scores. Conclusions: The moderate assessment of angiography services quality shows that there is a considerable room for improving these services. To this end, prevention and safety should receive the first priority in services quality improvement plans. Possible useful strategies in this regards include briefing the patients about the adverse effects of the drugs, trading them training on control and prevention of cardiovascular disease, and empowering them for self-care.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
167
172
https://ijhr.iums.ac.ir/article_7709_7e31135aad1e45ddb14f5d72fd6226d0.pdf
Relationship between Organizational Citizenship Behavior and Islamic Ethics of Business and in Health Staff
Fatemeh
Mohabati
Zabol University of Medical Sciences
author
Seyed
Pouria Hedayati
Zabol University of Medical Sciences
author
Somayeh
Bagheri
Zabol University of Medical Sciences
author
Mahbobeh
Mohabati
Shiraz University of Medical Sciences
author
text
article
2014
eng
Background and Objective: Organizational citizenship behavior (OCB) is referred to as the voluntarily activities that are not included as duties in the job description or the formal system of rewards. Development of OCB can have a great impact on human resources performance and organization’s achievements. Similar with many other organizational variables, OCB as well is dependent on contextual factors. In this study, we explore the possible relationship between the Islamic ethics of business (IEB) and OCB among the health staff. Methods: A sample of 260 individuals was randomly selected from the health staff of Zabol University of Medical Sciences. OCB and IEB were assessed by Inventory of Oregon and Joseph’s standard seven-tem questionnaire, respectively, after ensuring their validity and reliability. The relationship between variables was examined by Pearson’s correlation test. Findings: Correlation analysis identified IEB as a significant predictor of OCB (r = 0.31, P < 0.05). In addition, significant correlations were identified between IEB and different dimensions of OCB, including social customs (r = 0.24, P < 0.05), altruism (r = 0.25, P < 0.05), Job awareness (r = 0.38, P < 0.01), individual mutual coordination (r = 0.21, P < 0.05), protection of organizational resources (r = 0.192, P < 0.05), chivalry (r = 0.18, P < 0.05), courtesy (r = 0.19, P < 0.05). Conclusions: Given the context-dependent nature of OCB, the health organizations in the Islamic countries can improve the OCB in their employees by promoting IEB among them.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
173
176
https://ijhr.iums.ac.ir/article_7728_720e0797bc969595418e05fb034c00d4.pdf
Vulnerability Study of Health Human Resources in the Iranian Ministry of Health and Medical Education
Mohamad
Hoseini Kasnaviye
Department of Emergency Care, Iran University of Medical Sciences, Tehran, Iran
author
Gholamreza
Masoumi
Department of Emergency Care, Iran University of Medical Sciences, Tehran, Iran
author
Mohamadreza
Yasinzadeh
Department of Emergency Care, Iran University of Medical Sciences, Tehran, Iran
author
Mehrangiz
Haghgoo
University of Tehran, Tehran, Iran
author
Hasan
Tahmasebi Khob
University of Allameh Tabatabaee, Tehran, Iran
author
Milad
Amini
Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
author
text
article
2014
eng
Background and Objectives: Health human resources is the major asset of the health system. The status of human resources in upstream and regulatory health organizations can exert high impact on the effectiveness of health policies and the performance of health system. This study, hence, was designed to explore the possible area of human resource damage to the employees of the Iranian Ministry of Health and Medical Education (MOHME). Methods: A total of 316 MOHME staff was surveyed. A questionnaire containing 36 items related to three dimensions of human resources damage, including behavioral, structural, and contextual dimensions was designed and used as the study tool. The content validity of the questionnaire was ensured by applying the experts’ opinions. The reliability of the instrument was ensured by obtaining a Cronbach’s alpha of 0.93. T-test and Friedman test were sued for inferential analysis of the data. Findings: The behavioral dimension was perceived to represent the most vulnerable area of human resources damage, followed by structural and contextual dimensions. In regard to the behavioral dimension, ‘motivational factors’ was perceived to be the most important area of damage, followed by ‘job satisfaction’ and ‘job security’. Regarding structural dimension, ‘appointment and job promotion’ received the highest perceived significance, followed by ‘payment system’ and ‘recruitment’. Conclusions: This study ranks the area of damage to health human resources in MOHME. Our results support the previous studies highlighting the role of behavioral factors in bringing damage to human resources. Our findings, therefore, could be applied to development of human resources supporting plans aimed at improving the performance of upstream governmental health organizations. Specifically, providing motivating incentives and implementing strategies supporting job satisfaction and job security can bring significant protection to health human resources.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
177
182
https://ijhr.iums.ac.ir/article_7739_859d7afaf2e46ed3f5c68806898ba523.pdf
Evaluation of Prescriber Satisfaction in a University Testing Laboratory of Bacteriology
Hafsa
Lamrani Alaoui
University of Mohammed V. Souissi, Faculty of Medicine and Pharmacy, Rabat, Morocco
author
Ouafae
Sayegh
Ibn Sina Hospital of Rabat, Rabat, Morocco
author
Mimoun
Zouhdi
University of Mohammed V. Souissi, Faculty of Medicine and Pharmacy, Rabat, Morocco
author
text
article
2014
eng
Background and Objectives: Given the growing concern focused on the continuous improvement of the quality of care, safety and customer satisfaction, the Ibn Sina University Hospital (CHIS) has started an ambitious program for institutionalization of quality management at the establishments under the CHIS, in general, and the ISO certification 9001v2008 of its biomedical analysis laboratories, in particular. Furthermore, it is recognized that satisfaction of patients and prescribers is an evaluation of quality care, and an indicator of weaknesses in the services. The purpose of this study was to measure the prescriber’s satisfaction for the services provided by a university testing laboratory of bacteriology in order to identify the axes of improvement and meet their expectations. Methods: One of the goals of this study was to measure the overall and specific satisfaction of prescribers towards the services provided by Ibn Sina University testing laboratory of bacteriology (Rabat), to analyze the links with their characteristics, and to strengthen collaboration between the laboratory and prescribers services in order to identify the axes of improvement and meet their expectations. The starting point of this work was obtaining satisfaction scores by item. For this purpose, dimension and a final overall score were calculated. A validated questionnaire including 14 items, built according to the literature, was transferred to all clinical services asking for analyses. Then descriptive analyses were carried out to optimize the instrument that measures the aspects of the quality to prioritize the needs of prescribers. Findings: The participation rate was 76%, and the questionnaire allowed us to assess 4 underlying dimensions of satisfaction. Satisfaction scores were 50±26% for the transmission of information about the service activity; 43±26% for communication and relational exchange, and 42±27% for the quality and timeliness of reporting results. Identification of priorities and relevance of corrective actions on the basis of calculating a quality improvement score index showed that the quality aspects deserve priorities for actions to be undertaken to fully meet the benchmarks set out. Our study is one of the rare and pioneer researches in Morocco and at the CHIS since few studies are interested in prioritizing the expectations of prescribers in Morocco through the design of a simple and useful tool in practice of evaluation of quality improvement scores using the physicians satisfaction as an index to study the most important aspects to improve our services in line with the CHIS clinicians. Conclusions: It is possible to transpose our results with those of foreign works because of the similarities and differences between the health systems on one condition to adapt them to the Moroccan context. However, some aspects should be considered by our health professionals to ensure the required quality.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
183
192
https://ijhr.iums.ac.ir/article_10155_b8f1d473d1c2a929b94f3f6025d0a2fd.pdf
A survey of Physical, Psychological, and Social Health Indices in Shift Working Nurses
Seyed Ali
Majidi
School of Health Services Administration, Rasht Branch, Islamic Azad University,Rasht,Iran
author
Irvan
Masoudi
Islamic Azad University, Science and Research Branch, Tehran, Iran
author
Mohammad Taghi
Moghadamnia
Gilan University of Medical Sciences, Rasht, Iran
author
Maryam
Sharifi
Nurse of Rasoul Akram Hospital, Rasht, Iran
author
Mehdi
Barzegar
School of Health Services Administration, Islamic Azad University, Science and Research Branch, Tehran, Iran
author
text
article
2014
eng
Background andObjectives: Nurses comprise a majority of healthcare professionals. Therefore, their quality of life can directly impact the performance of health system at different level. The aim of this study was to explore the potential impact of work shift on physical, mental, and social aspects of nurses’ health. Methods: A sample of 300 nurses from hospitals of the Rasht city situated in northern Iran was randomly selected. Demographic and physical, psychological, and social health data were collected using corresponding researcher-designed questionnaires. Data were summarized using descriptive statistical methods. Findings: The majority of subjects considered the effect of work shift on chronic fatigue (88.7%) and illness (85.3%) to be important. Work shifts was found to be a perceived cause of severe physical problems in 77.3% of nurses and a perceived causes severe psychological problems in 59% of nurses. Conclusions: Give the high proportion of shift working nurses suffering from physical and mental problems, there is an urgent need for revising the currently established work shift program in the healthcare settings.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
193
198
https://ijhr.iums.ac.ir/article_7655_84b89a61f45745e0af6a8ccd7dcb06af.pdf
Indicators of Hospital Performance Evaluation: A Systematic Review
Hamed
Rahimi
Department of Health Services Administration, School of Management and Medical Information, Shiraz University of Medical Sciences, Shiraz, Iran
author
Mohammad
Khammar-nia
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
author
Zahra
Kavosi
Department of Health Services Administration, School of Management and Medical Information, Shiraz University of Medical Sciences, Shiraz, Iran
author
Marzieh
Eslahi
School of Health, Shiraz University of Medical Sciences,
Shiraz, Iran
author
text
article
2014
eng
Background and Objectives: The reliability of hospital assessment results depends on the appropriateness of the indicators used. In this study, we systematically review the literature to identify the major indicators of hospital performance evaluation, as employed in performance assessment literature. Methods: Literature databases including PUBMED, Scopus, Science Direct, Google scholar, DOJA, and OVID were searched using “hospital,” “indicator,” “criteria,” “evaluation,” “measurement,” and “performance” as keywords. The selected articles were critically appraised by two reviewers. The indicators were then extracted from selected articles. Findings: From the total of 8362 articles with relevant content, 4761 were selected based on the title. These were further filtered based on the specific objective of the research and eliminating the duplications, to obtain 249 mostly relevant papers. Among these, 23 articles which fulfilled the inclusion criteria were reviewed. A total of 218 indicators were found to be used in the literatures. The average length of stay and bed occupancy rate were used in hospital performance assessment most frequently.es. Conclusions: Our results indicated that evaluators were mostly interested in use of quantitative indicators in hospital performance assessment. In addition, a diverse range of indicators was used for evaluating hospital services quality. It is recommended that hospital managers select a combination of quantitative and qualitative indicators for accurate monitoring of their hospital performance.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
199
208
https://ijhr.iums.ac.ir/article_10152_71652f546ff23225c895757bd0f88613.pdf
Patient Safety Culture: A Meta-analysis of Hospital Data
Saber
Azami Aghdash
Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
author
Farbod
Ebadi-fard Azar
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
author
Aziz
Rezapour
Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
author
Kayvan
Mirnia
Tabriz University of Medical Sciences, Tabriz, Iran
author
Akbar
Azami
Department of Mathematics, Miandoab Branch, Islamic Azad University, Miandoab, Iran
author
Mohammad
Saadati
Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
text
article
2014
eng
Background and Objectives: Patient safety (PS) is one of the most important and essential elements of quality in healthcare setting. A systematic review and meta-analysis was performed to assess the status of patient safety culture using the Hospital Survey on Patient Safety Culture (HSOPSC). Methods: In this systematic review and meta-analysis study, data were collected through searching databases including Scopus, Google Scholar, Science Direct, PubMed, Cochrane Library, Magiran , and Iranian Scientific Information (SID) using keywords like “patient safety”, “patient safety culture”, and “patient safety climate”, combined with “hospital: ,“Hospital Survey on Patient Safety Culture”, “measurement”, “assessment” and “survey”. Out of 1764 retrieved articles, 30 articles were entered into the study. To calculate the overall PSC score and perform the meta-analysis, the computer software (CMA2—Comprehensive Meta-Analysis) was employed. Findings: Using HSOPSC and random effects, the PSC score was calculated to be 56.9%. While the dimension “teamwork within hospital units” generated the highest score (72%), the dimension “non-punitive response to error” received the lowest score (40%). According to PSC grade, “very good” grade had the highest score (%41.3). Approximately %46 of the respondents did not complete any event report in the past 12 months. Conclusions: It seems better that the interventions for improving PSC focus on the dimension of “non-punitive response to error”. The results of this study can be used by policy makers and managers to create and improve a patient safety culture.
International Journal of Hospital Research
Iran University of Medical Sciences
2251-8940
3
v.
4
no.
2014
209
217
https://ijhr.iums.ac.ir/article_10153_c347115ec0f9e4808bbdec42945e2e8e.pdf