Quarterly Journal of Management Strategies in Health System

Strategies for Operationalizing Patient and Family Community Participation in Infection Control Programs

2026-05-18T09:34:16+00:00

Infection prevention and control programs are critical components of healthcare quality and patient safety. While traditional infection prevention and control approaches have focused primarily on healthcare workers and system-level interventions, there is growing recognition of the vital role that patients and families can play as partners in infection control efforts. However, operationalizing meaningful community participation remains challenging in practice. This letter proposes concrete strategies to effectively engage patients and families in infection prevention and control programs, addressing a significant gap in current implementation frameworks.

Community participation in infection prevention and control extends beyond basic education to include active involvement in care processes, decision-making, and quality improvement initiatives. The World Health Organization emphasizes patient engagement as a key strategy for reducing healthcare-associated infections, yet practical guidance remains limited. Drawing from successful models in chronic disease management and patient safety, we propose the following operational strategies:

1-Structured Education and Empowerment Programs: Develop targeted educational materials using clear, accessible language and multiple formats (videos, pictograms, brochures). Implement "Infection Prevention Ambassador" programs where trained patient volunteers educate peers about hand hygiene, respiratory etiquette, and environmental cleanliness.

2-Family-Integrated Care Models: Integrate family members into care teams through structured programs that teach basic infection prevention and control principles. Designate "Family Safety Champions" who partner with healthcare staff to monitor and promote compliance with infection control measures in clinical areas.

3-Digital Engagement Platforms: Utilize mobile applications and patient portals to provide real-time infection prevention and control education, send reminders about hand hygiene and preventive behaviors, and enable patients to report concerns about infection control practices anonymously.

4-Participatory Quality Improvement: Establish patient and family advisory councils specifically focused on infection prevention and control. Include community representatives in infection control committees to provide input on policy development, environmental design, and educational materials.

5-Feedback and Recognition Systems: Implement structured mechanisms for patients and families to provide feedback on infection prevention and control practices. Create recognition programs that acknowledge exemplary patient and family participation in infection prevention activities. Implementation challenges include literacy barriers, cultural resistance to patient involvement in safety matters, and resource constraints. These can be addressed through culturally tailored approaches, staff training on partnership models, and phased implementation starting with pilot units.

Operationalizing patient and family community participation in infection prevention and control programs requires moving beyond token involvement to genuine partnership. The strategies outlined above provide a framework for healthcare organizations to systematically engage communities in infection control efforts. Future research should focus on evaluating the impact of these approaches on infection rates, patient satisfaction, and healthcare culture. Policy makers and healthcare leaders should prioritize the development of infrastructure and training programs to support meaningful community participation in infection prevention.

The Importance and Necessity of Palliative Care in the Types of Nursing Care

2026-05-18T09:34:15+00:00

Palliative care is a fundamental component of comprehensive care for patients at the end of their lives, and plays a crucial role in alleviating the pain and suffering caused by illness for both patients and their families. The purpose of this letter to editor is to promote the development of palliative care for terminally ill patients in Iran. The findings indicate that increased attention to palliative care contributes to improved quality of life and facilitates a peaceful and dignified death. Integrating palliative care into healthcare programs can lead to the provision of more humane, patient-centered, and dignity-based care.

Analyzing the Trend of Energy Carriers Consumption in a Super-Specialized Hospital and Presenting Necessary Strategies for Optimal Consumption

2026-05-18T09:34:12+00:00

Background: Neglecting the optimal consumption of energy carriers not only increases hospital costs but also leads to the waste of energy resources. This study was conducted to investigate the consumption trends of energy carriers in a super-specialized hospital and to provide optimization strategies.

Methods: This mixed-methods (quantitative-qualitative) study was conducted in three phases. In the first phase, time-series data of water, gas, and electricity consumption over a ten-year period (2011–2021) were collected from the studied hospital. In the second phase, the relationship between hospital performance indicators and energy carriers consumption was examined using the SARIMAX regression model. In the third phase, strategies for improving energy efficiency were identified through a review of previous studies and a survey of experts.

Results: The ten-year average consumption of water, electricity, and gas per active bed was 33.76 ± 1.63 cubic meters, 1919.66 ± 243.39 kilowatts, and 341.46 ± 38.96 cubic meters, respectively. Indicators such as occupied bed days, bed turnover interval, and average length of stay had a significant impact on water consumption. Electricity consumption was significantly influenced by the number of surgeries, and gas consumption was significantly influenced by the number of surgeries and intensive care unit patients. Water consumption was significantly higher in autumn, electricity in summer, and gas in winter compared to other seasons. Thirty-three optimization strategies were categorized into five general areas, including modification of electrical systems, cooling and heating systems, water resource management, optimization of the building structure, and energy policy-making.

Conclusion: The consumption of energy carriers in this hospital was primarily subject to seasonal variations. Optimizing the building structure in terms of thermal insulation and formulating effective energy policies can significantly prevent energy waste.

Explaining the Dimensions and Components of Resilience of Home Health Care Centers

2026-05-18T09:34:09+00:00

Background: In recent years, due to unforeseen global crises, particularly the COVID-19 pandemic, the demand for utilizing Home Health Care centers as an effective alternative to hospital care has increased. Maintaining the functionality of these centers in the face of unpredictable events requires an understanding of the dimensions and components of resilience. This study was conducted with the aim of presenting a model to explain the dimensions and components of resilience in these centers.

Methods: The present study was conducted using a multi-grounded theory approach and included systemic integration of theoretical (meta-synthesis of related studies over the past 20 years) and empirical data (interview with specialists) via purposive sampling. Data analysis and coding were performed using the constant comparative approach with MaxQDA ₂₀₂₀ software, and the integration of theoretical and empirical data led to the formulation of the theory.

Results:The research findings led to the design of a comprehensive model with four main dimensions: Responsiveness (to ensure service continuity), Prediction (for early threat detection and preventive planning), Growth and Learning (through continuous training and documentation of events), and Monitoring and Value Creation (focusing on data-driven monitoring, feedback, and continuous performance improvement).

Conclusion: This study provides a strategic and practical model that transforms resilience from a theoretical concept into an executable operational framework. The final model helps health sector managers and policymakers to understand the key components of resilience better, design more robust infrastructure, and build the necessary capacity to effectively deal with future crises in home health care centers. Applying this model can lead to enhanced service sustainability and guaranteed care quality even under abnormal conditions

Investigating the Relationship between Cultural Competence and Communication Skills among Intern Nursing Students at Shahid Sadoughi University of Medical Sciences, Yazd, in 2024

2026-05-18T09:34:20+00:00

Background: Effective communication between nurses and patients from diverse cultural backgrounds is vital for quality care. This study investigates the relationship between cultural competence and communication skills among nursing students at Shahid Sadoughi University of Medical Sciences in Yazd.

Methods: This was a cross-sectional, analytical study conducted on all clinical-stage nursing students at Shahid Sadoughi University of Medical Sciences in Yazd using a census sampling method during the Solar Hijri year 2024. Data collection tools; data were collected using the communication skills questionnaire developed by Javaher et al. and the cultural competence questionnaire developed by Naghizadeh et al. Data analysis was performed using SPSS ₂₇, employing descriptive statistics (median, mean, standard deviation) and inferential statistics, including independent-samples t-tests, Spearman’s correlation coefficient, Analysis of Variance (ANOVA), and Liner regression analysis.

Results: The analysis showed that the majority of students (63.3 %) demonstrated good communication skills. The highest mean score within communication skills belonged to the component of ‘Respect for the Patient/Client’, while the lowest was for the component of ‘Unconditional Acceptance of the Patient/Client’. Most of the dimensions of cultural competence had the median of 4, and the only dimension with a relatively lower function belonged to habits, behavior, and speaking. Moreover, 94.2 % of the students had a higher than average score in cultural competence. A positive and statistically significant correlation was found between students’ communication skills scores and their cultural competence scores ( , ). Furthermore, for every one-unit increase in the cultural competence score, the communication skills score was found to increase by an average of 0.147 units.

Conclusion: Based on the study findings, developing educational programs aimed at increasing nursing students’ knowledge of health behaviors, beliefs, and physiological differences, alongside strengthening their skills in the unconditional acceptance of patients, could lead to improved quality of nurse-patient communication and a more effective delivery of patient care

The Impact of Management Stability on Administrative Process Leadership with the Mediating Role of Professional ethics among Medical University Staff

2026-05-18T09:34:08+00:00

Background: Administrative Process Leadership constitutes a fundamental pillar of efficiency and effectiveness in any organization. It extends beyond routine management, focusing on leading transformation in work procedures. Accordingly, the present study investigated the effect of management stability on administrative process leadership, with the mediating role of professional ethics of staff at North Khorasan University of Medical Sciences within a causal model framework.

Methods: The present study, based on its purpose, is an applied research, and in terms of its implementation method, is a descriptive-survey study of the correlational type. The statistical population consisted of 147 staff employees of the headquarters of North Khorasan University of Medical Sciences. From this population, 108 individuals responded to the questionnaires via convenience sampling method. The research tools included researcher-made managemen stability questionnaire, the Standard Genuine Leadership Questionnaire by Avolio et al. (2004), and the Professional ethics Questionnaire by Ghasemzadeh et al. (2014) whose validity was confirmed by the field management's professors and their reliability was estimated by Cronbach's alpha (0.85), (0.87) and (0.87). To analyze the data in descriptive and presumption statistics, two SPSS ₂₄ and AMOS ₁₆ software were used.

Results: The findings revealed that the variable of professional ethics mediates the relationship between management stability and administrative process leadership. The indirect path was significant with a p-value of < 0.001. It is also confirmed that management stability has an indirect effect on self-awareness, ethical conduct, and relational transparency.

Conclusion: Considering the key role of management stability and its impact on administrative process leadership alongside professional ethics, it seems essential that managers and officials in the Organization of Medical Sciences pay special attention to these variables and, by eliminating obstacles, provide the necessary grounds for institutionalizing ethics and enhancing the professional ethics of employees.

The Impact of Knowledge Management on the Effectiveness of Strategic Human Resource Functions, Job Performance, and Innovative Behaviors of Employees: Case Study of Shahid Sadoughi University of Medical Sciences, Yazd

2026-05-18T09:34:05+00:00

Background: Considering the growing role of medical sciences universities in producing and transferring knowledge, identifying mechanisms to develop performance and innovation is of great importance. This study aimed to examine the impact of knowledge management on strategic human resource functions, job performance, and innovative behavior of employees at Shahid Sadoughi University of Medical Sciences, Yazd.

Methods: The research was applied in purpose and descriptive–survey in method. The statistical population consisted of all employees of Shahid Sadoughi University of Medical Sciences in 2024. Using a stratified random sampling method, 290 individuals were selected. Data were collected through standardized questionnaires on knowledge management, strategic human resource functions, job performance, and innovative behavior. The data were analyzed using SPSS ₂₆ and Lisrel_10.2 software through Structural Equation Modeling (SEM).

Results: The results indicated that knowledge management had a positive and significant relationship with strategic human resource functions. In addition, knowledge management directly influenced both job performance and innovative behavior. Moreover, strategic human resource functions also had significant positive effects on job performance and innovative behavior.

Conclusion: The effective integration of knowledge management and strategic human resource functions can simultaneously enhance productivity and innovative behaviors in academic environments. Accordingly, medical universities should invest in knowledge management infrastructures and design knowledge-based human resource policies to improve performance and support innovation.

Elements of Value-Based Health Care and Recommendations for Developing a Theoretical Framework: A Scoping Review

2026-05-18T09:34:03+00:00

Objective: Value-Based Health Care (VBHC) is an innovative approach to improving the delivery of health services, designed to maximize value for patients. Despite its development in several countries, a shared and comprehensive understanding of the concept has yet to emerge. Accordingly, this study was conducted to identify the key elements of Value-based healthcare and to examine how these elements are implemented in hospitals and health systems across different countries.

Information sources and selected methods for study: The study was conducted following Arksey and O’Malley’s six-stage framework for scoping reviews and in accordance with the PRISMA-ScR guidelines. A systematic search of ten databases and two websites was performed in English and Persian for the period 2006 to 2024 and was supplemented by a manual search. Reference management and study screening were carried out using Endnote 2020, resulting in the selection of 70 studies. These studies were subsequently coded in MaxQDA 2020, and the relevant elements were identified and categorized using Braun and Clarke’s six-phase thematic analysis approach.

Results: During the thematic analysis phase, 117 codes were identified and organized into 15 elements within eight groups, including defining value in the healthcare delivery system; delivering patient-centered, integrated, comprehensive, and coordinated care; measuring outcomes and costs; integrating care delivery systems; expanding the geographic scope of care; reforming service reimbursement systems; establishing an active health information technology platform; and conducting comprehensive evaluations to improve value. In most countries, greater emphasis had been placed on measuring outcomes and costs and on organizing integrated practice units compared with the other identified elements.

Conclusion: Not all of the six elements proposed by Porter and Tizberg have been implemented uniformly in different countries, and attention to other key elements is needed for a more comprehensive conceptualization of Value-Based Health Care. Also, the elements recommended based on the findings of this study in the following three groups can be helpful in developing a theoretical framework for value-based healthcar: defining the concept and determining how to measure value; providing patient-centered, integrated, comprehensive, and coordinated care; and comprehensive evaluation and improvement of value.

A Scoping Review of Digital Twins’ Applications and Challenges in Healthcare and Medicine

2026-05-18T09:34:01+00:00

Background: With the rapid growth of health data and advances in artificial intelligence and computational modeling, digital twin technology has emerged as a novel approach for simulating and analyzing complex systems. In medicine, the Medical Digital Twin (MDT) enables the creation of dynamic virtual representations of patients or clinical processes, allowing prediction of disease progression, monitoring of patient conditions, and support for clinical decision-making. This study aimed to systematically review the applications, opportunities, and challenges of MDT in healthcare using a systems-oriented perspective.

Methods: This study was conducted as a systematic review following the PRISMA guidelines. A comprehensive search was performed in PubMed, Web of Science, Scopus, and Google Scholar using the keywords “Digital Twin” and “Digital Medicine & Health.” A total of 465 records were initially identified. After removing duplicates and screening titles and abstracts, full texts were assessed according to inclusion criteria, including relevance to the research topic, publication in English or Persian, and a focus on the application of digital twin technology in healthcare. Ultimately, 25 studies were included in the final analysis.

Results: The findings indicate that MDT serves as a platform for integrating multimodal clinical, genetic, and physiological data and can be applied across a wide range of medical domains. These include hospital management and optimization of clinical processes, design and evaluation of medical devices and surgical procedures, drug discovery and development, personalized medicine, simulation of human physiology, and the design of clinical trials. The analysis also revealed that most studies primarily focus on technological and clinical applications, while comparatively limited attention has been given to systemic dimensions such as the role of digital twins in the health workforce and health system governance. Furthermore, several challenges hinder the broader implementation of MDT, including the integration of heterogeneous data sources, interpretability and generalizability of artificial intelligence models, data security and privacy concerns, and the need for scalable computational infrastructures.

Conclusion: The effective development and implementation of medical digital twins require a systems-based approach that extends beyond technological advancement to include integrated data infrastructures, interoperability standards, and robust data governance frameworks. Strengthening interdisciplinary collaboration among clinicians, data scientists, engineers, and policymakers is essential for ensuring the safe and effective use of this technology. Addressing existing technical and infrastructural challenges could enable MDT to become a strategic tool for advancing predictive and personalized medicine and improving managerial decision-making within health systems.