Quarterly Journal of Management Strategies in Health System

Knowledge translation; a big step to stakeholder participation in health systems

Morteza Arab-Zozani — 2024-06-19

Knowledge translation (KT) is defined as an intermediary process between researchers and stakeholders. Knowledge translation means the exchange, synthesis and application of research findings through a complex system of communication between researchers and users of knowledge. The ultimate goal of KT is to change the behavior. In this process, the most important findings and research results are expressed in a simple and understandable language for the general public.

Identification and Classification of Herbal Medicine Marketing Problems from the Perspective of Manufacturers, Pharmaceutical Distribution Companies, Pharmacies, and Consumers in Iran

Ali Abedini — 2024-06-19

Background: Despite the increase in the desire to consume herbal medicines and the growing concern of people about their health, as well as the increase in the number of specialized herbal medicine manufacturing companies and pharmacies, these products still have a small market share in the domestic market. Therefore, this research seeks to identify and categorize the marketing problems of herbal medicines with a systemic approach from the perspectives of actors active in this chain (companies producing herbal medicines, pharmaceutical distribution companies, pharmacies and consumers) and provide practical solutions to improve these problems.

Methods: The current research is exploratory in nature and qualitative in type. To better identify the marketing problems of herbal medicines, semi-structured interviews were used, and using purposive and snowball sampling methods, interviews were conducted with knowledgeable people in 14 manufacturing companies, 13 pharmaceutical distribution companies, 22 pharmacies and 40 consumers of herbal medicines in 2022. Quantitative content analysis was also used to analyze the text of the interviews.

Results: The identified problems are in three short-term, medium-term and long-term time frames, and from another perspective, these problems are located at the three organizational, industrial and macro level. About half of the marketing problems of herbal medicines are located in the three houses of the matrix, i.e. in the houses of organization-mid-term (16 %), industry-short-term (15 %) and organization-short-term (14 %). Also, based on the normalized data, about half of the marketing problems of herbal medicines are related to the non-availability of these medicines (7.7 %), lack of scientific visits by doctors (6.8 %), lack of appropriate and sufficient advertising (6.2 %), returns due to expiration dates (5 %), lack of confidence in the effectiveness (4.8 %), low offers and discounts (4.4 %), high prices (4.1 %), difficulty in collecting claims (3.6 %), low variety of products (2.9 %) and long production time (2.8 %).

Conclusion: The government managers of the country can address macro-level issues by controlling the inflation rate, accelerating the settlement time of insurance and government organizations with distribution companies, reducing the time of collecting claims, and raising public awareness regarding herbal medicines. In the industry sector, there is a need to establish national distribution companies for herbal medicines and enhance the research, supply, production, and distribution processes. It is also important to improve the collaboration between manufacturers and pharmacies, as well as facilitate communication with international scientific societies. At the organizational level, managers can boost productivity by enhancing the quality of products and packaging, conducting scientific visits, and publishing credible scientific articles to convince doctors and consumers about the benefits of herbal medicines

Identifying and Prioritizing Economic Opportunities for Medical Tourism Management: An Analytic Hierarchy process

Salman Abbasian-Naghneh — 2024-06-19

Background: As a growing industry, medical tourism includes many economic opportunities. This industry is the largest and most diverse industry in the world, with a foreign currency income which is equal to the automotive and military weapons industries. The aim of the current research is to identify and prioritize economic opportunities related to medical tourism management, using the Analytical Hierarchy Process (AHP) as a multi-criteria decision-making tool.

Methods: This was a descriptive-survey research with an applied and cross-sectional approach. A survey method was used to collect data, so this study can be classified as field research. The statistical population of the research included 25 people with experience and expertise selected through purposive sampling in the fields of management, tourism, and medicine. The method of collecting data was in the form of library and field studies. The tool for collecting data was a questionnaire of paired comparisons and a check sheet. Data analysis was done with AHP method and Expert Choice ₁₁ software. After collecting the paired comparison questionnaire and calculating the geometric mean, the inconsistency rate of the questionnaires was less than 0.1, which showed that the data had the required validity.

Results: First, using library studies, economic opportunities related to medical tourism were identified. These opportunities included cash generation, technological advancements, job creation, diversification of tourism industry, development of health care infrastructure, knowledge transfer and cooperation, services and ancillary industries, and regional development and diversification of economic activity. Opportunities were prioritized using the AHP method. Cash generation with relative importance of 0.191 was ranked first, job creation with relative importance of 0.162 was second, and technological advances was ranked third with relative importance of 0.131. Diversification to economic activities with a relative importance of 0.45 was ranked ninth which was the lowest.

Conclusion: Strategic marketing, delivering quality healthcare services, competitive pricing, specialized medical care, patient-centered experience, collaboration and partnership, continuous improvement, and strengthening medical tourism infrastructure are the pillars through which medical tourism management can not only generate sustainable revenue but also provide invaluable healthcare services to patients from across the globe.

Fuzzy Interpretive Structural Modeling regarding Factors Affecting Employees’ Experience Management in Mashhad University of Medical Sciences

Vahid Ghadam Kheyr — 2024-06-19

Background: Employees are considered internal customers of the organization, and today, employee’s experience has become a prominent topic in the field of human resources. This study aims to model the factors affecting employees’ experience management in Mashhad University of Medical Sciences using fuzzy interpretive structural modeling.

Methods: This applied study was descriptive-analytical conducted in 2023. 10 faculty members, managers, and staff of Mashhad University of Medical Sciences were selected using a purposive sampling method. Interpretive Structural Modeling (ISM) questionnaire consisting of a 7x7 matrix was then given to them, and they were asked to find the contextual relationship between the variables based on the pairwise comparison scale. In the analysis section, fuzzy interpretive structural modeling and MICMAC analysis were used to structure and analyze the status of the factors.

Results: 7 organized themes (organizational, physical environment, technological, job, managerial, cultural, and individual factors) were identified for employees’ experience in Mashhad University of Medical Sciences. Findings showed that cultural and managerial factors are at the lowest level of the structure and have more influence and less dependence. In other words, these are the most influential factors on employees’ experience. Job, technology, and organizational factors were placed at the second level. In contrast, individual and physical factors were at the highest level of the structure and had less influence and more dependence on other factors.

Conclusion: The findings indicate that Mashhad University of Medical Sciences should focus on strengthening and improving cultural and managerial factors to improve employees’ experience. Additionally, attention to job, technology, and organizational factors, along with addressing individual employee’s needs and providing a favorable physical environment, are essential for employees’ effective experience management at the university. This study, by providing a comprehensive model of factors influencing employees’ experience, assists universities and other organizations in gaining a deeper understanding of this concept and developing effective strategies for its enhancement.

Structural Model of the Effect of Organizational Climate on Life Satisfaction with the Mediating Role of Job Satisfaction among Employees of Emergency Medical Centers in Ahvaz

Effat Jahanbani — 2024-06-19

Background: Today, human power has a deep connection with organization, and the dimensions of personal and organizational life of people are intertwined in a complicated way. The present study was conducted with the aim of designing a structural model of the effect of organizational climate on life satisfaction with the mediating role of job satisfaction among employees of emergency medical centers.

Methods: The present descriptive-analytical study was conducted cross-sectionally in 2021. The statistical population of the research included 270 employees of emergency medical centers in Ahvaz city, including the headquarters, urban and road bases, who were all included in the study using the census method. Data collection tools consisted of Halpin and Croft's organizational climate questionnaires, life satisfaction and Spector's job satisfaction. Data were analyzed using structural equation modeling technique in Smart PLS ₃software.

Results: The findings showed that there was a significant and positive relationship between organizational climate and job satisfaction and job satisfaction and life satisfaction in emergency medical workers in Ahvaz city. Organizational climate has a significant and positive effect on life satisfaction through the mediation of job satisfaction. According to the path coefficients, the job satisfaction variable plays a mediating role in the relationship between organizational climate and life satisfaction with 0.51 units (0.776 x 0.663). The values of Standardized Root Mean Square Residual (SRMR) and Normed Fit Index (NFI) index were 0.089 and 0.571, respectively, which indicated the suitability of the presented model regarding the relationship between organizational climate, life satisfaction, and job satisfaction.

Conclusion: Considering the effect of organizational climate on life satisfaction and the mediating role of job satisfaction, it is possible to increase employees' life satisfaction by providing a favorable environment in the organization and improving job satisfaction.

Identifying Effective Policies in the Development of Knowledge-Based Companies in the Medical Field

Mohammad Mehdi Aghakouchak — 2024-06-19

Background: Considering the development of a knowledge-based economy in the world and Iran, identifying the effective components in the development of knowledge-based companies in the medical field is essential in line with the policy and economic development of the country.

Methods: In this qualitative research, data was collected through in-depth and semi-structured interviews from faculty members, specialists and managers of organizations in charge of the country's knowledge-based ecosystem. The statistical population was selected by snowball sampling, and the scientific interviews continued until the theoretical saturation stage, and finally 19 interviews were conducted. All data were analyzed based on Brovan and Clark's six-step theme analysis method.

Results: From data analysis, three main themes including the factors of " revision of the general policies of the country", "creating a suitable economic platform" and "revision of the performance of institutions in charge of knowledge-based economy" and 37 subthemes were extracted which were regarded as effective factors in the development of knowledge-based companies in the medical field.

Conclusion: It is necessary to review the general and executive policies of the country for the development of knowledge-based companies, and the government must provide the basis for the development of knowledge-based companies by creating a suitable economic context, fighting economic rents, creating economic stability and reforming the banking network. It is also necessary to review the processes in the Deputy of Science, Technology and Knowledge-Based Economy and the Ministry of Health, Treatment and Medical Education.

Evaluation of Service Quality of Clinical Diagnostic Using the SERVQUAL and SERVPERF Models in Two Simple and Weighted Types

Hossein Mohebbi — 2024-06-19

Background: Recently, a number of papers have discussed the importance of evaluating service quality provided to customers. The purpose of this study is evaluating service quality of clinical diagnostic in Yazd Central Laboratory from customers’ point of views using the SERVQUAL and SERVPERF models in two simple and weighted types, and also, identifying the most suitable model for service quality evaluation.

Methods: The present research was applied research in terms of purpose and descriptive-analytical in terms of method. According to Morgan's table, the statistical sample of this research included 250 people who referred to Yazd central laboratory in September 2023; they were selected by simple random sampling method and a valid and reliable questionnaire with 33 items which was distributed among them. In the next step, to analyze the data collected from the questionnaire, SPSS ₁₆ software was used to analyze Kolmogorov–Smirnov test, Student's t-test, analysis of variance, Fisher's Z test, and least squares method.

Results: The findings indicated that the expectations of service recipients are greater than their perceptions of the quality of the services received. The correlation coefficient between the overall satisfaction of the clients and the services and the level of service quality in the SERVPERF model (r = 0.7060) has a higher value than the weighted SERVPERF model (r = 0.6913), SERVQUAL model (r = 0.6890) and weighted SERVQUAL model (r = 0.6344). Moreover, the most valid models for measuring the quality of medical diagnosis services were respectively as follows: SERVPERF, weighted SERVPERF, SERVQUAL and weighted SERVQUAL.

Conclusion: Based on the research findings, it is recommended that managers consider the needs and demands of the clients in their future planning in order to improve the quality of services in medical diagnosis services, which are relatively more difficult to evaluate. Also, the level of standards required to provide health services in clinical diagnosis laboratories should be explained to the clients so that they have correct expectations and perceptions of the quality of services.

Configuring Desired Payment Systems in Healthcare with the “Iranian Tar Model”

Masoud Ferdosi — 2024-06-19

Background: Payment systems in healthcare organizations are critical, behavioral, and dynamic. Given the existing challenges in payment systems, characterized by imbalances in payment amounts and inequitable ratios within and across job categories, there is a pressing need for a novel model to configure desired payment systems which proposed in this paper.

Methods: A narrative review was conducted using the PubMed, and ScienceDirect databases with the keywords "payment methods" or "payment system" and "characteristics" or "components" and their Persian equivalents. A total of 16 articles were selected. Additionally, protocols for physician compensation methods and nursing service tariffs from the past five years were obtained and reviewed from the Ministry of Health website. Finally, a novel model was developed based on the research team's expertise and inspired by the Iranian Tar instrument.

Findings: The Iranian Tar Model is introduced as a guide for configuring desired payment systems. This model incorporates six tuning pegs (sufficiency, savings, desired behavior, ease of calculation, distinction, and equity) paired in twos within three axes for configuring payment systems. The positioning of common payment systems (including salary, capitation, Fee-for-Service, and Pay for Performance methods) within the three axes of the model is examined.

Conclusion: Previous studies have addressed payment system parameters in isolation, with limited attention to their interconnectedness. The Iranian Tar Model's six interrelated tuning pegs empower organizations to effectively configure their payment system at individual, intra-group, and inter-group levels.