Quarterly Journal of Management Strategies in Health System

Public-Private Partnership: An Effective Solution for Providing Health Services to the Elderly

Hojatolah Gharaee — 2024-09-28

Population aging has become a significant phenomenon in the 21st century due to rising life expectancy and declining fertility rates. The global elderly population, estimated at 727 million in 2020, is projected to double by 2050, with developing countries facing a greater proportion of elderly residents. This demographic shift will impact various sectors of society, including healthcare, leading to increased demand for medical services and higher costs. Public-Private Partnerships (PPP) are an effective mechanism to improve access to health services for the elderly, enhance service quality, and manage costs. It is crucial for policymakers to explore global experiences with PPP to develop strategies that address the unique economic and social conditions in Iran, ensuring an effective response to the rapid changes in healthcare needs for the aging population.

Promoting Women's Health by Managing Health Resources: A Letter to Editor

Shahla Khosravi — 2024-09-28

Advancing the health goals of society requires human resources management of health as one of the most important tools. Providing the opportunity according to the skill and knowledge of service providers is the basis for providing quality services while considering the cost. This article explains the position of reproductive health scholars as a group to advance the health goals of mothers and babies.

Simulating the Effects of Internal Marketing on Patient Satisfaction Development in Hospitals of Ardabil Province, Iran

Ghasem Zarei — 2024-09-28

Background: To gain and maintain stable competitive advantages, hospitals are currently seeking novel strategies for Patient Satisfaction Development (PSD). To this end, hospitals are required to establish strategies for improvement and provide basic platforms; one of these strategies is Internal Marketing (IM). This type of marketing typically demands customer-oriented behavior and thinking by all hospital staff in terms of dealing with patients. Accordingly, the current research recommends a simulation pattern for PSD within hospitals in Ardabil Province, Iran, considering the predominant factors affecting IM.

Methods: This study, utilizing a qualitative-quantitative research design, was conducted on a statistical population of 17 theoretical (the university professors) and experimental (hospital managers) experts. The sampling technique was of the non-probability type and purposive, and the data collection tools were interviews and questionnaires. In the qualitative phase, the main themes and sub-themes of IM in the hospitals of Ardabil Province, Iran, were initially identified by thematic analysis. Then, in the quantitative phase, the major factors were prioritized via the fuzzy Delphi method, and finally, the effects of IM on PSD were simulated through agent-based modeling. Data analysis in the qualitative phase was done with MaxQDA ₂₀ software, and Microsoft Excel and AnyLogic 8.9 were operated in the quantitative one.

Results: Based on the study results, 35 primary codes, 12 sub-themes, and three main themes (organizational, occupational, and individual) were obtained. In light of this, the organizational factors were introduced as the most effective ones. Besides, the study results suggested that the PSD prospect in the hospitals of Ardabil Province, Iran, reached 70 % at the end of the simulation.

Conclusion: According to the study results, it is suggested that hospital managers devote much attention to the effective factors in IM, specially the organizational ones, as they play a leading role in PSD.

Investigating the Relationship between Communication Skills of Treatment Staff and Patient’s Safety Culture: A Cross-Sectional Study

Seyed Masood Mousavi — 2024-09-28

Background: One of the most important effective factors in increasing patient satisfaction and improving health and treatment results is proper communication between physician and nurse, and the patient. The present study was conducted with the aim of determining the relationship between the communication skills of the medical staff and patient’s safety culture.

Methods: This was an analytical study conducted among 277 working medical staff including nurses, paramedics, full-time geographical employment doctors and anesthesia, and operating room technicians in Shahid Sadoughi Hospital in Yazd by stratified random sampling in 2022. The instrument used was the safety culture standard questionnaire made by the health care quality and research agency and communication skills of Barton J. Data analysis was done with SPSS ₂₅ software, Mann-Whitney, Kruskal-Wallis, and multiple linear regression tests.

Results: The overall mean and standard deviation of patient safety culture was 3.04 ± 0.23, which indicates the average status of safety culture in the studied hospital, and the overall mean of communication skills among medical staff was 3.36 ± 0.40. Which reports a relatively strong level of this skill. The results of linear regression showed that 2 components of communication skills (listening and feedback) have a positive and significant effect on the improvement of patient safety culture, so that they are able to explain 33 percent of the variance of patient safety culture changes.

Conclusion: Based on the findings of the research, the communication skills of the medical staff have a significant effect on patient's safety culture. Therefore, in order to improve the patient’s safety culture among them, special attention should be paid to communication skills because effective communication is considered a vital element in effective care, and in the medical system it has a significant effect on the quality of care and consequently increases the satisfaction of patients.

Designing the Model of Human Resources Analytics in Health System with Grounded Theory

Nahid Zarinsadaf — 2024-09-28

Background: Given the necessity of attracting, retaining, and developing human capital within the health system, the process of human resources analytics in this context is of paramount importance, and it plays a significant role in evidence-based decision-making and policy formulation. Therefore, the aim of the present study was to design a model for human resources analytics in the health system.

Methods: This research is practical in nature and utilized a qualitative approach based on grounded theory. In 2023, semi-structured interviews were conducted with 14 experts and managers from Kerman University of Medical Sciences, using purposive sampling until theoretical saturation was achieved. Throughout the process, interviews were continuously compared, and notes were taken during and after the interviews. The collected data from each interview were then analyzed using open, axial, and selective coding with the assistance of MaxQDA₂₀ software. Through categorizing the open codes, axial categories were identified and in the final step, relationships among core categories were established through selective coding. Additionally, the validity and reliability of the findings were assessed and confirmed based on the four criteria of credibility, dependability, confirmability and transferability.

Results: In identifying the codes and categories related to human resources analytics, a total of 370 open codes, 61 subcategories, and 24 main categories were generated. These were ultimately examined across 6 main axes, including the central phenomenon, causal conditions, contextual conditions, intervening conditions, strategies and consequences.

Conclusion: It is recommended that in order to enhance and develop the human resources analytics process within the health system, attention be paid to the extracted model and its dimensions and components, particularly the identified causal conditions, contextual conditions, and strategies

Investigating of Resilience Scale of Selected Hospitals in Yazd City during Disaster Conditions in 2023

Haniye Akhoondi — 2024-09-28

Background: The need for healthcare is one of the fundamental needs of humans in critical and emergency situations. Hospitals and healthcare centers are among the first units that can reduce casualties by providing optimal and timely healthcare services. Therefore, the present study aims to evaluate the resilience status of selected hospitals in Yazd city during the crisis in the year 2023.

Methods: This research is a descriptive-cross sectional study conducted in 2023 in 5 selected hospitals in Yazd (classified by hospital ownership: university hospitals A, B, C, charity hospital D, and private hospital E). The resilience level of the hospitals during a crisis was assessed using Zhong's standard questionnaire, which evaluated 9 dimensions of resilience. Responses to the questions were based on a 5-point Likert scale (always to never), and data were analyzed using SPSS 26 software. Quantitative data were reported with central (mean) and dispersion (standard deviation) indicators, followed by qualitative (demographic) data as numbers and percentages.

Results: The results showed that the overall resilience status of the hospitals in this study averaged 3.95 ± 0.69, which was evaluated at a good level. The highest score was for the private hospital E with an average of 4.30 ± 0.55, and the lowest score was for the public hospital A with an average of 3.75 ± 0.55. Hospital A's score was at a moderate level, while the remaining hospitals were rated at a good level.

Conclusion: Considering the average resilience of hospitals in a number of areas, it is suggested to develop and present training programs related to preparing for critical situations and holding maneuvers and conducting exercises with emphasis on training key employees.

Investigating and Evaluating the Requirement for Development of Universities and Research-Educational Centers of Environmental Health in Iran

Farhad Ghayurdoost — 2024-09-28

Background: As the subject of environmental health knowledge trains specialized and dedicated human resources and offers the quality and quantity of human resources needed for environmental health, future research and foresight are particularly crucial. This study examines research and educational facilities in the field of environmental health in terms of the presence of expert human resources and the development of facilities. This study addressed educational and research centers in the field of environmental health in terms of its development and the presence of expert human resources.

Methods: This descriptive cross-sectional research was conducted in 2018-2019. First, a description of the ten areas of higher education has been presented and information related to indicators such as the presence of health faculty, the number of professors and research centers has been presented in the form of tables and figures. The data were analyzed using SPSS ₂₂ software.

Results: The findings indicated that there are regional differences in the proportion of faculty members to the total population. This ratio was lower in regions 5 and 10, but was significantly higher in region 8 compared to the national average (4.5 persons per million people). Also, the eastern provinces had a high number of environmental health student training centers. There were differences in the number of environmental health research facilities across different regions, and some provinces had none at all. The highest number of people working with environmental health degrees was found in region 5, while the lowest number was found in region 7.

Conclusion: The findings showed that the development of education should be based on related factors, including population, and the environmental health facilities and priorities of each of the regions should be the basis of educational-research center development, student admission, and attracting faculty members and expert staff in order to be more productive in the field of environmental health engineering.

Investigating the Relationship between Moral Intelligence and Attitude towards Patient Safety in Nurses Working at Shahid Sadoughi Teaching Hospital in Yazd in 2023

Mohammad Ranjbar — 2024-09-28

Background: Moral intelligence in nurses is of particular importance due to the human and moral nature of their job and profession. Moral intelligence can provide a rule for the correct functioning of humans and is considered a predictive factor of behavior. The moral intelligence of nurses refers to their ability to distinguish right from wrong and adhere to ethical principles. Nurses with higher moral intelligence show more commitment to patient safety and adherence to professional protocols and have a more positive attitude toward patient safety. The purpose of this study was to investigate the relationship between moral intelligence and attitude towards patient safety in nurses working at Shahid Sadoughi Teaching Hospital in Yazd in 2023.

Methods: The present study was a descriptive-analytical one conducted cross-sectionally in 2023. The statistical population included 237 nurses working in Shahid Sadoughi Teaching Hospital, Yazd, who were selected by stratified random sampling. Two standard questionnaires with a 5-point Likert scale were used to collect data. Data were analyzed by SPSS₂₄ using descriptive statistics, one-way analysis of variance and Pearson's correlation coefficient.

Results: The average moral intelligence of the studied nurses was 135.22 ± 22.30, and the average attitude of the nurses towards patient safety was 72.65 ± 17.32, indicating high moral intelligence and an average attitude towards patients safety in nurses in Shahid Sadoughi University. The results of Pearson's correlation coefficient showed that there is a positive and significant correlation between moral intelligence and nurses' attitude towards patient safety (r = 0.19, p = 0.003).

Conclusion: Moral intelligence plays a role in predicting nurses' attitude towards patient safety; therefore, it seems that by strengthening the moral intelligence of nurses, their attitude towards patient safety can be influenced. To strengthen the moral intelligence of nurses and improve their attitude towards patient safety, professional ethics training, development of critical thinking skills and creation of ethical organizational culture can be used. Also, holding workshops to discuss ethical issues and support from ethical management can strengthen nurses in making ethical decisions and more responsible behavior in the field of patient safety.