Capability of Different Multi-Criteria Decision-Making Techniques in the Performance Assessment of the Hospitals in Terms of Medical Waste Management.

Background: Assessing the performance of hospitals in waste management requires considering several criteria of different types. The multiplicity of the criteria and how they are weighed and, ultimately, the ranking of hospitals; are among the most complex challenges faced by the environmental health authorities. This research tried to assess the capability of four commonly used multi-criteria decision-making methods, as well as a hybrid technique for performance assessment of six hospitals in Tehran City, Iran, in 2018 regarding waste management. Methods: The effective criteria and sub-criteria were identified by reviewing the relevant literature. The data collection tool was a self-constructed checklist developed based upon the identified criteria and sub-criteria and analysis of the collected data was done in MATLAB software. The sample hospitals were ranked based on the scores given to the management performance of hospitals. Results: The final rankings by the different techniques did not differ significantly. According to the results of the hybrid method, among six studied hospitals, the top three hospitals were Hospital C, B, and A respectively, regarding hospital waste reduction criteria. These hospitals generally had an acceptable performance in terms of waste management, especially waste disinfection and separation at the origin. Conclusion: In assessing the performance and ranking of hospitals in terms of waste management, hybrid multi-criteria decision-making techniques can be used as a useful tool in waste management planning. By identifying the areas in need of corrective actions and choosing the appropriate strategy, they pave the way for improving the performance of hospitals in the field of waste management.

A survey of the quality of nursing services for brain trauma patients in the emergency wards of hospitals in Guilan Province, Iran (2012).

BACKGROUND: Head trauma is the main cause of disabilities and death among young people, and the side effects of head trauma pose some of the greatest medical challenges. Rapid diagnosis and the use of proper treatments can prevent more severe brain damage. The purpose of this research was to determine the quality of nursing services provided to brain trauma patients in hospitals in Guilan Province, Iran. METHODS: The study was conducted as a descriptive, cross-sectional study in the emergency wards of selected hospitals in Guilan in 2012. The research population was comprised of all the brain trauma patients in these hospitals. We developed a two-section questionnaire, ascertained its validity, and determined that it had a reliability of 88% (Cronbach's alpha). Subsequently, we used the questionnaire for gathering data. The data were analyzed using SPSS statistical software, and descriptive analysis tests (frequency rate and average) and deductive analyses tests (chi-squared) also were used. RESULTS: The results showed that the quality of health services provided to brain-trauma patients in the emergency ward was at the moderate level of 58.8% of the cases and at a low level in 41.2% of the cases. CONCLUSION: Based on the results that showed that the services were of moderate quality, the staff members in the emergency ward were required to update their knowledge and use the required measures to minimize or prevent side effects in brain-trauma patients; clearly, mastery of such measures was a real need among the emergency ward's staff.