Pillars of Hospital Preparedness in Radiation Emergency Management.

Human beings have always suffered and have incurred irreparable damages from different disasters. The most logical way to deal with disaster is to be comprehensively prepared. In line with this, the readiness of hospitals in the vicinity of nuclear centers is of great importance, as this could lead to reduced injuries and damage. In this study, we aimed to develop a model by which hospitals could effectively react to nuclear incidents. This is a comparative study using library studies, including examining existing patterns, recommended policies and instructions of WHO and IEAE, and articles and documents of selected countries that have models for radiation disaster management. The primary developed model was discussed in expert panels and, ultimately, with some modifications, was finalized. The findings of the research indicated that the most important factors in the success of crisis management are skill in predicting a crisis and having a preparation plan for necessary measures at the time of an incident. Different countries have developed various approaches toward radiation incident management that are mostly focused on human resources, medical equipment, and physical space. The model plan developed here includes a two-part foundation with seven pillars. Intra- and intersectorial arrangements are considered as the foundation, and the pillars are physical structure, medical equipment, human resources, process and instructions, intra- and intrasectorial coordination, information systems, and organizational structure. Having an appropriate model for coping with radiation incidents is pivotal for hospitals active in areas with nuclear centers. Undoubtedly, existence of an effective and comprehensive model could reduce the consequences of radiation crises.

Evaluation of Facilitators and Barriers to Implementing Evidence-Based Practice in the Health Services: A Systematic Review.

BACKGROUND: Evidence-based practice (EBP) is an ambition for health service administrators. We aimed to systematically review the major relevant articles in case of barriers and facilitators to implementing evidence-based practice in health services. MATERIALS AND METHODS: The type of study was a systematic review. We searched the libraries and online sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, Scopus, Science Direct, Cochrane Library, and Google scholar. We used keywords included "Evidence-Based Practice", "Evidence-Based Management", "Healthcare", "Care Management, Evidence-Based Healthcare Management", "Health Care", Health", "Barrier", "Facilitator", policy and "Evidence-Based Healthcare". RESULTS: In total, 12 studies were included. Several barriers and facilitators were recognized through the included papers, the factors such as organization support and a helpful education system improved skills, knowledge, and confidence to EBP. The outcomes of studies were identified as the employ of the internet as a highest-rated skill for increasing EBP quality. CONCLUSION: Generally, the results showed health service administrators should first identify barriers of EBP then transferred them to facilitators to the implementation of proper and efficient EBP.

Designing a model of hospital information system acceptance: Organizational culture approach.

Background: The significance and influence of organizational culture on Information Technology acceptance, especially in healthcare field, has been recognized as a source of organizational inertia. This study aimed at developing a model of Hospital Information System (HIS) acceptance for non-teaching hospitals of Iran University of Medical Sciences to encourage the authorities to promote organizational culture and successful application of HIS. Methods: The proposed model was developed according to Michigan Organizational Assessment Questionnaire (MOAQ), Harrison, Hofstede models, and Comparative Values Framework (CVF). The questionnaires were designed based on the model and distributed among 400 HIS users in the hospitals under study, who were selected using stratified random sampling. The structural equation modeling method was used for data analysis in LISREL software. Results: According to the final model, the influences of developmental culture on perceived usefulness, the relationship of 4 types of organizational culture with mandatoriness according to CVF, and the relationships of hierarchical and developmental culture with system use were attested. The relationships between supervision and 4 variables of HIS acceptance were confirmed. Furthermore, the influence of process/ result oriented culture on user satisfaction was demonstrated. The normed chi square index (2.60) revealed that the final model was fitted to the data. The indices were as follow: GFI= 0.95, CFI= 0.97, AGFI= 0.88, RMSEA= 0.064. Conclusion: The components and structural relationships in the model of this study are applicable in the related hospitals, and using this model can promote organizational culture and acceptance of HIS by the users.

The Relationship Between the Customer Relationship Management and Patients' Loyalty to Hospitals.

BACKGROUND & AIM: Customer Relationship Management (CRM) with its various components has been considered as a tool causing customers' loyalty. The present study aims to investigate the relationship between the various components of customer relationship management and patients' loyalty to the place of their treatment. METHODS: This cross sectional and descriptive-analytical study was conducted among nurses and hospitalized patients in inpatient wards in selected hospitals in 2014. Using the stratified random sampling method, 224 valid and reliable researcher-drafted questionnaires were completed for CRM by nurses and 359 questionnaires were completed by patients for patients' loyalty in the studied wards. Data were analyzed using the SPSS(20) software. RESULTS: There was no statistically significant relationship between the level of patients' loyalty and organizational indicators, information technology and knowledge management (P Value>0.05). However, there was a statistically significant relationship between loyalty and the dimensions of the service process (P Value=0.04), human resources (P Value=0.002) and CRM (P Value=0.038). The strength of these relationships were 34, 40 and 36 percent, respectively all of which were positive. CONCLUSION: Customer Relationship Management is a tool for improving influencing factors on patients' satisfaction and loyalty. Therefore, attempts to implement customer relationship management as a process for improving hospitals performance and improving communication between service providers in hospitals and customers leading to enhance patients' loyalty should be taken into account by managers and policy makers in the health sectors.

Designing a model for trauma system management using public health approach: the case of Iran.

Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.