Background: Information technology is one of the most important issues in health systems. It has been developed in health sectors and is widely used by hospital managers. Identifying barriers in the use of hospital information systems can be the first step for better information management and better implementation of quality improvement and clinical governance plans. Objectives: The aim of this study is to investigate the barriers for the using of information systems in hospitals. Methods: This is a qualitative study, which used content analysis for analyzing to achieve study objectives. Sampling was done using purposive and heterogeneous methods and data collection continued until data saturation. The researcher was referred to hospital managers to identify individuals who had the most information regarding health information systems to identify barriers of using information system. Results: Results of this study showed that challenges and barriers of information management and use of information systems are related to each other. Based on the results of this study the most important challenges of using information systems are knowledge factors. Conclusions: Designing a comprehensive plan can eliminate barriers of using information systems because barriers and challenges are integrated and related to each other.
Background: It is of paramount importance to reduce the probability of clinical risks to improve the quality of health care services, make the relationship between service providers and patients more effective, enhance patient satisfaction, and decrease the rate of complaints regarding medical errors in hospitals. This study aimed at detecting potential and unacceptable risks occurring in the hospital ICUs. Methods: In this systematic review, all studies examining the risk assessment of ICUs in hospitals using Failure Mode and Effect Analysis method were reviewed. Google scholar, PubMed, Scopus, SID, Magiran and Web of Science databases were searched to find relevant articles published from 1980 to 2019. Results: The most frequent failures detected in the reviewed articles consisted of high risk of infection inwards for medical and nursing operations, high infection rates inwards for medical devices’ operation within the unit, and early discharge. Moreover, the processes through which potential high-risk Failures were examined in these studies were injection or prescription process, suction process, the process of inserting or removing endotracheal tubes, the process of transferring patients from the operation room to the unit or vice versa, pressure ulcers, and processes related to the medical devices’ operation. Conclusion: There are many possible reasons for failure occurring throughout these processes, and the failure modes occurring in these processes are more probable to cause serious damages to patients, have high repeatability with low probability of failure detection as the failures cannot be discovered by the personnel.
Introduction: Performance appraisal is a formal process to review and improve the organizational performance of employees regularly. Despite the appropriate organizational frameworks for performance appraisal, they are not apparently addressing the operational realities of health care organizations. This study thus aimed to examine the effectiveness of the current performance appraisal system of employees at Tehran University of Medical Sciences (TUMS) from the perspective of employees. Methods: The data were collected from 504 TUMS employees using researcher-developed questionnaire following the validation. It consisted of 46 questions covering such various dimensions as performance expectations, communication of performance objectives to employees, self-assessment, performance metrics, surveyors, and performance appraisal results. ANOVA, t-test, Post hoc and Tukey statistical tests were used during analysis process by SPSS 22. Results: The performance appraisal system was not found as effective as expected from the employees’ perspective and the scores for all its dimensions dropped below the average. The overall performance appraisal score was 2.71 (out of 5). There was also a significant correlation between the employees’ education and organizational job group and the score of performance appraisal (p<0.0001). Conclusion: The current appraisal system according to the results is not well functioning. Therefore, it seems necessary to make urgent changes. The lack of active participation from employees and managers in performance appraisal development process, and the subsequent low motivation to improve their performance seems to be a persistent challenge. A fairly desirable solution might be to decentralize the appraisal processes rendering more authority to managers and supervisors along with empowering managers.
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