Background: The proper triage of patients, supply chain management, and proper location, delivery, and distribution of health facilities and services in times of crises and disasters have always been challenging issues playing an important role in reducing damages and increasing the level of patient care during emergencies. Objectives: This study was conducted to design a model for allocating emergency first aid in pre-hospital triage. Methods: The model presented in this study is a two-level mathematical model using nonlinear programming to introduce a new location for the establishment and activation of distribution centers in the supply chain and distribution of pre-hospital health-oriented services during crises. This proposed hybrid model seeks to strike a balance between the concepts of efficiency, cost, and dispersion. By expanding the insurance coverage of health services, the number of services provided in the times of crises and triage of injured patients also increases, leading to the delivery of more profits and improvement in the effectiveness of medical services in the shortest possible time. Results: This model helps to select suitable candidate locations for the triage of patients and increases its performance. Therefore, the appropriateness of each place is measured according to the criteria set for them. This model considers different parameters for selecting places for the distribution and allocation of emergency services, including the efficiency of the centers selected for the triage of patients, the cost of the inventory system for providing primary services, the dispersion of selected triage centers, demands for sick and injured patients, the possibility of constructing additional distribution centers (e.g., field hospitals), and strategies to avoid the imposition of additional costs. Conclusions: This study showed that by maximizing the dispersion of desirable facilities, such as distribution centers, the demand coverage of different regions is appropriately improved. In other words, the health service distributor, as one of the important parts of the supply chain, helps service providers better meet the needs of injured patients during emergencies.
Background: Job satisfaction is one of the most critical and influential parameters to increase the productivity and efficiency of any organization. Crisis management during disasters is one of the most influential factors, and because disasters put pressure on health care systems, all medical staff, including those working in Rehabilitation, must have the necessary experience and skills to manage in an emergency. Therefore, this study aimed to investigate the relationship between job satisfaction and crisis-related factors in the staff of non-governmental rehabilitation centers under the supervision of the Tehran Welfare Organization with a preventive approach. Materials and Methods: The present study is a descriptive-correlational study, in which 1403 people from 28 rehabilitation centers in Tehran Province in 2018 were surveyed and selected by the census. We used the data recorded in the demographic section of the standard Employee Satisfaction Survey. This questionnaire consists of 39 items and 5 subscales to measure job status (10 questions), supervisor (8 questions), coworkers (10 questions), promotion (5 questions), and payment (6 questions). It included components of job activity, management, group activities, incentive system, and payment system. The study demographic characteristics were age, gender, level of education, work experience, and the number of working hours. Besides, a researcher-made questionnaire was used to assess the relationship between general safety status and firefighting as a criterion for crisis management and job satisfaction. In different cases, different tests were used. Finally, the data were analyzed using SPSS v. 20. Results: In this study, 657 (46.8%) men and 746 (53.2%) women participated. Findings showed that the average job satisfaction of employees was 3.12, which was at a moderate to high level (maximum score in each department was 5). There was no significant relationship between demographic information (such as age, work experience, level of education, and the number of working hours) and job satisfaction. However, there was a significant relationship between gender and job satisfaction, so that men had higher job satisfaction than women. Also, there was a significant relationship between public safety and firefighting and job satisfaction, so that an increase in the score of general safety and firefighting as an indicator of crisis management led to a significant increase in job satisfaction. Conclusion: According to the results of the researcher-made and validated questionnaires, the level of job satisfaction of employees in the studied centers is in a relatively good condition. Although the level of job satisfaction of the studied employees was moderately high, it needs to be improved. Job satisfaction in crisis management in emergencies can be very effective and improve the performance of the organization. Thus, it is recommended to implement programs for job satisfaction and crisis management in the centers.
Introduction:Respecting patients' rights practice and keeping patient satisfied is one of most important principles in ethical medicine. Increasing Awareness and respecting patients' rights result in better health care considering human and ethical rights. The Ministry of Health and Medical Education in Iran published a patients' bill of rights and mandated it be posted conspicuously for the patients. With regard to necessity of Patients' bill of rights, patients' role in decision making and respecting their right, this study aimed to investigate awareness of patients' bills of rights among medical staff in Mashhad medical university` teaching hospitals Methods: The current analytical cross-sectional study was conducted on 129 medical staff in the year 2014-15 in Mashhad medical university` teaching hospitals. The data were collected using a self-administer questionnaire with 28 questions whose reliability was 80 according to Cronbach's alpha. One-way analysis of variance, Student's t-distribution was used to compare means of Awareness via SPSS Ver. 21. Results:The results indicated that awareness of medical staff was M=65/3, SD=67/0. Nursing staff were the most aware and radiology staff were the less aware from patients' bills of rights. Conclusion: Today, observing patients 'rights is one of the most important issues that should be placed at the top of the attention of health care programs, observance of patients' bills of rights make people feel satisfied with respect for them at health care centers . So it is neceesery to inform patient and professional on patients' bills of rights by publishing more attention to patients' bills of rights result on better health care
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