Background:One of the most important indexes of the health care quality is patient’s satisfaction and it takes place only when there is a process based on management. One of these processes in the health care organizations is the appropriate management of the waiting time process. The aim of this study is the systematic analyzing of the outpatient waiting time.Methods:This descriptive cross sectional study conducted in 2011 is an applicable study performed in the educational and health care hospitals of one of the medical universities located in the north west of Iran. Since the distributions of outpatients in all the months were equal, sampling stage was used. 160 outpatients were studied and the data was analyzed by using SPSS software.Results:Results of the study showed that the waiting time for the outpatients of ophthalmology clinic with an average of 245 minutes for each patient allocated the maximum time among the other clinics for itself. Orthopedic clinic had the minimal waiting time including an average of 77 minutes per patient. The total average waiting time for each patient in the educational hospitals under this study was about 161 minutes.Conclusion:by applying some models, we can reduce the waiting time especially in the realm of time and space before the admission to the examination room. Utilizing the models including the one before admission, electronic visit systems via internet, a process model, six sigma model, queuing theory model and FIFO model, are the components of the intervention that reduces the outpatient waiting time.

Abstract:Background: In recent years accreditation programs have been developed to assess the quality of care and patient safety in hospitals. Quality is a multidimensional concept with patient satisfaction as one of the important facets. This study aimed to test any relationship between patient satisfaction and hospital accreditation. Material and Methods: A cross-sectional study of seven hospitals in Hamadan, Iran, was conducted in 2013. Patient satisfaction was analyzed through a self-made questionnaire and data on hospitals' accreditation scores were obtained from the Curative Deputy of Hamadan University of Medical Sciences. Statistical analysis was done using SPSS 20. Results: Our research found out a strong relation between satisfaction scores and length of stay, hospital type, human resources condition, information, communication and education, medical equipment and physical structure, accessibility to clinical services, emotional support, management and coordination of care. Findings also revealed a significant negative association between hospital accreditation and patient satisfaction except for the domain of emotional support. Conclusion: Findings support healthcare managers with helpful information about the variables that are related to patient satisfaction. This understanding will make them capable to meet needs and preferences of patients more effectively. Study also confirmed the importance of developing an accreditation system based on outcome parameters and providing responsive services to patients which can positively impact their satisfaction.

As the essence of health in humans, spiritual health is a fundamental concept for discussing chronic diseases such as cancer and a major approach for improving quality of life in patients is through creating meaningfulness and purpose. The present descriptive analytical study was conducted to assess the relationship between spiritual health and quality of life in 210 patients with cancer admitted to the Cancer Institute of Iran, selected through convenience sampling in 2014. Data were collected using Spiritual Health Questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ). Patients' performance was assessed through the Karnofsky Performance Status Indicator and their cognitive status through the Mini-Mental State Examination (MMSE). Data were analyzed in SPSS-16 using descriptive statistics and stepwise linear regression. The results obtained reported the mean and standard deviation of the patients' spiritual health scoreas 78.4±16.1and the mean and standard deviation of their quality of life score as 58.1±18.7. The stepwise linear regression analysis confirmed a positive and significant relationship between spiritual health and quality of life in patients with cancer (β=0.688 and r=0.00). The results of the study show that spiritual health should be more emphasized and reinforced as a factor involved in improving quality of life in patients with cancer. Designing care therapies and spiritual interventions is a priority in the treatment of these patients.

IntroductionForecasting the demand and supply of health manpower in an accurate manner makes appropriate planning possible. The aim of this paper was to review approaches and methods for health manpower forecasting and consequently propose the features that improve the effectiveness of this important process of health manpower planning.MethodsA literature review was conducted for studies published in English from 1990–2014 using Pub Med, Science Direct, Pro Quest, and Google Scholar databases. Review articles, qualitative studies, retrospective and prospective studies describing or applying various types of forecasting approaches and methods in health manpower forecasting were included in the review. The authors designed an extraction data sheet based on study questions to collect data on studies’ references, designs, and types of forecasting approaches, whether discussed or applied, with their strengths and weaknessesResultsForty studies were included in the review. As a result, two main categories of approaches (conceptual and analytical) for health manpower forecasting were identified. Each approach had several strengths and weaknesses. As a whole, most of them were faced with some challenges, such as being static and unable to capture dynamic variables in manpower forecasting and causal relationships. They also lacked the capacity to benefit from scenario making to assist policy makers in effective decision making.ConclusionsAn effective forecasting approach is supposed to resolve all the deficits that exist in current approaches and meet the key features found in the literature in order to develop an open system and a dynamic and comprehensive method necessary for today complex health care systems.

Background: Recent trends have led many organizations to use strategic planning for designing and implementing Total Quality Management (TQM) as a fundamental necessity. This study investigated the role of TQM in the quality maturity of hospitals from the employees' point of view. Methods: A cross-sectional study was conducted among the senior managers and officials of three Zanjan University of Medical Sciences (ZUMS) training hospital wards, including supervisors, matrons, and all hospital committee members. All the managers who were willing to participate and met the inclusion criteria were recruited. Two questionnaires, including TQM Assessment and Quality Maturity of Hospital Services were used. Statistical analyses were conducted by SPSS through multivariable regression modeling. Results: The obtained results affirmed a significant effect of TQM on the quality improvement of hospital services; a unit of increase in the mentioned variable resulted in 0.63 unit of change in quality maturity (P<0.05). Furthermore, among the different aspects of the quality management system, the most significant impact on quality maturity belonged to having a system-wide approach toward management (β=0.342). Conclusion: To improve the quality of hospital services, it is necessary to promote managers and employees' commitment toward the necessity of effectively implementing quality improvement programs. Establishing a process management approach, developing a culture of continuous improvement, adopting a systematic approach to control managerial issues, and encouraging employees to participate in quality improvement goals are necessary in this regard.

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Purpose Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality improvement focusing on compliance with clinical standards. The purpose of this paper is to assess evidence-based knowledge and skills among healthcare providers in Qazvin hospitals in 2016. Design/methodology/approach This was a descriptive study conducted among 300 health professionals working in hospitals affiliated by Qazvin University of Medical Sciences in 2016. A self-administered questionnaire was used to gather data on health providers’ attitude, knowledge and skill regarding EBP. Descriptive statistics and multiple linear regressions were used to analyze data using SPSS 16 software. Findings A total of 254 participants (84.6 percent) completed the questionnaire in which their attitude, knowledge and skill toward EBP were assessed at a low level. Study results indicated that among different occupational groups, physicians and those with greater awareness toward EBP terminology had a more positive attitude compared with others. Furthermore, a higher level of knowledge and skill toward EBP was associated with being a physician and having a positive attitude toward the issue. Practical implications Given the importance of EBP and due to insufficient knowledge of healthcare providers about the issue, it is necessary to hold appropriate educational courses to empower health workforce in implementing EBP principles. Originality/value The authors applied a self-administered questionnaire to assess health workforce knowledge and skills toward EBP. The results obtaining from the analysis not only highlights weaknesses related to service providers’ knowledge and capabilities to implement EBP but also reveals facilities required for realization of the subject in hospital settings.

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