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Article

Arash Rashidian and Ian Russell

Clinical guidelines aim to disseminate evidence and thus to change behaviour. This process is complex and needs a coherent approach. Aims to develop a model for…

Abstract

Clinical guidelines aim to disseminate evidence and thus to change behaviour. This process is complex and needs a coherent approach. Aims to develop a model for implementing clinical guidelines in primary care and thus influencing prescribing by general practitioners (GPs). A total of 25 semi‐structured interviews were conducted with GPs and primary care academics. To enrich the model an ongoing literature review of guideline implementation and changing prescribing behaviour was used. A simple model was derived to guide primary care organisations and GPs in implementing guidelines for prescribing, which comprises six steps: choose the condition; choose the guideline; identify influential people; identify organisational factors; plan and adopt an implementation strategy; and monitor the resulting adherence. The model provides a framework for planning the implementation of guidelines, and recognising barriers that hinder adherence to guidelines. It may help to explain why clinical guidelines vary in their uptake.

Details

Clinical Governance: An International Journal, vol. 8 no. 1
Type: Research Article
ISSN: 1477-7274

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Article

Mohammad Arab, Arash Rashidian, Abolghasem Pourreza, Maryam Tajvar, Roghayeh Khabiri Nemati, Ali Akbari Sari and Abbas Rahimi Forooshani

Valid and reliable measures are required for assessing patient satisfaction meaningfully. The purpose of this paper was to develop and validate a Persian-language…

Abstract

Purpose

Valid and reliable measures are required for assessing patient satisfaction meaningfully. The purpose of this paper was to develop and validate a Persian-language in-patient satisfaction questionnaire for patients discharged from Iranian medical and surgical services.

Design/methodology/approach

The cross-sectional survey included 400 patients randomly selected from six Tehran hospitals. A total of 405 patients responded to the questionnaire (76.3 percent response). To assess inter-item reliability and construct validity, factor analysis was carried out. Items belonging to each factor and their Cronbach's alpha coefficient were calculated.

Findings

A total of seven dimensions were identified: doctor-patient communication; nursing care; convenience; visitors; cleanliness; costs; and general satisfaction. Together, these dimensions explained 60 percent of the variance. All items, except three, revealed loadings above 0.4, while Cronbach's alpha exceeded 0.8 for all dimensions, except visitors (0.66). Patient satisfaction levels were relatively high.

Practical implications

Results must be interpreted cautiously owing to high satisfaction, which should not be considered as comprehensive evidence of high performance without important additional service-performance information. Qualitative studies are recommended to complement the authors' quantitative satisfaction study.

Originality/value

The patient satisfaction questionnaire strives to be a valid and reliable instrument for assessing in-patient satisfaction with hospital services in Iran.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 1
Type: Research Article
ISSN: 0952-6862

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Article

Ehsan Zarei, Mohammad Arab, Seyed Mahmoud Ghazi Tabatabaei, Arash Rashidian, Abbas Rahimi forushani and Roghayeh Khabiri

In the ever-increasing competitive market of private hospital industry, creating a strong relationship with the customers that shapes patients’ loyalty has been considered…

Abstract

Purpose

In the ever-increasing competitive market of private hospital industry, creating a strong relationship with the customers that shapes patients’ loyalty has been considered a key factor in obtaining market share. The purpose of this paper is to test a model of customer loyalty among patients of private hospitals in Iran.

Design/methodology/approach

This cross-sectional study was carried out in Tehran, the capital of the Islamic Republic of Iran in 2010. The study samples composed of 969 patients who were consecutively selected from eight private hospitals. The survey instrument was designed based on a review of the related literature and included 36 items. Data analysis was performed using structural equation modeling.

Findings

For the service quality construct, three dimensions extracted: Process, interaction, and environment. Both process and interaction quality had significant effects on perceived value. Perceived value along with the process and interaction quality were the most important antecedents of patient overall satisfaction. The direct effect of the process and interaction quality on behavioral intentions was insignificant. Perceived value and patient overall satisfaction were the direct antecedents of patient behavioral intentions and the mediators between service quality and behavioral intentions. Environment quality of service delivery had no significant effect on perceived value, overall satisfaction, and behavioral intentions.

Originality/value

Contrary to previous similar studies, the role of service quality was investigated not in a general sense, but in the form of three types of qualities including quality of environment, quality of process, and quality of interaction.

Details

Journal of Health Organization and Management, vol. 28 no. 6
Type: Research Article
ISSN: 1477-7266

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Article

Brahim Zaadoud, Youness Chbab and Aziz Chaouch

The purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to…

Abstract

Purpose

The purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to compare if the frameworks of performance measurement in primary health care have an influence on performances of health centers.

Design/methodology/approach

We conducted a systematic review of the literature to (1) identify the conceptual framework for measuring quality management systems, (2) assess the effects of conceptual framework on quality improvement and quality of care outcomes. We opted for the frameworks that are more cited in the literature and we analyzed and compared between these frameworks.

Findings

Eight dimensions were identified for assessing performance in Primary Health Care Facilities “PHCF” in more than 50% frameworks: Effectiveness, Safety, Accessibility, Equity, Efficiency, Acceptability, Patient Centeredness and Timeliness.

Research limitations/implications

The limits of this study can be represented by the following elements: (1) lack of exhaustiveness with regard to the current Frameworks. (2) The evaluation of reliability and validity of the qualitative studies remains difficult to appreciate. (3) Most of the evaluation tools of the primary health care are not validated yet. (4) The difference in performance levels between countries, especially for the developed countries and the multitude of the frames of measure of performance, limits the comparability of the results.

Practical implications

This study provides a conceptual and descriptive literature on the different conceptual frameworks for performance measurement in primary health care, and a practical and useful tool for comparison between the different conceptual frameworks. Several organisations of accreditation or certification introduced, developed, incorporated and checked the indicators of clinical quality in the organizations of health care. Some studies revealed links with the governance, the access, the continuity, the coordination, the efficiency and the strength primary care (Dionne Kringos, 2018). Improvements in the quality of care have been observed in the results of accreditation and certification bodies regarding hospital infection control infrastructure, organization and performance.

Originality/value

Even if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Until now, it is not still common to make evaluation of the quality of care in the “PHCF” to obtain the relevant information. The necessity of having performance measurement tools, which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.

Details

International Journal of Health Governance, vol. 25 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

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Article

Ali Kazemi Karyani, Satar Rezaei, Behzad Karami Matin and Saeed Amini

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and…

Abstract

Purpose

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and socio-economic inequality in poor HRQoL in Tehran city, Iran.

Design/methodology/approach

In total, 562 adults were included in this cross-sectional study. The cluster sampling method was used for data collection from May to June, 2016 in Tehran city, Iran. Data on HRQoL, using EuroQol 5-dimensions questionnaire, and data on socio-economic and demographic variables were gathered. Convenience regression method was performed to measure the concentration index (CI). Decomposition analysis was performed to determine the contribution of variables on socio-economic inequality in poor HRQoL. All analyses were performed by Stata v.14.

Findings

The prevalence of poor HRQoL was 28.3 percent. The value of CI for “poor HRQoL” was −0.299 (95% confidence interval: −0.402 to −0.195). Socio-economic status (SES) was the largest contributor to socio-economic inequality in poor HRQoL (69.44 percent of inequality was explained by SES). Age, obesity and race had a positive contribution to socio-economic inequality in poor HRQoL among the participants. Nonetheless, sex and smoking intensity had a negative contribution to inequality in poor HRQoL.

Originality/value

There is little evidence about the prevalence of poor HRQoL in insured people. This study provided new evidence in this area through the investigation of socio-economic inequality in poor HRQoL and its determinants among people with health insurance in Iran using decomposition analysis.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

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Article

Mazeyar Parvinzadeh Gashti, Rambod Rashidian, Arash Almasian and Ali Badakhshan Zohouri

In recent years, the textile industry has been required to develop new methods and technologies through introduction of some new materials in various processes rather than…

Abstract

Purpose

In recent years, the textile industry has been required to develop new methods and technologies through introduction of some new materials in various processes rather than employing the same conventional chemicals. The aim of this research was to investigate the changes induced on the cotton fibre by the nanoclay treatment using a pre‐treatment method.

Design/methodology/approach

The fibres were dyed with basic and direct dyes after the nanoclay pre‐treatment. Technical measurements were studied including Fourier‐transform infrared spectroscopy (FTIR), UV‐visible spectrophotometer, differential scanning calorimetry (DSC), thermal degradation analysis (TGA), scanning electron microscopy (SEM), moisture regain measurement (MRM), tensile strength test (TST), reflectance spectroscopy (RS) and fastnesses evaluation.

Findings

The intensity of the major peaks in FTIR spectra of the nanoclay treated sample is in favour of the chemical changes of the cellulose functional groups. Basic dyes showed a higher dyeability on the clay pre‐treated samples compared to raw materials. The results of the colour measurements showed that the more concentration of the clay mineral was used, the darker the colour of the dyed sample was. Some interesting results were obtained in the research.

Research limitations/implications

The nanoclay and a dispersing agent used in the present context were used as received. Besides, the type of the dispersing agent is important for preparation of a colloidal dispersion of nanoclay.

Practical implications

The method developed in this research provides a simple and practical solution for improving the dyeability of cotton with direct and basic dyes.

Originality/value

The method for enhancing the dyeability of cotton is novel and can be used in cotton processing with new properties.

Details

Pigment & Resin Technology, vol. 42 no. 3
Type: Research Article
ISSN: 0369-9420

Keywords

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Article

Mohsen Pakdaman, Sara Geravandi, Ali Hejazi, Mobin Salehi and Mahboobeh Davoodifar

Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on…

Abstract

Purpose

Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues.

Design/methodology/approach

This qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software.

Findings

Having analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of “insurance experts” and “insured” and ten subcategories of “informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization.”

Originality/value

This qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 5
Type: Research Article
ISSN: 2056-4902

Keywords

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