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High quality health-care delivery is not only the governments’ responsibility but also every prisoner’s right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers’ perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons.

A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data.

The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes).

Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process.

The medical consultation is one of the requirements in diseases diagnosis and patient treatment. In addition, a high-quality consultation is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to identify factors affecting the high-quality consultation in medical communications.

The following electronic databases were searched: MEDLINE (via PubMed), Web of Science, Cochrane, EMBASE, Scopus and ProQuest until December 2018. In addition, the authors searched Google Scholar. Qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme, Qualitative Checklist and the Center for Evidence-Based Management appraisal checklist, respectively. A stepwise approach was conducted for data synthesis.

Of 3,826 identified studies, 29 met the full inclusion criteria. Overall, after quality assessment of studies, 25 studies were included. The studies were conducted in the USA (n=6), the UK (n=6), the Netherlands (n=4), Canada (n=2), Belgium (n=2), Poland (n=2), Germany (n=1), Iran (n=1), Finland (n=1), Austria (n=1), Qatar (n=1), Denmark (n=1) and China (n=1), and five studies were excluded. Data synthesis showed that high-quality consultation consisted of three main categories: structural (4 main themes with 26 sub-themes), process (2 main themes with 33 sub-themes) and outcome (3 main themes with 12 sub-themes) quality.

Using the indicators of consultation quality improvement can develop physicians’ clinical competence and skills. Decision makers can use them to monitor and evaluate physicians’ performance. A high-quality consultation can be useful in social prescribing that helps patients to manage their disease.

Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries.

MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0.

Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I²=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I²=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I²=87.88, p=0.170).

In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.

It is necessary for organizations to have committed employees to perform properly and be able to survive in a competitive world. One of the key components of organizational commitment is implementation of ethical leadership. The purpose of this study is to examine the relationship between ethical leadership and organizational commitment in fire organizations of Tehran.

A descriptive-correlational study was carried out in 2019. The sample consisted of 200 randomly selected participants, active in executive and headquarters divisions of fire department in Tehran. To collect data, a questionnaire with three different parts: demographics, organizational commitment questionnaire and the ethical leadership scale, was used. Data analysis were performed by AMOS24 and SPSS software, and data are presented as descriptive statistics of frequency, percentages, mean ± standard deviation (SD) and Pearson’s correlation coefficient.

Mean and SD for organizational commitment and ethical leadership were 3.44 ± 0.7 and 3.66 ± 0.62, respectively. Affective commitment had the highest average score among organizational commitment dimensions (3.63 ± 0.75). Among ethical leadership dimensions, ethical management showed the highest average (3.79 ± 0.70). Each component of organizational commitment, i.e. affective commitment, continuance commitment and normative commitment, also showed a significant relationship with ethical leadership (p < 0.05). Model fit results revealed that independent variables could anticipate 87% of changes of dependent variables in organizational commitment.

The results show a significantly positive relationship between ethical leadership and organizational commitment among the firefighters. Therefore, by using ethical leadership method, i.e. being a role model, improving the relations between management and employees, establishing trust and mutual respect, managers of fire departments can increase firefighters’ organizational commitment, affective commitment, continuance commitment and normative commitment and prevent them from quitting.

Reducing informal payments (IPs) for health services has always been a top priority for health policymakers all over the world. As the newest attempts to reduce IPs, Iran’s Government applied a set of reforms in the health care system in 2014 called “Health Sector Evolution Plan” (HSEP). The purpose of this paper is to investigate the prevalence and nature of IPs one year after implementing this plan.

This descriptive and cross-sectional study was a nationwide survey on Iran's health sector informal payments carried out in 2016. To do this, a sample of 1,112 Iranain households was selected from all over the country using a multistage cluster-stratified sampling method. The prevalence and nature of IPs were determined through conducting face-to-face interviews using a standard questionnaire.

One year after implementing the HSEP, about 27.7 percent of sampled Iranians had at least one experience of IPs for health services. The prevalences of compulsory and voluntary IPs were 21.4 and 11.5 percent, respectively. IPs were reported by 26.1 and 12.5 percent in the inpatient and outpatient services, respectively.

According to the results, compulsory IPs are still prevalent in both the outpatient and inpatient services of Iran’s health system and it seems that the HSEP has not been completely successful in achieving the goal of eradicating IPs. It can be said that the HSEP has been the first step toward eradicating IPs in Iran and should not be the last one. The study provides useful results of the prevalence and nature of IPs after implementing the HSEP, which should be considered in designing the next steps.

Strategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM).

The authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM.

Five main factors affected strategic plan implementation. Although all five variables and factors are top level, “senior manager awareness and participation in the strategic planning process” and “creating and maintaining team participation in the strategic planning process” had maximum drive power. “Organizational structure effects on the strategic planning process” and “Organizational culture effects on the strategic planning process” had maximum dependence power.

Identifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers.

The authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

Accreditation helps to ensure safe and high-quality services in hospitals. Different occupational groups have various hospital accreditation experiences. The purpose of this paper is to investigate nurses’ accreditation experience and its effects on Iranian teaching hospital service quality.

This was a qualitative study involving a phenomenological approach to studying nurses’ hospital accreditation experience and understanding the effects on Iranian teaching hospital service quality. Data were collected using two focus groups in which nurses were selected using purposive sampling. Transcripts were analyzed using content analysis.

Nurses’ experiences showed that hospital administrators and nurses had greater role in implementing accreditation than other occupational groups. Accreditation improved patient-centeredness, patient safety, logistics and managerial processes and decision making. However, a weak incentive system, extra documentation and work stress were negative experiences.

Nurse experience, as the most important care team member, reveals accreditation’s strengths and weaknesses and its effects on service quality.

The author used a phenomenology approach to measure accreditation effects on service quality – a valuable tool for understanding a phenomenon among those that experience hospital accreditation processes.

The purpose of this paper is to determine accreditation effects on Iranian military hospital health service quality through nurses’ viewpoints.

The paper is a cross-sectional questionnaire-based study. Sampling drew from a hospital nurse census (n=160). Descriptive statistics were used to analyze participant demographics and nurses’ views. Linear regression analysis determined the independent variables’ overall effect on the accreditation quality results dimension (dependent variable).

From the nurses’ viewpoints, accreditation effects on services quality mean score was 3.60±0.61. Linear regression analysis showed that leadership and quality management were identified as the most important accreditation quality predictors. The R² value (0.698) showed that nearly 70 percent of the dependent variable changes were affected by the independent variables.

This study gives hospital managers a deeper insight into accreditation and its effects on military hospital service quality. Military hospitals benefit from military organization such as hierarchy and command chain, so managers should employ these characteristics to adopt appropriate policies to promote human resource management as a competitive advantage. Furthermore, results will guide public and private hospital managers on how to manage organizational variables that benefit from accreditation.

Accreditation was introduced as a hospital quality improvement program. However, implementing accreditation programs should be cost-effective. Hospital managers and employees should feel that accreditation can improve service quality. Nurses had positive viewpoints about accreditation and its effects on military hospital service quality.

The purpose of this paper is to identify the most important factors for strategic purchasing of health services in the health sector by the Iran Health Insurance Company and to provide an applicable model for other similar organizations in developing countries.

The present qualitative study was conducted in 2017 to identify the factors affecting the implementation of strategic purchasing of health services in the health sector by the Iran Health Insurance Company and to provide an indigenous and practical model through two phases: semi-structured interview followed by a Delphi process.

According to the findings of this study, Ministry of Welfare, Labor and Social Security plays a central role in the strategic purchasing. In addition, this was also approved by the representatives of citizens in communities concerning professional associations, insurance agencies and representative of the Council of Ministers. Model development explored 9 themes and 54 sub-themes.

Based on the model, most attention has been paid to consumer role and inter-sector leadership of the company with other relevant organizations and systems including other insurance organizations and the welfare ministry. More importantly, the health insurance company should be able to communicate with providers and to choose the best providers, receiving price information through competition in the most appropriate mechanism. Guided by this model, it can strategically buy the best and the most effective services for its insured population.

It might help developing societies to promote their health systems based on targeting the health budgeting and financial constraints so that it is prioritized according to the strategic purchasing criteria and consequently, economic evaluation.

The linchpins of the present study are as follow: first, the pragmatic model presented in the paper could help developing health systems to overcome the impediment in the implementation progress of strategic purchasing. Second, the model satisfies the need of enough knowledge to apply strategic purchasing in the health system. Third, the indigents have long been given special protection and consideration in the model that has continued to capture the attention of every policy-maker, in particular, developing countries, the portion of which is significant. Fourth, based on this model, attention has been paid to consumer role and inter-sector leadership of organization with other relevant organizations and systems. Fifth, this model could be correspondent for every insurance company in countries with similar developing conditions.

This study aims to identify and prioritize barriers to the implementation of medical equipment (ME) marketing strategies using the analytic hierarchy process (AHP).

This was an applied, cross-sectional and descriptive-analytic study conducted in 2017 in Iran. The study population included 30 medical equipment experts working in the Ministry of Health and Medical Education. A researcher made pair-wise comparison questionnaire was used for collecting the required data. The validity and reliability of this questionnaire were confirmed through getting five related experts’ opinions and inconsistency ratio (IR = 0.04). The AHP technique and Expert Choice 10.0 software were used to prioritize the barriers to the implementation of ME marketing strategies.

The results showed that among four categories of barriers to the implementation of ME marketing strategies, “managerial and strategic barriers” (FW = 0.339) and “structural barriers” (FW = 0.139) were the most important and the least important barriers, respectively.

This study, for the first time, has identified and prioritized barriers to the implementation of medical equipment marketing strategies using the AHP.