BackgroundMeasuring patients’ perception from health service quality as an important element in the assessment of service quality has attracted much attention in recent years. Therefore, this study was conducted to find out how the patients evaluated service quality of clinics at teaching hospitals affiliated with Tehran University of Medical Sciences in Iran.MethodsThis cross-sectional study was conducted in Tehran in 2017 and 400 patients were randomly selected from four hospitals. Data were collected using a questionnaire, the validity and reliability of which were confirmed in previous study. In order to analyze the data, T-test, ANOVA, and Pearson correlation coefficient were calculated using SPSS 23.ResultsThe results indicated that among eight dimensions of health service quality, the patients were more satisfied with physician consultation, services costs and admission process. The highest and lowest mean scores were related to physician consultation (Mean = 4.17), and waiting time (Mean = 2.64), in that order. The total mean score of service quality was 3.73 (± 0.51) out of 5. Outpatient services were assessed as good, moderate and weak by 57.5, 40 and 2.5% of the patients, respectively. There was a significant relationship between the positive perception of service quality and reason for admission, source of recommendation, gender, education level, health status, and waiting time in the clinics (p <  0.05).ConclusionThe majority of the patients had a positive experience with visiting clinics and perceived service provision as good. In fact, patients’ perceptions of physician consultation, provision of information to patients and the environment of delivering services, are the most important determinants of service quality in clinics.

Background:Maternal health program is one of the most important programs in Iran primary health care (PHC). Considering the necessity of its continuous quality improvement, the present study was designed to identify the challenges of Iran maternal health program from the midwives' perspectives. Methods: This is a qualitative study with 27 midwives working in East Azerbaijan province PHC system. The sampling method was purposeful and the inclusion criterion for participants included at least 5 years of experience in the maternal health program. The researchers conducted eight individual and group unstructured interviews and the content analysis method was used for data analysis. Results: This study identified 9 themes, 16 subthemes, and 39 items related to the challenges of the maternal health program from the midwives' perspectives. The main identified themes were human resources, information management, service continuity, cultural barriers, legal and administrative barriers, care facilities, medical equipment, monitoring and evaluation, and geographic access. Conclusions:The study results indicated that there are significant challenges to the maternal health program, which implies the urgent attention of the managers and policymakers to designing and implementing effective interventions.

Introduction:Screening and health check-up programs are most important sanitary priorities, that should be undertaken to control dangerous diseases such as gastric cancer that affected by different factors. More than 50% of gastric cancer diagnoses are made during the advanced stage. Currently, there is no systematic approach for early diagnosis of gastric cancer.Objective:to develop a fuzzy expert system that can identify gastric cancer risk levels in individuals.Methods:This system was implemented in MATLAB software, Mamdani inference technique applied to simulate reasoning of experts in the field, a total of 67 fuzzy rules extracted as a rule-base based on medical expert’s opinion.Results:50 case scenarios were used to evaluate the system, the information of case reports is given to the system to find risk level of each case report then obtained results were compared with expert’s diagnosis. Results revealed that sensitivity was 92.1% and the specificity was 83.1%.Conclusions:The results show that is possible to develop a system that can identify High risk individuals for gastric cancer. The system can lead to earlier diagnosis, this may facilitate early treatment and reduce gastric cancer mortality rate.

Background: Hospitals as the most common health care centers should be changed into high reliability organizations to achieve the best performance and also improve patient safety. High reliability organizations can manage adverse events better, and create a safe environment for patients and staff. This requires accurate planning, training, and high responsibility and commitment hospitals leaders to implement this model. Objectives: The current study aimed to determine the knowledge of Farabi eye hospital's managers and supervisors of the departments, and the success of this hospital to implement high reliability model before and after the training course. Methods: Study was a semi-experimental research. Data were collected through a questionnaire and a checklist in two phases, before and after the training course of high reliability model; 80 clinical and non-clinical managers and supervisors of Farabi eye Hospital in Tehran, Iran, participated in the study by census method. Results: After holding high reliability model training course, 52.2% of respondents expressed obtaining a keen knowledge of high reliability organizations model. Compared to knowledge of the managers and supervisors of the departments before the training course (18.8%), it was indicated that high reliability organizations model training course had a significant effect (P < 0.001) on the knowledge development. Also, the results of this research showed that implementation of high reliability organizations model after the training course increased (P < 0.001). Conclusions: Although, successful implementation of high reliability organizations is based on knowledge of managers and supervisors, the effectiveness of this model is still in the maturity and readiness phase.

Competent managers are essential to the efficient, effective and responsive of hospitals. This study aims to determine the competencies gaps in hospital management. This cross-sectional survey was carried out using a self-administered questionnaire among 127 hospital managers in the Iran. The questionnaire included 61 items and 11 dimensions. Participants were completed on a five-point scale ranging the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Managers felt most competent in terms of legal and ethical issues, health delivery, planning, change management. People management, leadership and strategic management and problem-solving were rated as being most important for the efficient and effective management of hospitals. The gaps were highest for people management (–0.97), leadership and strategic management (–0.82) and problem-solving (–0.80). The least skill gaps were in the areas of legal and ethical issues (–0.31), health service delivery (–0.32) and change management (–0.43). The findings of this study reflect the reality of the management in Iran and the needs of managers and will be helpful in the conceptualization, design and delivery of hospital management programmes aimed at improving current and future management and management capacity in the hospital in Iran.