Background: This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD) scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non-participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01) and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001) predicted the patients’perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non-punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

Introduction: The evaluation of service quality is a key measurement which provides the necessary information for effective decision making and providing high quality care. This study aimed to investigate the factors affecting the service quality gap for the provision of care from the perspective of surgical patients hospitalized in a teaching hospital in the Northwest of Iran in 2015. Methods: In this descriptive cross-sectional study a total of 300 patients and 101 nurses were selected by random sampling method. The data regarding patients’ expectations and perceptions of the quality of healthcare services were collected using the SERVQUAL questionnaire. Also, the nurses’ demographic data were assessed using the demographic data tool. Results: The mean and standard deviation of the patients’ expectations and perceptions of the quality of healthcare services were 66.59)8.52) and 51.81(11.97), respectively. In all dimensions of the quality of healthcare services, the patients’ perceptions were lower than their expectations. The greatest gap was observed in the dimensions of assurance and responsibility and the lowest gap was reported in the domains of reliability and empathy. There were statistically significant relationships between the nurses’ age, work experiences in surgical wards, professional experiences of nurses, patients’ income level and the gap in the quality of healthcare services. Conclusion: Despite great efforts directed at the field, the healthcare system still faces numerous challenges in the provision of high quality healthcare services to the patients. The health system should support low-income people and employ professional and experienced nurses for improving the quality of healthcare services.

Background: Medical errors are one of the major challenges which threaten patient's safety. Meanwhile, medication errors are common types of medical errors that have attracted the attention of many people. It is known as the eighth cause of death in USA. It has also caused many different injuries, death, or increase in medical costs in other countries. Regarding the importance of patient's safety and reduction of medical errors, this study was conducted to evaluate and analyze of medication errors and implementation of strategies to reduce errors in Hujjat Kuh-Kamari Hospital in 2017. Methods: This research is an analytical and interventional study. All reported errors in 2017 were summed up by personnel and patient safety staffs at monthly medical units and analyzed using the RCA (Root Cause Analysis) by medical error analysis team and were ultimately analyzed in Ishikawa diagram. Then, by identifying CPD (Caring Problem Delivery) and the SPD (System Problem Delivery) factors, the main causes of these errors were evaluated from the moment of prescribing and filing until giving the medication; then appropriate strategies were provided and approved to reduce these errors by the Error Analysis Team. These strategies were then provided to the treatment units. Finally, a reassessment of medication errors was performed again in 2018 and compared with the results obtained in 2018 to determine the strategies effectiveness. Results: The results of the study showed that the errors were in different forms, such as incorrect dose, incorrect registration of the drug, lack of registration of the drug, incorrect entry at list, failure to implement it, and wrong implementation of medication order. According to the analysis of the errors, the causes of the occurrence of these errors were the cases such as incorrect checking of the orders (20%), the problem with readability of the order (15.5%), the similarity of the medication in terms of the name, form and appearance (14%) the incomplete written name of medication by the doctor (7.8%) the incomplete written name of medication by the nurse (8.7%), and other errors. Ultimately, solutions were provided to the units as follows:• Checking the orders again by the next person in the next shift and matching it with the orders in patient's list.• Matching the medications in patient's list and records by the secretary of the unit at the time of registration in HIS system.• Sending letter to doctors to write the medication orders better and in a readable way.• Separating similar medications and identifying the risky and similar medications with yellow and red labels. These errors were assessed in 2018 again, and all errors were reduced by an average of 8.35%. However, the errors related to doctors' handwriting were increased up to 0.4%. Conclusion:Considering the importance of patient safety and receiving safe services in hospitals, it is important to identify errors and its causes, examine the strengths and weaknesses of reporting errors, share errors and find ways to reduce or eliminate...

Background:The crisis is the severity and peak of stress. According to the accumulative characteristic of stress, the accumulated stresses become a major crisis over the time. All those exposed to the crisis experience different posttraumatic psychological states. Some people suffer from post-traumatic stress syndrome. Some of them suffer from post-traumatic stress due to the observation of dangerous scenes and lose of the beloved ones. Of among, personal vulnerability is one of the most important factors that has a psychologically significant effect on the occurrence or absence of psychological disorders in post-crisis events. According to the importance of this issue, Marand Health Center s Psychology Unit intends to identify people who expose the risk of psychological disorders through a crosssectional assessment, and develop an operational program required for psychological interventions in crisis and disasters with a prospective approach. Methods: The present study is a research initiative idea and plan. The total number of households covered by health centers is 77,564 people. To execute this program, it is first necessary to hold meetings with psychiatric centers and clinical experts regarding the purpose and implementation procedure of this program. The evaluation form is then prepared and reviewed according to the psychologists' perspectives, and its validity and reliability was confirmed by experts. Finally, a training course was held for personnel involved in health centers and required training on how to complete the forms and identify those at risk was presented to them. As well as, in the context of post-incident crisis management (with a prospective approach), follow-up was conducted for those exposed events, and required interventions were provided to prevent the deterioration of the mental condition or the occurrence of psychological disorders. Results: As event-induced crises on the one hand predispose an individual to psychological disorders and, on the other hand, increase the potential forces and the use of psychological mechanisms, proper intervention on the one hand is therefore beneficial to prevent the immediate symptoms and psychological disorders and on the other hand, it will bring about the individual growth and prosperity. Conclusion: Since one of the basic discussions in crisis and risk management is the preparation before and the action at the right time, identifying people at risk and training ways to deal with stress can prevent psychological consequences of critical events based on this idea. According to the studies and surveys, the most pre-crisis intervention includes the analysis and readiness of structures, strength creation, and so forth. And there are few studies on the psychological hazards. Therefore, it is suggested that this idea is implemented and evaluated in some disastrous areas of the country.

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