Papers by Rouhollah Zaboli
Revista Inclusiones, Mar 30, 2019
Medical Ethics Journal, Jun 7, 2016
It is essential to managers do a serious action in terms of priorities toward removing barriers a... more It is essential to managers do a serious action in terms of priorities toward removing barriers and reducing error reporting, and attempt to improve patient safety culture.
Quarterly Scientific Journal of Rescue and Relief, Jan 15, 2011
Journal of Hospital, Dec 10, 2020
پژوهش سلامت, 2019
Introduction: Today, traditional management and leadership will not respond to bumpy and unpredic... more Introduction: Today, traditional management and leadership will not respond to bumpy and unpredictable healthcare organizations. A transformative leadership with an appropriate and efficient approach can make the strongest of the weakest organizations. The purpose of this study was to assess the transformational leadership indicators in the managers of a military hospital from the perspective of its employees. Materials and Methods: This study was descriptive-analytic and in terms of its purpose was practical. The statistical population of this study was all employees of the selected military hospital in 2016 which selected randomly. Data collected using standard questionnaire of Castiglione and then analyzed using SPSS 20 software, ANOVA, t-test and correlation coefficient methods. Results: The findings showed that the lowest mean of evaluated variables was related to the managerial attributes associated with charismatic management (21.11 ± 5.22), and higher mean value was in the components of managerial attributes related to intellectual motivation in the employees (75 / 28.34 ± 6.8). Also, the results of ANOVA showed that there was a significant relationship between the components of charismatic features and place of work and the age groups of employees as well as between the components of managerial characteristics related to charismatic management and evolving facilitator management features with previous history of management of staff and place of service (P <0.05). Considering that the most important factor in the evolutionary leadership of the managers in the military hospital is the characteristics associated with mental stimulation in the staff, it is now suggested that hospital managers provide new initiatives to evaluate staff and create an enterprise-based culture of continuous improvement, staffing encourages the development of new skills and rapid adaptation to change, in order to improve the field of health promotion and effectiveness.
Journal of Military Medicine, Jul 19, 2020
Background and Aim: In recent years, the construction industry, especially hospitals affected by ... more Background and Aim: In recent years, the construction industry, especially hospitals affected by sustainable development, have created concepts such as "sustainable building" and "green hospital". With the development of implementation and evaluation systems of Green Hospital, various methods were presented. The common point of all these methods was the three areas of optimal consumption of water, energy, and less waste generation. This study was conducted to investigate the status of these areas. Methods: This is a retrospective descriptive cross-sectional study. The research population includes a selected military hospital in Tehran, Iran. Information on the consumption and cost of energy, water, and also the amount of waste production over a period of three years (2014)(2015)(2016) in 2017 were collected and analyzed. Results: On average, the hospital consumes 80.79 kWh of electricity and 12.12 m 3 of gas at a cost of 25861 Rials and 10808 Rials per active day bed, respectively. This statistic is active for 1124 liters of water consumption at a cost of 16,993 Rials per day bed. Waste production was on average 3.67 kg per active day bed, of which 42% was infectious waste. The results showed that water and electricity consumption were 2.20 and 10.1 times the existing standards, respectively. The average production of total waste was 2.5 to 3.7 times and infectious waste was estimated to be 27% higher than international standards. It is recommended that hospitals adopt environmental protection strategies, hold training courses, manage waste, and allocate the necessary funds. In the macro dimension, the binding of these measures and the development of local indicators will be a useful solution. The lack of mandatory standards for measuring and reducing the studied indicators is a national challenge and it is suggested that the hospital reduces the statistics.
International Journal of Medical Reviews, Jun 27, 2015
Natural disasters are a severe rupture with high intensity, and require a high degree of interven... more Natural disasters are a severe rupture with high intensity, and require a high degree of intervention under extreme conditions, and associate with some consequences such as financial, health damages and disease, and cannot be controlled effectively using common methods and available resources (1-3). Unexpected events, as irrefutable component of human life, always has threatened human lives in different forms such as volcanoes, earthquakes, floods, hurricanes, and despite advances in technology, human being still remains incapable of predicting events (4-7). Major natural disasters have affected at least 800 million people worldwide over the past two decades, causing thousands of deaths and more than $ 50 billion economic damage. In addition, due to an increase in the density of the population in different parts of the world, human settlements in disaster-prone areas has increased (3). At the time of the accident, all the economic, political and cultural infrastructures of societies are threatened that all equipments and facilities available in the society need to be mobilized, and according to their responsibilities and restrictions in the form of crisis management combat it in terms of national plans to minimize the effects of crisis (8). In this regard, rescue and health management in times of crisis, with rapid appropriate predictions of events, and determining the needs and potential problems, is an important factor in preserving human being life (9). The primary objectives of response to the crisis include the prevention and reduction of mortality and illness and also encourage to return to normal (10). During the responding phase, having a systematic approach to the design, implementation, monitoring, evaluating the specific services, and providing the basic needs, good coverage, improved access and the high quality of service is desirable ( ). An appropriate response to unexpected events needs appropriate preparedness, and since each Disaster as an undeniable part of human life, is followed by some adverse economic effects. All equipments and facilities available in the society need to be mobilized according to their responsibilities and restrictions in the form of crisis management in order to combat it and to minimize the effects of crisis. Moreover, a systematic approach to the design, implementation, monitoring, evaluating the specific services, and providing the basic needs, good coverage, improved access and the high quality of service is desirable. It is obvious that Iran is not excluded from this rule, and like other countries, is an accidentprone country and can be considered as one of the most vulnerable countries to disaster. Evaluation of health care during natural disasters in Iran indicates the lack of coordination in providing health services. A comprehensive coordination is considered as the core activity before and during crisis. Therefore, the present review has aimed to study the coordination among organizations involved in the crisis, and the operational issues and solutions for effective and efficient responses, through search in valid Databases using some keyword such as Coordination in disaster, Coordination concept, Coordination barriers, Coordination facilitators, coordination in response, issue of coordination. Papers between 1995 and 2015 were searched and studied. It is not simple to coordinate among the responsible and service provider organizations and institutions, requiring a systematic approach in all actions and also inserting the coordination issue as a strategy in the comprehensive plan of crisis management. In order to reduce the adverse effects of crisis, in addition to apply a comprehensive plan in the crisis response phase, the coordination among the organizations should be promoted using some measures in the pre-crisis phase (preparation)
Journal of Health and Development, Nov 1, 2017
The normal vaginal delivery (NVD) promoting plan, with the aim of improving mothers and children ... more The normal vaginal delivery (NVD) promoting plan, with the aim of improving mothers and children health, is one of the programs of the health system reform plan. The aim of this study was to compare the rates of NVD and cesarean section before and after the health system reform plan in hospitals affiliated to Kerman University of Medical Sciences. In this descriptive cross-sectional study, data related to the total number of normal vaginal deliveries and cesarean sections were obtained from the documents sent to the census bureau and the department of midwifery of Kerman University of Medical Sciences. Data were analyzed through SPSS 19 and using paired t-test. Results: From the 7 hospitals under study in Kerman Province, from a total of 6559 delivery cases in the six months before the implementation of the plan, 3409 ones (51.97%) and from 6992 delivery cases in the six months after the plan, 3968 ones (56.57%) were performed as normal vaginal delivery. This shows growth of normal vaginal delivery rate by 4.75% after the health system reform plan, but was not statistically significant (P=0.093). In spite of partial achievement of the plan goals, other attempts such as focusing on physicians' attitudes increasing the knowledge and changing the attitudes of people in the society especially pregnant women are required to obtain desirable results with a better speed.
Journal of Health Promotion Management, Oct 15, 2014
Introduction: Unequal distribution of health in the developing countries is one of the main chall... more Introduction: Unequal distribution of health in the developing countries is one of the main challenges of health systems. This leads to inequality in social status, living conditions and social interventions of the government's efforts to fail. Current study aimed to develop a conceptual model of social determinants of health inequalities in Iran with a qualitative approach. Materials & Methods: This study was a qualitative content analysis. The participants were consisted of 33 experts of social determinants of health field which were selected through purposive sampling. Semi-structured interview was used for data collections. Directed content analysis with Nvivo software was conducted. Findings: This study resulted in 14 themes and 55 sub-themes as determinants of inequality on health in Iran. Main themes were disasters, socio-economic status, macroeconomic policies, leadership, social policies, public policies, culture and social values, social protection, social cohesion, religious, international factors, behavioural and biological factors, psychological factors, health system and socio demographic factors. Inequalities in health can be avoidable due to its main determinants of economic status, education, employments. Hence social factors determining health approach, is suggested to formulate macro-economic and social policies in the country and it requires more attention.
Hospital practices and research, Aug 12, 2017
Background: The high workload of nurses in hospitals has been identified as a patient safety and ... more Background: The high workload of nurses in hospitals has been identified as a patient safety and worker stress problem. Psychological empowerment is a motivational concept demonstrated in four dimensions: meaning, competence, selfdetermination, and impact. Objective: This study investigated the relationship between nurses' workloads and psychological empowerment using structural equations modeling (SEM). Methods: This descriptive correlation study was conducted using SEM. The study was conducted at 17 public hospitals affiliated with Iran University of Medical Sciences (IUMS) in the city of Tehran. The population study was nurses employed in critical care departments. Two questionnaires were used to gather data: the NASA and the Psychological Empowerment Questionnaires. Differences in categorical variables were analyzed using one-way analysis of variance (ANOVA). Confirmatory factor analyses were used to confirm the relationships between latent variables and indicator variables; SEM was used to find the direct and indirect effects of nurse's workload on psychological empowerment. Data analyses were performed using SPSS 18, and all models were tested in LISREL 8.8. Results: Correlations among indicators of nurse's workload showed that highest correlations were performances (0.61), and the highest correlations among psychological empowerment were competence (0.03). The overall correlations among nursing workloads and psychological empowerment were 0.74. The proposed structural model fit was acceptable (χ2 = 525.5, df = 89, RMSEA = 0.13, GFI = 0.91). Conclusion: Increasing the workload of nurses in hospitals will better engage the nurses and allow them to face new problems they encounter in their jobs.
Rāhburdhā-yi mudīriyyat dar niẓām-i salāmat, Mar 16, 2024
Electronic physician, Aug 25, 2016
Introduction: Clinical practice guidelines are structured recommendations that help physicians an... more Introduction: Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital. Methods: This study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area of blunt abdominal trauma clinical practice guidelines. Sampling was based on purposive and nonrandom methods. A semistructured interview was done for the data collection. A framework method was applied for the data analysis by using Atlas.ti software. Results: After framework analyzing and various reviewing and deleting and combining the codes from 251 codes obtained, 15 families and five super families were extracted, including technical knowledge barriers, economical barriers, barriers related to deployment and monitoring, political will barriers, and managing barriers. Conclusion: Structural reform is needed for eliminating the defects available in the healthcare system. As with most of the codes, subconcepts and concepts are classified into the field of human resources; it seems that the education and knowledge will be more important than other resources such as capital and equipment.
Journal of Military Medicine, Jan 15, 2011
Aims: Risk management assessment in the hospital is the infrastructure of planning in field of cr... more Aims: Risk management assessment in the hospital is the infrastructure of planning in field of crisis management and is one of fundamental issues in medicine. This study was performed with the aim of assessing the risk management in selected hospitals of Tehran. Methods: This observational cross-sectional study was performed on the wards staff of selected hospitals. Data was collected by a researcher-made questionnaire using five-point Likert scale. Data was analyzed using variance analysis and independent t-test by SPSS 16 software. Results: Staffs' understanding of risk management scored 3.2±0.69, risk management organizing state scored 3.58±0.74, the state of policies and trends in risk management scored 3.72±0.7, education scored 3.71±0.8, risk management position scored 3.59±1.49 and monitoring of risk management assessment and control scored 3.72±0.75. Results of statistical test of components' means only showed significant statistical difference in monitoring and assessment of risk between different sex groups. Conclusion: Hospital managers' regard to the position of risk management is essential for developing the quality of treatment and creating a safe environment for the staff and patients. Adopting policies and planning for education and monitoring risk management activities in hospitals should be pursued seriously.
Aims: Leadership is the very factor playing a significant role in improving the efficiency of any... more Aims: Leadership is the very factor playing a significant role in improving the efficiency of any organization. It is in fact the variable distinguishing a creative and innovative organization from other ones. The present study was an attempt to examine the management style in some selected military hospitals and its relationship with hospital performance indicators in 2011. Method: This was a cross-sectional descriptive-analytical study. Seven hospitals were selected using stratified sampling from among the military hospitals in Tehran, Iran. The leadership style questionnaire with Likert scale was used for data collection. Data analysis was done using Mann-Whitney test, Chi square, and Spearman correlation coefficients using SPSS 19 software. Results: Results showed that 56.1, 22.7, and 21.2 percent of senior managers' leadership styles were consultative, participative, and benevolent-authoritative respectively. There was no statistically significant relationship between leadership style and hospital performance indicators. Conclusion: The results showed that approximately 10 to 15 percent of hospital beds are not being used, and in order to increase the efficiency of a hospital, managers need to move towards participative leadership styles.
EBNESINA, Oct 15, 2013
Introduction: Reviewing hospital performance not only can identify the strengths of that organiza... more Introduction: Reviewing hospital performance not only can identify the strengths of that organization but can also improve our understanding of hospital management. This study aimed to analyze the functional aspects of hospital management in selected military hospitals using Weisbord's six-box model. Material and Methods: The present study, which was a descriptive and analytical one, was carried out in 5 selected military hospitals in 2013. Data collection was done using a standardized questionnaire whose validity and reliability had already been confirmed (α =%88). 280 randomly selected employees, determined using Cochran's formula, took part in this study. Results: The results showed that having a clear organizational structure with a mean of 4.08±0.27 achieved the highest score while having a clear rewarding mechanism with a mean of 2.98±1.25 received the lowest rating in the Weisbord's sixbox model. Generally, the functional aspects of management in the studied hospitals were acceptable. Significant relationships were observed between the inter-organizational communication and the organization's rewarding mechanism (p=0.04), the organizational structure index and the rewarding mechanism (p=0.03), and the existing job coordination and having pre-specified organizational goals (p=0.01). Conclusion: The focus of the senior management team on the functional aspects of management in hospitals can improve their performance. Due to the significance and diversity of military hospital performance and missions, the assessment of the organization's internal environment, present conditions, and performance as well as the identification of its problems and potentials seem to be quite necessary.
Journal of Military Medicine, Apr 15, 2013
Aims: Learning in crisis is an approach to help employees deal with critical situations. The natu... more Aims: Learning in crisis is an approach to help employees deal with critical situations. The nature of critical care departments is similar to the nature of critical situations. The present study was an attempt to identify the most important learning strategies in staff in emergency department of a military hospital so that the facilitative learning strategies could be identified and the main obstacles in this regard would be determined. Method: The present study was a qualitative phenomenological piece of research in which semi-structured interview was used to collect data. Purposeful sampling with maximum variation was used for data collection with 20 emergency department staff taking part in the interviews. The sampling continued until the point of theoretical saturation. Analytical framework was used for data analysis. The interviews were indexed by Atlas-Ti software, and the expected themes and sub-themes were identified. Results: In this study, 8 themes and 28 sub-themes were extracted as factors affecting learning strategies in crisis. The main themes were the importance of learning at work, barriers of learning in crisis, opportunity of learning in crisis; factors affecting learning in crisis; types of learning strategies in crisis; role of management in learning in crisis; role of environment in learning in crisis, and psychological characteristics of employees. Conclusion: The good management of the staff, paying attention to their financial concerns, making them interested in the job they do, and devising a specific structure for instruction are all steps to take to help facilitate learning in crisis.
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Papers by Rouhollah Zaboli