Efficiency improvement of dentistry clinics: introducing an intervening package for dentistry clinics, Isfahan, Iran

In Isfahan, the second metropolitan in Iran, there are 1448 dentistry treatment centers that most of them are inefficient. Today, efficiency is the most important issue in health care centers as well as dentistry clinics. The goal of this research is to investigate the affordability and efficiency of dentistry clinics in Isfahan province, Iran. The current work is a quantitative research, designed in two methodological steps, including a survey and experimental studies, for understanding current deficiencies of Iranian dentistry clinics. First, we ran a survey. Then, we analyzed the results of the questionnaires which guided us to find a particular intervening package to improve the efficiency of the clinics. At the second step, we chose an inefficient clinic named Mohtasham [Iran, Isfahan] to evaluate our intervening package. Based on what the interviewees answered, we mention the most important issues to be considered for improving the efficiency of dental clinics in Isfahan. By considering mentioned problematic issues, an intervening package was designed. This intervening package was applied in Mohtasham clinic, since June 2010. It improved the clinic's income from 16328 US$ with 4125 clients in 2010, to 420,000 US$ with 14784 patients in 2012. The proposed intervening package changed this clinic to an efficient and economic one. Its income increased 5.08 times and its patient's numbers grew 4.01 times simultaneously. In other words, Mohtasham's experience demonstrates the reliability of the package and its potentiality to be applied in macro level to improve other dentistry clinics

Clinical risk assessment in intensive care unit

Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin's Social Security Hospital [Razi Hospital] through Failure Mode and Effect Analysis [FMEA]. This was a qualitative-quantitative research by Focus Discussion Group [FDG] performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number [RPN] was in respiratory care "Ventilator's alarm malfunction [no alarm]" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care