Designing an Elderly Hospital Admission Risk Prediction Model in Iran's Hospitals.

BACKGROUND: The identification of elderly at risk of new functional disabilities in activities of daily living at admission to the hospital may facilitate referral for purposive interventions to prevent decline and institutionalization. This study was aimed at designing a risk prediction model for identifying the elderly at risk of admission in Iran's hospitals. MATERIALS AND METHODS: This is a cross-sectional descriptive study conducted in 2017. In order to formulate and validate a prediction model, the study was done in two development and validation cohort study. Functional decline was defined as a decline of at least one point on the Katz ADL index at follow-up compared with preadmission status. RESULTS: In development cohort, the mean age was 71 years including 54% of men and 46% women, 22% of men and 17% of women experienced functional decline after 3 months. In the validation cohort, the mean age was 70 years, including 49% of men and 51% women, 19% of men and 15% of women, functional decline after 3 months was observed. CONCLUSION: On the basis of the findings, aging at risk of hospital admission can be identified by easy designed model with four questions: (1) Is the patient's age more than 85 years? (2) Does the patient's mini mental status <22? (3) Does the patient need help for using general transporting? (4) Has the patient lost weight <5% over the past 6 months and body mass index <18.5? And also geriatrics experts can use the designed model as a predictive tool in order to improve the quality level of healthcare services to elderly as a vulnerable and high risk group. The important point of model is easy to use even for nonspecialists.

Identification of common indicators of hospital performance evaluation models: A scoping review.

BACKGROUND: Hospitals in developed countries allocate itself about 40% of health-care costs and in developing countries up to 80%. In this study, researchers reviewed the related article in the field of the hospitals' performance evaluation due to the identification of common indicators used in different models with the aim of providing simple list for evaluating hospitals' performance to the researchers who are interested to these issues. METHODS: The databases for the search included Medline, Google Scholar, and Scopus. A search strategy leads to the extraction of 403 related articles that after the removal of inappropriate and duplicate articles, 42 studies were selected for the scoping review. RESULTS: This scoping review showed that 9 of 42 selected articles use data envelopment analysis model, 6 of them Pabon Lasso model, 3 of them balanced scorecard, 3 of them organizational excellence model, and the remaining articles used key performance indicators to evaluate hospital performance. A process approach was used to categorize the common indicators because the literature review indicated that common indicators mainly evaluate data, process, output, or impact of performance. The findings included 36 input, 39 process, 27 output, and 8 impact common indicators for evaluating performance. DISCUSSION: This scoping review of related literature indicated that despite differentiation in the time and place of past studies in the field of performance evaluation models, there are some indicators that are common in most popular performance evaluation models. These simple lists can apply for evaluation of hospitals' performance instead of complicated models.

Affecting Factors on the Performance of Community Health Workers in Iran's Rural Areas: A Review Article.

BACKGROUND: This study aimed to use a mixed-method approach to investigate affecting factors on the performance of Community Health Workers (CHW) in Iran's villages. METHODS: This study was conducted during 2014-2015 with a mixed method in three phases of literature review, Delphi technique and developing a rich picture. Overall, in order to finalize the affecting factors and their relationships between qualitative content analysis, Delphi technique, AHP technique and Focus Group Discussion were used, respectively. RESULTS: Affecting factors on CHW performance were divided into four main categories, 10 sub-themes and 35 contents. Increase in the level of people's awareness, disease patterns, demographic structure and lifestyle were placed in four priorities respectively on the basis of importance. CONCLUSION: To the most extent CHW cannot face current needs of rural communities. It challenges equitable access to healthcare services and also conflicts with the primary philosophy of CHW presence in rural areas. CHW can be used in two forms; either as an assistant to rural family physicians or with the same previous functions.

Patient safety culture in hospitals of Iran: a systematic review and meta-analysis.

BACKGROUND: Nowadays, for quality improvement, measuring patient safety culture (PSC) in healthcare organizations is being increasingly used. The aim of this study was to clarify PSC status in Iranian hospitals using a meta-analysis method. METHODS: Six databases were searched: PubMed, Scopus, Google Scholar, Cochrane Library, Magiran, SID and IranMedex using the search terms including patient safety, patient safety culture, patient safety climate and combined with hospital (such as "hospital survey on patient safety culture"), measurement, assessment, survey and Iran. A total of 11 articles which conducted using Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire initially were reviewed. To estimate overall PSC status and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software v. 2 was employed. RESULTS: The overall PSC score based on the random model was 50.1%. "Teamwork within hospital units" dimension received the highest score of PSC (67.4%) and "Non-punitive response to error" the lowest score (32.4%). About 41% of participants in reviewed articles evaluate their hospitals' performance in PSC as 'excellent/very good'. Approximately %52.7 of participants did not report any adverse event in the past 12 months. CONCLUSION: The results of this study show that Iranian hospitals' performances in PSC were poor. Among the 12 dimensions of HSOPSC questionnaire, the "Non-punitive response to error" achieved the lowest score and could be a priority for future interventions. In this regard, hospitals staff should be encouraged to report adverse event without fear of punitive action.