The supply chain management of medical equipment and consumer goods is full of uncertainties and unexpected issues and one of the major challenges of hospitals is the suppliers’ evaluation and selection. study aimed to provide a model for selecting the best supplier in a hospital using a combination of artificial neural network and fuzzy VIKOR. This was a descriptive study conducted in a military hospital in three phases in 2016. The results showed that the most effective factor in supplier selection was ‘quality’ (weight = 0.165). After that, the highest weights were, respectively, related to ‘price’, ‘timely delivery’, ‘packaging and transporting quality’, ‘the supplier's background’ and ‘payment terms’. According to the results of the present study, the most important factor influencing the supplier selection was ‘quality’. Given the direct impact of medical equipment and consumer goods on patients’ recovery and nurses and physicians’ proper functioning and performance, it can be recommended that the hospital managers and the staff of purchasing unit should develop the quality assessment protocol of equipment and supplies and it should be evaluated periodically by nurses, physicians and patients.

Background: Hospital pharmacy is responsible for controlling and monitoring the medication use process and ensures the timely access to safe, effective and economical use of drugs and medicines for patients and hospital staff. Objectives: This study aimed to optimize the management of studied outpatient pharmacy by developing suitable queuing theory and simulation technique. Patients and Methods: A descriptive-analytical study conducted in a military hospital in Iran, Tehran in 2013. A sample of 220 patients referred to the outpatient pharmacy of the hospital in two shifts, morning and evening, was selected to collect the necessary data to determine the arrival rate, service rate, and other data needed to calculate the patients flow and queuing network performance variables. After the initial analysis of collected data using the software SPSS 18, the pharmacy queuing network performance indicators were calculated for both shifts. Then, based on collected data and to provide appropriate solutions, the queuing system of current situation for both shifts was modeled and simulated using the software ARENA 12 and 4 scenarios were explored. Results: Results showed that the queue characteristics of the studied pharmacy during the situation analysis were very undesirable in both morning and evening shifts. The average numbers of patients in the pharmacy were 19.21 and 14.66 in the morning and evening, respectively. The average times spent in the system by clients were 39 minutes in the morning and 35 minutes in the evening. The system utilization in the morning and evening were, respectively, 25% and 21%. The simulation results showed that reducing the staff in the morning from 2 to 1 in the receiving prescriptions stage didn't change the queue performance indicators. Increasing one staff in filling prescription drugs could cause a decrease of 10 persons in the average queue length and 18 minutes and 14 seconds in the average waiting time. On the other hand, simulation results showed that in the evening, decreasing the staff from 2 to 1 in the delivery of prescription drugs, changed the queue performance indicators very little. Increasing a staff to fill prescription drugs could cause a decrease of 5 persons in the average queue length and 8 minutes and 44 seconds in the average waiting time. Conclusions: The patients' waiting times and the number of patients waiting to receive services in both shifts could be reduced by using multitasking persons and reallocating them to the time-consuming stage of filling prescriptions, using queuing theory and simulation techniques. Keywords: Queuing Theory; Patient Simulation; Pharmacy; Hospitals

Background: Evidence-based practice (EBP) is an ambition for health service administrators. We aimed to systematically review the major relevant articles in case of barriers and facilitators to implementing evidence-based practice in health services. Methods and Materials: The type of study was a systematic review. We searched the libraries and online sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, Scopus, Science Direct, Cochrane Library, and Google scholar. We used keywords included “Evidence-Based Practice”, “Evidence-Based Management”, “Healthcare”, “Care Management, Evidence-Based Healthcare Management”, “Health Care”, Health”, “Barrier”, “Facilitator”, policy and “Evidence-Based Healthcare”. Results: In total, 12 studies were included. Several barriers and facilitators were recognized through the included papers, the factors such as organization support and a helpful education system improved skills, knowledge, and confidence to EBP. The outcomes of studies were identified as the employ of the internet as a highest-rated skill for increasing EBP quality. Conclusion: Generally, the results showed health service administrators should first identify barriers of EBP then transferred them to facilitators to the implementation of proper and efficient EBP. [GMJ.2020;9:e1645]

Background: The measurement of service quality had an important role in managing service provided, diagnosing the problem, and assessing service performance. Patient satisfaction is one of the key indicators of quality in health-care organizations. This study aimed to measure the service quality gap of patients' perceptions and expectations in five dimensions at a military Specialized Dental Clinic in Iran using SERVQUAL tool. Materials and Methods: This was a cross-sectional and descriptive-analytical study conducted at a Specialized Dental Clinic affiliated to the Armed Forces of Islamic Republic of Iran in Tehran in 2013. All 385 patients referring to the studied clinic during two working shifts of morning and evening in one month, August, were selected. The required data were collected using the modified SERVQUAL questionnaire. The collected data were analyzed using SPSS 20.0 through statistical tests including Mann–Whitney and Kruskal–Wallis tests. P < 0.05 was considered statistically significant. Results: The results showed that the quality of services provided to patients was significantly lower than their expectations and the quality gaps were statistically significant in all studied dimensions (P < 0.001). Furthermore, the highest and lowest quality gap was related to empathy (−1.16) and reliability (−0.61), respectively. Conclusion: According to the results, the managers of this clinic should take steps toward improving the quality of services in all dimensions, especially responsiveness and empathy, through planning properly, prioritizing services, and reviewing processes with regard to the patients' expectations.

Objective. Medication errors are the most common types of medical errors which considerably endanger the patient safety. This survey aimed to study the factors influencing not reporting on medication errors from the nurses’ viewpoints in Abbasi Hospital of Miandoab, Iran. Methods. This was a cross-sectional, descriptive and analytical study conducted in 2012 in which all nurses () working in different inpatient units were studied using a consensus method. Required data were collected using a questionnaire. Collected data were analyzed through some statistical tests including Independent -test, ANOVA, and chi-square. Results. According to the results, the most important reasons for not reporting on medication errors were related to the managerial factors (), factors related to the process of reporting (), and fear of the consequences of reporting (), respectively. Also, there was a significant relationship between employment status and fear of the Consequences of reporting on medication errors (). Conclusion. This study results showed that managerial factors had the greatest role in the refusal of reporting on medication errors. Therefore, for example, establishing a mechanism to improve quality rather than focus only on finding the culprits and blaming them can result in improving the patient safety.

Context: Pre-hospital care plays a vital role in saving trauma patients. Objectives: This study aims to review studies conducted on the pre-hospital emergency status in Iran. Data Sources: Data were sourced from Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, and non-Iranian electronic databases, such as Medline, Embase, Cochrane Library, Scopus, and Google Scholar. In addition, available data and statistics for the country were used. Data Selection: All Persian-language articles published in Iranian scientific journals and related English-language articles published in Iranian and non-Iranian journals indexed on valid sites for September 2005 - 2014 were systematically reviewed. Data Extraction: To review the selected articles, a data extraction form developed by the researchers as per the study’s objective was adopted. The articles were examined under two categories: structure and function of pre-hospital emergency. Results: A total of 19 articles were selected, including six descriptive studies (42%), four descriptive-analytical studies (21%), five review articles (16%), two qualitative studies (10.5%), and two interventional (experimental) studies (10.5%). In addition, of these, 14 articles (73.5%) had been published in the English language. The focus of these selected articles were experts (31.5%), bases of emergency medical services (26%), injured (16%), data reviews (16%), and employees (10.5%). A majority of the studies (68%) investigated pre-hospital emergency functions and 32% reviewed the pre-hospital emergency structure. Conclusions: The number of studies conducted on pre-hospital emergency services in Iran is limited. To promote public health, consideration of prevention areas, processes to provide pre-hospital emergency services, policymaking, foresight, systemic view, comprehensive research programs and roadmaps, and assessments of research needs in pre-hospital emergency seem necessary. Keywords: Pre-Hospital Emergency; Iran; Systematic Review