The Health Technology Assessment (HTA) in action is the first journal dedicated to health technology assessment in developing countries. IR's National Institute for Health Research publishes this journal under the supervision of Tehran University of Medical Sciences (TUMS).

Journal of HTA in action is a peer-reviewed journal that aims to publish topics related to health technology assessment; it is noteworthy that HTA in action offers a fast route for publishing high-quality peer-reviewed research. The journal covers studies evaluating medical equipment, medicines, vaccines, procedures and systems developed to solve a health problem in the form of original studies, review articles, case reports, brief communications, and letters. HTA plays an important role in the process of macro and micro policy and decision making, therefore it is expected to witness an improvement in the pace, efficiency and validity of policy making via publishing HTA studies.

Current Issue

Vol 5, No 1 (2021)

Articles

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    Introduction: Quality is a key factor in the distinction of services and it is a potential source of sustainable competitive advantage, increase productiveness and patient satisfaction. The identification of strengths and weaknesses in quality of provided services can help to recognize priorities and develop improvement strategies. The purpose of this study was running Importance-‌Performance Analysis (IPA) on the quality of services which were provided for patients in hospitals affiliated with Ahvaz Jundishapur University of Medical Science.

    Materials & Methods:This study was a descriptive-analytical study that performed by cross-sectional method on patients of Educational and medical Hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences  in year 2016. The sample of the present study included 307 patients of these hospitals who were selected by stratified random sampling. Data collection tool was The standard questionnaire included demographic information and  questions of quality of service provided in 6 dimensions (Tomes & Chee Peng Ng questionnaire). In addition to IPA , data were analyzed using descriptive statistics, ANOVA tests and Pearson correlation and Chi Squared using SPSS version 21 software.

    Results: The study results showed that are »important« all dimensions quality.The situation performance in the hospitals studied in dimensions non-tangibles (2.0±99.99) tangible (2.0±50.95) and physical environment(2.0±90.98) Which were located in the second region of the IPA matrix, were estimated »relatively inappropriate«. While the dimensions relationship based on mutual respect (3.0±26.88), perception disease (3.0±30.99), religious needs (3.1±18.24) and Total Quality (3.0±05.84) were located in the first region of the IPA matrix and they were estimated »relatively appropriate«. Gap were estimated in dimensions non-tangibles)-1.03‌(, relationship based on mutual respect(-1.01) , perception disease (-1.08) ,‌religious needs)-1.03(, tangibles (-1.52), ,physical environment(-1.49) and Total Quality(-1.18).There was a significant relationship between age and education of respondents with quality.

    Conclusions: Given that the largest gap in importance and performance in the dimensions was related to the tangible dimension of quality and in order to improve the quality of services and competitive position, hospital managers, must consider tangibles' dimension as a priority rather than any other dimension of services quality.

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    Background: Due to the high volume and variation of information in different fields, healthcare facilities are dependent on hospital information systems. These systems are a prerequisite for effective and high-quality healthcare provision in hospitals. The present study intended to prioritize the executive barriers to these systems in patient payment reduction and visitation quality improvement packages of the Health System Reform Plan (HSRP) from the perspectives of users and experts in selected academic hospitals of Yazd in 2019.

    Methods: The present study was a descriptive-analytical study conducted in 2019. The study population included 110 participants, including IT unit experts, hospital managers, and personnel of the administrative and medical units dealing with the hospital information system. The data collection tool was a researcher-made questionnaire based on similar studies, the validity of which was evaluated by a committee of experts, while its reliability was investigated and confirmed before the study using the Cronbach's alpha method and a sample of 30 participants. Data analysis was performed using SPSS software version 21.

    Results: Among the six barrier dimensions, the highest mean score belonged to the professional factors (3.46±1.03) followed by human barriers (3.44±0.83). Among professional barriers, the lack of motivation of the personnel in IT learning and get training on the IT-related skills had the highest mean score of 3.67.

    Conclusion: According to the results, outsourcing such services and special budget allocation for hardware and software update and support, conference holding, and practical training provision in this field are suitable strategies for better implementation of such systems.

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    Introduction: Spiritual competence in personal and work life increases compatibility, adaptation, problem solving skills, finding meaning in life events, inner and outer peace, dynamism and vitality and can have positive effects on other aspects of life. The first step to improve the status of spiritual competence in society is to evaluate it, which currently has few tools in Persian to measure it, so the purpose of this study is to translate and validate the Spiritual Competence Questionnaire.

    Methods: After Persian translation, the formal validity of this questionnaire was inference using the opinions of nine experts based on Waltz and Basel and Lawshe's theory. Also, 179 people completed the research questionnaire to inference the reliability and perform exploratory factor analysis. Excel and SPSS24 software were used for statistical analysis.

    Results: The validity of this questionnaire in two dimensions was 90% CVI = (simplicity of questions = 88%, relevance of questions = 96%, clarity of questions = 87%) and 97% CVR = standard. The reliability of this tool, which was calculated based on Cronbach's alpha test, was 89%. The KMO index in exploratory factor analysis was 88% and the mean-variance for seven factors was 67%.

    Conclusion: In addition to proper reliability and validity, this tool; is quite simple and fluent. Also, with the ability to complete in 15 to 20 minutes, it has the necessary features to assess the spiritual worthiness of people in different age groups.

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    Introduction: Improving the quality of clinical nursing education requires continuous review of the current situation to correct weaknesses and students are the best sources to identify clinical education problems, thus this study aims to gain a deeper understanding of students’ views on the problems of effective clinical education.

    Methods: This qualitative study was conducted by in-depth interviews among nursing students of selected hospitals in Mahabad City, Iran in 2019. Twenty students were selected by purposive sampling. Data were collected through in-depth interviews based on the real experiences of nursing students of learning in a clinical education environment with answers to nine open-ended questions. The qualitative content analysis method was used to analyze the data.

    Results: The texts of the extracted interviews were analyzed and conceptual codes were extracted from it, and then the codes were divided into four general concepts and related sub-concepts, which included factors related to the clinical education environment, learners, clients and clinical education instructors.

    Conclusion: Nursing education planners and officials can identify these factors with the help of nursing students which can improve the quality of clinical education and develop students' competencies to better care for patients, so that by improving the conditions of clinical learning environments in terms of facilities, empowering educational instructors, increasing students' self-confidence and client-to-student trust, more interest and motivation in students will be created.

     

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    Background: Emerging infectious diseases are contagious, made of a newfound lineage of a microorganism. The aim of this survey was to evaluate knowledge, attitude, and practice of Health sciences students regarding emerging and re-emerging infectious diseases.

    Methods: This cross-sectional survey was conducted on 462 randomly selected students from several constituent colleges of Birjand University of Medical Sciences, including the Colleges of Nursing, Medicine, Dentistry, and Paramedical (from October to March 2019). For data collection, a structured Knowledge, Attitude, and Practice (KAP) questionnaire was used, which its validity was checked by professionals. At the end, the collected data were analyzed by SPSSV19 using independent t-test and ANOVA.

    Results: A number of 230 (49.8%) participants were female. According to the collected data, the mean knowledge, attitude, and practice were at a medium level, which are not ideal and show that, there are several weaknesses in the curriculum. The mean knowledge scores for medicine, dentistry, laboratory science, and nursery students were 42.53±15.78, 46.24±20.99, 39.63±15.35, 40±19.43. The mean attitude scores were 60.25±6.13, 59.68±5.86, 58.60±5.06, 57.77±6.59, and their practice mean scores were 58.99±25.11, 67.80±25.72, 62.46±24.48, and 62.29±21.08. Conclusion: According to the collected data, paying more attention to the microbiology course plan is recommended in all medical and paramedical disciplines. Moreover, Further education should be given to prepare students for having proper practices preventing from the spread of infection.

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    Background and Objectives Reporting of medical errors is one of the common methods for identifying and preventing errors in hospital care. The purpose of this study was determine the barriers of error reporting from nurses' viewpoints in Ahvaz teaching hospitals.
    Material and Methods: This was a descriptive-analytical study with a sample size of 206. Nurses working in teaching hospitals of Ahvaz were selected by stratified random sampling. The measurement tool used in this study was a researcher-made questionnaire which its validity was confirmed by content validity and its reliability using Cronbach's alpha was calculated 0.84.
    Results: The causes of failure to error reporting included educational, attitudinal, process, structural and management factors. The mean score of the set of dimensions was 3.88± 0.53. Over ninety percent of nurses remarked educational, attitude and process factors were important and very important, and more than seventy percent of nurses stated structural and managerial factors were important and very important. There was a significant difference between the reasons for not reporting errors and education as well as the reasons for not reporting errors and work experience.
    Conclusion: Due to causes of non-reporting errors include educational, attitudinal, process, structural and management factors, and also error reporting has an undeniable impact on reducing future error occurrence and enhancing proper patient care, it is therefore desirable that officials develop strategies to remove barriers or Reduce the causes of failure error reporting such as: Educate nurses, use team-based and forward-looking approaches, adopt an impersonal, systematic approach, and modify error reporting rules.

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    Introduction: Health systems are making reforms to ensure and promote public health. Measuring the effects of reform is one way to determine its effectiveness and can lead to improved consequences. This study was aimed to investigate the effect of the Iranian Health Sector Evolution Plan (HSEP) implementation with the focus on the type of delivery on maternal and neonatal health indicators in East-Azerbaijan Province.

    Material and Methods: This descriptive-analytical study was conducted in 2017. The data on a total of 800 patients were randomly selected through the dataset of 8 hospitals equally in the two time periods of before and after the HSEP implementation. A researcher-made checklist was used to data extraction. Data were analyzed by SPSS-22 software using descriptive statistics, t-test, and chi-square.

    Findings: The mean age of mothers in both periods was 27 years. Most of the participants did not have a previous delivery and had a diploma or a lower level of education. The rate of natural childbirth increased from 34.5% (before the HSEP) to 44.2% (after the HSEP) (p <0.05). Maternal and neonatal mortality rates decreased from 0.3% and 0.8% to 0.0% and 0.5%, respectively. Maternal and neonatal mortality and stillbirth rates were not significantly different based on the study period and type of delivery (p >0.05).

    Conclusion: The findings indicate a significant increase in the rate of natural childbirth after the HSEP implementation. Maternal and neonatal mortality rates have also decreased. These results can guide policy-makers in deciding whether to continue and review the reform.

Review Article

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    Healthcare supply chain management is the regulation of the flow of medical goods and services from manufacturer to patient. Supply chain management encompasses the planning and management of all activities involved in sourcing and procurement, conversion, and all logistics management activities. Hence, it greatly helps material managers to manage with continuous improvement efforts while maintaining the quality of care, in our case the food quality and the patient’s satisfaction. As we all know the importance of IT is far more important in this field “Healthcare and Logistics”. In this context plotting the role of digital services in improving the clinical regime of patients Something inevitable. With that been said, we will present different approaches by distinguishing the main types of hospital logistics such as physical flows management, food safety cold chain management, and technology that improves the field. As a result, we are proposing a Hospital Enterprise Architecture and starting by modeling the system, to have a base for building a digital catering service that improves the clinical regime of patients.

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