Document Type : Original Article
Authors
- . Reza Moradi
- . Saeid Karimi 1
- . Mohammad Hossein Yarmohammadian 2
- . Mohammad Zakaria Kiaei 3
- . Elaheh Mazaheri 4
1 Department of Health Care Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences
2 Health Management and Economics Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences
3 Department of Health Care Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
4 Department of Librarianship and Medical Information Sciences, Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan
Abstract
BACKGROUND: Given new reforms in Iran’s health‑care system and due to the need for gathering
evidence regarding the implementation of this plan, this study aimed to investigate opportunities and
challenges created by resident specialist attendance plan guidelines in university hospitals.
MATERIALS AND METHODS: This study used the qualitative method. Semi‑structured interviews
were used for data gathering. The study population included all experts of Isfahan University of
Medical Science. Sampling was carried out using purposeful sampling method and continued until
data saturation was reached. In total, 16 experts were interviewed. Criteria such as “reliability of
information,” “trustworthiness,” and “verifiability of the information” were considered. Interviewees
were assured that their names would keep hidden and that all information is confidential. Subject
analysis method was used for data analysis.
RESULTS: The findings of this study based on subject analysis led to extracting three themes in
regards of challenges in the implementation of resident (specialist or fellowship) plan in hospitals
including structural, management, and resource challenges and one theme in the area of opportunities
which were improved quality and timely provision of services.
CONCLUSION: The findings showed that despite the strengths of this guideline, there are some
fundamental challenges in various areas and need better attention by national level policymakers.
These results help health‑care policymakers to evaluate the problem with a better attitude and
improve the necessary plans for implementation of these guidelines.
Keywords
of American health care system. Health Inf Manag 2011;8:101.
2. Saltman RB, Figures J. European health care reform: Analysis of
current strategies. Br Med J 1998;316 (7142):1468.
3. Gibbons DW, Gardner TJ, Goldstein LB, Moller JH, Yankee CW.
The American Heart Association’s 2008 statement of principles
for healthcare reform. Am Heart Assoc 2008;118:2209‑18.
4. Iranian Ministry of Health and Medical Education. Collection
Guidelines for Health System Reform Plan. Health Deputy; 2014.
Available from: http://www.darman.umsha.ac.ir/uploads.
[Last accessed on 2015 Jul 20].
5. Iranian Ministry of Health and Medical Education Evaluation
of Health System Development Plan in the Area of Treatment;
2015 Available from: http://www.alef.ir/vdcdnf0×fyt0596.2a2y.
html?271691. [Last accessed on 2015 Aug 21]
6. Guidelines for Health System Reform Plan. Ministry of Health
and Medical Education; 2014. p. 26.
7. Cass HD, Smith I, Unthank C, Starling C, Collins JE. Improving
compliance with requirements on junior doctors’ hours. Br Med
J 2003;327:270‑3.
8. Gharibi F, Janati A, Farajollah Beiknoori M, Amini Daghalian B.
Managers and nurses’ experiences of healthcare reform in Tabriz
Taleghani hospital. Depiction Health 2015;6:1‑10.
9. Gajic O, Afessa B, Hanson AC, Krpata T, Yilmaz M, Mohamed SF,
et al. Effect of 24‑hour mandatory versus on‑demand critical care
specialist presence on quality of care and family and provider
satisfaction in the intensive care unit of a teaching hospital. Crit
Care Med 2008;36:36‑44.
10. Branney SW, Pons PT, Markovchick VJ, Thomasson GO.
Malpractice occurrence in emergency medicine: Does residency
training make a difference? J Emerg Med 2000;19:99‑105.
11. The IOM medical errors report: 5 years later, the journey
continues. Qual Lett Healthc Lead 2005;17:2‑10.
12. O’Malley AS, Draper DA, Felland LE. Hospital emergency on‑call
coverage: Is there a doctor in the house? Issue Brief Cent Stud
Health Syst Change 2007;115:1‑4.
13. Polit DF, Beck CT. Nursing Research: Principles and Methods.
Philadelphia: Lippincott Williams & Wilkins; 2004.
14. McGarry J, Krall SP, McLaughlin T. Impact of resident physicians
on emergency department throughput. West J Emerg Med
2010;11:333‑5.
15. Jafari M, Soltani F, Fathian N. A Comparative Assessment of the
implementation of Healthcare Reform topics of Program. Isfahan
International Conference on Sustainable Development in the
Health System; 2015. p. 108.
16. Gajic O, Afessa B. Physician staffing models and patient safety in
the ICU. Chest 2009;135:1038‑44.
17. Ghanbari F, Heidarzadeh A, Jafaraqayy F, Barari F. Challenges
Facing the Healthcare Reform Plan: Inequality in Health Care
Delivery. Isfahan International Conference on Sustainable
Development in the Health System; 2015. p. 68.
18. Behzadifar M, Behzadifar M, Saki K, Keshavarzi A. Senior
Health Administrators and Experts About the Challenges of
Health Reform Plan: A Qualitative Study. Isfahan International
Conference on Sustainable Development in the Health System;
2015. p. 9.
19. Ferdowsi M, Kabiri SH, Shojaei B. Cash on Healthcare Reform
Plan Based on Policy Analysis Triangle. Isfahan International
Conference on Sustainable Development in the Health System;
2015. p. 49.
20. MahuriA, Heshmati F, Noruzinia H, AbbasivashR, Noruzinia SH,
Salmani M. The role of the anesthesiologist resident at reducing
deaths Intensive Care Unit. J Iran Soc Anaesthesiol Intensive Care
2003;21:17‑22.
21. Kabirzadeh A, Zamani Kiasari A, Bagherian Farahabadi A,
Saravi M, Hassanzadeh F. Effect anesthesiologist stay on the
intensive care unit of a hospital mortality of Imam Khomeini (RA)
in Sarrey.J Mazandaran 2006;16:138.
22. Levy C, Palat SI, Kramer AM. Physician practice patterns in
nursing homes. J Am Med Dir Assoc 2007;8:558‑67.
23. Kerlin MP, Small DS, Cooney E, Fuchs BD, Bellini LM,
Mikkelsen ME, et al. A randomized trial of nighttime physician
staffing in an intensive care unit. N Engl J Med 2013;368:2201‑9.
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