Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 Management Strategies of Recovery Centers for Coronavirus Patients in Iran 1 3 FA adel eftekhari Ph.D. of Health in Emergencies and Disasters, Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran najmeh baghian Ph.D. of Healthcare Management, Clinical Research Development Center, Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran The global and Iranian pandemic crisis of the coronavirus caused the health system to face the problem of lack of resources. Outpatient convalescence for coronavirus disease is one of the most effective ways to reduce hospital load and costs. In order to set up any position related to the issue of health, it is necessary to formulate the necessary laws and regulations and standards to be set up in which different levels of decision-making and implementation must play a role. Formulation of goals, laws, coordination, provision of equipment and space, manpower and cost coverage are among the things that should be considered in highlighting the role and function of convalescents by the authorities. In this study, our aim is to review the management strategies of coronavirus patients.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 An Overview of Spiritual Health and Experts` Viewpoints Concerning the Role of the Ministry of Health and Medical Education in Its Excellence in Community 4 7 FA Ali Akbar Haghdoost Professor, Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. Bagher Larijani Professor, Endocrinology & Metabolism Research Center, Endocrinology & Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Mohammad Hossein Nicknam Professor, Department of Internal Medicine, Molecular Immunology Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Reza Dehnavieh Associate Professor, Health Foresight and Innovation Research Center, Institute for Futures Study in Health, Kerman University of Medical Sciences, Kerman, Iran. monireh balochi MSc in Social Worker, Health Foresight and Innovation Research Center, Institute for Futures Study in Health, Kerman University of Medical Sciences, Kerman, Iran. khalil kalavani Ph.D. student of Health Services Management, Management and Leadership Research Center in Education, School of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran. The spiritual dimension of health is the subject of much controversy; since it is not seen as a purely scientific and quantifiable aspect of health. However, it is exactly this quality of spiritual health that makes the thorough examination of the concept worthwhile. Furthermore, a comprehensive assessment of the theoretical concepts associated with it should be prioritized. The present study is a combination of a literature review followed by a series of expert interviews. First, articles addressing the different aspects of spiritual health were identified and acquired from academic databases. After a thorough assessment and evaluation, the findings were listed and prioritized in order to determine the most important aspects of spiritual health. Then, the most significant features were specified and interpreted. The interpretations were then sent to a group of experts for assessment and evaluation. The expert reviews and comments were then collected and analyzed in order to refine and improve the primary interpretations. The responsibilities of the health sector do not end with the provision and maintenance of the physical aspects of health or even the non-medical population. It includes not only promoting spiritual health in health sector graduates and personnel, but also conducting profound scientific studies, providing documentation, and interpreting the evidence for beneficiaries. However, establishing a new university major to train professionals exclusively for pursuing this objective and even adding new university credits in this field does not seem to be necessary from the point of view of experts and studies. In addition to providing the education necessary for students and personnel of each organization, providing adequate spiritual health and promoting the essential education and related skills are also the responsibilities of the health sector. Instead, it is suggested that an active secretariat be established to oversee the promotion of spiritual health in all sectors using the minimum independent facilities and manpower.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 Validation of Persian Version of Stewart Patient-Centered Care Scale (2004) 8 17 FA Raziyeh Montazeralfaraj Associate Professor, Health Policy and Management Research Center, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohamad Amin Bahrami Associate Professor, Health Human Resources Research Center, School of Management & Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Mohsen Hoseinzadeh MSc student in Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Sara Jambarsang Background: Provision of patient-centered services is one of the values of any health care system. Patient-centered means giving importance to the patient's rights and entitlements in all areas related to treatment and involving the patient in decisions throughout the process of rendering services to the patient. The purpose of this study was to translate and validate the Stewart Patient-Centered Questionnaire and to provide an appropriate and valid tool to assess the patient-centered rate in the provision of medical services. Methods: The present descriptive methodological study was conducted in 2020. Initially, Stewart patient-centered questionnaire was translated using the forward-backward method. Later, the translated version was examined by the research team to establish cultural compatibility with Iranian culture. The validity of its content was assessed by obtaining the opinions of 15 health management specialists and its face validity was assessed by 15 patients. The internal reliability of the questionnaire was assessed using the opinions of 30 patients and Cronbach's alpha coefficient was calculated using SPSS 22 software. The construct validity was assessed according to the opinions of 283 patients in the study population through STATA 15 software. Results: Based on the content validity results, all items of the main questionnaire had acceptable CVR and the CVI index was 0.87 for this questionnaire. The face validity also confirmed all the statements. Cronbach's alpha coefficient of the whole questionnaire was calculated as 0.976 and thus the internal reliability of the questionnaire was confirmed. Based on the results of the confirmatory invoice analysis GFI (0.988), RMR (0.048), and CFI (0.984), the translated questionnaire had suitable construct validity and all questions were retained. Conclusion: The questionnaire can be applied as a valid and applicable tool for assessing patient-centered care in the Iranian health care system.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 Providing a Model for the Optimal Allocation of Hospital Beds Based on Markov Chain Approach (Case Study: Shiraz-Shahid-Faghihi Hospital) 18 27 FA Mehdi Kabiri Naeini Assistant Professor, Department of Industrial Engineering, School of engineering, Payame Noor University, Yazd, Iran Zeynab Elahi MSc student of Industrial Engineering, School of engineering, Payame Noor University, Tehran, Iran Abolfazl Moghimi Esfandabadi Tutor, Department of Industrial Engineering, School of engineering, Payame Noor University, Yazd, Iran Background: As was observed in the corona crisis, in situations, such as war or natural disasters or epidemic diseases, the intensity of the applicants for medical services causes congestion problems. In this situation, due to the limited capacity of the system, queuing phenomenon for service applicants and in some cases, rejection of clients occur. Reducing the length of hospital stays by improving performance productivity can compensate for the shortage of hospital beds. In order to increase the productivity of personnel and equipment, it is necessary to eliminate unemployment and improve service scheduling. One of the ways to achieve these goals is to optimize the distribution of beds between wards. In the present study, in the form of Markov chain approach, according to the referral rate and service rate, the existing beds were allocated to different wards of the hospital to maximize service and minimize rejection of patients. Methods: The present study is an applied study conducted in 2019 for the optimal distribution of beds between the 3 wards of Shahid Faghihi Hospital in Shiraz. The research problem was modeled in the form of Markov chain approach and assuming the referral of clients according to the continuous-time Markov chain, the model parameters value was identified. The obtained mathematical model was solved by GAMS 24.1.3 software. Results: The proposed model led to an improvement in ward performance in terms of reducing patient waiting time and increasing the number of admitted patients. The proposed model reduced patient rejection by 8.6 %. According to the patients' referral rate to the wards and the service rate of each ward, based on sensitivity analysis, the number of beds allocated to each of the 3 wards was determined. Conclusion: Queuing theory can be applied as a tool to analyze the phenomena of the treatment system and determine the features of the waiting time, queue length, and capacity of the system. Appropriate allocation of hospital beds results in improving the efficiency and decreasing the patient rejection. Therefore, it could be useful in crisis, congestion in patients, and when increasing facilities is required.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 Developing a Model for Evaluating Patient Experience in Educational Hospitals of Mashhad University of Medical Sciences 28 39 FA Mojtaba Najib Jalali MSc student in Healthcare Management, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran Ali Vafaee Najar Professor, Social Determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Jamshid Jamali Assistant Professor, Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Elaheh Hooshmand Assistant Professor, Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Background: Understanding the "patient experience" is a key step in moving towards patient-centered care. The purpose of this study is to design a patient experience evaluation model to evaluate the effective components in the patient experience in hospitals of Mashhad University of Medical Sciences. Methods: This was a comparative descriptive study conducted using databases and information resources and based on a comprehensive review, and the models used in other parts of the world were extracted based on the research protocol and entered into a comparative matrix. The reliability of the extracted framework was verified using the agreement coefficient of the parties. In order to validate the model, the questions were prepared in the form of a questionnaire and validated by the specialists of Mashhad University of Medical Sciences during two-round Delphi using SPSS 16 software. Results: In this study, 10 models were obtained for evaluating patient experience in different countries, each of which was composed of several dimensions and some of them had overlap. The models included American model (8 dimensions), Swedish model (10 dimensions), British first model (7 dimensions), British second model (8 dimensions), Scotland model (6 dimensions), Hong Kong model (9 dimensions), Norway first model (6 dimensions), Norway second model (5 dimensions), India model (10 dimensions), and the model of Ethiopia (5 dimensions). The final model with 10 dimensions and 29 sub- dimensions was approved and validated. Conclusion: The results showed that the suitable pattern for Iran had 10 dimensions and 29 sub-dimensions. Among the dimensions, respect for the patient's privacy and dignity had the highest score and the way patients are discharged from the hospital had the lowest score.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 The Outsourcing Model in the Ministry of Health and Medical Education with Fuzzy Delphi Technique in order to Improve the Quality of Health Services with Emphasis on Hospitals 40 53 FA Hasan Ali Nejad Ph.D. student of Government Policy Management, Rafsanjan Branch, Islamic Azad University, Rafsanjan, Iran Mohamad Ziaaddini Assistant Professor, Department of Management, Rafsanjan Branch, Islamic Azad University, Rafsanjan, Iran Amir Rajabi Behjat Assistant Professor, Department of Computer, Rafsanjan Branch, Islamic Azad University, Rafsanjan, Iran Mohamad Reza Hosseinipour Assistant Professor, Department of Economics, Rafsanjan Branch, Islamic Azad University, Rafsanjan, Iran Background: Outsourcing in the Ministry of Health is based on the reforming the structure of the health system and improving the quality of services. Therefore, the present study wanted to present the outsourcing model of services in the Ministry of Health and Medical Education with fuzzy Delphi technique in order to improve the quality of health services with emphasizing on hospitals. Methods: The present research in terms of purpose, data research type, implementation method, was part of the exploratory research which has been done quantitatively and qualitatively in 2021. The statistical population was the outsourcing experts for a study between 59 universities of medical sciences in the country, 50 people were selected by purposive sampling method. They were selected for interviews to collect outsourcing indicators to present a suitable model. The indicators were mined data using the information gain method by Matlab software and the indicators were prioritized according to the scores given. A questionnaire was obtained from the prioritized indicators, which were summarized in 19 dimensions, and the same experts were given to complete in 2 consecutive periods. After completing the questionnaire by experts, fuzzy Delphi method was used for final analysis. Results: According to the obtained model, 44 factors are effective in outsourcing .These factors entered the Delphi poll. During 2 stages of fuzzy Delphi, consensus was reached on all 44 indicators. And the highest degree of expertise agreement with the flexibility component and the lowest level of agreement with the component of the certificate of competency to provide services were outsourced by the company. Conclusion: According to the obtained model, various factors are effective in outsourcing services that need to be considered more in the planning of health centers, especially hospitals. According to the findings, it can be said that the related dimensions with considering the outsourcing services are specifically important .Due to the possibility of outsourcing among many health care units; it can be used for flexibility in providing services and patient satisfaction to manage health centers and hospitals.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 Psychometrics of Assessment Tools to Examine the Challenges of Physicians' Participation in Accreditation Programs 54 63 FA Hosein Ebrahimipour Professor, Social Determinate Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Elahe Houshmand Associate Professor, Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Mehdi Varmaghani Associate Professor, Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Seyyed Morteza Mojtabaeian MSc student in Health Services Management, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran  Background: Many organizations believe that physician involvement is important in quality and safety of health services, but they did not properly define, measure, and improve it, so because of the importance of the quality of health care and increasing the involvement of physician this study was conducted to evaluate the validity and reliability of a questionnaire on the challenges of physicians' participation in quality improvement programs. Methods: In this cross-sectional study conducted in the hospitals of Mashhad University of Medical Sciences, a researcher-made questionnaire about challenges of physicians' participation in accreditation activities used for data gathering. The content validity ratio index and content validity index were also calculated. To measure the internal consistency of the instrument, the questionnaire was distributed among 14 physicians, Cronbach's alpha coefficient was determined. For stability or reproducibility of the instrument, test - retest and correlation coefficient were calculated. By distributing questionnaires among 14 people those meeting inclusion criteria, the correlation coefficient was measured twice and at intervals of 2 weeks. SPSS 21 software was used for data analysis Results: The initial questionnaire was consisted of 61 items, which were reduced to 38 items after face and content psychometrics. The questionnaire has 12 sub-concepts. Cronbach's alpha coefficient of the questionnaire was 0.83 and the intragroup correlation coefficient in 2 measurements 2 weeks apart was 0.94. Conclusion: This questionnaire is the first and only valid and reliable dedicated tool in the field of challenges of physicians' participation in accreditation activities in Iran, which can measure and prioritize the challenges in each health center and it can be used to improve health care quality services that are performed by doctors.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 6 1 2021 6 1 Survey the situation of perceived organizational justice in the Iranian health care system; a systematic review and meta-analysis 64 79 FA Milad Shafiei Assistant Professor, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Najmeh Baghian Ph.D. of HealthcareManagement, Clinical Research Development Office, Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Amin Salehi Associate Professor, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohammad Ranjbar Assistant Professor, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Maryam Hajipour MSc student in Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Background: Perceived organizational justice is a concept used to describe job-related justice. Considering the role of perceived organizational justice in the healthcare system to increase the satisfaction, motivation, and efficiency in providing quality services, this study was conducted to investigate the situation of perceived organizational justice in the Iranian healthcare system through systematic review. Methods: In the present study, an electronic search was conducted on the Persian websites SID, Iranmedex,  Medlib, civilica, Irandoc and English Web of science, Pubmed, Scopus, and Google scholar using the Persian and English keywords of ‘Justice, Equality, Equality, Organizational Justice, Perceived Justice, Health System, University of Medical Sciences, Health Centers, Hospitals. As a result, 520 articles were studied and evaluated step by step and 469 papers were removed after reading the title and abstract. Finally, the full text of 51 articles was reviewed. Finally, 30 articles that measured the average level of perceived organizational justice were selected and other articles were excluded due to lack of necessary criteria and irrelevance. To analyze the heterogeneity between the studies, the meta-analysis method was used using Stata 14 software and Q test and  index. Results:  To study the status of perceived organizational justice in the health care system in a systematic and meta-analysis, all 30 studies were illegible. With regard to the dimensions of distributive, procedural, and interactive justice, 23 studies of 30 studies had the required conditions to enter the research.  The total mean score of perceived organizational justice was obtained as 60.71 and the mean scores of 54.74, 58.52, and 62.41were calculated for dimensions of distributive, procedural, and interactive justice, respectively. Conclusion: The findings showed that the situation of perceived organizational justice in the Iranian health care system was favorable. The dimension of interactive justice, related to managers' behaviors and relationships with employees, was relatively more favorable than other dimensions of organizational justice. Moreover, the situation of perceived organizational justice and its dimensions in private hospitals was more favorable than other research environments, including public hospitals, staff units, and hospitals selected using the mixed method.