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Hadian, S.A. ,
Rezayatmand, R. ,
Ketabi, S. ,
Shaarbafchizadeh, N. ,
Pourghaderi, A.R. Bmc Health Services Research (14726963) 25(1)
Background: Hospitals are a vital pillar of the health system, and measuring their performance by an appropriate quantitative model is crucial. This study evaluated the performance of hospitals affiliated with Isfahan University of Medical Sciences. It deals with the nature of dynamics (the performance of evaluation indicators over time), examining controllable, uncontrollable, and undesirable input and output indicators. Methods: This study evaluated the performance of 26 Isfahan University of Medical Science hospitals in terms of efficiency and productivity with hybrid Data Envelopment Analysis (DEA) models, namely, the additive classic, Malmquist productivity index (MPI), and super-efficiency models, from 2019 through 2022. Thirteen indicators (four inputs and nine outputs) were selected as model variables by brainstorming in the expert panel. Results: The average technical efficiency of hospitals during the four periods was 0.86, indicating an average inefficiency of 14%. Malmquist productivity index results over four periods showed hospitals operating with an average of 11% positive growth, reflecting an overall increase in productivity. Notably, some hospitals with high technical efficiency displayed lower total productivity growth rates due to fluctuations in specific indicators. On average, in the four under study years, 12 hospitals were efficient, of which 75% (9 hospitals) had performance progress (average MPI > 1). On the contrary, among the 14 inefficient hospitals during the four studied years, more than 90% of the hospitals had improved performance. Conclusion: This study introduces a multidimensional and dynamic model for evaluating hospital performance. While classic DEA models provide a statistical performance evaluation, the Malmquist Productivity Index reveals dynamic performance changes over time. These findings underscore the need for hospitals to adopt advanced quantitative models to optimize resource allocation and enhance service delivery. © The Author(s) 2024.
Hadian, S.A. ,
Rezayatmand, R. ,
Ketabi, S. ,
Shaarbafchizadeh, N. ,
Pourghaderi, A.R. Journal of Education and Health Promotion (22779531) 14(1)
Evaluating the performance of hospitals, the largest budget consumers of the health system, is challenging. This scoping review aimed to identify and classify hospital performance evaluation models and their dimensions. A literature search was conducted across three databases using keyword combinations. The studies included performance evaluation models along with evaluation of efficiency, effectiveness, and efficiency related to the hospital. Eighty English language studies published between 2012 and 2022, the majority from Iran, USA, Brazil, and China, were included. The extracted models were classified into two categories: quantitative and qualitative. The quantitative models were divided into two main groups: 'parametric' and 'non-parametric'. Parametric models were divided into four methods: regression models, stochastic frontier analysis, neural network models, and factor analysis. Non-parametric models can be classified into five groups: data envelopment analysis (DEA) models, multi-criteria decision-making methods, performance management models, service quality models, and other models. The DEA model, which includes extensive functions, was the most common model used for evaluating hospital performance. Quantitative models for evaluating hospital performance focused on performance and efficiency terms. A key priority for future research is to compare the extracted models with real data from different hospitals and provide the most useful model according to the contextual factors of the hospital. © 2025 Journal of Education and Health Promotion.
International Journal of Healthcare Management (20479700) 17(1)pp. 63-75
Nowadays proper management of hospital resources has played an important role in reducing the economic pressure on hospitals. Unprecedented challenges have arisen for healthcare systems including further resource constraints due to the Covid-19 pandemic. So different countries faced the low capacity of hospitals' resources to admit and care for patients during the crisis. Medical staff, beds and personal protective equipment are among the scarce resources in this period. In this study, the patient flow in public hospitals has been modeled using System Dynamics (SD) simulation to manage the available capacity of intensive care units (ICU) and wards during the COVID-19 period. The model has been implemented in Vensim PLE and verified for public hospitals in Amol, Iran. The results have shown that hospitals face bed shortages in the period coinciding with the growing incidence of COVID-19, being forced to cancel or delay the admission of selected patients and nonemergency surgeries. Different scenarios based on possible strategies for managing hospital bed capacities have been also evaluated. The best strategy is the one in which the allocated bed capacities to COVID-19 patients are altered based on infection rates during different stages of the pandemic, resulting the shortage of beds is postponed the most. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
Hadian, S.A. ,
Rezayatmand, R. ,
Shaarbafchizadeh, N. ,
Ketabi, S. ,
Pourghaderi, A.R. Bmc Health Services Research (14726963) 24(1)
Background: Hospitals are the biggest consumers of health system budgets and hence measuring hospital performance by quantitative or qualitative accessible and reliable indicators is crucial. This review aimed to categorize and present a set of indicators for evaluating overall hospital performance. Methods: We conducted a literature search across three databases, i.e., PubMed, Scopus, and Web of Science, using possible keyword combinations. We included studies that explored hospital performance evaluation indicators from different dimensions. Results: We included 91 English language studies published in the past 10 years. In total, 1161 indicators were extracted from the included studies. We classified the extracted indicators into 3 categories, 14 subcategories, 21 performance dimensions, and 110 main indicators. Finally, we presented a comprehensive set of indicators with regard to different performance dimensions and classified them based on what they indicate in the production process, i.e., input, process, output, outcome and impact. Conclusion: The findings provide a comprehensive set of indicators at different levels that can be used for hospital performance evaluation. Future studies can be conducted to validate and apply these indicators in different contexts. It seems that, depending on the specific conditions of each country, an appropriate set of indicators can be selected from this comprehensive list of indicators for use in the performance evaluation of hospitals in different settings. © The Author(s) 2024.
Journal of the Operations Research Society of Japan (04534514) 67(2)pp. 46-64
Planning surgical activities is not an easy task due to many decision variables and uncertainty. A basic strategy to avoid surgery cancellation, over or under-utilization of operating rooms (OR) is to plan for the surgeries based on the OR resources in the first phase of OR Scheduling. This study proposes a concurrent model for case-mix planning and OR capacity assignment problems, in which the volume of elective surgeries and the number of OR blocks for surgical services are determined at the same time in such a way that the limited OR capacity is utilized based on the uncertain demands for surgeries. The model would be a stochastic Integer Goal Program and has been solved based on scenario-based programming using GAMS software for some real case studies. Based on the results of applying the model for the case study, the average of unsatisfied demands lies in [0.07%,1.49%] and the OR overtime is zero. © The Operations Research Society of Japan.
European Journal of Industrial Engineering (17515254) 18(2)pp. 191-224
Intensified competition leads companies to integrate decision-making on design, supply, and marketing policies for the new product development (NPD). This integration is more substantial for the manufacturers of configurable product families (CPF) such as cars. This study aims to develop a profit-maximisation model to concurrently optimise all main variables of configuration selection, components’ supply policy, price, modules’ warranty length, and launch time for NPD in CPF. The proposed model is a mixed-integer nonlinear program and is solved through an adapted differential evolution (DE) algorithm. Different numerical cases extracted from one automobile company are studied, and sensitivity analysis on the main parameters is performed. The results approve the significant effects of integrative decision-making based on new variables on the profit. Due to the diversity of the decision variables, the model can be applied in a wide range of situations. Furthermore, considering more realistic assumptions helps to achieve more practical solutions and applicable results. [Received: 10 February 2021, Accepted: 30 December 2022] Copyright © 2024 Inderscience Enterprises Ltd.
Operations Research for Health Care (22116923) 40
With the growing demand for healthcare resources, pressure on efficient usage of available bed capacity is increasing. Peaks in bed demand corresponds to overcrowding in upstream units such as emergency department or operating rooms. With a balanced schedule in elective surgeries integrated into the master surgical schedule, peak traffic can be leveled across the week without changing resource capacity. Hence, overcrowding is reduced without turning away any patients or increasing bed capacity. This study formulates the integration of master surgical and elective surgery scheduling problems as an Integer Programming model to minimize the fluctuation in the required ward beds for elective inpatients admitted for surgery to the hospital, by changing the day of surgery. This demonstrates the opportunities for smoothing the expected patient demand for beds by adjusting the operating room schedule. This decision is made at the tactical level. The model has been examined using data on the elective patient demand for beds in the hospital during typical weeks driven from Hamilton Health Sciences in Ontario, Canada. The integer programming model has been solved using GAMS/CoinCBC MIP Solver. The model enhances bed management by not only smoothing but also reducing the peak demand. The optimal schedule reduces the peak patient demand for bed by about 3–19% for the test samples. The model can be extended to cover the demand for other resources such as ICU beds. © 2023
Medical Physics (24734209) 50(5)pp. 3148-3158
Background: In recent years, with the development of artificial intelligence and deep learning techniques, it has become possible to predict the three-dimensional distribution dose (3D3) of a new patient based on the treatment plans of similar recent patients. Therefore, some new questions have arisen for the above issue: how to make use of the predicted 3D3 obtained from deep learning, to facilitate treatment planning? How to convert the predicted 3D3 to a clinical deliverable Pareto optimal plan? Little research has been done and limited software has been developed in this regard. Purpose: In the current research, an attempt was made to contribute the knowledge-based planning by presenting a new mathematical model, and to take a novel step towards optimizing the treatment plan derived from both predicted 3D3 as well as dose prescription to generate a semi-automated clinically applicable optimal IMRT treatment plan. Methods: The presented model has benefited from both prescribed dose as well as predicted dose and its objective function includes both quadratic and linear phrases, so it was called the QuadLin model. The model has been run on the data of 30 patients with head and neck cancer randomly selected from the Open-KBP dataset. There are 19 sets of dose prediction data for each patient in this database. Therefore, a total of 570 problems have been solved in the CVX framework with commercial solver Mosek and the results have been evaluated by two plan quality approaches (1) DVH points differences, and (2) satisfied clinical criteria. Results: The results of the current study indicate a strong significant improvement in almost all plan evaluation indicators compared to the reference plan of the dataset, 3D3 predictions, as well as the results of previous research, based on the Wilcoxon signed ranks test with a significance level of 0.01. Accordingly, for all regions of interest (ROIs) (or structures) of all 570 problems total clinical indicators have improved by more than 21%, 15%, and at least13%, on average, compared to the predicted dose, the reference plan, and previous research, respectively, with 341 s as the average of solving time. Conclusions: Evaluation of the research results indicates the significant effect of the QuadLin model on improving the dose delivery to the target volumes while reducing the dose and preserving organs at risk. Based on the literature, the proposed model has generated the best-known treatment plan from the predicted 3D3 so far. © 2023 American Association of Physicists in Medicine.
International Journal of Services and Operations Management (17442370) 45(3)pp. 332-354
This paper considers a green inventory-routing problem (IRP) for perishable items in a two-level supply chain including a distributor (manufacturer/plant) and some retailers. Each item has a fixed expiry date. The product price depends on its age. The retailer demand for each product is fixed. The product cannot be sold after the expiry date. The possibility of hiring extra space for holding excessive amounts of inventory and hiring vehicles to exploit the advantage of the higher number of deliveries are considered. The problem is formulated to a mixed-integer linear programming (MILP) model. Some small, medium and large-sized random generated samples are solved using OPL software and a proposed combined ant-generic algorithm. The results show the positive effect of partial outsourcing on the amount of profit. Furthermore, the volume of orders is influenced by taking the environmental effects of transportation into account. Copyright © 2023 Inderscience Enterprises Ltd.
Computers and Industrial Engineering (03608352) 170
In this article, we integrate dynamic slot allocation and inventory management to improve liner shipping decisions. Multi-leg revenue management concepts are used to model the problem of marine transporting full and empty containers. The model considers market distinctions, service diversity, and no-shows. The transportation of empty containers is planned to balance the inventory of empty containers in the ports. The problem is formulated as an integer program. Our objective is to maximize the total profit (revenue from shipping full containers minus the overall costs of transporting, leasing, and holding empty containers). An illustrative example based on Iranian liner shipping is solved, and the sensitivity of the results is analyzed. To evaluate the proposed deterministic model, we compare its results to those of the first come first serve (FCFS) method in a stochastic environment using simulation. A comparison between the proposed and traditional FCFS models shows a significant increase in profit. © 2022
Sustainable Energy Technologies and Assessments (22131388) 52
Iran's electricity distribution network (EDN) includes three stages of generation, transmission, and distribution, with different types of input and output criteria and complex communications with both parallel and serial structures. This study formulates a Fuzzy Network DEA (FNDEA) model for assessing the efficiency of Iran's EDNs components with sustainability considerations and uncertain data. In order to utilize all input and output criteria, this study also proposes a fuzzy linear programming model to determine the optimal lower bound for all input and output weights. Furthermore, appropriate policies are suggested based on the strengths and weaknesses of each EDN to improve its efficiency. Finally, a sensitivity analysis has been implemented to validate the proposed model. The results of the present study reveal that the transmission stage performed better than the generation and distribution stages. It also shows that the distribution stage has the greatest impact on the overall performance of Iran's EDN. © 2022 Elsevier Ltd
Journal of Engineering Design (14661837) 33(1)pp. 15-38
Considering the integrative design, production, and marketing policies for a configurable product family (CPF) (such as automobile, computer, cell phone) in decision making in a simultaneous manner is essential. This paper aims to provide a profit-maximisation model for integrating policies for CPFs by optimising the main variables of product configuration selection, components’ supply policy, price, and modules warranty lengths for each product. The existing models are not concerned with all these variables. Discrete decisions should be made on selecting the appropriate components for different modules and whether to buy or make them; simultaneously, the price and warranty are determined. The proposed model is a mixed-integer nonlinear problem and solved through a Genetic Algorithm (GA) and an adapted Particle Swarm Optimization (PSO) algorithm. The results of applying GA and PSO for different numerical cases and sensitivity analyses indicate the model's abilities and the algorithms’ effectiveness. The findings can introduce new insights for managers and engineers and a focal point for researchers to run new and extensive studies in this field. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
International Journal of Operational Research (17457653) 43(4)pp. 479-497
In this article, the surgical case assignment problem (SCAP) with uncertain duration of surgeries is assessed. This problem is defined as assigning the subsets of patients on the waiting list to the time blocks of operating rooms (ORs) in a given planning horizon. To further increase the OR utility rate and service rate, a novel modified block scheduling strategy is proposed and modelled as a mixed integer programming model. Then a robust optimisation model is proposed to tackle uncertainties in surgery duration. A set of real-based instances from 'Al Zahra Hospital', a teaching hospital in Iran, is applied to verify the proposed deterministic model. The optimal solution is compared with the actual hospital plan indicating the efficiency of this proposed model in practice. A robust model is evaluated through a set of instances. Numerical results indicate that the average percent of overtime reduction is 51.95% by applying the robust model. Copyright © 2022 Inderscience Enterprises Ltd.
International Journal of Procurement Management (17538432) 14(1)pp. 1-29
This paper aimed to evaluate the performance of Iran's special economic export zones by considering export performance improvement criteria of companies operating in these zones. The panel data envelopment analysis was employed for performance evaluation from 2005 to 2016. The Delphi method and snowball sampling were utilised to obtain evaluation criteria from the participation of 77 experts and directors of special zones in three steps. The research questionnaires were filled out by 212 representatives of companies based in special economic zones to survey qualitative evaluation criteria such as zone brand image and zone corporate marketing knowledge. Copyright © 2021 Inderscience Enterprises Ltd.
Jordan Journal Of Mechanical And Industrial Engineering (19956665) 15(3)pp. 251-263
Data Envelopment Analysis (DEA) is a technique for evaluating homogeneous Decision-Making Units (DMUs) that consume similar inputs to produce similar outputs. An essential principle in this method is to identify inputs and outputs; the identified inputs (outputs) must be independent of each other. However, in the real world, there are situations where there is a correlation between two or more inputs (outputs), and then one of them should be considered in the performance evaluation. This issue can cause problems in practice. The main question, in this case, will be that" Which of these two or more correlated variables should be considered in evaluating DMUs?". In this paper, a method for determining an essential variable using a DEA model is presented. In this way, the basic models of DEA have been integrated with the 0-1 programming to achieve the above objective. The proposed method is then improved by using Centralized Data Envelopment Analysis (CDEA) model, followed by refining the performance evaluation variables. At last, the application of the proposed method has been verified for different examples. Results show that the proposed method selects the appropriate variable from among the correlated variables. Also, improving the method using a centralized approach leads to the selection of a variable that increases the total efficiency. The application and implementation of the proposed method is simple and does not have computational complexity. It also does not need experts’ judgment, so it is a cost-effective way © 2021 Jordan Journal of Mechanical and Industrial Engineering. All rights reserved
International Journal of Services and Operations Management (17442370) 39(2)pp. 262-282
The facility layout problem (FLP) is concerned with finding the optimal facility arrangement in the existing layout. A layout generation and its evaluation are often challenging and time consuming due to their inherent multiple objectives in nature and their data collection process. This paper aims to propose an integrated approach of fuzzy analytic hierarchy process (AHP), computer simulation and data envelopment analysis (DEA) for facility layout design improvement and optimisation. Computer simulation is used to determine quantitative measures. AHP is used to determine first, the weight of qualitative measures for layout alternatives and second, their qualitative measures. DEA is performed by employing total cost and wait time as the input variables, accessibility and flexibility as the output variables to evaluate different layouts. Then, the alternative layouts are ranked by solving the super-efficiency DEA model for the layouts. The results imply that the proposed methodology is more reliable compared to the existing approaches. © 2021 Inderscience Enterprises Ltd.. All rights reserved.
International Journal of Management Science and Engineering Management (17509653) 16(1)pp. 43-57
The growing diversity in demand and the shorter life cycle of products necessitate integrating policies of design, production, and marketing to decide on which products, with which attributes should be designed and by which strategies should be supplied to the market. This necessity increases in the manufacturing of the Configurable Products Family (CPF) such as cars, laptops, cell phones. The existing decision-making models either do not deal with all the three policies or are not concerned with the main variables. This study aims to develop a profit maximization model to integrate policies for CPFs by optimizing the main variables: the product’s configuration, supply policy of components, price, and warranty lengths for product’s modules. A new demand function is developed for such decision-making as well. The model is mixed-integer nonlinear programming, so an adapted Particle Swarm Optimization (PSO) is applied to solve different numerical cases and perform several sensitivity analysis. The results depict significant changes in the company’s policy and profitability due to applying the model. The findings can introduce new insights for managers and engineers and a focal point for researchers to run further studies. © 2020 International Society of Management Science and Engineering Management.
International Journal of Electrical Power and Energy Systems (01420615) 122
Purpose: In recent years, most organizations have been dealing with many economic, environmental and social problems. Iran's Electricity Distribution Network (EDN) with different supply stages involving generation, transmission, and distribution is a good case of a complex system engaging in sustainable activities; they must incorporate environmental and social concerns into traditional economic objectives. Assessing the sustainability of EDNs is complicate because it involves a variety of inputs, outputs and inter-related inputs/outputs at any stage of the network for which the importance of each stage may vary. Methodology: This paper proposes a new network data envelopment analysis (NDEA) model for assessing the sustainability of EDNs and their components. The proposed method has the following characteristics: All generation, transmission, and distribution stages, as well as the overall performance of the network, are evaluated in a unified framework; Undesirable outputs, re-work, and external inputs are considered in the model; Different weights for stages, determined by decision-makers, have been implemented to cause different effects on the network performance; The strengths and weaknesses of EDNs’ components are identified; The effect of each dimension of sustainability on the performance of EDNs’ components is investigated. Finding: The result of this study indicates that the Gharb EDN with an efficiency score of 0.8487 has the best performance and Mazandaran EDN with an efficiency score of 0.4667 has the worst performance. Based on the results, the paper proposes how to reduce inefficiencies in each stage of the network. © 2020 Elsevier Ltd
Decision Science Letters (19295804) 7(3)pp. 243-256
The purpose of this study is to develop a fuzzy Analytic Network Process (ANP) model that has the ability to evaluate employee performance in different strategies. A team of experts in the field of strategic human resource management and senior management of an organization engaged in steel production were involved in the study. The data collection tool was a questionnaire that was designed based on the criteria of organization's performance appraisal system. The results showed that in cost leadership strategy, compliance of work hierarchy, quantity of work and the ability to make important decisions constituted the highest coefficients, while in the focus strategy, participate in group work, power of supervision and administration and decision making ability had the highest importance. In differentiation strategy, innovation and creativity, quality and offering constructive suggestions received higher ratings than other criteria. Finally, the developed model was used to evaluate the performance of a sample employee. © 2018 Growing Science Ltd. All rights reserved.
International Journal of Process Management and Benchmarking (14606739) 8(2)pp. 142-155
The purpose of this study is to evaluate the performance of emergency departments. The multi-criteria comparison between the wards of different hospitals is not only useful for the patients but also important for the hospital’s management to improve their performance and for the medical policy makers to plan strategic decisions. In this paper, it is intended to consider the aspects of efficiency beyond the traditional evaluation of check list. The factors which have been chosen are divided into two subsets: first, input factors consisting of no. of active beds, no. of physicians, no. of nurses and medical equipment and second, output factors including no. of discharge, percentage of revival, average waiting time and patient satisfaction. The input oriented and constant returns to scale model of data envelopment analysis (DEA) technique is used to evaluate the efficiency of each emergency department. The model can be used to find out the causes of inefficiency and how to improve the performance. The method has been applied to evaluate and compare 24 EDs of hospitals in Isfahan. DEA model reveals that 37% of them are inefficient. The results may be then used to suggest the improvement strategies based on the input factors. Copyright © 2018 Inderscience Enterprises Ltd.
Journal of Industrial and Production Engineering (21681023) 35(2)pp. 91-101
Cellular manufacturing is a practical aspect of grouping technology in where similar parts and dissimilar machines are grouped into cells to exploit the cost-effectiveness of mass production and flexibility of job shop manufacturing. In this research, a Genetic Algorithm (GA) approach is developed to solve the grouping problem in cellular manufacturing systems. The grouping problem of both machines and parts is formulated as a multi-objective mathematical program; first, minimizing intra-cell and inter-cell movement costs and second, maximizing the importance of allocating the parts to the cells with regards to the location of the machines. The weight of each part for each machine is calculated by Analytical Hierarchy Process. Then, the multi-objective GA has been solved by allocating weights to objectives. The results have also been compared with the results of heuristic Jaccard Coefficient method. © 2018 Chinese Institute of Industrial Engineers.
International Business Management (discontinued) (19935250) 10(7)pp. 1207-1214
Today, Stock Exchange is one of the most influential institutions in the economy of any country this is to a degree that researchers and experts have considered its status as a measure of the economic health of a given society. In financial markets, several tools are used to create transparency in the market. The purpose of this study is to provide a performance evaluation model and to rank the top companies listed on Tehran Stock Exchange to explain the strengths and weaknesses and to determine opportunities and threats they face so that the results of its implementation provide the possibility of analysis and review of policies and programs and improvement of the performance of companies. On the other hand, it helps investors to reconsider their past investments so that they can make decisions about new investments according to the rankings based on performance evaluation. In this study, the list of top companies, 38 companies selected based on investment criteria, listed on Tehran Stock Exchange during 2011, announced by this organization every 3 months and the information needed per share were calculated. Then with the help of a ranking model, a combination of multi-criteria decision-making and Analytic Hierarchy Process (AHP) was used to analyze the structure and determine the weights of ranking criteria and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) Method was used for ranking. Finally, concerning the priorities and aspirations of the investor, a goal programming model was used for selecting optimal investment portfolio. According to the results, the optimal investment portfolio includes shares of National Iranian Copper Industries Co, Mobile Communications Company of Iran (MCI), Chemical Industry and Fanavaran Petrochemical Co each of which have respectively 169, 244, 17 and 52 shares. © Medwell Journals, 2016.
International Journal of Services and Operations Management (17442370) 25(3)pp. 390-412
Mass market strategy does not have a big chance for success in a competitive market. Therefore, by segmenting a heterogeneous market in to some smaller and homogenous markets in which customers have similar characteristics, it is expected that the resources can be more efficiently utilised. The purpose of this study was a mathematical modelling of market segmentation of an Iranian steel-making company using value proposition elements. The model mentioned was used for the analysis of data related to six value proposition elements from 129 major customers of the company. This model was solved using GAMS software and the optimal number of segments was 9. In this study, the results obtained were compared with those achieved by the conventional segmentation methods such as K-means and SOM and two-step clustering. Further, for the validation of the mathematical model used, discriminant analysis of research data was done after segmentation and the success percentage of the ranking rule was found to be 95.3%. Also, the similarity criterion was computed for each potentially new customer. Copyright © 2016 Inderscience Enterprises Ltd.
International Journal of Services and Operations Management (17442370) 23(3)pp. 277-297
The present study sought to investigate the value proposition concept from the perspective of a steel-producing company and to identify elements provided by the company for its customers. Value proposition concept has been widely used by academicians and industrial practitioners recently. In order to identify the value proposition elements for different groups of customers, many interviews were first held with the managers and the experts of the organisation. The elements identified for the recommended value proposition were 'providing high-quality products', 'on-time delivery', 'provision of technical and commercial information and guides', 'development of products portfolio with emphasis on specific products', and 'competitive pricing and sustainable customers' needs satisfaction'. Then, the data were analysed by multi-attribute decision-making techniques (MADM). Besides, Shanon's entropy method and simple additive weighting (SAW) technique were used for weighing the criteria and AHP technique was used for ranking the choices. The results revealed the ranked elements of the value proposition for every customer group and also, for the overall customers. Finally, some recommendations were proposed for the business model definition and the improvement of competitive conditions. Copyright © 2016 Inderscience Enterprises Ltd.
Pakistan Journal Of Medical Sciences (1682024X) 31(3)pp. 717-720
Medical Record Department (MRD) has a vital role in making short and long term plans to improve health system services. The aim of this study was to describe performance improvement indicators of hospital MRD and information technology (IT). Collection of Data: A search was conducted in various databases, through related keywords in articles, books, and abstracts of conferences from 2001 to 2009. About 58 articles and books were available which were evaluated and finally 15 of them were selected based on their relevance to the study. MRD must be capable of supporting tasks such as patient care and continuity, institute management processes, medical education programs, medical research, communication between different wards of a hospital and administrative and medical staff. The use of IT in MRD can facilitate access to department, expedite communication within and outside department, reduce space with electronic medical records, reduce costs, accelerate activities such as coding by use of coding guide software and facilitate retrieval of records that will ultimately improve the performance of MRD. © 2015, Professional Medical Publications. All rights reserved.
Ketabi, S. ,
Ganji, H. ,
Shahin, S. ,
Mahnam, M. ,
Soltanolkottabi, M. ,
Hadian, S.A. Benchmarking (14635771) 22(6)pp. 978-993
Purpose – Different surgical services demand operating rooms (OR) to treat elective patients, each competing for a limited supply of OR time. The purpose of this paper is to obtain empirical measures of performance in the management of OR. The current research compares technical efficiency of 11 specialties in elective operating theatre of Alzahra Hospital in Isfahan, Iran in autumn of 2009. Design/methodology/approach – Data envelopment analysis (DEA) can be used as tools in management control and planning. First, the input oriented and variable returns to scale model of DEA technique has been applied and separate benchmarks for possible reductions in resources used has been derive, and significant savings are possible on this account. Findings – The efficiency scores of inefficient specialties are between 0.62 and 0.96. Neurosurgery and general surgery are the best and the worst units. DEA results determine by how much hospitals can increase elective inpatient surgeries for each specialty. Originality/value – The originality of this study is to obtain empirical measures of performance in the management of OR. DEA has not been applied to measure the efficiency of different department in an organization. The measures are common in different units and have been collected in a similar way. © 2015, Emerald Group Publishing Limited.
Prensa Medica Argentina (discontinued) (0032745X) (3)pp. 162-173
The hospital discharge process, from the moment of the discharge order until the patient leaves the hospital, plays a key role in hospital patient management. Improving the discharge process is an important strategy that has links to many hospital activities. The process of discharge is the most important stage affecting the patient’s satisfaction. If this process takes long, it makes patients dissatisfy but it also will not be beneficial for the hospital. In this research, the main objective is analysing the discharge process at Kashani Hospital in Isfahan, Iran. The process may be formulated as a network of queues, and will be analyzed by discrete event simulation. The main factors affecting average waiting time are patients’ financial problems, unnecessary activities and insurance confirmation. Simul8, a visual simulation software, is used to show how the proposed strategies will affect the waiting times in the discharge process. © 2015, Ediciones Medicas del Sur S.R.L.. All rights reserved.
Prensa Medica Argentina (discontinued) (0032745X) 101(3)pp. 162-173
The hospital discharge process, from the moment of the discharge order until the patient leaves the hospital, plays a key role in hospital patient management. Improving the discharge process is an important strategy that has links to many hospital activities. The process of discharge is the most important stage affecting the patient’s satisfaction. If this process takes long, it makes patients dissatisfy but it also will not be beneficial for the hospital. In this research, the main objective is analysing the discharge process at Kashani Hospital in Isfahan, Iran. The process may be formulated as a network of queues, and will be analyzed by discrete event simulation. The main factors affecting average waiting time are patients’ financial problems, unnecessary activities and insurance confirmation. Simul8, a visual simulation software, is used to show how the proposed strategies will affect the waiting times in the discharge process. © 2015, Ediciones Medicas del Sur S.R.L.. All rights reserved.
Pakistan Journal Of Medical Sciences (1682024X) 29(1 SUPPL.)pp. 423-426
The aim of this research was to determine impact of implementing scenarios' simulation on idle and service time at Emergency Room (ER) after one year. Participants in the study included the patients who received services in emergency department (ED). The arrival and service times in different stations were collected for 1092 patients during 17 days. For data analysis, SPSS and simulation technique were used. Results showed service time in the Ear Nose Throat (ENT) and Neurosurgery dramatically reduced as well as other services. Health care managers, in the ER are usually physicians who are not familiar with principals of management.
Journal Of Medical Systems (01485598) 36(3)pp. 1165-1171
Medical Records Department (MRD) is an important unit for evaluating and planning of care services. The goal of this study is evaluating the performance of the Medical Records Departments (MRDs) of the selected hospitals in Isfahan, Iran by using Analytical Hierarchy Process (AHP). This was an analytic of cross-sectional study that was done in spring 2008 in Isfahan, Iran. The statistical population consisted of MRDs of Alzahra, Kashani and Khorshid Hospitals in Isfahan. Data were collected by forms and through brainstorm technique. To analyze and perform AHP, Expert Choice software was used by researchers. Results were showed archiving unit has received the largest importance weight with respect to information management. However, on customer aspect admission unit has received the largest weight. Ordering weights of Medical Records Departments' Alzahra, Kashani and Khorshid Hospitals in Isfahan were with 0.394, 0.342 and 0.264 respectively. It is useful for managers to allocate and prioritize resources according to AHP technique for ranking at the Medical Records Departments. © Springer Science+Business Media, LLC 2010.
Ajami, S. ,
Ketabi, S. ,
Yarmohammadian, M.H. ,
Bagherian, H. Medical Archives (0350199X) 66(1)pp. 53-57
Emergency Department (ED) provides urgency clinical and Para clinical care for patients who injured in accidents and incidents. Simulation is one of the decision supporting techniques that analyze risk factors and strategies in decision-making. The aim of this study was to determine the waiting time in emergency department services at Ayatolahkashani Hospital to propose scenarios for reducing waiting time. This study was an analytical and cross-sectional in which data collected by forms and observations. Population included waiting and service time in all stations related to ED's treatment processes along with diagnostic departments (e.g. Laboratory, Radiology, Ultrasonography, and C-T Scan) over a two-week period for 663 patients. For data analysis, SPSS software and simulation technique were used. Results show that add one intern to the Ear Nose Throat (ENT) service makes the most reduction on the waiting time from 112.19 to 99.24 minutes. In this option the mean of ENT services time will be reduced to 26.54 minutes, neurology services time will be reduced to 6.58 minutes and the mean of orthopedic services time were reduced to 5.98 minutes. Health care managers, in the ED are usually physicians who are not familiar with principals of management. Hence, they need simple tools for logical decision-making. Operation research methods such as simulation should be suitable for them.
Journal Of Medical Systems (01485598) 35(2)pp. 143-150
The purpose of this study is to evaluate the performance of the Cardiac Care Units (CCU) of hospitals in Isfahan, Iran. The multi-criteria comparison between the wards of different hospitals is not only useful for the patients but also important for the hospitals management to improve their performance and for the medical policy makers to plan strategic decisions. In this paper, it is intended to consider the aspects of efficiency beyond the traditional evaluation of check list. There are some measures which are used in the existing health audit system and several quantified ratios. Among them the most important ones, based on the patient satisfaction and resource efficiency, have been selected using the weights obtained from their paired comparisons. The factors which have been chosen are divided into two subsets: first, input factors consisting of average number of active beds, medical equipment, personnel (such as doctors, nurses and technicians), and technological capabilities, and second, output factors including bed occupancy percentage, average length of stay, total percentage of survival and performance ratio. The input oriented and variable returns to scale model of Data envelopment analysis (DEA) technique is used to evaluate the efficiency of each CCU ward. The model can be used to find out the causes of inefficiency and how to improve the performance. The method has been applied to evaluate and compare 23 CCUs of hospitals in Isfahan. Although the current health audit system, which uses a check list, has reported 21 of them as first class CCU, DEA model reveals that 11 of them are inefficient. The results may be then used to suggest the improvement strategies based on the output factors. © 2009 Springer Science+Business Media, LLC.
Ajami, S. ,
Ketabi, S. ,
Yarmohammadian, M.H. ,
Bagherian, H. Studies in Health Technology and Informatics (09269630) 164pp. 196-200
The aim of research was to reduce waiting time at ED. Population includes the patients who received services in ED. The arrival and service times in different stations were collected for 663 patients. For data analysis, SPSS and simulation technique were used. Results shows that add one intern to the Ear Nose Throat (ENT) service makes the most reduction on the waiting time from 112.19 to 99.24 minutes. Health care managers, in the ED are usually physicians who are not familiar with principals of management. © 2011 ITCH 2011 Steering Committee and IOS Press.
Health Information Management Journal (18333575) 36(2)pp. 37-42
Strategies for improving the patient discharge process have a beneficial effect on many hospital activities. The main objective of this research was to analyse the discharge process at Kashani Hospital in Esfahan, Iran in the fall of 2004. This study took the form of a case study in which data were collected by questionnaire, observation and checklist. SPSS and Operations Research (O.R.) methods were used to analyse data. The results showed that the average time for patients to complete the discharge process was 4.93 hours. The hospital personnel involved identified the main factors affecting average waiting time as patients' financial problems and distance between different wards. The longest hospital stay was 5.7 days in the Neurology ward. Findings showed there was a queue in completing medical records at the nursing and medical equipment stations.
Iranian Journal of Science and Technology, Transaction A: Science (10286276) 30(3)pp. 315-323
The problem of finding the minimum cost multi-commodity flow in an undirected and complete network is studied when the link costs are piecewise linear and convex. The arc-path model and overflow model are presented to formulate the problem. The results suggest that the new overflow model outperforms the classical arc-path model for this problem. The classical revised simplex, Frank and Wolf and a heuristic method are compared for the problem. © Shiraz University.
Journal of Global Optimization (09255001) 24(1)pp. 79-88
The Network Design Problem has been studied extensively and in many of these models the cost is assumed to be a concave function of the loads on the links. In this paper we investigate under which conditions this is indeed the case for the communication networks. The result is presented as a theorem, the Concavity Theorem, and a list of conditions that can easily be verified. It is also shown how the theorem can be extended to other applications, like in the area of road transportation.
