Investigating the effect of readiness of comprehensive health service centers in dealing with disasters on organizational performance in Asadabad University of Medical Sciences, Hamadan province in 2016

• Main Authors: mostafa hushmandi, fatemeh darabi
• Format: Article
• Language: fas
• Published: Iran University of Medical Sciences 2020-05-01
• Series: Salāmat-i kār-i Īrān
• Subjects: accidents and disasters; comprehensive health service centers; organizational performance; hospital
• Online Access: http://ioh.iums.ac.ir/article-1-2878-en.html
• ISSN: 1735-5133; 2228-7493

Background and aims: Manpower is considered as one of the most important factors in advancing the goals and improving the productivity of organizations. Therefore, improving the performance and improving the human resources is an undeniable need for organizations and performance management is a tool to achieve this goal. Today, the consequences of life and financial injuries caused by natural and unnatural accidents have a tremendous and undeniable impact on the way of life and human health. One of the most important factors affecting the performance of the organization in the event of natural and man-made disasters is the readiness of comprehensive health service centers as the first organization providing health services. The more successful the performance management in achieving these goals, the more productivity will be ensured as a result of the success and continuity of the organization. For this reason, it can be said that the performance of an organization indicates its survival status in the environment. Various factors affect organizational performance one of the factors is the level of preparedness of comprehensive health service centers in the face of disasters. Health centers, especially hospitals, are among the places where dangerous accidents and disasters occur; injured people face high referral rates. The purpose of this study is to investigate the effect of comprehensive health service preparedness centers in the face of disasters on organizational performance in Assadabad University of Medical Sciences. Method: This descriptive cross-sectional study was performed among 100 employees of Asadabad Comprehensive Health Service Centers. A questionnaire was used to collect research information. This questionnaire consists of two parts: service center preparation, which used a researcher-made questionnaire to examine this variable, and organizational performance, which used the standard organizational performance questionnaire.  The final tool had 108 questions. Demographic information questions (7 questions); And organizational performance section includes; Preparedness program (6 questions), response scene management system (6 questions), communication and early warning (9 questions), internal and external coordination (12 questions), providing infectious disease services (10 questions), providing environmental health services (8 questions) Question), providing non-communicable disease services (9 questions), providing psychosocial health services (9 questions), water and food storage (3 questions), firefighting (3 questions), storage of supplies and equipment (3 questions), agents Structural (5 questions), non-structural factors (6 questions), organizational performance (6 questions), readiness of service centers (6 questions). The questionnaire is a closed answer type and the scale for measuring questions; Likert. The face and content validity of the questionnaire was determined using the corrective opinions of relevant experts. Qualitative face validity 20 subjects in the target group were asked to comment on the name of the questionnaire, the clarity and comprehensibility of the items. Both qualitative and quantitative methods were used to evaluate the content validity. To evaluate content validity quantitatively, two content validity ratios (CVR) and content validity index (CVI) were measured. To examine the content validity ratio, each item was evaluated based on the following three-part spectrum: 1) necessary 2) useful but not necessary 3) not necessary. Expert opinions were then quantified through CVR. The numerical value of the content validity ratio was determined with the help of Lavache table. The CVR calculated in the present study was 0.87. The CVI content validity index is the degree to which experts agree on the relevance of each item. In this study, CVI 0.8 and above is an acceptable value, which was calculated to be 0.91 in the present study. The reliability of the questionnaire was assessed using a retest test method among 15% of the samples with an interval of two weeks. Cronbachchr(chr('39')39chr('39'))s alpha test score for organizational performance was 0.83 and for service center readiness was 0.98. The internal reliability of the questionnaires was obtained using Cronbachchr(chr('39')39chr('39'))s alpha test 98 0.98 and ᾳ = 0.83, respectively. The method of analysis is descriptive and structural equations. In order to analyze the data, descriptive indicators and statistical tests of Kolmogorov-Smirnov test, Pearson correlation coefficient and path analysis were used in SPSS and LISREL statistical software. Results: According to the results of the present study, 32% of the employees were male and 68% were female. Most employees were in the age group of 40-50 years with 42%, and the lowest frequency percentage (12%) was in the age group above 50 years. Of the main variables studied, only the average response scene management system is less than the average value and is equal to 2.79. Examination of the highest averages showed that the organization and structure have the highest average with a value of 3.95. The results showed that out of 19 main and sub-hypotheses, 17 hypotheses were confirmed (p <.05) and two hypotheses were rejected (p <.05). The results showed that all three main hypotheses were confirmed (p> 0.05). Based on this, the relationship between readiness and organizational performance, the relationship between readiness with structural factors and the relationship between readiness and non-structural factors are confirmed (p> .05). The direction of all three relationships is positive and the strongest relationship between organizational readiness and performance with a coefficient of 0/62. It can be seen. The results showed that out of 16 sub-hypotheses, 14 hypotheses are confirmed (p> .05). The two hypotheses that have been rejected include the relationship between infectious disease services and organizational performance, and the relationship between water and food storage and organizational performance. The direction of the relationship of all sub-hypotheses is positive and the strongest relationship between the sub-hypotheses is related to the relationship between internal and external coordination with organizational performance with a coefficient of 0/53, and then related to the relationship between stage management system and organizational performance with a coefficient 0/51. Also, all research variables have a normal distribution (p <0.05). According to the calculated indices, the data fit well with the factor structure of the research and the overall validity of the model is confirmed. For example, the square root of the estimated variance of the approximation error (RMSEA) is less than 0.08. The three indices CFI, NFI and GFI are greater than 0.90. The PGFI value is more than 0.60 and the ratio of chi-square to degree of freedom is between 1 and 5, which all fitting indices indicate the approval of the research model. Conclusion: Health centers, as the first disaster prevention centers, must be prepared to deal with accidents and disasters. Lack of preparedness of health centers in the face of disasters is one of the important factors that have a direct impact on the vulnerability of the country.  Based on the results of the study; the preparedness of comprehensive urban and rural health service centers in the face of disasters improves organizational performance. In the dimension, structural and effective factors in health centers in dealing with disasters were achieved. Weaknesses in structural problems, lack of facilities and inadequate organization in the allocation of available resources are the most important problems of health centers in the face of accidents and disasters. In the dimension of non-structural factors such as safety, control and communication, lack of facilities, increase in capacity, etc. The results indicate the consideration of alternative locations and the existence of programs to prioritize the provision of services in emergency situations will increase the capacity of health centers. In terms of management in health centers, the present study is at a good level, which indicates that in the health centers studied on the command area is well planned and officials, command teams, structure and job description are specified. In terms of functional factors, scene management system, early warning of preparedness, providing infectious disease services, providing non-communicable disease services, providing environmental health services, providing psycho-social health services, water and food storage, storage of technical equipment and equipment for centers Comprehensive health services, firefighting, balance of readiness of structural factors, stability of readiness and structural factors, general and technical factors and non-structural factors were positively correlated with the readiness of urban and rural health centers. According to the results of this study; In order to increase the efficiency of providing medical services in emergency situations and to promote the two-way relationship between the organization and readiness structure of comprehensive health service centers and also to improve organizational performance, it is necessary to provide strategies in the organization by the organization management. Also, due to the unpredictability of some disasters such as earthquakes, preparing staff by providing theoretical and practical training programs, while holding operational maneuvers in an emergency with an emphasis on repetition at appropriate intervals can be useful. Based on these results, it is recommended that while developing short-term training programs in the field of crisis management and their continuous implementation, even non-structural rehabilitation of medical centers should be considered as a priority. Also, in order to increase the effectiveness of training programs, in addition to the managers of the centers, other staff should also participate in training programs to increase the readiness of the centers in a centralized and comprehensive manner.