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Strategic orientation is one of the critical principles affecting the marketing and strategy selection of an organization’s activities, reflecting the strategic tendencies implemented by the organization to create behaviours, leading to organizational efficiency and better employee performance. Therefore, this paper aims to study the relationship between strategic orientation and performance in Qazvin teaching hospitals through green supply chain management (SCM) to improve employees' performance.

This was a descriptive– analytical and cross-sectional study. The total number of employees in medical centres was 2,256 people. According to Morgan’s table, the required number of samples was 328, including 10% of the sample loss. The questionnaire was given to 365 staff in different hospitals in proportion to the number of staff. Two statistical software, SPSS24 and AMOS23, were used to evaluate the results.

All three variables were relatively moderate in the hospitals. The results of evaluating the structural model of the research showed that all the studied hypotheses were significant, except for the relationship between organizational performance and strategic orientation hypothesis. The results also show that this model had a good fit.

The findings can lead to saving the environment, creating a better social image and reducing costs and profitability, allowing managers to know the strategic orientations rather than depending on institutional pressure issues and monitoring guidelines.

Considering the significant relationship between the dimensions of green SCM and the hospitals’ performance, the authors suggest: establishing multilateral co-operation in environmental issues, improving the environmental status of hospitals, reducing waste rates and paying attention to social responsibility of hospitals. In addition, the findings help hospital management to comprehensively understand the strategies for implementing green SCM procedures.

A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. The purpose of this paper is to investigate the influencing factors of sentinel events in the emergency department of a military hospital in Tehran to find out some of the effective solutions.

In this qualitative study with content analysis approach, 20 hospital healthcare personnel participated as participants from the fields of medicine and nursing. Purposive random sampling and semi-structured interviews were used for data collection. Atlas.ti software version 5.2 was used for data analysis.

Four themes and 32 subthemes were identified by numerous revisions and combining the codes. The four main themes of sentinel events were: causes, incidence barriers, cause prevention solutions, and barriers’ improvement solutions. Moreover, these main factors were related to these issues: staff and patients’ education, communication, assessment, patients and their companions, employee rights, leadership, care continuum, human factors, physical environment, information management and medication use. Some solutions were also suggested according to these factors and a policy was recommended.

Hospital managers and authorities should try to find the main causes of sentinel events by periodical analysis to find ways to prevent them in the future, using logical and reasonable solutions.

This study confirms that strategies to reduce the sentinel events in emergency departments should focus on empowerment of all staff.