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Strategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM).

The authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM.

Five main factors affected strategic plan implementation. Although all five variables and factors are top level, “senior manager awareness and participation in the strategic planning process” and “creating and maintaining team participation in the strategic planning process” had maximum drive power. “Organizational structure effects on the strategic planning process” and “Organizational culture effects on the strategic planning process” had maximum dependence power.

Identifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers.

The authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

This study aims to prepare probiotic sodium caseinate-gelatin films containing Lactobacillus paracasei, Bifidobacterium bifidum and Lactobacillus plantarum, and evaluate their application on the microbiological, chemical, mechanical and sensory properties of rainbow trout fillets during 12 days of refrigerated storage.

The physical, chemical and mechanical properties of the designed films were assessed. In addition, the rainbow trout fillets were examined for microbiological, chemical parameters and sensory attributes.

According to the results, a negative correlation was found between the survival of probiotic bacteria and the storage time of the films. The counts of L. paracasei, B. bifidum and L. plantarum showed a decreasing trend during the study, starting from (2.9, 3.9 and 1.9 log CFU/g, respectively) at day 0 and reaching (6.79, 5.84 and 6.14 log CFU/g, respectively) at the end of the study (day 12).

It was observed that the sodium caseinate-gelatin probiotic films delayed the microbial growth in rainbow trout fillets compared to the control group. Furthermore, significant differences in chemical changes were found in all treated fish fillets compared to the untreated group.