Journal of

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Background: The scarcity of resources and growing demand for health care, as well as moral, socioeconomic and political imperatives for efficient use of resources, make cost information and adoption of an accurate methodology an integral part of the modern management.
Materials & Methods: At first, a research protocol including literature review strategies, inclusion and exclusion criteria and data gathering methods, was designed. Afterwards, using an electronic search of several databases, some relevant studies were identified.
Results: In the costing literature the economic and accounting approaches are distinguishable. Two methods of marginal and average unit cost analyses are attributable to these approaches. Considering the type of the problem to be decided about and cost targets, costing methods can be different. Factors such as types of cost analyses and economic evaluation, timing overview, analysis approach and advantage or disadvantage of economy of scale have a significant role in determining the costs.
Conclusion: Having no consensus of opinion on the most appropriate principles to use in costing process is one of the main challenges of the time. There is a trade-off between the accuracy and cost of achieving cost information... Therefore, standardization of costing methodologies and adoption of comprehensive approaches for the main issues will predispose an economical international and organizational comparability.

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Background:In the healthcare system, teamwork is important to improve the quality of services and provide safe and effective cares. Operation room, as a high-risk environment, requires high levels of teamwork employees to secure performance. This study aimed at assessing the teamwork among surgical teams of hospitals affiliated to Social Security Organizations in Tehran City.

Materials and Methods: In this cross-sectional study "Observational Teamwork Assessment for Surgery" checklist was used to evaluate teamwork skill in surgical teams. Sixty surgical teams from two hospitals were assessed. In order to data analysis, descriptive statistics was used to calculate mean and standard deviation of age, work experience and teamwork scores in surgical, nursing and anesthesia sub teams. Two-Way ANOVA test was used to study relationship between scores of three surgical phases, sub teams and behaviors domains.

Results: Mean and standard deviation of age and work experience of participants were 42.81±8.57 and 10.62±6.18 years, respectively. Mean score of teamwork was 3.60±0.51 (out of 6) that showed higher than average team performance level. Among three sub teams, nursing achieved the highest score (3.78±0.44). There was a significant difference between nursing sub team and others (p<0.05).

Conclusion: Although mean score of teamwork was in higher than average level in studied teams, but discrepancies between three sub teams were high and worrisome. Use of educational solutions utilization can be effective to improve teamwork and increase quality of behaviors in operation room. 

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Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences.
Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013).
Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations;  analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning  and creating an organizational structure.
Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.
 

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Background: One of the most important ways to promote the quality and attractiveness of the journal for readers is the accurate evaluation of the published articles research methodology in the journals. The purpose of this study was to investigate the research methods of the articles published in the Journal of Hospital.
 
Materials & Methods: In this descriptive study, the research methods of all articles published in the Journal of Hospital from Fall 2016 to Fall 2018 including qualitative or quantitative, field or library research , data collection methods, data analysis software, location of research, nature of the research (descriptive or analytical, etc.), topics, as well as the number of authors were investigated.
 
Results: Data of 55.29% of papers was qualitative that was turned to quantitative, 47.06% of articles had descriptive-analytical method, and 68.24% of papers had employed a field research method. In addition, 51.76% of articles had used questionnaire and the SPSS software was used in 52.08% of the articles. The location of 45.45% of researches was in Tehran province. Finally, the subject of 23.53% of papers was policy making, planning, leadership, and management in hospitals.
 
Conclusion: Most authors of the articles have followed a very similar research method during the mentioned period. So, creating diversity in the nature of the researches, using other methods of collecting information rather than questionnaires, doing more library research, and not limiting the researches to Tehran province are the most important suggestions for future researchers.
 

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Background and purpose: Considering the important role of doctors in the implementation of accreditation standards and the necessity of their involvement in this process, this study was conducted in order to identify the views of doctors regarding the challenges of participating in accreditation programs in social security hospitals in Mashhad.
Materials and methods: This study is a cross-sectional descriptive-analytical research that was conducted in two hospitals of the Social Security Organization of Mashhad, Iran. in 2022. The participants were 56 full-time working doctors with at least one year of work experience in the hospital. Data analysis was done using SPSS version 26 software.
Findings: Among the challenges of doctors' participation in accreditation programs , the dimensions of the motivational mechanism (3.96±0.63) , provision of suitable resources for the implementation of accreditation (3.83±0.78), physician empowerment programs (3.78±0.73) and the role of the quality improvement office in attracting doctors' participation (3.75±0.74) were more important from the doctors' point of view, and  patients' demands (2.90±0.75) and role ambiguity 2.77±0.96), were less important in their opinion.
Conclusion: Managers should consider that employee motivation and resource allocation are necessary for the effective implementation of the accreditation standard. Empowering doctors in the implementation of accreditation standards as well as the participation of quality improvement offices to interact with doctors and attract their participation are very important factors.

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Background and purpose: Effective management of human resources is crucial for improving healthcare services, as personnel are an organization's most valuable asset. This study aims to identify challenges in human resource management and propose solutions to enhance service quality in hospital settings.
Methods: This qualitative study employed semi-structured interviews with 53 managers and key decision-makers from Social Security hospitals in Tehran, using purposive and snowball sampling techniques. Thematic analysis was utilized to analyze the data. The validity and reliability of the qualitative findings were ensured through participant and expert review methods.
Results: The study identified numerous human resource challenges, categorized into five main groups and 20 subgroups. Key issues included flawed recruitment and hiring processes, unfavorable working conditions, weak human resource organization, inadequate staff training, and ambiguity in employment laws and regulations. Proposed solutions, classified into five main groups and 29 subgroups, encompassed: enhancing recruitment and hiring processes, fostering a dynamic organizational culture, improving human resource productivity and efficiency, transforming hospitals into learning organizations, providing comprehensive and effective training, and increasing transparency in rules and regulations, particularly in job descriptions.
Conclusion: Regular identification of human resource management challenges and implementation of evidence-based, scientific, and operational solutions can significantly improve human resource management and, consequently, hospital performance in Social Security hospitals.