Journal of

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Background & Aim:‌ Improving the quality of work life in hospital personnel is introduced as one of the important factors for ensuring the sustainability of the health system. The aim of this study was to investigate the relationship among organizational justice and commitment, and job satisfaction with quality of work life in Pour-Sina state hospital personnel. 

Materials & Methods: ‌The study design was descriptive and cross-sectional, and statistical population included all of physicians, nurses, radiology and administrative staff and service workers of Poursina State Hospital in Rasht. 216 individuals were selected by quota sampling and filled the questionnaires on demographic information, quality of work life, organizational justice and commitment and job Descriptive Index‌(JDI).All data were analyzed with SPSS 16 software and by correlation coefficient and multiple regression.

Results:‌ Among the demographic characteristics, only work history had a significant negative correlation with quality of work life ‌(r=-0.155,‌P<0.05).‌ All dimensions of organizational commitment‌(except continues commitment) and organizational justice had a positive and significant relationship with quality of work life(P<0.0001).in regression analysis variables of distributive justice (P=0.0001,β=0.318),pay satisfaction (P=0001.0,β=0.288), affective commitment (P=0.007,β=0.144), promotion satisfaction (P=0.003,β=0.172), procedural justice (P=0.013,β=0.139 ), and normative commitment (P=0.003, β=0.172) significantly predicted the levels of  quality of work life and totally explained 60% of shared variance‌‌(P<0.0001,F=46.913).

Conclusion: individuals working in hospital are always at risk of burnout. Thus, it is proposed that much attention be paid to dimensions of job satisfaction, organizational commitment and justice in order to increase the quality of work life in hospital environments.

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Background: This study investigated the Length of Stay (LOS) in the Intensive Care Unit (ICU) and its influential factors as a step toward revising hospital policies, more appropriate resources usage and improving health system performance.

Materials and Methods: this cross-sectional study was conducted on 246 patients, among nine general ICUs of Tehran University of Medical Sciences. Variables such as age, type of disease, existing nosocomial infection and APACHE II (Acute Physiology and Chronic Health Evaluation) score were studied. SPSS software utilized for statistical analysis using Mann Witney U and regression.

Results: The mean and median of LOS was 8.6±19.2 and 2 (1-7) days, respectively. Mortality rate was 19.9% (N=49). The mean age was 52.7±22.07 yrs which LOS enhanced with increasing age (r=0.35, p<0.001). The mean  of APACHE II score was 14.2±6 and it raised  with increasing patients LOS (r=0.19, p=0.01). Average length of stay in patients with surgical diagnosis was 6.71 days less than others. Among effecting factors, nosocomial infection (p<0.001), need for mechanical ventilation in the first 24 hours of hospitalization (p<0.001) and a past medical history (p=0.012) which prolonged LOS significantly.

Conclusions: In this study, type of disease, hospital infection and age were the most important affecting factors on the length of stay. Thus, implementing effective interventions in order to maintain patients' health and safety is recommended. Since, half of the patients were hospitalized less than two days, providing protocols are necessary to make better use of ICU resources for patients who really need.

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Background: Decision to stop or continue the treatment after awareness about complications and risks is patients' rights. On the other hand, patient`s discharge against medical advice could threaten patients' health. This study aimed to determine the causes of patient`s discharge against medical advice to prevent negative effects on patients and health costs.

Materials and Methods: In this study, 342 patients who left hospitals regarding discharge against medical advice were enrolled. Up to 48 hours of leaving hospital, the patients were received telephone contact, and if consented, were asked about the potential causes and whether or not the explanation of nurses or physician about the risks and side effects of discharge against medical advice. Furthermore, causes of discharge against medical advice were categorized as patient, hospital condition and combined causes.

Results: Study findings revealed that 48.5% of patients with personal reasons, 26% because of dissatisfaction with the service and 25.5% due to a combination of causes left the hospital. Most of the patients were in emergency department (p<0.001). There was relationship between type of disease (p= 0.037) and referred shift of patients (p=0.002) with type of discharge.

Conclusion: Given to the study results, it seems that planning for providing and maintaining human resources, training staff especially new entrance, monitoring medical team performance and organizing the triage system are essential in patient`s discharge against medical advice.

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Background: Personnel training and development of readiness are important to attain individuals to personal and orgnazational purposes‌ (job career) and Mentor/ coach quality performance is crucial in this regard. The sensitivity of this issue can be in the spotlight in hospitals. The present study aims to examine relationship between emotional intelligence, job satisfaction, perceived organizational commitment and justice with mentoring performance in hospitals personnel.
 
Materials and Methods: The present research was a cross-sectional one which study population included all of physicians, nurses, radiology and administrative staff and service workers of Poursina public Hospital in Rasht. Four hundred and three individuals were selected by quota sampling and responded to demographic information, emotional intelligence, organizational justice, job satisfaction, organizational commitment and mentoring function questionnaire. data was analyzed using SPSS software version 20.
 
Results: hierarchical regression analyses with enter method revealed that each three component of Organizational Justice, namely distributive justice, ‌interactional justice, procedural justice‌ could explain significantly 60% shared variance results of Mentoring function of one component of job satisfaction specifically Supervisor Satisfaction‌, and one component of emotional intelligence specifically self-management (F=26.18, P<0.0001).
 
 
Conclusion: The employees' perceptions of organizational justice, supervisor satisfaction and also the ability of people to control emotions and appropriate reactivity in different situations is related to quality of Mentor/ coach function in hospital. According to the obtained results and effective variable on Mentoring, it is recommended to make decisions for hospital/manageral interventions related to emotional intelligence, organizational justice and job satisfaction.

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Background: Reduction of errors is necessary to improve the quality of healthcare, promoting communication between the hospital staff and patients, and decreasing the patient's complaints in hospitals. Due to the high probability of error in the operating room (OR), this study aimed to detect the potential errors in the OR of Nemazee hospital using FMEA.
Materials and Methods: This study was a qualitative one which assessed Failure Mode and effects of OR in six steps using FMEA technique. At First, the OR activities were listed, then the failure modes were recognized. Next, the Risk Priority Number (RPN) of each error was calculated according to the indicators of Occurrence (O), Severity (S) and Detectability (D).
 Results: Totally,204 failure modes in 36 activities in five process in surgery ward were recognized.15.7 percent of failure modes classified as high risk factors (RPN ≥ 100). The most and the least distribution of origin factors were related to human and organization and technical errors, respectively.
Conclusion: The majority of errors in OR was set in of human skills category. Besides, the most and the least failure modes were belonged to “patient anesthesia by circular activity number 20, RPN=1795.23)” and “not to oxygenation for patients (the activity number 36, RPN=99.33) respectively. Identification of 36 activities and 204 errors in the 5 processes of Operating Room represents the comprehensiveness of HFMEA method in the identification, classification, evaluation and analysis of the health system errors.