Journal of

Background: Operating room efficiency is a major determinant of hospital cost. Maximizing throughput, while maintaining quality, is therefore paramount to maintenance of financial viability. Cancellation of surgery may increase a hospital's cost and affect the efficiency of operating room and waste of resources. This study was conducted to determine the rate and causes of canceled surgeries, and identifies areas for improvement in a teaching hospital in Tehran.

Material & Methods: We carried out a descriptive study of the reasons for canceling scheduled operations. Data were collected during 9 consecutive months. The reasons for cancellation were identified by theatre staff. We grouped all the reasons into 13 reasons. Other necessary information like operated surgery was obtained from IT department. Descriptive statistics (frequency, percentage, 95% confidence interval) were used to analyses of data.  Statistical analyses were performed using SPSS and Excel Microsoft office.

Results: in this study, 18.2% of the 3381 scheduled operation were canceled on the day of surgery, 32.1% of them because of vascular surgery, followed by orthopedics (18.7%), general surgery (15.5%) and nose and throat surgery (13.7%). The common reasons for cancellation were lack of theatre time, clinical change in the patient's condition, lack of paraclinic tests and consultant's report on patient flow problems, blood preservation, drug and necessary equipment for surgery. 

Conclusion: This study demonstrated that most cancellations of scheduled operation are due to hospital deficiencies and medical team reasons that most of them are preventable. Several changes like better infrastructural facilities, enhanced interdepartmental communication are suggested to try and reduce the cancellation rate.

Background: Suitable budget allocation of organizational activities can deliver the resources distribution, enabling operational monitoring and providing expected access to the cost results. The aim of this study was to calculate the cost of final units in one of the Armed Forces Hospitals.

Materials and Methods: One of the Armed Forces Hospitals selected in 2013.Data gathered from all cost centers to costs calculation and evaluated based on theory of Activity-Based Costing analysis. General wards and intensive care units, operating rooms, dental, emergency and dialysis were considered as final units. Cost calculation performed using Excel software version 2007.

• Total cost of hospital was 244,416 million rails in 2013 which direct and indirect allocated costs were 52% and 48%, respectively. The CCU, surgery ward, ICU and operating rooms had the highest and clinics and dental had the lowest in case of costs. More than 50 percent of the direct costs of all the units have been spent on manpower except the operating room. After labor costs, medication costs accounted for the largest percentage of direct spending units.

Conclusion: Paying attention to human resources in terms of number and distribution of all units especially in the final units, also considering medications use particularly in middle units and consumables in overhead ones especially can be result in reduction and adjusting hospital costs.

Background: Beside qualified and capable nursing personnel, nursing care development requires motivated nurses to work in an appropriate environment. This study aimed  at determining the relationship between organizational climate and nurses' job motivation in selected Army hospitals of Tehran city in 2015.

Materials and Methods: In this study was a descriptive -analytical and cross sectional one. The sample size consisted of 340 employed nurses in hospitals with at least one year work experience which were stratified randomly selected based on work experience among four army hospitals in Tehran. Data were collected using two questionnaires including job motivation and organizational climate. In order to data .analysis, descriptive and analytical tests such as Pearson correlation coefficient were utilized.

Results: One hundred and eighty nine of participants (55.4%) were female. Mean age of nurses’ average was 32.22 ±9.8 years. More than half of nurses had evaluated group spirit as high level and hindrance, engagement, intimacy, consideration, spacing, thrust and production emphasis as moderate level. There was a direct significant relationship between all components of job motivation and engagement, intimacy, consideration, spacing, thrust and production emphasis (P<0.05). Furthermore, mental and official components of job motivation had an inverse significant relationship with hindrance component respectively (P=0.014, P=0.019).

Conclusion: Regarding the relationship between all components of the organizational climate with job motivation, attempt to improve these components will have significant impact on motivation improvement, reducing absenteeism and job dissatisfaction.