Journal of

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Background: The admission department as a first point of patients contact with hospital needed special attention. This study has tried to estimate number of needed personnel with work measurement of general functions of admission department.

Material & Methods: This study was a descriptive-analytical and practical research. This study tried to measure real and expected time and determined difficulty degree and skills needed for each task of admission department, then determined total work units and needed personnel in admission department of Children's Medical Center affiliated with Tehran University of medical sciences in 2009.

Results: Total work units in admission department were approximately 10780 units for one month. Counting at least 987 units for every person per month, the number of human resources needed for this unit was 11, while current number of human resources in this department is nine.

Conclusion: Finding of this study show that  Children's Medical Center  involves with inadequate human resources and  multiple pressure  due to insufficiency  in mentioned department, and tries to promote the  technology using in this department and increase the personnel and reset the  payment  system based on work load

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Background: Hospital is the most expensive part of a health system. Manpower is the mainly valuable factor in productivity and service delivery. Since personnel costs make up more than 60% of hospital costs, increasing productivity and efficiency of human resources are significant. The most important ways to increase utilization of this valuable resource is to standardize the quantity and composition of the human distribution. This study determined the standardizing of nurses resources in a sample hospital.

Materials & Methods: The descriptive and cross-sectional study applied in 2008. Data of study collected by questionnaires and library studies by using descriptive statistics were analyzed. Sample of study is the private general hospital with 85 active beds, including gynecology, surgery, men and children, women, surgery, neonatal intensive care wards. Data collection tools were tables containing the number and composition of nurses and hospital performance indicators. After gathering data, it compared with the standards and recommendations were conducted. Using standard of job hours of nursing care required for each group of patients and protocols of Ministry of Health and Medical Education.

Findings: The numbers of nursing staff in the hospital were 96 people, including 38 nurses, 16 assistance nurses and 42 aid nurses. The optimum numbers based on average annual bed occupancy in different sectors were: 94 nurses, including 60 nurses, 34 assistance nurses and aid nurses.

Conclusion: A sample hospital uses healthcare workers as an aid nurses to assist in a wide range of patients' care. With regard to development of medical sciences and become more specialized nursing care industry and major changes in techniques and equipments, to move on from traditional invasive surgical procedures to non-invasive medical practices and the incidence of further complex cases, it will be effected to replace them with educated nurses to care of patients.

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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: Today, the lack of financial protection against the health costs is recognized as a major flaw in the health systems. It seems that the first step towards solving this problem is exact identification of household health expenditure`s components which will result in better selection of prevention policies and appropriate procedures to solve the problem. Materials and Methods: This study is a qualitative research conducted in two stages. The first stage consisted of interview with a sample formed by households from eight provinces of the country to identify the different components of household health expenditure. After that, a panel of experts categorized the identified components to direct and indirect costs. Results: In The first stage, 93 kinds of households’ health expenditure were identified. In the next stage, 61 cases of these were categorized as direct costs and the other 32 cases were categorized as indirect costs. Conclusion: The exact identification of the components of health expenditure of households and dividing them into two categories of direct and indirect costs can be useful for a more accurate calculation of the household health expenditure in future studies.

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Background: Managers can provide manpower motivations activity contexts and real efficiency through identifying and anticipating according to organizational goals. Since, today’s working motivations have not been realized in hospitals, this study aimed at determining and comparing the importance of hygiene-motivational factors in both Kosar and Faghihi hospitals in Shiraz. Materials and Methods: In this cross-sectional survey, study populations included all staffs of Kosar and Faghihi hospitals in Shiraz. One hundred fifty selected by stratified randomly sampling participated in the study.The study questionnaire was designed based on Herzberg theory. Questionnaire validity proved by available experts and Cronbach alpha calculated 0.95. Statistical analysis was done using SPSS software and independent t-test. Results:The most important hygiene factors were "job security" and "supervision" and the most significant motivational factors were "success" and "appreciation". Hygiene factors are more important than motivational ones in both hospitals. Hygiene and motivational factors had more mean score in Kosar hospital compare to Faghihi hospital. Conclusion: In the Kosar charity hospital hygiene-motivational factors were significant more than faghihi governmental hospital from the staff viewpoints. Hence, the directors of the hospitals should organize appropriate incentive actions owing to differences in terms of ownership toward quality improvement and efficiency of hospitals.

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Background: The goal of clinical risk management is to improve the quality of health care organization’s services and to ensure patients' safety. Thus, this study has identified and evaluated the potential failures by Failure Mode and Effects Analysis (FMEA) approach to eliminate errors occurrence of an Intensive Care Unit (ICU) in a hospital in Tehran city.

Materials and Methods: This study is a descriptive one in which data were gathered qualitatively by direct observation, document review, and Focus Group Discussion (FGD) with the process owners in an Intensive Care Units (ICUs) of a Tehran non-governmental hospital in 2014. According to FMEA method, quantitative data analysis was carried out based on failures’ Risk Priority Number (RPN).

Results: By FMEA, 378 potential failure modes in 180 ICU tasks were identified and evaluated. Then, with 90% confidence, 18 failure modes with RPN≥100 are identified and analyzed as non-acceptable risks totally.

Conclusion: Identifying 18 failures as non accepted risk from identified 378s, and identifying causes, analyzing and then suggesting correction actions reveals the FMEA high capability to identify, evaluate, prioritize and analyze potential failure modes in a such complex and critical hospital ward(ICU).

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Background: Activity-Based Costing Analyzes the Activities Performed in the Service Delivery Process and Accurately Identifies Costs to Improve The Performance and Efficiency of The Delivery Units and Calculates the Cost of Each Activity by Identifying Services and Activities. The Purpose of This Study Was to Calculate the Cost of Radiology Services Based on Activity Based Costing Method In Firooz Abadi Hospital.
 
Materials and Methods: This is a descriptive retrospective study conducted in 2018. Data were collected through interview with Hospital officials, direct observation and from existing documents in hospital. Data entry was done through Excel software and analyzed Based on activity-based costing system in eight steps.
 
Results: Based on the Findings of this Study, Four Types of Imaging Services Were Commonly Found In Firooz Abadi Hospital. From Total Radiology Costs, 79.3% Were Estimated to Be Related to Direct Costs and 20.7% to Indirect Costs. Finally, the Cost Per CT Scan Service Was 725,133 Rials, Mammography 608,054 Rials, Radiology 809,165 Rials and Ultrasound Service 512,692 Rials.
 
Conclusion: Results of the Study Indicated that Direct Costs accounted for most Costs in Radiology Unit, So Improving Performance and Policies in Health System, Particularly in Human Resource Management, Service Consumption Standardization and Staff Training Suggested to Cost Reduction.