Journal of

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Background: Nowadays, health care section is one of the most important parts of sustained development in human societies because of having relationship with human health. Achieving this goal needs to have healthy and motivational staff, including nurses. We see nurses in all hospital wards who have been interested in their works when entering the hospital, but feel fatigue after several years and may give up their jobs. This survey has been conducted to study of effective factors on nurses' job motivation in Kerman University of Medical Sciences hospitals.

Material and Methods: This is a cross-sectional survey that studies 232 nurses occupied in Kerman university of medical sciences' hospital inpatient wards who were selected by stratified random sampling using a questionnaire which had 31 questions in 5 area: psychological, educational, financial, administrative and welfare factors. For determining the reliability of questionnaire, we conducted a pilot study and its _Krunbakh was 0.92. we used spss11.5 and Kruskal-Wallis and Mann-Whitney tests to analyze data.

Results: The results show the statistical relationships between welfare factor and hospital type (P=0.012), between psychological factor with sex, job experience and marital status (respectively, p=0/002, p=0/043 and p=0/011). But there weren't any statistical relationships between nurses' age and educational status and the studied area of motivation.

Conclusion: In this study, nurses who have following characteristics, have also better motivation status: occupying in hospital B, being married, being man, having master of science degree, having more than 10 years job experience and being between 30-40 years old.

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Background: Organizational Citizenship Behavior indicates an individual cautious behavior that although is not known by formal organizational reward system directly, can have a positive and effective role on the organizational performance and lead to functional improvement. In this study the relationship between Organizational Citizenship Behavior and its determinant factors has been surveyed.

Materials & Method: This is  a cross- sectional study that was done on an accidental sample of 130 staff working in Shiraz University of  Medical Sciences (SUMS). The required data was gathered by using a questionnaire and descriptive statistics and person regression test were applied in significant level of 0.05.

 Results: Results showed that there were statistically positive significant differences   between OCB and organizational culture, personality and internal control focus (p<0.001) in contrast with the reversed and significant differences between OCB and job stress (p<0.001).In addition there were statistically positive significant differences   between various dimensions of OCB with each other (p<0.001). furthermore , between courtesy  and organizational culture, control focus and personality, citizenship behavior and organizational culture, sacrifice with culture and personality and between conscience and culture, the statistically positive significant differences   were observed in spite of the statistically negative significant differences between courtesy, citizenship behavior,  conscience with job stress and also between  conscience and personality(p<0.05).

Conclusion: reducing job stress , existing organizational justice and the group oriented organizational culture and also staff` characteristics the same as personality , control focus, etc can have an effective role on the incidence rate of Organizational Citizenship Behavior shown by staff in Shiraz University of  Medical Sciences . So attention to each of these dimensions and key factors and attempts for amplifying and supporting them by managers can develop these behaviors and lead to functional improvement in the organizations.

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Background: The inefficiency of financing health care in developing countries made led in manyhealth policy-makers to consider alternate means of service provisions. Outsourcing public financed health services in private sector organization is one of the interventions. Advocates claim that the contracting out of health care services will improve the service delivery performances throughstimulating competition among providers and also by creating economic incentives to improve performance through linking payment to provider performance. Materials and methods: The purpose of this cross sectional study was to provide decision matrix to guide decision-makers whether outsource hospital services or not. Tow kind of questionnaire were developed and used. Results: Findings showed that the most propensities of outsource is in nutrition services (87%), and the least is in nursing services (43.4%) based on administrators’ attitude. Shaping of decision matrixshowed propensity to outsourcing of nursing, radiology, laboratory services are high while nutrition services is been low.some differences between results of decision matrix and administrators’ propensity to outsourcing in radiology and laboratory services. Lack of attention in characteristics of the hospital services might be one of the reasons. Cost saving is the main reason for outsourcing the services while administrators should consider as an effect and side effect ofoutsourcings

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Abstract Background: Hospital managers' decision-making styles indicate the usual pattern managers use to make their decisions. This paper is aimed to determine the variety of managers' decision-making styles` in public and private hospitals in Shiraz. Materials & Methods: In this cross-sectional study, 106 administrative, financial, internal and nursing managers were selected from 28 public and private hospitals through census sampling technique to participate in this study. The data were collected by a 22-item questionnaire (α = 0.86) and analyzed using T-Test and ANOVA in significance level of 0.05. Results: Studied managers used rational decision-making style more often than avoidance of decision-making style. Older and official managers and private hospital managers used the intuitive decision-making style more often.Managers who had not attended management training courses used the intuitive and dependent decision-making styles more often. Managers who were teaching in the fields of nursing and midwifery used rational decision-making patterns more often. Conclusion: It seems necessary to provide sufficient ground for scientific and evidence-based decision making for all hospital managers. Therefore identifying present obstacles and providing an environment in which managers could improve their decision-making skills is recommended.

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Background: Nowadays, Medical error as a major challenge has been attention of health authorities and community. The main purpose of this study was survey of medical errors in Shiraz public hospitals. Materials & Methods: This study was a survey which conducted as analytical in 2013. Study population was Shiraz public hospitals which 10 hospitals were examined. Standard checklist was used for collecting data of medical error documentations. Data entered in SPSS software version 21 and used of descriptive, spearman and chi-square test for data analysis. Results: the number of medical errors in hospitals during the one year was 4379 recorded and the most of error was related to larger hospitals. Nurses committed wrong more than other groups and systemic error had the highest frequency. There was a significant relationship between trespassing, time and type of error, (P=0.000). Moreover, there was a significant relationship between type of error with wards and hospitals). P=0.000, P=0.011 respectively) Conclusion: The number of errors occurring in hospitals is symptoms of poor performance, therefore to prevent and reduce the medical errors and costs, managers should pay more attention to hospital performance and treatment guidelines are revised. Moreover, the hospital staff, especially nurses should pay more attention to their activities.