Journal of

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Background: Learning and teaching is a bilatheral connection between student and teacher ,so evaluation of both of them is an important necessity in academic Institues.if we accept that teachers ability lead to effective learning in students or their unability can reduce education outputs, so we conclude that teacher,s function score must be related with student,s educational function score.
Material and Methods: This study is a descriptive correlation study .all of faculty members , were teaching special courses ,and 62students in second semester of 85-86 from librarian, medical records and health care management majors were contributed in study. teacher,s evaluation score and student,s mean scores were provided through educational chancellor of university. Anlyzing was done by spss software ,and use of descriptive statistic and correlation index.

Results: Evaluation mean score of teashers and mean score of student,s courses were different in 3 educational groups. correlation between of teacher,s evaluation scores and student,s mean scores was adverse and was,nt sicnificant.(r=-0/095 in health care management),(r=-0/1in med.records),(r=-0/6in libererian).

Conclusion: We accept that teachers ability can lead to effective learning in students or inability can reduce education outputs.in this study There was no significant relation between of two variables.so we conclude educational system must notice more and more to evaluatin tools for accurating, richment and updating those.

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Background: of this study try to determine the Relationship between organizational culture & organizational Maturity of staffs in Isfahan Medical University Hospitals (IMUHs ).

Material and Methods: Three questioners (organizational culture , organizational Maturity) was used for accomplishment of this descriptive & Corelational research.The reliability of These questioners was assest with the cronbach alpha coefficient .this questioners were distribute between 360 employees of IMUHs .Data was analysed by SPSS software.

Results: Funding showed that the organizational culture scores of 5 hospitals were average & 6 hospitals were lower than average . The level of organizational Maturity was average .

Conclusion: There was a significant relationship between organizational culture & organizational Maturity .Hospital Manager should change their organizational culture in order to increases the level of organizational Maturity .

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Background: If a managers try for further income or productivity so they must attentive their staff incentive. One of the most issue in the management process is that managers can distinguish strength of staff but they can't determine their weakness . ACHIEVE model present seven factors ( ability, clarify, help, incentive , evaluation, validity , environment ) that effective to staff performance . and this model help manager to determine cause of performance problem. And create change strategy for solving those problem .
Material & Methods: It is descriptive , survey and inferential study , the population is university hospital managers in Esfahan university. data is gathered through achieve questionnaire that supported by member of management faculty.The reliability is supported based on α koren bakh . for analysis of data use spss soft ware .
Results: Finding show that : Average number of ability factor is (87/5+12/2) , clarify factor (82/3+14/8), help factor (82/6+15/7) , incentive factor ( 81/4+ 15/4), evaluation factor (77/2+15/6) , validity factor (82/7+ 17/3),and environment factor is (85/2+12/8). and base on Pierson test (p<0/05) all of the factor are effective on staff performance.
Conclusion: Today the important problem in health care organization is staff effectiveness . in fact , performance improvement is the most step for organization improvement.

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Background: Multiple environmental factors have roles in producing anxiety. Individualized differences and environmental conditions can affect the anxiety level. So, hospital environment and especially cardiac surgery ward have a great importance because they can save the patient's life.

Material & Methods: The present study is a descriptive- analytical one which has been conducted upon studying the level of anxiety pre and post coronary artery bypass graft surgery in the hospitals of Tehran University of Medical Sciences and preparing an educational program for such patients, was the other goal of the study.

Study population consists of 150 patients under examination that at the time of the study have been voluntaries to coronary artery bypass graft surgery. The sample was studied 24 hours before and weeks after surgery. The sample was selected randomly and data collected through a questionnaire with two separate parts. For the purpose of data analysis, SPSS software was employed.

Results: The result of the study shows that the level of anxiety before coronary artery bypass graft have been more than the level of anxiety after  the operation. The difference between of the levels of anxiety have had significant relations with some of independent variables of the study such as sex, age, number of children and marital status, but there were not significant relations between occupation, educational level, non cardiac disease background, background of MI, non cardiac surgery background, the period of suffering from coronary disease background of hospitalization.

Conclusion: It seems that the men's ability to return to pre-operation socio-economic condition reduces their post operation anxiety. When people become older, they will be more fearful regarding the future's events but people older than 46 years old will obtain more life expectancy after surgery due to more extended familial relationship.

Married people experience less anxiety due to post operation, familial responsibilities and relief of cardiac symptoms. It can be concluded that anxiety reduction in these patients can result from cultural, socio-economic and demographic variables. Believes as cultural factors in the life have a great role in appearance and the level of anxiety.

 

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Background: Reporting of  medication errors  leads to saving Patients &apossafety and also is counted as a valuable information source for further prevention of mistake in future.  The aim of this study was to determine the reasons for refusing to report medication errors from the viewpoints of nurses.

Material and Methods:In this descriptive study, 140 of 200 nurses who were employees of Baharlo hospital of Tehran participated in the study (response rate = 70%). Data were collected through a questionnaire. Test- retest analysis conducted for measuring reliability of the questionnaire and content and face validity of the instrument confirmed by key statisticians and methodologists. . SPSS software and descriptive statistics were used for analyzing the collected data. 

Results:Our findings indicate that the reasons of not reporting medication errors were Management factors (3.68 ± 1.12), Fear of reporting outcomes (3.09 ± 1.68) and Process related to reporting (2.73± 1.26). Management factors domain was the major cause of refuse of reporting medication errors. 

Conclusion:Since medication errors seem to be unavoidable, suppression, decreasing medication error depends on using a systematic approach with emphasis on management and nursing care. 

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Background: Since, multidisciplinary & Combination of different factors that affecting on productivity of human resources are different in organizations due to variation in indoor and outdoor features, so the aim of this study was to prioritize the factors effecting on human resources productivity by viewing of middle level managers to make the basis of human resources management decisions to manpower planning and maintenance for reducing costs due to staff quitting.

Materials & Methods: This cross-sectional & descriptive study was carried out in 2009 .Middle class managers in Isfahan University of Medical Sciences examined as a statistical population. Data collected used by researcher constructed questionnaire that validation was confirmed through interviews with faculty members and experts. Cronbach alpha was calculated for reliability (0/935). Data analyzed by SPSS statistical software the maximum means score was 5 and the minimum was 1.

Results: Management style with a mean score of 4.41 was the most important factors in human resource's productivity. Factors related to individuals with a mean score of 4.3, culture with a mean score of 4.1, organizational structure with a mean score of 4.06, compensation systems with a mean score of 4, courses of training with a mean score of 3.85 and environmental factors that related to physical space with a mean of 3.769 compared to other options had less consequence.

Conclusions: Reforming employment systems and organizational structures, job enrichment, needs of educational planning, devolution to the middle levels managers and decision supervised measuring in the volume and balance with each other  and further fields. Health incentive programs with job skills and staff development can be affected to increase productivity of human resources and promoting health system.

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Background: Payment method is one of the most important control knobs in the health system. All organizations that mobilize funds for health sector must be decided: who should be paid? Why this money should be paid to them? And how much should be paid? So the main purpose of this study is to identify different methods of paying to the doctors in referral system of selected countries, and ultimately providing some suggestions for Iranian social security organizations- direct medical service provision.
Materials & Methods: This was a comparative study designed in 2008. First we studied theoretical issues and analyzed them within the framework of the current situation. Then we conducted a comparative study to find some solutions for it. Then we validated selected suggestions using by Delphi technique.
Results: Most selected countries use a combination of methods to pay to the physicians. Usually for employed physicians in insurance organizations, salary makes a large part of doctor`s income. In countries where GPs play the role of gatekeeper, the per capita payment method has a special room. In American Health Maintenance Organizations (HMOs), based on employment or contractual relationship, they pay physicians by one of three methods: "Per Capita", "Salary Monthly" or "Prepayment". In addition to Salaries (if any employment relationship), specialists usually receive some fees for their Services widely.
Conclusion: Bonus payment in exchange for quality indicators is considered as a recently developed payment method for both GPs and specialists, but due to wide infrastructures, it needs accurate designing and plenty of arrangements.

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Background: Health service providers' attitude profoundly influence quality of patient care and safety, and lead to increase effectiveness, cost controlling and decreasing complaint. This study aims to examine staff attitudes' about patients' safety culture in Noor & Ali Asghar hospitals in Isfahan province.
Materials & Methods: The survey was a cross-sectional study and was done in 2011. Data were collected from all the staff groups in hospital (n=106). A standard questionnaire from Agency of Healthcare Research and Quality (AHRQ) with a =79% is used to evaluate staff attitudes' toward different aspects of patients' safety culture. This study used SPSS 16.0 to perform the statistical analysis.
Results: The response rate for the survey was 89%. The study revealed that 53.7% of the personnel were not reporting errors in 12 months before. Results showed that the average of staff attitudes' scale toward patients' safety culture was (64±5.28) the highest scale was belong to supervisor/ manager expectations & actions promoting patient safety (72.8±15.8) and the lowest one to handoffs & transitions (56.4±14.8).
Conclusions: According to scale of staff attitudes about patients' safety culture and its effect on service quality, doing reengineering of work environment, Patients' Safety Initiatives including personnel collaborative, communication openness about error, designing of education plan and making error reporting should be recommended.

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Background: There are various departments in hospital that produce hazardous, infectious, pathological and radioactive wastes. Utilizing proper methods of waste management is of high priority in order to prevent from releasing these wastes to environment. This study aimed to evaluate waste management efficiency in Karaj hospitals.

Material & Methods: This cross - sectional study was conducted in Karaj during 2011-2013. All hospitals of Karaj had been selected as statistical population of this study (n=8) by census. The data had been collected by separating and weighting produced hospital wastes for 4 month (during one week at each month) and filling related checklists of health ministry. Collected Data had been analyzed using SPSS software.

                               

Results: The daily capita of waste was 4.1 kg per active bed, 5.6 kg per occupied bed  and 9.4 kg per patient. The overall percentage score of present status of hospital waste management was assessed 88% and in 12% which indicate moderate and weak levels respectively. Hospital waste management had been evaluated weak in terms of collection, transportation and personnel but seen from the viewpoint in the separation and temporary storage, it was assessed moderate. However, in terms of disposal, assessment of hospital waste management showed it is in a desirable status.

Conclusion: The present status of hospital waste management was far beyond the expectations  among studies hospitals. Thus, developing an operational plan and monitoring its implementation is highly recommended to. Given the main weakness of hospital waste management was related to production, collection, separation, and transportation, taking these areas consideration  is of high priority.  

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Background: Emergency response of hospitals to deal with disasters is essential to success in providing qualified emergency services. The aim of current study was to evaluate emergency response of hospitals in Karaj against disasters.

Materials and Methods: This study was a cross sectional one which performed among 13 Karaj hospitals in 2013. To collect data, emergency response Checklist WHO (2011) was utilized with 90 questions prepared in 9 domains (Command and control, Communication,  Safety and security, Triage, Surge capacity, Continuity of essential services, Human resources, Logistics and supply management and Post-disaster recovery).  Data analysis carried out using SPSS version 20 with descriptive tests.

Results: mean score of emergency response was 44.17%. The most and the worst dimensions were hospital triage 70.30% and accident reconstruction after the emergency 24.84% respectively.

Conclusions: Based on WHO checklist, only 44.17% of studied hospitals were able to respond disaster events. Planning and providing a systematic framework to deal with disasters is a necessity, and the major role of hospitals should not be ignored in providing services considering its priority in plans and budgets in disasters conditions. 

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Background: providing human resources is one of the most important factors to achieve the organization goals. Human resources are the most valuable aspect in production and service delivery. Staff shortages and excesses can be effective in reducing quality of services.This study aimed at assessing the hospitals' human resources condition from 2001 to 2014.

Materials and Methods: This review article extracted required information from ISI, Pubmed, Scopus, Wiley, Proquest, Emerald, Magiran, SID ,Iranmedex, Google, Google scholar and other related database considering keywords Human resource, Human resource management, Staff, Workforce, Hospital ,Iran, staff nursing, medical, physician personnel with Persian equation.  Searched Articles Search Based on article objectives analyzed step to step with arrangement with study title, abstract and full text.

Results: Findings revealed that the majority of hospitals faced to lack and inappropriate distribution of human resources especially in medicine and nursing but there was no shortage in logistic, financial, paramedics and allied professional human resources.

Conclusions: Correct and appropriate human resources management, planning due to compensated inadequate human resources and raising them to a standard level can enhance the efficiency and effectiveness of hospital activities.