S Rezaei, T Miraki, N Jahanmehr, F Gharibi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: the using of economic tools such as production function is one of the ways to improving performance and efficient use of hospital resources. The aim of this study was the estimation of production function in educational hospitals of Kurdistan University of Medical Sciences during 2007- 2011.
Material & Methods: the number of inpatient as dependent variable and the numbers of active beds, nurses, doctors and other staffs as explanatory variables was considered. These data For 12 of hospitals since 2007 to 2011 was collected by production form. Also with Eviews software version 6 and panel data, the production function of hospitals was estimated.
Results: the elasticity and marginal of production for all variables explanatory was positive. The marginal of production for bed active, physician, nurse and other staff was 16.7, 54, 23.6 and 40.9 respectively. The total of input coefficient was equal 1.08 and the return to scale was increasing.
Conclusion: according to the positive marginal of production for all variables explanatory, for improving of productivity and efficient use of hospital resources is suggested that the managers of hospitals in exposure to regular and irregular demand can be used elasticity of production.
M Keshavarz, A Akbari Sari, A Rahimi Foroshani, M Arab,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Accreditation is a program that is designed for evaluation of health care organizations and measured processes and structures according to predetermined standards. The purpose of this study is to survey the safety situation and quality of care in selected hospitals of Tehran University of medical sciences based on the Joint Commission International (JCI) standards and determination of their strengths and weaknesses.
Materials and Method: This descriptive, analytical and cross-sectional study was carried out in 5 hospitals. Translated Joint Commission International (JCI) questionnaire checklist with 14 standards was used as the study tool. Data entry and statistical analysis were performed using the SPSS.13 and K Independent Samples tests were used to compare hospitals.
Results: Highest quality and safety of care score belonged to the hospital B (84%) and then to hospitals C (83%), A (72.75%), E (72%) and D (70.5%). Central indices like patient and family rights, quality improvement and patient safety, infection prevention and control standards in the studied hospitals are completely different according to the statistical results.
Conclusion: Study results show that the status of hospitals in terms of safety and quality of care are almost appropriate but in some cases there is a large distance between JCI standards and their current status and the studied hospitals have to make appropriate and related policies in order to plan and implement proper programs to improve their situation in quality and safety of care.
S Rafeiyee, A Pour Reza, A Rahimi,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Human resource management has a critical role in organizations and organization culture is an outcome of human resource management performance. One of the dimensions of the organizational culture is power distance. This study aims to investigate the attitude of employees of selected hospitals of Tehran University of medical sciences towards the power distance in the organization and its consequences.
Materials and Method: This is a cross sectional study with a descriptive research design conducted in a sample of 306 employees and managers from Tehran University of Medical Sciences hospitals located in Tehran, Iran. A distinctive questionnaire for each group was developed, distributed and collected as a main procedure to gather data. Data were analyzed using SPSS 16.
Results: Study results indicates that there is a positive and significant relationship between power distance and employee participation, organizational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities in the level of 95%(p value<0.05). The moderated multiple regression results also supported the hypothesis that managers’ attitude towards power distance had a significant relationship with their manner with the employees, noticing their qualifications and abilities, giving them independence and responsibility and supporting them in their role.
Conclusion: A limited power distance in an organization will result in more committed and satisfied employees with positive perception toward justice in the organizational interactions and ready to accept job responsibilities and movement toward the organization objectives.
Z Farahnaki, A Pournajaf, A Karami, A Abbasi, M Karchani,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Shift work can be associated with decreasing performance, changing eating habits, getting into conditions such as fatigue and insomnia, developing individual and social life disorders and health problems. This study is aimed to investigate the prevalence of shift work disorders among nurses working in Ilam’s teaching hospitals in order to provide solutions for dealing with these disorders.
Materials and Methods: This is a descriptive – analytical study in which 84 nurses of Ilam’s teaching hospitals had been chosen by simple random sampling. The data had been collected by “Survey of Shift Worker” (SOS) questionnaire and analyzed using SPSS (version 18) and descriptive statistics and Chi-2 test.
Results: Results indicated that shift work disorders are prevalence among nurses. Emotional and Mental problems (96.4%), Social Life (84.5%), digestive problems (81%) have the highest prevalence rate respectively. Nurses who volunteered to work shifts have more job satisfaction than the ones who were obliged to do that (P<0.05). In addition prevalence of problems was far less among nurses who get satisfaction from shift work than the others who do not.
Conclusion: Choosing shift work voluntarily results in more satisfaction with shift work which eventually decrease problems caused by shift work.
H Dargahi, F Forouzanfar, M Bakhtiari, Z Rajabnejad,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Nowadays Medical devices have an important role in diagnosis, treatment, rehabilitation of patients and also in medical education. However, in the recent years usage and maintenance of these devices have not been in a good situation in developing and even some developed countries. Therefore fundamental changes and reprocessing has begun among management and usability of medical devices in these countries. This research is aimed to determine the management situation with the approach of usability evaluation in order to change and reprocess the management system among Tehran University of Medical Sciences general teaching hospitals at 2012-2013.
Materials& Methods: This study was a descriptive and cross sectional research among eight general teaching hospitals of Tehran University of Medical Sciences in 1391. The research tool was a self-made check list consisting of 38 questions about medical devices management condition and Nielsen questionnaire about usability of these devices which were completed by head nurses of CCU, ICU and OR departments with the help of medical devices supervisor in 56 departments of these hospitals. Data were collected and analyzed by SPSS software.
Results: We found that medical device management and the usability of these devices were not in a good situation in these hospitals as well as usage of electronic information technology.
Conclusion: Regarding the results of this research specially in the usability of medical devices, we recommend that users and supervisors of medical devices should be trained about usability criteria and evaluation procedures of these criteria, and the relationship between management styles and applications of quality improvement and pay attention to reprocessing of medical devices management among hospitals administrators and healthcare policy makers to select and purchase the best devices.
J Beikzad, A Hoseinpour , M Hejazi Bavil ,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Responsibility and job satisfaction are important issues. This study is aimed to investigate the relationship between responsibility and job satisfaction of nurses working in teaching hospitals of Tabriz University of Medical Sciences.
Materials &Methods: Statistical population includes, nurses in teaching hospitals of Tabriz University of Medical Sciences. 316 samples had been selected by stratified random sampling. The data had been collected through a questionnaire and analyzed by using SPSS software.
Results: There is a significant relationship between responsibility and two dimensions of job satisfaction (job satisfaction and promotion satisfaction) but there is not significant relationship between responsibility and other three job satisfaction dimensions (satisfaction of supervision and monitoring, satisfaction of colleagues, satisfaction of salaries and payments).
Conclusion: Responsibility is an accurate predictor of performance in wide range of occupations .It has a significant relationship with job satisfaction. The more a nurse feels responsible for her or his duties, the more efficient she or he is in delivering health services to patients .Therefor nurses feel more satisfied of their jobs.
J Saeidpour, M Ghazi Asgar, H Rahmani, M Khoshkho,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Educating patients and improving their self-care skills are main factors to achieve maintaining and improving health as health care organizations prime priorities all over the world. This study is aimed to assess nurses and doctors viewpoints on obstacles and facilitators of educating patients.
Materials and Methods :This quasi experimental research were undertaken in Kermanshah Razi hospital.85 nurses and doctors were selected by Simple Random Sampling method. The data were collected by a questionnaire based on Likert scale consisted 32 questions in 3 parts. Validity and reliability of the questionnaire were confirmed by Content validity and Test-Retest methods respectively.
Results : Shortage of nurses and lack of sufficient financial resources among inhibiting factors and holding seminars on teaching and learning strategies and also considering educating patients as a annual evaluation determinant among enhancing factors were the most important ones .
Conclusion: Providing efficient resources and facilities and running personnel`s training courses seems necessary to overcome current obstacles.
M Hosseini, M As’adi,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Conducting further research on medical tourism as a lucrative business is required. Very little research has been conducted into medical tourism barriers and a large amount of them just note structural barriers. This study is aimed to identify the most important communicational barriers of medical tourism and provide and examine a model of such barriers considering medical tourism`s intercultural nature.
Materials & Methods: This study is applied by purpose and survey by method. The three stages in completion of this study are : 1) Identifying the most important communicational barriers of medical tourism in Iran,2) designing a model of identified barriers by using interpretive structural modeling approach 3) examining the designed model in a sample of 300 individuals.
Results: Correlation test indicates a positive and significant relationship between variables in less than 0.01 significant level. Regression analysis confirms that all independent variables are significant predictor of the dependent variables .Therefore all hypotheses are confirmed.
Conclusion: This survey identified main medical tourism communicational barriers in Iran as: Lack of understanding, Perceived linguistic difference, Lack of trust, Perceived cultural difference, Prejudice, Stereotyping. Overcoming to Lack of understanding as the major obstacle has a dramatic effect on operating medical tourism.
Keywords: Communicational Barriers, Medical Tourism
M Hosseini, M As’adi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Conducting further research on medical tourism as a lucrative business is required. Very little research has been conducted into medical tourism barriers and a large amount of them just note structural barriers. This study is aimed to identify the most important communicational barriers of medical tourism and provide and examine a model of such barriers considering medical tourism`s intercultural nature.
Materials & Methods: This study is applied by purpose and survey by method. The three stages in completion of this study are : 1) Identifying the most important communicational barriers of medical tourism in Iran,2) designing a model of identified barriers by using interpretive structural modeling approach 3) examining the designed model in a sample of 300 individuals.
Results: Correlation test indicates a positive and significant relationship between variables in less than 0.01 significant level. Regression analysis confirms that all independent variables are significant predictor of the dependent variables .Therefore all hypotheses are confirmed.
Conclusion: This survey identified main medical tourism communicational barriers in Iran as: Lack of understanding, Perceived linguistic difference, Lack of trust, Perceived cultural difference, Prejudice, Stereotyping. Overcoming to Lack of understanding as the major obstacle has a dramatic effect on operating medical tourism.
Aa Nasiripour, Hr Pasha, Kha Mohammadzadeh,
Volume 13, Issue 1 (6-2014)
Abstract
Backgrounds: Explanation of Cognitive empowerment & Human Sources Productivity is
theoretically & practically important . This research is aimed to examine the relationship between
psychological empowerment of staff with human resources’ productivity.
Materials & Methods: This study is applied by purpose and survey by method and correlation was
used to investigate the mentioned relationship . The statistical population consist of administrative and
financial stuff of Hashemi Nejad hospital. The data were collected by questionnaire and interviewing
and observing. Two types of questionnaire had been distributed among statistical samples for testing
survey’s hypotheses witch their questions were based on Likert scale of seven. First questionnaire’s
reliability was 0.95 and second one was 0.93. Due to achieve survey’s objectives, both analytical and
descriptive statistic had been used.
Results: using Pearson correlation coefficient, the survey’s testing hypothesis showed a significant
correlation between component of cognitive empowerment and four variables of human recourses
productivity (organizational commitment, organizational participation, job creativity and job
satisfaction). The relationship between the empowerment component and four other variables were
0.95, 0.90, .0.86 and 0.85 respectively.
Conclusion: using effective psychological empowerment components can play a major role in stuff’s
productivity.
H Yaghfoori , A Sahrai , S F Khalifelo ,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: Zone 3 of Zahedan City includes the most deprived areas in province and country. The purpose of this research was assessing the distribution of the health care center (hospitals) and determining the underserved areas based on hospital locating concidering standards and criteria.
Materials and Methods: In order to achieve accurate results based on GIS software, spatial and descriptive data using statistics and field observation gathered and connected to database. Besides, AHP Model used to set priorities in locating the optimal urban spaces for building hospitals in the city.
Results: Suitable zone with special symbol severance divide from another zones was determine to develop landuse based on dependency to health care centers aimed at providing services in local level . Similarly, two Places recommended constructing health care centers in complete suitable zone. Unsuitable and compeletly Unsouitable zones was determined in zone three of zahedan city in finaly map.
Conclusion: study analysis based on urben percapita, population and needed availibilty to health care centers suggests that Zahedan city need two new hospitals setting which has been indexed on final map.
M Arab , M Sharifi , M Mahmoudi , B Khosravi , R Hojabri , A Akbari Sari , B Ahmadi , F Eftekhar,
Volume 13, Issue 2 (8-2014)
Abstract
Background:In recent years, clinical governance introduced as amodel to determine continuous quality improvement principals in health services. This study considers assessing the readiness of selected hospitals clinical governance programsimplementation by using CGCQ instrument.
Material and Methods: The survey was conducted in 14 private and public Hospitals in order to assess hospitals’ readiness to clinical governance programs implementation in Tehrancity. In this regards, 800 health professionals including physicians and nurses were inquired. Collected data analyzed by SPSS17 using correlation coefficient, mean comparison and descriptive tests.
Results:Based on study results, both private and public hospitals had readiness to implement clinical governance program. Results of field survey revealed mean score of organizational climate of clinical governance (3.14) is higher than average score (2.5) in selected Hospitals.
Conclusion: This survey demonstrated the necessary readiness to implement clinical governance programs is in an acceptable rangein assessed hospitals. Moreover, there is a big effort to use a unique and comprehensive strategy with the intention ofcontinuous quality improvement in health services.
E Zarei , F Farzianpour , B Pouragha , P Abbasi Borogeni , M Mohammadzadeh ,
Volume 13, Issue 2 (8-2014)
Abstract
Background: Identification of development needs is a first important step in a systematic management development effort. This study aimed at assessing management development needs from the viewpoint of middle managers of hospitals affiliated to Tehran University of Medical Sciences. Material and Methods: This cross-sectional study was conducted in the hospitals affiliated to Tehran University of Medical Sciences. The population study was 227 of middle managers employed in 16 hospitals. Data were collected using a 42-items questionnaire which its reliability and validity was confirmed. Data were analyzed using main components analysis in software SPSS17. Results: designing and innovation indicator among managerial roles, human skills indicators in managerial skills, psychological abilities among managerial talents, social trust in personal characteristics, comprehensive thinking indicator in philosophic mindedness and leadership in managerial knowledge components were the most important from the perspective of the middle managers Conclusion: managers play the specific managerial roles in order to perform their managerial tasks. They need to develop administrative skills, abilities, knowledge, personality and philosophic mindedness to play the best managerial roles.
Sh Nosratnejad , A Purreza , M Moieni , H Heydari ,
Volume 13, Issue 2 (8-2014)
Abstract
Background: Nowadays Social health insurance does not cover all health expenditures because of increasing cost of diagnosis and treatment services which results in private insurer entry to health market. This study is aimed to determine key indicators which have important effect on the demand for private health. This identification of indicators leads to better planning for prospering private health insurance.
Material & Method: This is a a descriptive and analytical study. The data were collected by questionnaires which has been filled by a sample of 950 households .The samples had been chosen by three-stage cluster sampling. The model had been estimated by econometric methods based on models of Probit and extreme value distribution..
Result: The result indicated that having basic health insurance, doing exercise each day routinely, having regular medical checks, being landlord and being retired raised the probability of demand for private health insurance. On the other hand, demanding private health insurance is less common among older adults and people who use to wear seat belts.
Conclusion: Identification of important factors which influence the demand for private health insurance would assist policy makers to provide essential structures for expanding private health insurance coverage.
S J Tabibi, S Heidari , A A Nasiri-Pour , M Hosseinishokouh , A Ameryoun , F Mashayekhi ,
Volume 13, Issue 2 (8-2014)
Abstract
Background:Hospital is the most important health care services provider center.Undoubtedly, properand effective management performance can be very important. This study aimed at assessing professional and non-professional managers’ performance among selected hospitals in Tehran.
Materials and Methods: In thisdescriptive study the population was staffs of ten selected hospitals in Tehran. With the intention of performing the study, a 41-items questionnaire was used which confirmed its validity by experts and its reliability by Cronbach alpha(=90).After data entry in SPSS software,frequency distribution tables, diagrams and central tendency and dispersion were used. With the intention of measure probable correlation Contingency Correlation Coefficient - C was utilized.
Results:The comparison betweenprofessional managers’ responses with non-professional ones revealed an incremental trendfrom “seldom” to “always” in all domains of management functions (including planning, organizing, coordinating and control)and Contingency Correlation Coefficient - C indicated statisticallysignificant relation between domains and types of managers (professional and non-professional)P = 0.003, P = 0.006, P = 0.001, P0.0001 respectively.
Conclusion:Managers’ professional education is inevitable for hospital managing duties.
Rahmani, Eftekhar, Saeedpour, Sharifi , Hojabri,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: This study attempts to review dimensions and indicators of organizational culture in Petroleum Industry Health Organizations utilizing Denison navigation framework and provide practical solutions to improve the situation based on strengths and weaknesses identification.
Material and Methods: Thisapplied study was a descriptive - analytical one which performed using field assessment.Population study included all staffs of the organization's headquarters in Petroleum Industry Health Organization using systematic random sampling based on employeeslist and 110 staffs were selectedfinally. SurveyingOrganizational Culture Denison (DOCS, 2007) was used for data collectionin which the overall cultureOrganization and its characteristics and indicators were measured and the results compared with the global average.
Results:The overall score of the corporate culture was in the middle status (2.8) and score of four maincharacters had fluctuation in the range 2.6 to 2.9. Fundamental values (3.1) had the most score and customer orientation (2.2) and development of capabilities (2.4) obtained the least scores in 12th indicators which these two indicators were identified as significant points to improve organizational culture.
Conclusion:The scores revealed considerable distance with average global rates, but the scores are similar to other Iranian studies. The weakness of organizational culture in two indicators including “customer orientation” and “development of capabilities”can affect optimal organization performance through organization's compliance ability with environmental changes
F Akbari Haghighi, Z Koohi Rostamkalaee, A Pourreza , A Rahimi Forshani ,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: Organizational commitment is an important occupational attitude which demonstrates personnel staffs liability for their organization. This study aimed at assessing the level of nurses’ organizational commitment in selected hospitals of Tehran University of Medical Sciences in 2011.
Materials and Methods: In this cross - sectional study, 363 nurses with BS and MS degree who employed in selected hospitals of TUMS were chosen using random sampling method. Data were collected using a 2-section questionnaire including demographic variables and organizational commitment. With the intention of data analysis, descriptive statistics, independent t -test, chi square, Kruskal-Wallis, Mann-Whitney tests were conducted. Significant level assumed at 0.05.
Results: Study results confirmed that organizational commitment and its all dimensions (affective, continuous and normative) were in moderate level (65.87± 15.32). The Level of organizational commitment had significant relation to job position (P<0.001), ward type (P<0.001), years of experience (P=0.03), and the hospitals (P=0.004). There was no significant relationship between demographic variables and organizational commitment (P>0.05).
Conclusion: Since, None of the demographic variables revealed significant association with organizational commitment and occupational and organizational factors had significant relation with organizational commitment, it seems that personal factors should not be considered as the main criteria of recruiting committed nurses
L Vali , M ,amini Zade, T Sharifi , N Oroomiei , S Mirzaee , R Ghorbani Nia ,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: EMS technicians are faced with numerous stressful situations during a working day. These mental tensions may significantly effect on delivered services quality actually. This situation can be considered as a threaten risk for people who use the EMS. This study aimed to determine the most common stressful factors influencing the EMS technicians in Kerman.
Materials Methods: In this cross-sectional study 140 EMS technicians participated. Sampling method was census and data collection was done by using a valid and reliable nursing tension factors questionnaire. Data analyzing was performed by SPSS software version 19 using Pearson correlation coefficient, Spearman and regression tests.
Results: The most and least common stressful factors were patient care (Mean=3.24) and environmental tension (Mean=2.64) respectively. Regression analysis revealed significant relation between age and environment tension factors (β = -0.155, p=0.034,) and managerial stressful factors had significant relation with gender (β= -2.955, p= 0.047) and educational level of EMS technicians (β= -0.23,p=0.05).
Conclusion: Patient care and personal factors cause stressful situations among EMS technicians. Therefore, it is recommended emergency managers to provide strategies toward decreasing job stress in order to improve the quality of working life and organizational commitment to help EMS technicians.
A Outofi , E Kharazmi , A Yousefi , A Heidari ,
Volume 13, Issue 2 (8-2014)
Abstract
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.
Alireza Hatam, Sajad Rezaei, Leila Kouchaki Nejad, Shahrokh Yousefzadeh,
Volume 13, Issue 4 (3-2015)
Abstract
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.
