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Showing 320 results for Type of Study: Original Article

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.
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, P0.0001 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.
Dr. Khodakaram Salimifard, Leyla Keshtkar, Mohammadsadegh Moradi,
Volume 13, Issue 3 (12-2014)
Abstract

Background: Emergency department performance can be evaluated in quantitative and qualitative criteria. Some quantitative criteria are considered such as length of stay, patient waiting time, the percentage of patients that treat in a specific time and etc. In this paper the performance of emergency department was evaluated in terms of these criteria. Then four scenarios by using simulations was proposed. Materials & Methods: patient flow was modeled by discrete event simulation (DES) and the simulation was done by Arena software. Data was gathered randomly and patient waiting time, length of stay and the percentage of patients by noticing 6-hour boarding limit for EDs were performance criteria. Result: The result show 70% of patients were hospitalized in ED over 6 hours and it is an important bottleneck. The fourth scenario is that best of the scenarios, that improve in waiting times for hospital admission (85%), total waiting time before hospitalization (63%) and the percentage of the beds utilization (15%). Conclusion: the findings of this paper show that the fourth scenario has greatest improve in the process. In this scenario, to reduce waiting times for patients admitted to the emergency department as well as to reduce the high percentage of occupied beds, 3 beds and 1 nurse were added.
Mohammad Akbari Booreng, Maryam Khodadadi, Majid Akbari,
Volume 13, Issue 3 (12-2014)
Abstract

Background:An organization`s  effectiveness and efficiency is strongly dependent on its staff`s   commitment.  Therefore, identification of organizational commitment and its related variables seems necessary. This study is aimed to examine the relationship between emotional intelligence and organizational commitment.
Materials & Methods: This is a  descriptive correlation survey. Our study statistical population included all administrative staff of in southern Khorasan province` hospitals. 110 samples were chosen by a stratified random sampling. The data were collected by standard questionnaires of emotional intelligence and organizational commitment and analyzed by using descriptive and inferential statistics. 
Results: The results showed that organizational commitment is in the moderate level among administrative staff. There is a statistically significant relationship between emotional intelligence and organizational commitment. There is a statistically significant relationship between emotional intelligence and commitment subcomponents(normative and emotional commitment). By performing  multiple regression analysis ,the outcome showed among the all  emotional intelligence subcomponent ,solely “self-awareness” can predict organizational  , emotional  and normative commitment .
Conclusion: Improving individual's emotional intelligence should be taken into consideration due to the  strong bond between  emotional intelligence and organizational commitment.

Mahboubeh Asadi, Seyed Saeed Tabatabaee, Saeed Khayatmoghadam,
Volume 13, Issue 3 (12-2014)
Abstract

Background & objectives: one of new and unique tools for survival of organizations among their competitors having comprehensive knowledge of all the environmental factors affecting the organization, means organizational intelligence, that with its measurement Strengths and weaknesses of the organization are identified and can affect the performance of organization and in this way, they help to organization in the measurement and evaluating progress in achieving its goals. Materials and Methods: This descriptive analytical study was performed in 12 general hospitals affiliated to Mashhad University of Medical Sciences in 2012. Study samples were 375 employees who were selected through stratified sampling method. The study Tool of data accumulation was Albrecht organizational intelligence standard questionnaire and checklist of hospital performance indicators that was determined by the Ministry of Health. To determine score organizational intelligence was used the five-point Likert scale. Data were analyzed by SPSS v.16 using Statistical tests and Pearson correlation coefficient (P=0/05). Results: we found that there was a significant positive relationship between hospitals’ organizational intelligence and all the performance indicators of the exception of “Bed occupancy ratio”, “Ratio of surgeries to operation beds” (P<0.05), and organizational intelligence had the highest correlation with indicators of Bed Turnover Interval (r = 0.739) and the average length of patient stay (0.691) Conclusion: it seems that attention and planning to strengthen and increase organizational intelligence can be effective in improving the performance of hospitals.
Mohammad Khammarnia, Dr Ramin Ravangard, Mohadeseh Ghanbari Jahromi, Asra Moradi,
Volume 13, Issue 3 (12-2014)
Abstract

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.
Farshad Faghisolouk , Ali Valinejadi, Roghaye Ershad Sarabi , Pouran Raeissi,
Volume 13, Issue 3 (12-2014)
Abstract

Background: Hospital as core of health and care system requires an effective leadership style and suitable strategy for organizational differences and conflict’ solving. Main goal of this study is to survey of relationship between leadership style and strategy of conflict management among chief executive officers of Urmia hospitals. Materials and Methods: This analytical-descriptive cross-sectional study was implemented in Urmia hospitals in 2013. Study population of the research includes thirty top managers in ten hospitals of Urmia. Data gathered through three questionnaires (personal and job characteristic leadership style with method of Fiedler LPC and conflict management). Data analyzed through SPSS software, mainly by Chi 2, Kruskal–Wallis and Spearman's Rho tests. Results: Results showed that Leadership style had significant statistical relationship with average of managers work experience (p=0.040). Also age and strategy of control had significant statistical relationship (p=0.01). Leadership styles and strategies of conflict management weren’t significantly with other descriptive variables such as (position, level of education, marriage situation, work experience, managerial studies and second job). Leadership styles and strategy of conflict management weren’t significant relationship, finally. Conclusion: Since that the determination of leadership style and methods of dealing with conflict management in hospitals is important, it is recommended that ever done comprehensive research on the effects of other factors such as organizational culture, social culture, character on leadership style and conflict management.
Reza Ahmadi Kahnali,
Volume 13, Issue 4 (3-2015)
Abstract

Background: The main mission of hospital is to promote care quality for patients and to meet their needs and expectations. The present study aims at identifying and prioritizing the patients’ expectations of the hospital services quality, which is considered to be the first step toward accomplishing such an important mission. Material & Methods: The present study is descriptive and applied. The data was collected through pairwise comparisons questionnaire that was distributed among 150 patients in a public hospital in Bandar Abbas, 104 patients filled out the questionnaire. The obtained data were analyzed by the use of AHP. Results: The results show that among the different dimensions of hospital service quality investigated in the present study, the patients listed 5 main dimensions in order of priority: accessibility (0.251), medical services(0.232), environment(0.202), administration(0.160), and relation(0.155). Among different criteria, access to medicine and blood(0.054) was the first priority and attention to the patient(0.010) was the low priority. Conclusion: Due to the key role of the patients in defining and assessment of service quality, the present study presents a framework for evaluation of hospital service quality according which the priorities of patients were determined. The managers are advised to prioritize the quality improvement practices based on the patients’ priorities in order to satisfy the patients and make the processes customer-oriented.
Dr. Hamid Ravaghi, Dr. Zhaleh Abdi, Dr. Ali Heyrani,
Volume 13, Issue 4 (3-2015)
Abstract

Abstract Background: Hand hygiene is the simplest and most effective preventive measures to reduce cross infection in hospitals. However, compliance with recommended instructions is commonly poor among healthcare workers. The present study aimed to explore potential behavioral determinants of hand hygiene compliance among healthcare workers in intensive care units. Methods and Materials: A qualitative study was conducted, consisting of 42 semi-structures interviews with physicians (attending physicians, non-attending physicians, residents), nurses, nursing students and medical students, who worked in the intensive care units. Results: Participants mentioned self protection as the main reason for the performance of hand hygiene. According to the participants, hand hygiene was often performed after direct contacts and tasks that were perceived to be dirty. Participants were most concerned about knowledge gaps in hand hygiene practice. Most participants believed that having a good theoretical knowledge of hand hygiene guideline may strengthen healthcare workers' attitudes toward hand hygiene. Junior practitioners believed that the superiors' hand hygiene practice could influence their performance both negatively and positively. Participant also believed that the lack of formal and informal control may hinder compliance among healthcare workers. High workload, interruptions, and limited access to hand hygiene products were mentioned as primary barriers to hand hygiene. Conclusion: The findings revealed that a number of factors can influence had hygiene practice. Recommendations of the current study are of value to future researches aiming to improve compliance with hand hygiene behavior among healthcare workers.
Reyhane Shahraki, Alireza Pooya,
Volume 13, Issue 4 (3-2015)
Abstract

Abstract: Background: Recently, hospitals in order to improve strategic and operational work have been under a lot of pressure Nonetheless, lack of taxonomy researches have been noticed in Health care. The purpose is to present taxonomy of health care operational systems and strategies of Mashhad hospitals sections in correct order in the base of their aims and operational decisions and afterwards assign Proportionate strategies and systems with each other. Materials and Methods: Considering its objective, this study is applied. It is exploratory and based on survey regarding its method. 84 samples of remedial hospitals sections in Mashhad have been chosen by chance and after final survey and justifiability implement research to analysis data using from k-means cluster analysis and in order to assess the validity of this analysis, the multiple discriminant analysis has been used. The test of independence was used to assess the correlation between strategies and recognized systems. Results: for each strategies and operational systems 3 clusters have reconnoitered that each of them in a correct order is emphasizing on goals and different decisions. Also the results of performing independence test is expressive the proportion between Leaders of service- centric strategy with operation leading system and cost- based follower strategy with creative cautious system. Conclusion: This study dose not only provides a useful description of the operational situation and operational position of a hospital, but also provides a necessary setting for more professional studies and theorizing.
Dr Mohammad Moosavi Jed, Dr Siroos Ghanbari, Khalil Zandi, Bita Rafeizad, Hamed Seifpanahi, Maryam Noradini,
Volume 13, Issue 4 (3-2015)
Abstract

Abstract: Background: According to reports, the nurses frequently and directly are faced with the deaths, suffering and pain, thus a major mechanism for administrators is empowering of staff. With this approach, the object of study was examining the role of ethical leadership at promote nurses' psychological empowerment. Material and Methods: Considering the purpose of this study, it was applied & considering the data collection methods, it was descriptive –analytical. Statistical population was nurses in working in Sanandaj public hospitals (410 people) and 148 subjects were selected using random sampling. Data gathering tools were two questionnaires: Ethical Leadership (Salehnia: 2012) and psychological empowerment Questionnaire (Wooten & Cameron, 1998). Data analysis was performed by SPSS (Version 16) and Confirmatory Factor Analysis, Pearson correlation test and Multiple Regression (Method: Enter). Results: Results showed that the items of questionnaires can be reduced to the fundamental dimensions. Results also showed that there was a significant relationship between ethical leadership and psychological empowerment. Finally, it was found that components of Pattern and Pragmatism are predictive of psychological empowerment. Conclusion: According to study findings, hospital Administrators can by display appropriate ethical behaviors and efforts to strengthen interpersonal relationships and encourage such behaviors among members provide Contexts improving nurses' Psychological Empowerment
Jafar Sadegh Tabrizi, Saeide Alidoost, Amir Bahrami, Mohamad Asghari Jafarabadi,
Volume 13, Issue 4 (3-2015)
Abstract

Background: Given the importance of quality in health care and meeting the needs of patients, it seems important to measure the quality of services and identify the weaknesses from the patients' perspective. The purpose of this study is to assess the service quality (SQ) of care as perceived by people with Type 2 Diabetes (T2D). Materials & Methods: A cross-sectional study was conducted among 180 people with Type 2 diabetes in diabetes clinic using convenience sampling method in Tabriz, Iran in 2012. Service quality was calculated using: SQ=10 – (Importance ×Performance) based on importance and performance of non-health aspects from the patients' perspective. Validity and reliability of questionnaire was reviewed and confirmed. Independent sample T-test and ANOVA were used to investigate relationship between service quality and categorical variables. Data analyzed bySPSS13 software. Results: The average service quality score was 8.17 of 10. From the participants' perspective, of 12 aspects of service quality, communication and prevention had the highest score for importance. Dignity had the highest score for performance. However, the highest service quality values were for continuity of care, dignity and confidentiality. Conclusion: overall service quality achieved inadequate quality and there is an opportunity to improve quality of care.
Dr Abbas Ziari, Dr Kambiz Abachizade, Dr Maryam Rassouli, Dr Mohamad Ali Haidarnia, Dr Mariam Mohseny,
Volume 13, Issue 4 (3-2015)
Abstract

Background: Different approaches have been suggested to improve the quality of health care and the clinical governance is one of the main models. In the country, Clinical governance is initiated as a national model in 2009 and hospitals were forced to implement it. Only two hospitals of Shahid Beheshti University of Medical Sciences were approved according to evaluation of clinical governance implementation. This study aimed to describe and explain the barriers of clinical governance implementing in educational hospitals of Shahid Beheshti University of Medical Sciences. Materials and methods: In this qualitative study, conventional content analysis has been done. Twenty five participants involved in implementing clinical governance, including nurses, physicians, managers and the experts of hospitals and Ministry of Health, have been selected through purposive sampling method and interviewed in a semi-structural way till data saturation. Data were collected and analyzed simultaneously. Member check and peer check have done for data rigor. Result: Nine themes include human resource challenges, financing resource shortage, incomplete records and documentation systems, inappropriate organizational culture, lack of awareness of managers and employees, incomplete documented policies and procedures, inappropriate monitoring and evaluation, lack of inter-sector coordination and weak leadership were obtained and were placed in two domains input and process. Conclusion: The findings of this study indicate that there are several barriers for implementing clinical governance in hospitals that there is need to prioritize needs and to provide them appropriate solutions.

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