Journal of

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Background: Various studies have highlighted the importance of accreditation as a ubiquitous performance measurement system of hospitals. However, the effectiveness of this mechanism has not been addressed, as much it deserves, in developing countries. Therefore, current study intends to investigate the performance of the system using the SERVQUAL model.
Material and Methods: This research is an applied and cross-sectional survey. Decision-making Board of Hamedan Hospitals (N= 200) constitutes the target group. A self-administered questionnaire including both structured and open-ended questions has been used for data collection. Analysis of the quantitative and qualitative data was conducted using SPSS and Thematic Content Analysis (TCA), respectively.
Results: Only 39 percent of the target group had high awareness of current accreditation programme. The highest rate of gap, 55.8%, between the group's perceptions and expectations from accreditation system, belonged to the indicator of staff's satisfaction and the lowest rate, 17.3%, to structures and establishments.
Conclusion: The low score of the target group's perceptions towards the accreditation programme could be a sign of the low degree of their satisfaction, which might result in their poor cooperation. More and effective attention to hospital managers' views, recommendations and reactions might be an appropriate preventive solution.

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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: One of the necessities of hospital administrations is that the top and middle managers should be familiar with leadership styles and conflict management strategies completely and select a right managerial method. Through this, they can actively play a significant role in improving effectiveness and efficiency of hospital performance. The main objective of this research is surveying the relationship between Fidler's LPC score (as a sign for leadership style) and conflict management strategies (avoidance oriented, solution oriented, control oriented).

Materials and Methods: For surveying leadership styles Fiddler's Least Preferred Coworker questionnaire and for surveying conflict management strategies, another questionnaire was used. The reliability of these two was 0.90 and 0.88 respectively. The survey population was consisted of the high and middle managers of Kerman's educational hospitals (81), and a sample 67 individuals was selected for survey.

Results: The result showed that respondents mostly use communication oriented style and employed conflict management strategies are avoidance, solution and control respectively. Also it was observed that there is a positive and significant relation between LPC score and avoidance and solution strategies (r= 0.512 and 0.298 respectively). But there is a negative and significant relation between LPC score and control oriented strategy (r= -0.474).

Conclusion: According to the findings it is suggested that, the reasons of using avoidance strategy should be surveyed and try to encourage people to state their inconsistent ideas and converse freely. This could help organization to improve its performance. But communication oriented style is suitable and its maintenance should be taken into consideration.

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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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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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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.

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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.

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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.

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Background:  hospital is one of the most key institutions in the modern health care system and accountability is the most essential organizational functions. Accountability strengthens the main factors to responsibility regarding functions by pushing them up. This study aimed at assessing the situation analysis of  performance accountability in teaching hospitals affiliated to Tehran University of Medical Sciences

Materials and Methods: This descriptive and analytical study performed at 12 teaching hospitals of Tehran University of Medical Sciences in 2013. Data collection performed by performance accountability checklist. Analysis was done by SPSS software version 19 using descriptive and analytical statistics test (Pearson correlation coefficient).

Results: In general, the condition of accountability for hospitals' performance (Mean =1.5 from 2) measured "good"(moderate to high). Strategic planning dimension achieved the highest score (Mean±SD:1.85±0.21) and Stakeholder Participation had the lowest score (Mean±SD: 1.12±0.46). There was a positive significant correlation between all variables (except Motivation) and performance accountability.

Conclusion: Weakness in any part of performance can affect other parts and have negative impact on total hospital performance. Mentioning the current situation of accountability for hospitals' performance and its importance, reinforcing weak dimensions and addressing deficiencies in  performance accountability should be consider as managers' top priority.

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Background: Strategic plan in hospitals will not be run spontaneously and managers encountered with some barriers in order to have a successful strategic planning implementation. This study aimed at recognizing the barriers of strategic plan implementation from hospital managers' perspective.

Materials and Methods: This cross-sectional study was performed in all Kerman hospitals in 2014. Fifty three individuals including chairmen, internal administrators, quality improvement managers, matrons and strategic plan executers participated by census sampling method. Data was collected using a questionnaire including demographic information and human, processes, structures and institutions factors affecting the strategies implementation. Data analysis was performed by SPSS software version21.

Results:  Study results revealed that the barriers to strategic plan implementation were structural factors (27.71±6.68), process agents (19.54±10.06), human factors (19.09±5.37) and institutional factors (15.73±4.52) respectively. There was no significant association between management background and barriers of strategic plan implementation in hospitals (P < 0.05).

Conclusions: In order to achieve desired results, chairmen and hospitals managers should be entirely conscious about barriers /failure factors of strategic decisions concerning foresight and appropriate managing or approaches change during strategic management process implementation. 

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Background: Providing high quality, safe and effective health care services requires competent and motivated employees. Employee’s creativity plays a significant role in motivation and health care system productivity. Various individual and organizational factors influence employees’ creativity. This study aimed to examine the relationship between managers’ leadership style and employees’ creativity in Qazvin hospitals.

Materials and Methods: Creativity and leadership questionnaires were used to conduct this descriptive and cross-sectional study. The questionnaires were distributed among 800 employees in ten hospitals using stratified sampling method. Descriptive and analytical methods utilized for data analysis using SPSS software.

Results: The mean score of hospital employees’ creativity was 47.5 out of 60 (moderate level). The prevalent leadership style of managers was transformational. There was a significant statistical association between employees’ creativity and managers’ transformational leadership style.

• Since, leadership styles of hospital managers influence employees’ creativity, they have to apply appropriate leadership style to motivate employees and develop their creativity in order to improve hospital productivity.

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Background: In the current turbulent world of business, organizations have to try and compete to identify, recruit and retain the most qualified managers as a competitive advantage. The aim of this study was to investigate the relationship between leadership competencies of managers and administrative staff with the performance of hospitals.

Materials and Methods: This descriptive correlational study was conducted in2015. This study was done in a public teaching hospital, a public non-teaching hospital and a private hospital in Tehran that were general and in average size. The study population was head for all units and departments in accordance with accreditation standards. Sampling methods was Census and leadership competencies using clinical leadership competency framework(CLCF) questionnaire and hospital performance using evaluation scores based on national accreditation standards in2014 that were used in2015 as the basis for the ranking were assessed. Data using Pearson correlation coefficient and test-t, chi-square, regression and ANOVA analyzed.

Results: results showed significant positive correlation between leadership competencies and performance of hospitals(α=0/001,R=0/556). All components of competency (personal qualities(R=0/446), working with others(R=0/529), managing services(R=0/569), improving services(R=0/445), setting direction(R=0/269)) have also positive and significant correlation with performance. Leadership competencies with education (R=0/368), type of employment(f=5/209) and type of hospital(f=15/252) and performance with marital status(R=0/038), type of hospital(f=4/352) and management experience(R=0/273) have showed a significant positive correlation.

Conclusion: Today, organizations will be success if they able to attract and maintenance the most qualified, and employ their services in proper place. Neglect of this important and non-use of existing potentials could have negatively impact the performance of individuals, units and hospitals.

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Background: Hospital managers inevitably have a major impact on their employees' health and because professional cohesion acheives in the shadow of psychological balance; possessing mental health is important among hospital staff. Therefore, current study aimed to determine the status of managers' leadership style and its relationship with mental health staff of hospitals affiliated to Tehran University of Medical Sciences in 2014.

Materials and Methods: This study was a cross-sectional and descriptive-analytical one and sample size consisted of 91 executives, intermediate managers and 320 employees of hospitals affiliated to Tehran University of Medical Sciences. Fiedler leadership style instrument and general health questionnaire were used. Collected data was analyzed by SPSS software version 22 using descriptive and inferential statistics tests.

Results: Responsive rate was85% (272/320). Most of managers adopted task-oriented leadership style. There was a statistically significant relationship between leadership style and mental health, physical problems, anxiety, social function and depression among staff (P<0.05).

Conclusion: Managers can be effective on mental health staff using relationship-oriented leadership style adoption and it seems necessary to train managers in adopting appropriate leadership models and styles in order to prevent and reduce mental health disorders among employees in different situations.

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Background: In year 1995, new system administration plan of hospitals (fee for service) was notified. This scheme was implemented in hospitals for 20 years. In the early September 2104, new guidelines of performance-based fee for service plan with the aim of deficiencies in the previous plan was reviewed and implemented in hospitals in Isfahan. This study aimed at investigating reform strategies to improve monitoring performance and infrastructure implementation development of the new scheme of fee guidelines in 2014.

Materials and Methods: This study was a qualitative one based of phenomenology. Depth interviews were used to collect data. Eleven individuals assessed including top and middle managers and professors of Isfahan University of Medical Sciences using content analysis method.

Results: In this study, eight main themes and ten sub-themes extracted including appropriate policy making, health management reform in health system, cultural building in monitoring, proper planning, physicians' motivation, infrastructure improvement, improving training, informatics and constructive interactions between senior managers and hospitals' directors.

Conclusion: With the aim of rationalizing the health system, new instructions and fee for service plan should be considered well to tackle weak points. It seems that coping with these weak spots in new fee for service plan, has feasibility to provide more satisfaction among physicians and staff. To achieve main goal of the project which defined as patients and staff satisfaction, using new reform strategies to facilitate plan implementation, continuing observation and stronger mentoring recommended.

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Background: Hospitals directly affected by disasters and crises which will be provided services facing with crises by well-informed and high performing personnel. This study aimed to determine self-efficacy level in disasters among senior managers of hospitals.

Materials and Methods: This study was a descriptive-analytical and applied one which was conducted in all public and private hospitals affiliated to Tehran University of Medical Sciences in 2015. Study population was all senior managers of hospitals and data was collected by a researcher-developed, valid and reliable questionnaire.  Data analyzed using descriptive and Inferential statistics.

Results: Self-efficacy facing with crisis was assessed on average level (101 out of 130) and high among married men with previous experience in disasters. Also, self-efficacy level reported high among aged and position of ED managers. Nevertheless, there was no significant relationship between self-efficacy and participation in educational course and hospital ICS membership.

Conclusion: Given the relationship of self-efficacy with the aged and prior experience in disasters, these variables should be considered in selecting proper people for these positions. Moreover, having successful experiences dealing with challenges enhances the level of Self-efficacy among managers. Hence, using some techniques such as simulation or providing maneuvers can acquaint managers with the possible conditions facing with disasters. 

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Background: Health of hospital staff has a determinant role in increased productivity and since the main mission of hospitals is community health promotion, in order to achieve this important issue, monitoring, maintaining and improving general health is essential; this study developed to assess general health of staff affiliated to Tehran University of Medical Sciences and identify its related factors.
Materials and Methods: This Cross-Sectional, Descriptive-analytical study was conducted among 320 staff members of the Tehran University of Medical Sciences who selected using random sampling. In order to data collection, the General Health questionnaire was used. Collected data were analyzed using SPSS software through t-test and ANOVA tests.
Results: Study findings revealed that 47.5% of participants had psychological disorders suspiciously; prevalence of physical symptoms, anxiety, social dysfunction and depression were 53.9%, 49.3%, 79.5% and 14.6% respectively. There was a significant relation between general health and demographic features such as gender, marital status, major, job department, housing situation and type of employment (p<0.05).  Also, the personal characteristics of managers influenced on the general health staff.
Conclusion: General Health of staff in hospitals Tehran University of Medical Sciences in comparison with similar studies at inside and abroad is not in good condition, therefore, it is recommended that policy makers and managers concerned the programs and solutions towards priorities in order to promote health personnel.

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Introduction: Since incorrect selection of  a manager might lead to incorrect choices of other members, organizations need to consider this important issue  and use well-sought mechanisms for managers’ selection process. Accordingly, this study aims to rank the key factors associated with the selection of operational managers in Tehran University of Medical Sciences.
 
Materials and Methods: This research employed a logical and systematic trend to develop and rank the indicators using fuzzy TOPSIS method. In order for prioritization of key indicators of qualification of operational-level;  after reviewing the literature and using experts’ viewpoints , the dimensions of performance have been selected and using, the SMART technique the key criteria were weighted. A validated and reliable questionnaire was used for data collection.
 
Results: Fifty individuals participated in this study. 37 (74%) and 13 (26%) were male and female respectively. The mean and standard deviation of age of participants were 41.68 and 7.06 years. Literature reviews and related studies indicated 48 indices  for choosing qualified managers. Among these, according to the  expert’s opinion in management science and managers, 36 indices were selected as key indicators. Based on the FTOPSIS analysis, indicators of higher education in the field of management, compliance time, power of expression, adornment and belief in law and order achieved coefficients as 0.205, 0.204, 0.203, 0.202 and 0.197, rank first to fifth.
 
Conclusion: According to the results management related education and expertise in technical aspects of organizational management control  were at the top of ranking . Results of this study can help  medical universities and health service organizations to develop guidelines for selecting their managers.

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Introduction: Hospitals have conflicts because of their complex nature, so they need managers with high emotional intelligence for effective conflict management. There are contradictory results in the correlations between demographic characteristics, emotional intelligence and conflict management; therefore, this study was conducted to investigate the correlation between them in different managerial levels of the hospitals.
Material & Methods: This analytical observational study was conducted on 100 senior and middle level managers (samples) of 8 selected hospitals affiliated to Tehran University of Medical Sciences in 2019.  We used a three-part questionnaire: Demographic characteristics, Emotional intelligence and Conflict management strategies, to collect data. SPSS 20 and statistical correlation tests including Pearson, t-test and analysis of variance were used for data analysis.
Findings: There was a significant direct relationship between the mean score of emotional intelligence and its domains with problem-solving strategy (P <0.001). Also, statistically significant correlations were observed between age, marital status, major, organizational position, and work experience in a managerial position with emotional intelligence (P <0.05). In addition, there was a direct and statistically significant relationship between avoiding and problem-solving strategies with age and work experience, respectively (P <0.05).
Discussion& Conclusion: It is necessary to take appropriate action to raise emotional intelligence and improve conflict management in hospitals, and according to the significant and direct relationships that observed, we can pay attention to select relevant managers for the hospitals.

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Background and purpose: In today’s competitive organizational landscape, the significance of recruiting and developing competent human resources has become paramount. Organizations not only aim to select and attract capable and efficient personnel but also seek to enhance and expand their capabilities. Consequently, the concept of meritocracy has become a key concern for modern organizations. This study aims to investigate the factors influencing succession planning in the leadership of healthcare organizations in Iran.
Methods: This qualitative study was conducted using content analysis in 2020. The statistical population comprised key decision-makers and policymakers in successful and prominent Iranian organizations known for effective succession planning, such as the Islamic Revolutionary Guard Corps (IRGC) and the public banking system. A total of 15 experts were selected through purposive and snowball sampling, with data collection continuing until theoretical saturation was achieved. Data were gathered through structured interviews, and the analysis and coding were performed using MAXQDA 11 software.
Results: The study identified five main themes: alignment of strategic goals and needs analysis, strategic communication and organizational structure, talent identification and empowerment, development and excellence of qualified individuals, and monitoring of succession planning programs. These were further divided into 13 sub-themes.
Conclusion: Organizations and managers should provide comprehensive support and demonstrate commitment to the effective implementation of succession planning programs. This will lead to improved organizational decisions and policies, ensuring that competent and qualified individuals are placed in key positions. Additionally, this approach will enhance work quality, boost employee motivation, reduce resource wastage, and improve career advancement opportunities for staff.