Journal of

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Background: In case of disasters hospitals as one of the first centers to admit casualties need to be well prepared. This study aimed to determine the scale of preparedness of the hospitals located in the northern areas of Iran to deal with disasters.
Materials and methods: This applied and cross-sectional study was carried out in 2011. In this study all therapeutic-educational affiliated hospitals of Universities of Semnan, Shahroud, Mazandaran, Babol, and Guilan were investigated using the census method (53 hospitals). The data were collected using instruments were a managers' awareness Questionnaire (40 items) and a 141-item checklist which were filled using the self-assessment method. The data were analyzed using SPSS statistical software and Mann-Whitney , Kruskal Wallis and Pearson correlation coefficient statistical test.
Results: The average score of managers' awareness of the disaster confronting Preparedness status was 41.89±9.12 and hospital`s preparedness to confront disasters was 56.88±5.12 which show a mediocre level in all hospitals studied. There was a significant relationship (P=0.007) between the awareness of managers and receiving training on management of disasters. The least score was related to field of planning for decreasing structural risks (40.56±29.4 ).Significant relationships were observed between preparedness of hospitals in different universities and management plans for unanticipated events (P=0.047), hospital training program (P=0.019), planning for supporting vital services (P=0.005) and environmental health measures to deal with unanticipated events (P=0.001).
Conclusion: Regarding the previous of disasters in the studied provinces and the mediocre preparedness of the hospitals, educational planning to confront disasters, strengthening the hospital buildings and organizing practical maneuvers will be effective in enhancing the preparation of the hospitals.

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Abstract Background: Several factors have an impact on hospitals` crisis preparedness including the status of “internal factor ”. This study is aimed to investigate the relationship between the status of hospitals `internal factors and their level of preparedness in crisis. Materials and Methods: This correlative, applied, and cross-sectional study was conducted in 12 hospitals of Kurdistan University of Medical Science in 2008. The data were collected using the standard Weisbord questionnaire and hospital preparedness checklist to measure the status of internal factors and the hospitals` level of crisis preparedness ,respectively. The data were analyzed using descriptive and analytical statistical methods. Results: Changing internal factors would result in 74% of the changes in level of hospital preparedness in crisis in all studied hospitals . The preparedness level and the organizational structure of the hospital had strongest relationship and preparedness level and personnel’s attitude to changes had the weakest respectively . Conclusions: Hospitals should analyze their internal factors status in order to improve their preparedness level in crisis. Concentrating on different aspects of internal factors, reviewing objectives, improving increasing teamwork, involving personnel in decision-making, using performance-based rewards, forming communication committee, improving leadership styles, training organization `s managers and leaders, and facilitating internal and external coordination could be effective .

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Background: The present research aimed to assess the readiness of selected hospitals of Tehran University of Medical Sciences to implement quality improvement programs and clinical audits from the viewpoint of managers.
Materials and Methods: A descriptive-analytic study was conducted in May 2017 in four selected hospitals of Tehran University of Medical Sciences. The study population of this study was 20 managers of selected hospitals who were selected by census sampling method and entered the study. The data gathering tool was a two-part questionnaire whose validity and reliability were confirmed. In this study, we used SPSS software version 23 and statistical tests to analyze the data.
Results: The effectiveness and readiness of hospitals to implement a clinical audit program was equal to 60% in the field of data and information, cardiology and feedback; 55% in resources, design and implementation, clinical audit management, and evidence and standards; 50% in illness and education; and 45% in manpower. Also, with increasing frequency of clinical audits, hospital readiness for quality improvement processes increases.
Conclusion: Due to the effectiveness and low readiness of hospitals in implementing a clinical audit program, especially in the field of human resources (45%), it is necessary that managers and planners of clinical audit programs in hospitals have a precise knowledge of these factors in order to control the organizational environment and help improve the effectiveness of audit programs.