Journal of

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Background: Hospital is the most expensive part of a health system. Manpower is the mainly valuable factor in productivity and service delivery. Since personnel costs make up more than 60% of hospital costs, increasing productivity and efficiency of human resources are significant. The most important ways to increase utilization of this valuable resource is to standardize the quantity and composition of the human distribution. This study determined the standardizing of nurses resources in a sample hospital.

Materials & Methods: The descriptive and cross-sectional study applied in 2008. Data of study collected by questionnaires and library studies by using descriptive statistics were analyzed. Sample of study is the private general hospital with 85 active beds, including gynecology, surgery, men and children, women, surgery, neonatal intensive care wards. Data collection tools were tables containing the number and composition of nurses and hospital performance indicators. After gathering data, it compared with the standards and recommendations were conducted. Using standard of job hours of nursing care required for each group of patients and protocols of Ministry of Health and Medical Education.

Findings: The numbers of nursing staff in the hospital were 96 people, including 38 nurses, 16 assistance nurses and 42 aid nurses. The optimum numbers based on average annual bed occupancy in different sectors were: 94 nurses, including 60 nurses, 34 assistance nurses and aid nurses.

Conclusion: A sample hospital uses healthcare workers as an aid nurses to assist in a wide range of patients' care. With regard to development of medical sciences and become more specialized nursing care industry and major changes in techniques and equipments, to move on from traditional invasive surgical procedures to non-invasive medical practices and the incidence of further complex cases, it will be effected to replace them with educated nurses to care of patients.

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Abstract Background: Medical tourism industry as one of the tourism dimensions results in a sustainable development and dynamic economy in countries. This study was conducted to examine performance of Tehran’s selected public and private hospitals in attracting medical tourists from foreign costumers’ points of view. Materials & Methods: This cross - sectional study was conducted in Tehran’s selected public and private hospitals in 2011. The study population included 79 foreign patients who referred to four hospitals in Tehran as medical tourists. Data were collected using a self-made questionnaire which consisted of 23 questions which evaluated eight hospital performance components in attracting medical tourists. Descriptive and analytic statistics was used for data analysis. Results: Overall, the hospitals` performances were evaluated to be in an appropriate level. Through Patients` viewpoint, three components including staff number, staff performance quality and staff`s up to date knowledge and skills were in a proper level. Moreover, Staff’s acquaintance with foreign languages and giving proper notifications were reported to be in a very poor level. There was a significant relationship between all of the performance components in attracting medical tourists and hospital ownership excluding staff’s acquaintance with foreign languages and their familiarity with the facilities. Conclusion: Teaching international languages to key staffs and empowering their communication skills can be effective in attracting medical tourists. Considering this, both public and private hospitals must have a serious plan to achieve this goal.

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Background: ‌ Based on increasing the privatization in hospitals, conducting researches in various fields of private hospitals and comparison with public hospitals is greatly felt.This study aimed at investigating the relationship between job satisfaction and burnout among employed nurses in selected public and private hospitals in Shiraz city.

Materials and Methods: This was a comparative-correlational study. The study population was composed of employed nurses in public and private hospitals in Shiraz city in 2012. sample size was estimated 320 using Cochran formula. The questionnaire of Spector job satisfaction” and “Maslach burnout” were used for data collection. Study conducted in two private and two public hospitals in Shiraz and data gathered randomly among nurses. In order to analysis descriptive and interfere statistics including mean and standard error, Pearson correlation coefficient, MANOVA and independent t- test.

Results: There was a significant and negative relationship among job satisfaction and three dimensions of job burnout in both public and private sectors (p<0.001). In addition, the results revealed that there was a significant difference among the emotional exhaustion and depersonalization between private and public sectors (p<0.05).  However, there was no significant difference between job satisfaction and reduced productivity performance of these two sectors.

Conclusion: According to the findings, by increase in the nurses' job satisfaction, particularly in the public sector, the adverse effects of burnout can be prevented.

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Background: Three aspects of health, responsiveness rate and equitable financing introduced as the main goals of health systems. In this study, responsiveness rate was assessed among private and social security hospitals in 2013.

Materials and Methods: The descriptive-analytical study conducted as a cross-sectional one among 10 hospitals in Tehran city (20 percent of total social security and private, 8:2 respectively) in 2013. Study population consisted of all inpatients and outpatients referee to eight private and two social security hospitals and 333 subjects selected to data gathering randomly. The valid and reliable World Health Survey questionnaire was utilized. Data was analyzed by SPSS₁₇ using descriptive statistic, Mann–Whitney and Kruskal–Wallis tests.

Results: In points of view among inpatient and outpatient, the mean score of responsiveness rate were 4.1±0.71 and 3.7±0.60 respectively. These amounts estimated 4.4±0.46 and 3.2±0.82 for inpatient and 3.8±0.58 and 3.5±0.63 for outpatient in private and social security hospitals respectively. Also, the mean score of responsibility rate assessed 4.4 in private hospital which was higher than social security ones (3.2); and this difference was statistically significant (P<0.001).

Conclusion: Responsiveness rate dimensions were evaluated moderate to high among assessed hospitals. These results were enhanced in private hospitals rather than social security ones. It is recommended that hospital managers should pay more attention to client and mechanisms to improve responsiveness rate and providing more services quality. 

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Background: Health care systems especially hospitals often encounter several risks which has weaken efficiency and hospitals performance entirely. Resilience engineering (RE) enables to remain high risk systems stable faced to sudden changes or minimizes negative effects of changes.

              

Materials and Methods: This study considered a new hybrid framework concept regarding the non-value added waiting time and resilience engineering indices as efficiency indices to evaluate private and public hospitals performance. With the intention of evaluating the hospitals performance, a hybrid framework including simulation and MADM methods utilized. Output-oriented Data Envelopment Analysis (DEA) approach used as MADM method.

Results: The results revealed that RE factors play a significant role in hospitals performance's promotion; also the private hospitals had better performance compared to the public ones.

Conclusions: Study results indicated that teamwork efficiency index compare to other efficiency indices had more effect on hospitals performance. Health system managers should be considered improved performance and efficiency policies and focus more on other RE indices parallel team work index.

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Background: Organizational culture has a crucial role in hospitals’ productivity. The success or failure of strategies and plans in organisational change depend on organizational culture. This study aimed to examine the organizational culture of Tehran hospitals in 2014.

Material  and Methods: This descriptive-analytical study was carried out in 18 hospitals (public, private and semi-public hospitals) that were selected out of 114 hospitals of Tehran using quota- randomized sampling method. About 696 employees in diagnostic, curative, administrative and logistic departments participated in the study. Data was collected through a valid and reliable questionnaire and analyzed using SPSS20. Spearman, U Man- Whitney and Kruskal- Wallis statistical tests were applied.

Results: The mean score of organizational culture was 3.62 out of 6 (moderate). There was a significant relationship between organizational culture and the type of hospitals (p=0.002). The mean score of organizational culture was higher in Private and Semi-public ecurity hospitals respectivey. Attention to details and customer orientation dimensions were high in public and semi-public hospitals and private hospitals respectively. The most and the least mean score of organizational culture was related to administrative and support services units. 

Conclusion: Organization culture was evaluated in moderate status in hospitals of Tehran city. Thus, it is recommended  that hospital managers  improve hospitals 'organizational culture  specially in creativity, innovation, integration and teamwork dimensions using organizational engineering culture plans.