Journal of

Background and Aim: Stewardship and delivery of health services are considered as the most important areas in the healthcare system of the Islamic Republic of Iran in 1404. This study was conducted to investigate the main challenges in medical education stewardship because of its importance in the management and leadership of education from the viewpoint of education process providers.

Materials and Methods: This qualitative research was conducted using thematic and framework analyses to obtain the collective view of faculty members of Medical Sciences Universities in Iran. The data were collected applying deep semi-structured interviews. To increase the acceptability of the study, four criteria of Lincoln and Gupta were used. Codes, categories and themes were extracted by expert researchers of qualitative studies who had no conflict of interests with the topic.

Results: Of the 24 faculty members interviewed, 7 were females and 17 were males. They comprised 5 full professors, 8 associate professors, 9 assistant professors and 2 lecturers. The findings of the interviews were categorized in three main lines of stewardship in health system in the form of main and sub themes so that there were 2, 2 and 5 main themes in each line, respectively.

Conclusion : Since many of the challenges extracted from the present interviews are considered as essential interventions for achieving the stewardship functions of health system -- and, as a result, medical education -- , it is important to pay more attention to these challenges and at the same time conduct more complete studies to get more practicable solutions to these problems.

 Background and Aim: One of the most important factors to present successful managers is general health. If managers have not highly general health, then they will encounter many problems. Therefore, this research is aimed to induce the general health among Tehran University of Medical Sciences hospitals’ administrators. 

 Materials and Methods: A cross-sectional, deceptive and analytical study was conducted among 25 Tehran University of Medical Sciences hospitals administrators in Tehran, Iran. The research tool was general health questionnaire developed by Goldberg and Hillier to assess the administrators general health and its demographic details. Data was analyzed by SPSS software and using analytic statistical methods.

 Results: The results of this study showed that the hospitals administrators had normal range of general health. Also, there was significant correlation between anxiety with physical dysfunctions, and depression with physical dysfunctions, and anxiety with social functions.

 Conclusion: The rate of general health among TUMS hospitals administrators is higher than the other mangers compared with similar studies in Iran and out of Iran. Therefore, we suggest periodic medical examination, general health training, and consultant services to develop or maintain the general health among healthcare managers.

Background and Aim: One of the perennial questions for hospitals and insurance organizations are the real cost of g lobal surgery. The aim of this study was to compare the cost of global surgery bills with approved tariffs in hospitals affiliated to Tehran University of Medical Sciences Medical Sciences .

Materials and Methods: This was a cross – sectional study . The study population included all hospitalized patient bills eligible for global tariff at nine selected hospitals (include: Imam Khomeini, Shariati, Arash, Fatemeh Alzahra, Zanan, Cancer Institute and Razi) affiliated to Tehran University of Medical Sciences in 2012. Checklist was used for data collection. Data about the real costs of surgical procedures were collected from the patients' bills . Data were analyzed using descriptive statistics in SPSS version 16 software .

Results: The results showed that a total of 90 included global tariff surgical, 68 surgical procedures were performed in nine selected hospitals. Except seven surgical procedures in other cases (61 cases), the real costs of surgical procedures average 3 -312 percent more than approved global tariff. The surgical procedure "Septoplasty" had the most difference with global tariff.

Conclusion: The results showed that surgical global tariff are not real, and lead to the hospitals financial loss. Therefore, it is recommended that to prevent the hospital financial loss in the calculation of the g lobal t ariff factors such as patient age , presence or absence of comorbidity and complication, disease severity, length of stay and inflation rates in country to be considered .

Background and Aim: Employees are an organization's greatest assets and organizational performance is dependent to employee’s performance. Presence of inefficient employees can make other employees to be less productive. To improve inefficient employees to high performance level, it is necessary to analyze the performance of employees. This study aims to identify and determine poor performance dimensions and cluster inefficient staffs.

Materials and Methods: This study was an analytical and descriptive research. The research made questionnaire developed for data collection and Principal Component Analysis (PCA) and Cluster Analysis (CA) techniques in SPSS used to analyze the research data.

Results: The PCA results showed that six poor performance dimensions were behavioral problems, low results, lack of self-efficacy and creativity, sabotage, postponing, and individualism. The CA results declared that poor performers can be classified to five clusters include poor behavior, lazy, jobber, poor ability, marginal, managers believed that root of employees’ in inefficiency attributed jobber, poor ability, and lazy employees to internal causes, and attributed bad behavior and marginal employees to external causes.

Conclusion: The type of inefficiency and its dimensions should be identified in order to make effective decisions for inefficient employees. Employees clustering propose a new attitude toward inefficiency differentiation comparing to literature,  and this five group clustering based on empirical data expected to be more applicable in practice.

Background and Aim: Modeling of organizational knowledge creation process is one of the key areas of research in knowledge management. The aim of this paper was to determine solutions for developing and improving evolutionary knowledge creation model based on the model validation results in real world.
Materials and Methods: This study was an analytical and empirical research that was done by multi case study and simulation strategy. The committee was formed to collect information from various source of data including organizational documents and interview with senior managers about knowledge creation history for 5 years in Development and Planning Management department of Tehran University of Medical Sciences. Data analysis was done using descriptive statistics and qualitative analysis. Also, the mathematical formulation was analyzed using simulation in Excel.  
Results: In most of analyzed knowledge creation cases, knowledge absorption from external source through changing managers or employing consultant following integration with exist knowledge was occurred. Also, simulation results show that, mathematical relations were not well defined and changing them makes results more acceptable. 
Conclusion: Knowledge grow in organization has occurred through three ways including planned knowledge creation based on managerial decisions, planned knowledge absorption based on managerial decisions, and random knowledge creation mechanism, and all of them have impact on essential knowledge contents.