Journal of

Background and Aim : Lactoferrin is one of the milk components with the main role in iron absorption and transfer. As a result of this action the pathogens that need iron for their life cannot grow, so the infection will be controled, indirectly. Moreover, because the lactoferrin production is stopped in the women with breast cancer, evaluation of this protein in milk may be the first step in detection of breast cancer tumors, and making decision about the appropriate treatment methods. Therefore, with due attention to the important role of lactoferrin in health and disease, determination of its normal dose in milk is very essential for the differences that may occur comparing with the normal situation. Also since the normal amount of lactoferrin in the milk of Iranian women was not evaluated in this study the amount of protein in more than 100 sample was measured.

Materias and Methods: The lactoferrin amount was measured by SRID method in 104 human milk samples of mothers that were referred to two public health centers in Tehran for vaccination of their children, and also in women that were hospitalized after childbirth in 2 health centers of Qom city. The data such as age, time of childbirth, etc were obtained by asking them and filling pre-designed questionnaire. All laboratory experiments were conducted in the Immunology unit of pathobiology department of School of Public Health, Tehran University of Medical Sciences.

Results: The mean concentration of lactoferrin was 4.39 g/L, in the early milk (6-10 days after childbirth) was 3.79 g/L and in the mature milk (11-60 days after childbirth) measured as 2.45 g/L.

Discussion and Conclusion: The mean concentration of Lactoferrin in milk (g/L) has a significant difference with the day after childbirth (P<0.05) and was highest in Colostrums and then in primary milk. After that this amount is reduced extremely. This indicates the important role of lactoferrin in the primary days of infants, because of the protective role that it has against infections. Also the results of this study showed no significant correlation between human milk and factors such as age and childbirth time.

Background and Aim: In any country, one of the fundamental goals of health policymakers is to facilitate the people's access to treatment and health care services. Therefore, the aim of this study was to identify factors that influence recievers' access to delivered services in urban health care services.

Materials and Methods: We performed this descriptive and cross sectional study in year 2008. We used the multi-stage sampling method for selecting 57 staffs of urban health care centers as statistical samples. The valid and reliable questionnaire for gathering data was designed. Data was analyzed by SPSS 2 version 13 software.

Results: Our findings indicate that mean scores of individual, geographical, financial and structural factor was 2.29 (61.4% with high impact), 2.42 (57.9% with high impact), 2.27 (56.1% with high impact) and 2.58 (86% with high impact), respectively. (Our mean score range was 0 to 3).

Conclusion: According to the assessment of employee's viewpoint of Urban Health Care Centers, all of four individual, geographical, financial and structural factors had high influence on person's access to health care services in Urban Health Care Centers. Consequently this study has presented suggestions (according to the findings) for improving access to delivered services in urban health care centers.

Background and Aim: Waiting time is one of the factors affecting patient satisfaction of service quality which is offered. In This Study waiting times referred to some clinics like Shahid Dastani integrated clinical training center, treatment and researching center like Shariati Hospital was performed.

Materials and Methods: Six sigma model in four stages together with qualitative and quantitative methods was used in this study. The study population consisted of the all patient referred to specialist clinics like Shahid Dastani during every week. We selected 10% of all patients as a sample size referred to specialist clinics (n= 266). Data were collected by interviewing and filling the checklists using a stopwatch. Measured waiting times were registered in a blank form. Data entry and analysis were performed using SPSS.

Results: Mean and standard deviation of waiting time were 121± 33.73 minutes. The most important processes from referred entrance to leaving the physician's office consisted of comprehensive workflow processes, overall workflow, times forming, funds, medical records, previous bloom times, refunds and discount at all costs, and complaints.

Conclusion: The first three factors of prolonged time form health care providers and referees view are simultaneous increase in the number of referees, physicians being on time and shortage of doctors. This collection extends the time of giving services by clinice, providing human resources and modifying the physical spaces wich were some of recommendations to reduce waiting times.

Background and Aim: Accountability is a process by which all service organizations including hospitals are required to legitimize their activities. This research aims to study the seven aspects of accountability in Iran's teaching hospitals.

Materials and Methods: This is a cross-sectional analytic study performed in the second half of 1390 in five major medical-educational hospitals in 5 points of the country. A research-made questionnaire with seven dimensions (ethical, cultural, financial, operational, legal, informational, and structural) was used. The collected data were analyzed using descriptive and inferential statistics.

Results: The total number of subjects was 454, of whom 45.6% were males and the rest were females (n = 247). They were mostly (40.1%) in the age group of 21- to 29-year-olds, and the least figure (6.8%) pertained to those older than 50 years of age. The average mean of structure turned out to be the highest (3.54 ± 0.97) and the informational dimension had the lowest (3.45 ± 0.97). The average accountability score was the highest in Rasht hospital (99.3 ± 0.61) and the lowest in Tehran hospital (3.02 ± 0.67). The correlations between all dimensions were confirmed. Moreover, accountability as evaluated in the studied educational hospitals was above average.

Conclusion: Patients' attitude towards accountability in Iran's teaching hospitals was assessed to be above average. The findings show that an office or a unit for accountability, validation, and continuous audit of its dimensions is essential to advance the high goals of the hospitals.

Background and Aim: Focus on organizational health could ensure the future success of any organization. Considering the fast changing conditions of hospitals and the necessity of effectiveness, employees are required who can show voluntary behavior towards the organization and customers. Therefore, this study mainly aims to survey the relationship between organizational health and organizational citizenship behavior in selected hospitals of Tehran University of Medical Sciences(TUMS).

Materials and Methods: This cross-sectional, descriptive-analytic study was conducted in 2010. The population of the study comprised the entire staff of TUMS selected hospitals. In total, 312 employees were selected. The researchers gathered their data using questionnaires of organizational health and organizational citizenship behavior. For data analysis, both descriptive statistics(percentage, mean, standard deviation and variance) and inferential statistics(Pearson correlation and regression) were applied. The data were analyzed using SPSS18 software.

Results: The correlation between the organizational health and five dimensions of organizational citizenship behavior(Conscientiousness, Altruism, Helping Behavior, Civil Virtue, Sportsmanship, and Courtesy) was significant(p = 0/0001).

Conclusion: Given this significant correlation between organizational health and organizational citizenship behavior, organizations can make improvements in employees' behavior. This can be achieved by creating harmony among members and through continuous improvement and growth.

 Background and Aim: Investigating the effect of intellectual capital on an organization’s ongoing processes is a way of determining its weaknesses as well as appropriate strategies which help managers to make decisions. The main purpose of this study was to confirm intellectual capitals through improving organizational culture among staff managers of IKRF—deputy for support and health.

 Materials and Methods: This is a cross-sectional descriptive study that was conducted in 1389. The respondents were selected among staff managers of IKRF—deputy for support and health(N=50). Data collection was a questionnaire which consisted of three parts developed by the researcher. Data analysis was performed with SPSS version 16 with the help of descriptive statistics and Pearson correlation test.

 Results: Most of the top and middle managers enjoyed an average organizational culture(top managers=58/3% middle managers=78/3%). The intellectual capital of most managers of this study was below average(mean=2.23). Finally, with respect to the entire managers—both top and middle—, there was a significant relation between organizational culture and intellectual capital( P<0/001).

 Conclusion: Taking into account the significant relation between OC and IC and also the point that organizations try to apply appropriate human resources it becomes further important to improve managing intellectual capitals. In this respect, organizational culture is the most basic substructure.

Background and Aim: Analysis of functions enables organizations to identify their special capabilities and weak points accurately and thus they can enhance capabilities and reduce impacts of threats and obstacles through such analysis. The main goal of this work is investigation of status of Weisbord Model's variables (6 variables) as functional dimensions of management in hospitals of Tehran University of Medical Sciences.

Materials and Methods: This was a descriptive - analytical study. The study population consisted of 384 staffs from hospitals of Tehran University of Medical Sciences. Standardized questionnaire for organization recognition was used for data collection. Descriptive statistics (frequency distribution, frequency percentage) and inferential statistics (Pearson correlation coefficient and significance level) were used for statistical analysis and data analysis was run using SPSS software.

Results: The results showed that there is a significant difference (p=0.0001) in hospitals in terms of the internal situation. Internal situation of all hospitals in the study was evaluated as favorable condition by obtaining 94.5 score out of 125. Among the hospitals, Hashemi-Nejad Hospital with highest score (113) showed the better condition and Rasoul Hospital had the lowest score (87) and lower condition as compared to other hospitals.

Conclusion: Necessity of systematic perspective in designing and development of fair compensation mechanism with presence of representatives of employees is an action which can considerably influence improvement of current situation in the hospitals and facilitates achieving predetermined goals of the organization

Background and Aim: The Effectiveness and success of an organization depends on two factors one is the employees’ Performances and the other is the level of understanding between managers and employees in prioritize of different job motivators. The aim of this study was to determine factors that affect staffs’ performances in Qazvin teaching hospitals based on the Herzberg’s theory.

Materials and Methods: This research was a descriptive study. To achieve the main aim of this study, one hundred and ten employees were selected through a multi- stage sampling method .In this study, for data collection a self-report questionnaire was used. The five-point Likert scale was used to determine the degree of importance of any hygiene and multinational's factors affecting the performance of the employees.

Results: Among hygiene factors, the prevailing place was for Job security with an average 4/39 and then followed by a suitable salary with an average 4/38 of 5 scores. Among multinational's factors, job responsibility with an average 4/38 and job interest with an average 4/38 were placed as the most important factors in employees’ performance. %70/8 employees mentioned that two factors of suitable salary and job security are the most important obstacle for improvement of employee’s performance.

Conclusion : The data of this study reveals that, Attention and Planning in providing

 proper salary and job security as hygiene factors and sense of responsibility and success as motivational factors, may play a more effective role in improving employees’ performance than any other factors.

 Background and Aim: Since employees satisfaction have important effects on achieving the goals of organizations and also organizational justice is a key factor in employees satisfaction, The aim of this study was to determine the relationship between organizational justice and organizational citizenship behavior in selected hospitals of Tehran University of Medical Sciences.

 Materials and Methods: This study was a descriptive and cross-sectional analysis. The study sample was composed of 312 employees from selected hospitals of Tehran University of Medical Sciences by cluster Stratified Random sampling. Data collected by using two questionnaires: Moorman& Niehoff Organizational Justice and Yaghoobi Organizational Citizenship Bahavior. The questionnaires reliability was supported and based on Cronbach s Alfa (OJ=94%, OCB=93%) and questionnaire validity was confirmed by specialist point of view. Data was analyzed by SPSS 18 software.

 Results: The result of analysis revealed that Hasheminejad hospital had the highest score of organizational citizenship behavior in all dimensions except for altruismin dimension. The score in each of the dimensions for organizational justice except for interactional justice in Hasheminejad hospital were the highest There was significant relationship between organizational justice and organizational citizenship behavior in the following dimensions: Altruism, Conscientiousness, Courtesy, Sportsmanship (p=0/0001). 

 Conclusion: As shown, there was a relationship between organizational justice and all aspect of organizational citizenship behavior in selected hospitals and also there was a positive relationship between involving staffs in organizationl activities with facilitating achievement of organizational goals and improvement of hospital performance, Therefore, strategies should be adopted in line with organizational justice to increase citizenship behavior.

 Background and Aim: Healthcare processes have caused many dangers to patients, and the increase of medical errors is one of the most important consequences of such processes. The present research is conducted to reduce medical errors through presenting a model to control them.

 Materials and Methods: In this mixed (quantitative-qualitative) research, a conceptual model was assembled. Then using the model and an interview, a questionnaire was made. The interview and the researcher-made questionnaire were used to collect data. The statistical population included the related people and the practitioners involved in medical errors in Tehran University of medical Sciences (TUMS) hospitals. The sample consisted of 252 employees who were non-randomly selected from those hospitals. Once the affecting factors were determined, the data were analyzed through factor analysis technique. The gathered data were analyzed using descriptive and inferential statistics. Finally, the research model was presented.

 Results: The selected individuals pointed out 9 factors controlling the medical errors: culture, factors associated with patients, factors related to providers, factors associated with errors, structural factors, role of disclosure, error registration, individual factors related to reporting, and organizational factors related to reporting. The 9 factors are the subdivisions of three main factors which account for 57/46% of the total variance of data. The most decisive power is related to disclosure 0.737 and the least (0.053) pertains to structure.

 Conclusion: Discloser of medical errors and their registration are factors which are effective and essential in controlling medical errors in TUMS hospitals.

Background and Aim: In health sector, improving quality of treatment services and patient safety are considered as vital. The objective of this study was to determine the relationship between the quality improvement and patient safety (QPS) and the hospital performance indicators. 
Materials and Methods: In this descriptive analysis research, the statistical population included managers, matrons,  one of the members of the quality improvement committee and one of the clinical governance office members of Shahid Beheshti University of  Medical Science teaching hospitals (N=44). In order to evaluate QPS, data were gathered through questionnaire and the hospital performance indicator data were gathered through interview and observation. Also independent T test was used to determine the relationship between the quality improvement and patient safety and performance indicators.
Results: All five areas of (QPS) including leading and planning, designing clinical and managerial processes, collecting the data, analyzing the data and improvement were significant in QPS score and   according to independent T-test, the relationship between (QPS) and bed occupancy percentage, average length of inpatient stay, bed turnover interval, bed turnover rate and gross death rate was significant (p-value<0/05).
Conclusion: Considering (QPS) standards can improve hospital performance indicators.

Background and Aim: Growing the number of private institutions offering health care and fierce competitive market conditions in the private hospitals industry cause to pressure these hospitals to provide high-quality services. The purpose of this study was to examine the effect of service quality on patient satisfaction in private hospitals of the Guilan province. 
Materials and Methods: Based on standard model of Büyüközkan et al (2011) a new dimension professionalism to SERVQUAL model was added that has used six dimensions including tangibles, reliability, responsiveness, assurance, empathy and professionalism as the dimensions of service quality. The number of samples was 360 patients hospitalized in four private hospitals and a standard questionnaire was used to assess the quality of services. Pearson Correlation Coefficient and Simple and Multiple Linear Regression was used to analyze the data and then by using ANOVA and Duncan’s and by Fuzzy Analytical Hierarchy Process technique, ranking of private hospitals was performed.
Results: Four dimensions: tangibles, responsiveness, empathy and professionalism on patient satisfaction have been found to be effective while Components of trust and assurance in private hospitals of the Guilan province had no significance effect.
Conclusion: Based on the effects of service quality dimensions except trust and assurance recommend that hospitals can increase patient satisfaction if they pay special attention to patient in empathy, updating facilities and technology in tangibles, fast response to patient in responsiveness, employing professional and skilled human resources in professionalism dimensions.

Background and Aim: The issue of organization fit is an important factor for attracting expert individuals within the organization and get their loyalty and commitment. Therefore, this study aimed to investigate and determine the relationship between person–organization fit with organizational commitment of managers of Alborz University of Medical Sciences.
Materials and Methods: This cross-sectional study was done on all managers who employed in Alborz University of Medical Sciences. Data collection conducted using a questionnaire which had two parts: person – organization fit and organizational commitment. The validity and reliability of the questionnaire was confirmed and about 180 questionnaires had been collected. And for analyzing data, Mann-Whitney and Kruskal-Wallis methods were used. 
Results: The average score of person – organization fit was 5.16 with 0.28 standard deviation and the average score of organizational commitment was 4.91 with 0.44 standard deviation. The results showed statistically significant relationship between person – organization fit and organizational commitment (r=0.63, p=0.000).
Conclusion: Managers of Alborz University of Medical Sciences had average fit with their organization and high organizational commitment. So it is suggested that managers should be oriented about the goals and values of the organization. Moreover, policy makers and leaders of this university should be aware about the characteristics and values of the manegers. In addition, they must  pay more attention to the issue of person–organization fit.