Journal of

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: In medical centers, after obtaining visceral clinical samples in suitable containers under certain circumstances, they are sent to mycology laboratory. Since sometimes it is impossible to test specimens immediately, therefore, they should be kept in the refrigerator. Thus, possibility of keeping samples, the confidently time of samples keeping in a refrigerator and the appropriate guidelines for the maintenance of visceral samples for clinical centers have a particular importance for practical purposes and are the aim of this study.

Materials and Methods: At first, the specimen was examined by KOH direct microscopic examination for detection of fungal elements. After primary culture of visceral samples on the Sabouraud dextrose agar with chloramphenicol (SC) medium, the samples were sequentially placed in a refrigerator at temperature 2-8 ºc for 1, 2, 24 and 48 hs and each sample with the specific mentioned time culturing was performed on the Sabouraud dextrose agar (S) and SC media. Then the results of growth were recorded.

Results: From 100 samples, 79 samples had grown, 20 samples with lack of growth and in 1 sample reduced growth were observed.

Conclusion: After 48 hours of cold temperatures (2-8 ºc) visceral fungal clinical samples are able to grow in culture media. So samples which were not tested immediately, could be stored at temperatures 2-8 ºc in the refrigerator.

Background and Aim: Job rotation is one of the management policies in human resource management. If these policies are done with proper planning, they can impress job satisfaction and job burnout of the employees. Present survey has been conducted in order to find relationship between job rotation with job satisfaction and job burnout.

Materials and Methods: A descriptive analytical methodology was used in 2013. The statistical community included all personnel with job rotation at the deputy of development in Tehran University of Medical Sciences (n=200). A researcher-constructed questionnaire was used to collect data. The data was analyzed by SPSS.

Results: The mean job rotation and job burnout among men were more than women. A direct and significant relationship exists between job rotation and job burnout among the women. Job rotation and job burnout were inversely and significantly correlated.

Conclusion: Job rotation can have influence on increasing employees’ incentives and satisfactions and reduce Job burnout. Thus, the managers need to create an environment which contributes to knowledge transactions within an organizational framework together with promotion of encouraging their mentalities and with designing a good incentive system for teamwork, through the movement of workers in different occupations.

Background and Aim: Nowadays, hospitals believe that applying the principles of management improve quality, and enhance competition and development. One of the ways to achieve these goals is the use of 5S. This study is aimed to determine and compare  supporting departments of Amir Alam Hospital before and after the implementation of 5S.

Materials and Methods: This descriptive analytical and cross-sectional study was conducted within three departments: Kitchen, laundry and the maintenance & repairs departments  of Amir Alam Hospital. Five checklists were designed for collecting information before and after the implementation of 5S within each department. Data analyses was performed using Wilcoxon test and SPSS version 19.

Results: Average rating after running 5S was more than before within the kitchen Section. However, there was a significant relationship before and after running 5S in only stage one and five. Within maintenance & repair and the Laundry departments, average rating after implementation of 5S was higher than using it before. In addition, all purposes with the exception of employees’ adornment, were statistically significant in all of five stages.

Conclusion: Implementation of 5S systems will contribute to increase in employees & patients’ efficiency and satisfaction, which in turn will lead to achieving higher productivity and economic growth. Therefore, we recommend other hospitals and departments to apply the concept of 5S.

Background and Aim: Today, regarding the role of accurate final information, and decision-making, designing and implementation of a sound costing system that can detect, identify and calculate the exact cost of the delivered services is of great importance. The aim of this study is to estimate the final cost of student education in the School of Allied Medicine, Tehran University of Medical Sciences, through Activity-Based Costing method in 2013.

Materials and Methods: This research was a descriptive and applied study. The study population included School of Allied Medicine. The consumed costs in financial year 2012-2013 was investigated with costs classification, and finalized costs by activity based costing method. After identification of calculated costs and changed to allocation costs, The accumulated costs according to shared basic principle was given to all of delivered services. Finally, the finalized costs for student education based on the number and kind of courses collected and calculated by Excel software 2010.

Results: The results indicated that the final cost for student education in PhD-level was 118,312,679 Rials, which was the highest amount, and was 76,714,824 Rials in MSc. level, and the lowest amount was related to BSc. student as 42,312,537 Rials.

Conclusion: Paying attention to activity-based costing system with complete flexibility reveals the drawbacks of the traditional programs used by universities. The reason for higher costs in higher levels is due to the fewer number of students, particular facilities in these level and their own special expenses

Background and Aim: Inclusive implementation of Electronic Medical Records (EMR) is more serious because of physicians’ perception. This study was carried out to identify the effects of organizational contextual factors on physicians’ perception regarding EMR’s adoption in 2013 (The merger of Tehran University and Iran). 
Materials and Methods: This was a descriptive, analytical and cross- sectional study in which a sample of 270 physicians working in hospitals affiliated to Tehran University of Medical Sciences was selected. Physicians’ perception toward adoption of EMR has been assessed by Technology Acceptance Model or TAM questionnaire and organizational context variables. Collected data were analyzed by SPSS. The study model was tested by Structural Equation Modeling (SEM) and represented by AMOS. 
Results: The findings showed that perceived usefulness (PU), perceived ease of use (PEOU), management support, physicians’ involvement, physicians’ autonomy, and physician- patient relationship have direct and significant effect on physicians’ attitudes toward EMR adoption. However, training has no significant effect on TAM variables. Moreover, the results showed authorizing proposed conceptual path model explained about 56 percent of the variance of EMR adoption.
Conclusion: The present study revealed that organizational context factors had significant effect on physicians’ attitude toward EMRs’ adoption. The study clearly identified six relevant factors that affected physicians’ perception regarding EMR adoption. These factors should be considered when comprehensive implementation is pursued.  

Background & Aim: One of the most important and useful models for assessing hospital performance is the Pabon Lasso Model, a graphical model that determines the relative performance of hospitals using three indicators: 1. Bed Occupancy Rate (BOR); 2. Bed turnover (BTO); 3 Average Length of Stay (ALS). The aim of this research is to investigate the performance of the hospitals affiliated with Tehran University of Medical Sciences in Iran during the year 2011 based on the Pabon Lasso Model.

Materials & Methods: This descriptive and cross-sectional study conducted in 2011.  All the 16 hospitals affiliated to Tehran University of Medical Sciences formed the study population. Data was analyzed by Excel software and Pabon lasso model.

Results: The following average results for each performance indicator were obtained: Average Length of Stay (ALS) = 6.55 days. Bed Occupancy Rate (BOR) = 74.151% and Bed Turnover (BTO) = 70.24 times per year18.75% hospitals were located in the Pabon Lasso Model zone 1.25% hospitals in zone 2.25% of hospitals in zone 3, and 31.25% hospitals in zone 4 of the model.

Conclusion: The study showed that 75% of the studied hospitals were inefficient. Applying Pabon Lasso model compared hospital's performance. Thus, using one of the active ways of problem recognition in hospitals and perceiving the relation of performance indicators will be helpful in establishing new policy and reviewing current policy in order to maximize performance capacity.

Background and Aim: Giardiasis is the most common pathogenic gastrointestinal parasite worldwide and transmitted by ingesting parasite cyst, through water and food and person-to-person contact. Therefore in food handlers and child care workers it is of high importance. In this study we surveyed the job of individuals with giardiasis.
Materials and Methods: This study was a pilot descriptive-analytic study. Hundred and nine stool samples were collected from individuals referred to medical centers affiliated to Tehran University of Medical Sciences for health certificate. 
Samples were examined with wet mount smear and formol-ether concentration methods. Also a questionnaire was given to each individual.
Results: Sixty nine samples were infected with Giardia lamblia. among positive samples for Giardia lamblia 25 (36.23%) were related to food handlers and occupations which are most  frequently associated with food, one (1.44%) nurse, one (1.44%) managing director of the nursery, two (2.89%) housekeepers  and one servant (1.44%).
Conclusion: Person-to-person Giardia lamblia transmission is often associated with poor hygiene and sanitation, most commonly by food handlers.
Also, day- care workers have a higher risk of infecting children attending day-care centers. Therefore particular attention should be paid to health of this workers as well as three times stool examination.

Background and Aim: Due to social development, population growth, industrialization of countries and require some work, most of the employees are working with program shift. The purpose of this study was determination of relationship between nurses shift rotation and personality characteristics and coping strategies in selected private hospitals in Tehran, Iran.
Materials and Methods: In this descriptive and cross-sectional study standard shift work questionnaire and Eysenck personality questionnaire was used. After confirming the validity and reliability (Cronbach's alpha 0.73), the questionnaire was distributed among 305 nurses and 6 non-governmental hospitals in Tehran on the cluster random sampling method. Descriptive and analytical methods were used for data analysis using SPSSv.22 software.
Results: 43.6 percent of nurses participating in the study were introverted and 56.4 percent were extroverted. The results showed that there was a meaningful statistical relationship between age and health (p=0.008), gender and physical health (p=0.015), education level and physical health (p=0.014), gender and physical-cognitive anxiety (p=0.006), age and family- socioeconomic status (p=0.001), marital status and family-socioeconomic status (p=0.001), second occupation and family-socioeconomic status (p=0.001). 
Conclusion: Planning according to nurses working hours standard and to avoid overtime, especially nurses who have more experience can prevent severe complications of shift work and improve health and the quality of care. 

Background and Aim: By conducting cloud computing and using cloud library, better library's services were prepared for universities’ libraries. The present research aims to determine the possibility of conducting cloud computing in Medical Sciences Universities’ libraries in Tehran from the librarian's perspective.
Materials and Methods: This was a descriptive, cross sectional study. A questionnaire survey was used for the collection of data. Face and content validity of the questionnaire has been examined by librarian experts, and also Cronbach’s Alpha Coefficient (0.77) was used for confirmation of reliability. Questionnaires were mailed to 42 selected library professionals, and a total of 40 libraries filled out the questionnaires. The results were analyzed by SPSS software and calculating independent t-test, binomial and chi-square test.
Results: In the present study, the result showed that the mean of librarians skills for management viewpoint (22.5), the specialist personnel (19.6), the librarian attitudes toward security issues associated with cloud computing (13.15), and situation infrastructures (18.13) were significantly meaningful in all of the cases. Also budgeting and availability of electronic services were found to be the least significant. With comparing the requirements of conducting cloud computing and library features by Chi-square test, 80.7 vs. 19/3 respectively showed that libraries have good position.
Conclusion: It was found that the cloud computing by using different technological advantages is a solution for providing better and quicker services with lower prices where budgets are limited and facilities are inadequate in Tehran's medical sciences universities’ libraries. 

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. 

Background and Aim: With the assumption that health is as one of the luxury goods, therefore making efforts in reducing health spending and inflation in this section will be ineffective.
But if health is an essential service, then in the national level for better redistribution of the resources and financial protection of the households against the health expenditures will be needed. The main objective of this study was determination of income impact of health care expenditures in Tehran household in years 2011-2012.
Materials and Methods: This study was a population based survey. The instrument of data gathering was a "WHO questionnaire" which was integrated by interview with an acquainted person in each one of the 792 families who live in Tehran. The least ordinary squares, Granger causality test, Breusch-Pagan-Godfery and White heteroskedasticity test were used for data analysis. Eviews 8 software was used for running the tests. 
Results: The results showed that heath is a cause for increasing income but the converse is not true. Otherwise, Health with income elasticity equal to 0.25 is an essential service, and is not perceived as luxury goods. Moreover results represented that income is not a good variable for rationalizing the variation of health expenditures.
Conclusion: Health was an essential good, and although income changes affect the expenditures of health care, but the sensitivity is not high and recommended that health policy-makers should in adoption policies such as tariff increases do a comprehensive survey because prices increase are borne by the consumers.