Journal of

Background and Aim: Clinical governance is the application of mechanisms at the right time and place to do tasks for patients properly and obtain maximum clinical results. The implementation of clinical governance definitely requires the skills and inclinations of those working in healthcare sector. The main objective of this study is to identify the relationship between human resource management (HRM) on the one hand and the implementation of clinical governance and the optimal establishment of its framework on the other hand through offering strategies for effective human resource management.

Materials and Methods: This is a descriptive analytical study conducted in a cross-sectional way in 2012. The sampling method was a two-step cluster sampling. Shariati, Imam Khomeini, and Hashemi Nejad were randomly selected from among the hospitals of Tehran University of Medical Sciences (TUMS). The data collection instrument was a researcher-made questionnaire and a checklist. In each hospital, 30 questionnaires were randomly distributed. The gathered data were analyzed by SPSS.

Results: The minimum and maximum scores of clinical governance pertained to Imam Khomeini (594) and Hashemi Nejad (753) hospitals, respectively. Moreover, significant relationships were found between variables of training, recruitment and employment, salaries and benefits on the one hand and clinical governance on the other.

Conclusion : Considering the significant relationship between HRM and the implementation of clinical governance, investment in this aspct of clinical governance as the one that influences success in other aspects can be effective in the establishment of clinical governance.

 Background and Aim: X-Ray departments are among the most essential and expensive parts of any healthcare organization. Meanwhile, the proper application of hospital information systems (HIS) leads to the quality enhancement of health services and to the cost reduction of medical departments. The purpose of this study is to evaluate the knowledge of radiology department staffs in hospitals affiliated to Hamadan University of Medical Sciences (HUMS) about HIS applications.

 Materials and Methods: In this descriptive research (2012), the knowledge of radiology department staffs in HUMS hospitals was studied using a two-part questionnaire including a demographic part and standard items to evaluate the HIS knowledge of radiology department staffs. Finally, the obtained data were analyzed statistically by SPSS (version 17).

 Results: The results showed that 3.8% of staff members had a weak awareness, 65.4% an average awareness, and 30.8% a good awareness about HIS applications. Perfect awareness was not observed in this study.

 Conclusion: According to the results of this study, running related and up-to-date courses for staff members working in radiology departments is recommended. 

 Background and Aim: Evidence Based Medicine (EBM) is the explicit use of current best evidence in making decisions about the care of individual patients. Hospital information system (HIS) can act as a bridge between medical data and medical knowledge through merging of patient's data, individual clinical knowledge and external evidences .The aim of this research was to determine the Capability to establish EBM by HIS.

 Materials and Methods: This descriptive cross-sectional study was carried out on HISs of 30 hospitals from March to October 2011. Data were collected using a researcher- constructed checklist including applicant’s background information as well as information based on research objectives. Validity of the checklist were assessed by the qualified specialists and then the data were analyzed using descriptive statistics and SPSS software.

 Results: HISs lacked the essential components for providing access to CDSS, Reference databases and internet-based health information in 19, 16 and 20 hospitals were 63.3%, 53.3% and 66.7%, respectively. Twenty-two hospitals (70%) had more than two-thirds of the essential components to access clinical and administrative data repositories 23 hospitals (76.7%) had at least one essential component to access contextual and case specific information.

 Conclusion: The Capability of HIS is better in order to place EBM in having access to the clinical and administrator data repositories while it needs more attention in other areas.

 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: 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: Complaint is the expression of dissatisfaction that needs a response and investigation. It is an effective tool to improve the quality of services. The aim of this study was the survey of complaints, factors affecting them, and the complaint process in Firoozgar Hospital.

 Materials and Methods: This was a retrospective descriptive study. All registered complaints, such as written, verbal and telephone complaints were reviewed in 2012. The data were extracted from the complaint forms of Firoozgar Hospital, which included several parts: personal information, ward name, person complained of, and explanations about the problem. Then, effective factors in complaints were classified and then analyzed by descriptive statistics.

 Results: The most frequent complaints were related to nurses (192 cases). Complaints about doctors were 171 cases. Inappropriate communication (23.64%) was at the top of patient complaints and complaints about fees (14.18%) was the next. Among paraclinical and support units, installations unit had the highest number of complaints (52 cases).

 Conclusion: Since inappropriate communication was the point being complained of more than any other issue, interventions in this area should be considered. Hospitals should identify the root of problems systematically.

 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: Managers are always looking for better ways to improve productivity of staff. The aim of this study was to introduce a model based on work and time measurement for Staff Management based on performance in hospital.

 Materials and Methods: This descriptive - practical study was conducted in ten steps for a medical documents expert’s in a general hospital. The main activities of employees were determined via interview and direct observation. Then expected time, tolerances, final coefficient and work units for each activity were calculated. Finally, the total working units were calculated. 

 Results: Implementation of introduced model for a medical documents expert’s in a general hospital showed that the total work units which the staff was obliged to do in one month was 918 units and the remaining (1160-918) was the extra units.

 Conclusion: Using appropriate models for the performance management of hospital staff workloads, can help to improve the hospital productivity and staff satisfaction.

 Background and Aim: Readiness to face changes and transformation in health fields is one of the main factors in health organizations’ success. The main purpose of the present study was to determine the relation between culture and readiness to accept transformation in single-specialty hospitals.

 Materials and Methods: Readiness to face changes and transformation in health fields is one of the main factors in health organizations’ success. The main purpose of the present study was to determine the relation between culture and readiness to accept transformation in single-specialty hospitals.

 Results: Studied hospitals had low power distance, high uncertainty avoidance, feminist, collectivist and short-term orientation. There was a significant relation between readiness to accept transformation with factors such as: Power distance (P<0/05, r=-0/236), uncertainty avoidance (P<0/05, r=0/143) and being feminist (P<0/05, r=-0/239). There was no significant relation between readiness to accept transformation with factors such as collectivist and short-term orientation (P>0/05).

 Conclusion: Low power distance, high uncertainty avoidance and being feminist are effective factors in accepting transformation among studied hospitals’ staffs. These staffs are culturally prepared to accept evolution plans.

Background and Aim: Nurses are major end-users of hospital information systems (HIS). Therefore their views about strengths and weaknesses of the system are important, and, if addressed, could improve the software system and, in turn, the hospital performance. The purpose of this study was to assess the nurses' perspective about the impact of HIS in Farabi Hospital on nursing process in terms of precision, accuracy and speed .

 Materials and Methods: This was a cross-sectional study . Validity of the adopted questionnaire was approved by a panel of experts in the field. Its reliability was confirmed by Cronbakh-α coefficient test.

 Results: Sixty one percent of responding nurses were somehow satisfied with the implemented HIS, while a remaining 30.5 percent had a complete satisfaction. Also, nurses comments on HIS showed, in general, it enhanced the effectiveness of their related processes.

 Conclusion : According to the nurses, HIS has improved the speed, precision and accuracy of the processes. However, at the same time references was made to some shortcomings in the system, such as low-speed and lack of envision for some important processes, such as appropriate forms for documentation.

Background and Aim: Tele pathology is one of the medical subdivisions that has opened a new approach in the telepathology, e specially to organize consultations. In this research, feasibility of Telepathology implementation in teaching hospitals of Tehran University of Medical Science was studied.

Materials and Methods: This study was a cross-sectional and descriptive study. The study population was included 8 hospitals directors and administrator, 20 pathologists, and 8 informatics staffs, in four teaching hospitals of Tehran University of Medical Sciences. A researcher constructed questionnaire was used for data collection . The validity of the questionnaire was confirmed by expert panel and using by Test – retest method confirmed its reliability. The data was collected and analyzed by SPSS software to prepare descriptive findings.

Results: The R esults showed that 65.6% of hospitals had hardware facilities . Procedures based on legal issues related to information security and privacy was 95.71%, while t here was no guideline for telemedicine and telepathology.

Conclusion: I t could be concluded that in line with considrating the importance and benefits of telepathology, it is necessary to provide software requirements and hardware infrastructure. It should be noted that available properties also must be improved in terms of implementation of telepathology. Also, rules to support patients’ and staff’s rights should be developed for better implementation of such new technologies

 Background and Aim: Patient safety standards are a set of requirements that are crucial for the implementation of patient safety in hospitals. Process evaluation of patient safety in hospitals has developed a mechanism to determine the level of patient safety. This mechanism can also start a program aimed at improving patient safety and evaluate programs that are being used. 

 Materials and Methods: This analytic study was to determine the status of compliance with critical safety standards for patients in 10 hospitals in Tehran in May to August 2013. All segments of the population are hospitals in Tehran and were selected randomizely. Research tool was a checklist and its validity and reliability was approved. SPSS version 16 software for data evaluation and statistical techniques were used.

 Results: According to the data of this study, the mean level of standards was 76.69%. Also, according to the average standards, the highest level of respect in Group D (80.40%) and minimum standards in group B (56.33%) were observed. Hospitals that had more than 400 beds (71.73%) and hospitals with less than 200 beds (66.22%) have been met with standards.

 Conclusion: According to these results, we can increase patient safety standards of our country by establishing the culture of patient safety, patient-centered approach to service delivery, training of staff and patients and legal barriers.

Background and Aim: Based on theories and researches, three variables effective in the organizational citizenship behavior are e thical values, job satisfaction and psychological empowerment. The present study aims to explore the relationship between these variables and the organizational citizenship behavior (OCB) among the staff members of private hospitals in Shiraz.

Materials and Methods: This is a cross-sectional correlational study. Some 330 staff members (147 males and 183 females) were selected using stratified sampling technique. The data collection devices consisted of five standardized questionnaires, the reliability of which turned out to be 0.85, 0.93, 0.70, 0.89, 0.90 and 0.70 Besides, the construct validity was confirmed through factor analysis. The data were analyzed inferentially using Pearson’s correlation test, stepwise regression analysis and SEM.

Results: The findings revealed that there was a significant positive correlation between ethical principles, psychological empowerment and job satisfaction with organizational citizenship behavior (p<0/001). Moreover, the findings of stepwise regression analysis showed that ethical climate played a significant role in predicting OCB.

Conclusion: The staff members’ effort to enhance OCB is mostly influenced by psychological empowerment in private hospital.