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Background and Aim: Nowadays, Information conduct health care system and its substantiation depend on available correct data and reliable information. This study was performed to determine the accuracy rate of statistical indicators in Kashan educational hospitals.

Materials and Methods: This was a cross-sectional descriptive study carried out in March2009- August 2010. Data(the items that need for evaluate of each indicator) were gathered with self-designed checklist. The accuracy of items and hospital indicators were compared with items and indicators that researcher had gathered or calculated. Data(frequency and percent) was presented with descriptive statistical method.

Results: Findings showed that maximum rate of accuracy was found in gross death percentage(68%), and minimum rate was found for the average bed count(24%). The accuracy rates of other indicators were: bed occupancy percentage(39%), bed turn over rate(47%), and bed occupancy average(61%). Net death percentage and bed turn over interval both were(49%). Totally, the accuracy of hospital indicators were 53% which was in a moderate level.

Conclusion: The accuracy of hospital indicators is low. Use of monitoring methods for improvement of its accuracy is recommended.

Background and Aim: Staff satisfaction is one of the basic and important indicators for assessment of contract management. The aim of this study was to survey relationship between contract management and staff satisfaction in hospitals affiliated to the Tehran University of Medical Sciences in 2011.

Materials and Methods: This research was a cross-sectional and descriptive study. Six hospitals which were deployed a contract management system in recent years were chosen. A questionnaire with Likert scale was designed to measure the satisfaction.
One hundered and twenty three employees filled the questionnaire. The data analysis was performed using descriptive statistics and paired t test.

Results: The average staff satisfaction score before implementing contract management system was 3/04(out of 5) and after implementation was 2/86. The correlation of satisfaction among workers before and after the out sourcing was significant(P<0/005). It was clear that satisfaction was reduced after the transfer.

Conclusion: The average staff satisfaction score before implementing contract management system was 3/04(out of 5) and after implementation was 2/86. The correlation of satisfaction among workers before and after the out sourcing was significant(P<0/005). It was clear that satisfaction was reduced after the transfer.

Background and Aim: In many countries, hospitals have triple ownership (governmental or public, for-profit, and not-for-profit). Numerous studies have been performed in order to investigate the differences among these hospitals in accordance to expenditures, presentation of uncompensated therapeutic services, number of outgoing patients and other measurement devices of hospital performance. The aim of this research was to investigate the role of ownership on total Factors Productivity changes in Qazvin`s selected hospitals.

Materials and Methods: Descriptive-analytic study was conducted in three periods of time from 2005 to 2007 in 8 selected hospitals of Qazvin. Inclusion criteria included the active beds and the value of intermediate consumptions in hospitals.The exclusion criteria included the total number of inpatient and surgical operations. Data collection tool, was researcher-designed checklist. Data were analyzed using DEAP 2/1 software and ANOVA, HSD and TUKEY tests.

Results: There was a significant difference between the mean productivity of three hospital groups due to the existence of various ownership(p=%012), Also a significant difference was observed between the mean of technological efficiency of the three groups of hospitals(p=%006), No significant differences was found between the mean of technical efficiency of the three groups of hospitals(p=%23).

Conclusion: Cause of the variation in total factor productivity in private hospitals, is due to their suitable production technology which is always improved. But in respect to their efficiency promotion and optimization of production and products, there was no distinguishing difference with other hospitals.

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: Hospital internal evaluation is considered as one of the most important steps in strategic planning. Therefore, besides the recognition of the weaknesses and limitations of the organization, especially affecting issues on the performance, the responsibility of the organization will be defined. This study was performed for the assessment of internal environment of the Gachsaran's Shahid Rajai Hospital based on Weisbord Organizational Diagnosis model.

Materials and Methods: In a cross-sectional study, 123 hospital staff were selected using random sampling formula. Data was collected using Weisbord Questionnaire which consisted of 35 questions in seven areas. Data analysis was conducted using SPSS statistical software and the t-test.

Results: Among six variables studied, variable communication with 3/15 ± 1/25 mean and standard deviation has the best situation and reward mechanism with the mean and standard deviation of 4/59 ± 1/32 was the worst. There was a meaningful difference among all variables except for the leadership variable.

Conclusion: Based on the findings of this study, Gachsaran's Shahid Rajai hospital has strength in the fields of goals, organizational structure, coordination, and internal organizational communication

Background and Aim: Assessment of hospital performance increases responsiveness and efficiency of limited resources. One of the most useful models of hospital performance assessment is Pabon-Lasso, a graphical model that determines the relative performance of hospitals using three indicators: Bed Occupancy Rate Bed Turnover and Average Length of Stay. The present study aims to compare the performance of Lorestan University of Medical Sciences (LUMS) hospitals using the above-mentioned tools.

Materials and Methods: In this descriptive cross-sectional study, fourteen LUMS hospitals were selected through census. The data-gathering instrument was the standard data form verified by the Ministry of Health and Medical Education. Bed Occupancy Rate, Average Length of Stay, and Bed Turnover Rate were calculated and Pabon-Lasso graph was drawn using SPSS 15.

Results: The average length of stay, bed occupancy, and bed turnover rates turned out to be 3/21 days, 53/07% and 95/54, respectively. Five hospitals were in Zone III, indicating a satisfactory level of efficiency. Four hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. Three hospitals were placed n Zone II. And two hospitals were in Zone IV.

Conclusion: Among 14 studied hospitals, just 5 were considered as efficient. Therefore, it is necessary that policy-makers develop solutions to improve the performance of other hospitals and distribute health resources appropriately.

Background and Aim: Self-reliance is a psychological belief that is formed in an individual during growth and is not changed easily and quickly.
The present study aims to evaluate the relationship between nursing managers' self-reliance and patients' satisfaction in hospitals affiliated to Tehran University of Medical Sciences(TUMS).

Materials and Methods: In this cross-sectional study, 400 individuals(200 nursing managers and 200 patients) were interviewed in various clinical wards of TUMS hospitals. Nursing managers' self-reliance and patients' satisfaction were evaluated using a structured questionnaire.
The data were entered into Stata 11 software and analyzed with non-parametric ANOVA and Spearman's correlation coefficient tests. The significance level was determined to be p<0.05.

Results: Of the nursing managers, 58(29%) were male and 142(71%) were female. The mean and SD of their self-reliance were 134.9 and 19.8, respectively. The patients, however, comprised 81(40.5%) males and 118(59.5%) females. The mean and the standard deviation of patients' satisfaction were 57 and 18.2, respectively the only individual factors affecting their level of satisfaction were educational level(p<0.005) and insurance status(p<0.0001). Besides, a multivariate analysis showed that there was a significant negative association between managers' self-esteem and patients' satisfaction(P=0.04).

Conclusion: The findings revealed that female managers had less self-esteem than male managers. Moreover, it showed that managers' higher self-esteem would cause patients' lower satisfaction. Furthermore, patients with higher education and/or with health insurance were more satisfied than others.

Background and Aim: The Emergency Medical services(EMS) is a community-based health management system that has coordinated with the entire health care system and the employees are the most important asset of it. The purpose of this study was to identify the stressful factors that cause dissatisfaction of employee in the pre-hospital EMS in Kerman.

Materials and Methods: This study was a qualitative study and sampling was targeted. Acception criteria for the study was more than three years of experience as a technician operating in urban and road sites in the EMS. In this study, semi-structured interviews were conducted with 15 personnels and data was analyzed using "frame structured analysis" was used.

Results: This study identified four main axis and fifteen sub axis. The main issues related to the tensions and dissatisfaction include the employees personal problems, organizational problems, poor coordination, and problems with the community.

Conclusion: Considering Psychotherapy for staff and the creation of job rotation between the bases are the constructive suggestions for improving employee performance and improve the system of EMS is Kerman.

Background and Aim: According to the objectives of the information systems and to avoid duplication and help to improve the quality of care and reduce costs, HIS ongoing evaluation should be conducted to achieve these goals. This study has evaluated hospital information systems in selected hospitals with the use of "integrated hospital information system evaluation criteria-2011".

Materials and Methods: This study was a descriptive-sectional research. The study population consisted of information systems in Shohada, Rsool Akram, Khatamolanbia, Imam Khomeyni and Milad hospitals. The data collection tool was a checklist of HIS indicators. Checklist was completed with direct observation and interviews with HIS users in selected hospitals. Data was analyzed by SPSS statistical software, and results were presented in statistical tables and charts.

Results: In the studied hospitals most of the subtypes of organizational and server components of the hospital information system has been set up and used. However, pharmacy, decision support, medical services, communication services and telemedicine information systems, are not yet fully set up in the studied hospitals.

Conclusion: Most subtypes of organizational and server components, currently exist in all fields in the studied hospitals.

Background and Aim: Based on theories and researches, two variables effective in the continuous improvement of services are trust in and identification with hospital goals. The present study aims to explore the relationship between such variables among nursing staff members in private hospitals of Shiraz.

Materials and Methods: This research is a cross-sectional correlation study. Some 340 nurses(58 males and 282 females) were selected using the stratified sampling technique.
Three questionnaires for the assessment of identification with hospital goals, measurement of continuous improvement, and determination of trust in hospital were used. The reliability of data collection devices turned out to be 0.70, 0.70 and 0.79, respectively. Besides, the construct validity was confirmed through factor analysis. Data were analyzed inferentially using Pearson's correlation test and hierarchical regression analysis.

Results: The findings show that the relationship between identification with hospital goals and trust and nurses' effort to improve continuously is positive and significant. Moreover, the results of hierarchical regression analysis show that after controlling gender, age, experience and education, first identification with hospital goals and then trust in hospital play a significant role in the effort to improve continuously.

Conclusion: Nurses' effort to improve continuously is mostly influenced by identification with hospital goals rather than trust in hospital.

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: Considering the information needs of users improves the quality of care . We aimed to Survey the Compliance Rate of Surgical Information Systems with The Information Needs of surgeons.

Materials and Methods: This was a descriptive and original study. Statistical Society consisted of two groups. First was the hospital information systems in hospitals of Tehran University of Medical Sciences and Shahid Beheshti were the first group. The Second group were 982 surgeons. Hospitals that had the highest number of surgeries were the research sample. Researcher gathered data in two steps. First by questionnaire and then checklist was used to collect the data by interviewing the technicians’ of systems . All data has been analyzed by descriptive analysis.

Results: In Rasul and Emam hospitals surgical information systems in scheduling section(50%) had highest conformity with surgeons needs. In flexibility section in all hospitals except of Shariati, they had 50% conformity with information needs of surgeons.

Conclusion: From surgeons view flexibility capability, scheduling and accessing data had highest priority although systems from display capability had not the conformity with the user needs. In designing the surgical information systems in future it is better to consider these capabilities.

Background and Aim: Clinical laboratories, due to their succeptibility to potential risks, are priorities in all activities concerning safety issues in hospitals.
Total Quality Management (TQM) is a model considered by WHO for clinical laboratories safety development. This study aimed to assess how safety standards were followed at the clinical laboratories of hospitals affiliated with Tehran University of Medical Sciences (TUMS) based on TQM safety regulations.

Materials and Methods: This descriptive study was conducted on a research population including TUMS hospitals clinical laboratories in 2012. For data collection, census was applied and sampling was not considered. The data gathering instrument was a checklist measuring seven safety components based on TQM. The validity of the instrument was determined through content validation, and Cronbach alpha was calculated to be 0.82. For the analysis of the results, descriptive statistics including frequency percentage of scores was employed.

Results: The safety of research population turned out to be suitable in terms of four factors: designing, existence of general safety items, conducting standard safety activities, and safe disposal of laboratory wastes. Besides, implementation of safety programs and increase in employees’ knowledge to cope with accidents were relatively acceptable. The emergency evacuation program, however, was estimated as poor.

Conclusion: The studied laboratories enjoy relatively safe conditions, but imperfect implementation of safety protocols can endanger safety conditions. Therefore, it is necessary to take the required correcting measures to ensure full safety in clinical labs.

Background and Aim: Pre-hospital delay is an important cause of increasing mortality in acute myocardial Infarction. There are conflicting data regarding the relationship between sex and pre-hospital delay for patients with acute myocardial Infarction. The aim of the present study was to determine the relationship between pre-hospital delay and sex.

Materials and Methods: This cross-sectional survey was conducted on 162 consecutive patients with acute myocardial Infarction admitted to Cardiac Care Unit (CCU) in Dr. Heshmat hospital in Rasht between May 2010 and September 2011. A convenient sampling method was used. All patients were interviewed within 7 days after admission by using a data collection form.

Results: Mean of pre-hospital delay for women was more than men. Majority of men had chest pain. The women often experienced different and non specific symptoms compared to men. Regression analysis showed no significant relationship between patients' characteristics and pre-hospital delay in women whilst, pre-hospital delay was significantly related to perceiving symptoms to be serious and interpreting symptoms to a cardiac origin in men.

Conclusion: Results of the current study suggest that pre-hospital delay for women was longer than men with acute myocardial Infarction as women often experienced no specific symptoms compared to men. Therefore, it recommended that clinicians educate public, particularly women, on acute myocardial infarction to enable them to recognize the signs and symptoms of acute myocardial infarction correctly and realize the benefits of early treatment.

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: Transforming government hospitals into autonomous units improved hospitals. This study was performed to evaluate the responsiveness of board of trustees hospital according to the world bank’s organizational reform model (Preker Model) in isfahan city.

Materials and Methods: The study was a qualitative research method. In this research, depth and semi-structured interviews were carried out and purposive sampling was used.

The study population were top managers of Amin and Alzahra hospitals . Sampling was started with the first participant until saturated level of information, participants completed the 8 cases.

Results: According to interviews, the current role and contribution of non-university institutions (e.g. municipalities representatives) in hospital board of trustees is neither bold nor transparent. These hospitals can address minimum changes in their mechanisms of accountability after developing board of trustees.

Conclusion : It is rational for hospitals as they undergo organizational reform and developing board of trustees, to have more rights for decision making. Further more, their accountability mechanism should change accordingly.

Background and Aim: Having a preparedness program for earthquake in hospital, with regard to its function for victims of accidents, is very important. The main objective of this study was evaluation of effective factors on the rate of preparedness of Tehran University of Medical Sciences’ teaching hospitals, to deal with earthquake danger of earthquake .

Materials and Methods: This cross-sectional analytical survey was performed in the follow ing hospitals: Sina, Farabi, Roozbeh, and Razi. Data was collected by checklists and questionnaire. Data analysis was performed using statistical software (SPSS19) and Pearson correlation , ANOVA, t-test statistical tests.

Results: The most and the least preparedness against earthquake was in disaster management and construction mitigation plan fields respectively. Relationship between the field of hospital curriculums with construction mitigation plan (p= 0/045 and r=0/644) and hospital environmental health action plan (p=0/048 and r=0/636), was significant.

Conclusion : Average of Hospitals preparation against earthquake was evaluated in an intermediate level (51.81percent). Due to the significant relationship between education and other fields that are listed above it is suggested that in addition to short-term training programs, non-structural retrofitting of hospitals should be considered as a priority.

Background and Aim: Development of information and communication technology has led to enormous changes in different areas. Electronic medical records system is valuable to access patient data in hospitals. This study aimed to investigate and compare the educational hospitals of Uemia University of Medical Sciences in case of technical, organizational and legal to establish the system.

Materials and Methods: The study was a descriptive cross-sectional study. The study population consisted of 98 senior and central managers. In this study population census was used and the entire population were considered as the sample. A questionnaire was used for data collection, which included two sections in order to determine the level of research community awareness and to analyze the standards related requirements for the implementation of the system. Validity and reliability were assessed and the data was analyzed by SPSS.

Results: Sample awareness in 5 hospitals of this study was moderate. In terms of requirements, there was a significant difference between the means of Electronic Medical Records in terms of three variables between hospitals "D" and the rest of the hospitals. And no significant difference was seen among other hospitals.

Conclusion : Three hospitals, "a", "c" and "b", among five studied hospitals are in preparation for the deployment of electronic medical records. Other two hospitals were not prepared. However, the implementation of electronic medical records, increases health care quality, patient safety and patient care and also decreases health costs. So it is suggested that hospitals do necessary efforts to establish EMR.

Background and Aim: Today, healthcare system is exposed to inappropriate human resources distribution challenges in all over the world. So far there is not an appropriate policy for human resources distribution in Iran. This deficiency may cause several problems for providing healthcare services. This research was aimed to determine the situation of human resources distribution among Tehran University Of Medical Sciences (TUMS) Hospitals.

Materials and Methods: This is a cross-sectional definitive study induced in four general and special TUMS hospitals. The research tool was a checklist that determine the number of nurses, paraclinic and supportive employees and finally the decrease and increased of the human resources among the departments of the hospitals regarding Iranian Ministry of Health (MOH) issues. The data was collected and analyzed by SPSS software and determined the differences between current situation in accordance to MOH issues.

Results: We observed the deficiency of human resources among all studied hospitals. Also the distribution of human resources among most of the hospitals departments was not coordinated with MOH issues.

Conclusion : It seems the distribution of human resources among Iranian healthcare system is not followed by a special model. Therefore, we suggest the model of health human resources planning should be determined and related by information, providers, services, education and policy as healthcare system factors and overlapping of these factors.

Background and Aim: If the evaluation is done from the perspective of users, Successful development of measures and features related to use and implementation of hospital information system and identify areas that need further consideration is to be provided. The main purpose of this study was assessment the views of physicians and nurses of hospital information system identify the effective criteria for the use of it and their satisfaction.

Materials and Methods: Present research is a descriptive cross-sectional study and was applied in public- education hospitals of Tehran University of Medical Sciences in 2012- 2013. The main tool was a questionnaire prepared by reviewing relevant literature in databases Iranmedex, Magiran, SID, PubMed, Science direct, Google scholar, and surveys by experts. In order to determine the validity, a questionnaire was distributed among 5 experts in the area of ​​information technology. After completion of the questionnaires, results were analyzed using software SPSS17.

Results: Information systems in half of the hospitals surveyed from the perspective of research community have an average of 30 - 60 percent capabilities in order management. Also users in all surveyed hospitals with more than 43 % agree the ease of using hospital systems.

Conclusion : User satisfaction is a guarantee for the implementation of information system. To improve the situation and move towards the ideal condition we suggest users needs in hospital information systems should be considered. Also design and system should be Compatible with the skills and knowledge of users as possible.