Journal of

Background and Aim: Organizational agility is regarded an important factor for hospital effectiveness. Considering the necessity of hospital effectiveness, focus on organizational health can ensure the future success of an organization. This study mainly aims to determine the relationship between organizational agility and organizational health in hospitals affiliated to Shahid Beheshti University of Medical Sciences (SBMU).
Materials and Methods: This is an applied, descriptive-correlational research. The population of the study included all SBMU hospital employees. The 375 members of the sample were selected based on Morgan and Krejcie table. The sampling method was multistage. Data collection tool was the questionnaires of organizational agility and organizational health. The questionnaires were valid based on the expert’s judgment, and Cronbach's alpha reliability value of the questionnaires was 0.88. The data were analyzed by descriptive and inferential statistics (Pearson correlation, regression, and t-test), using SPSS software.
Results: The correlation between organizational agility and organizational health was positive and significant (r=0.66, P<0.05). A significant difference was observed between mean organizational agility and mean reference (-0.43, P<0.05) and also between mean organizational health and mean reference (-0.55, P<0.05).
Conclusion: Hospital managers need to work hard to promote organizational agility so that in addition to obtaining competitive advantage, they can improve organizational health by giving an appropriate and timely response to changes and taking advantage of the obtained opportunities.

Background and Aim: Health and equal access to quality care regardless of age, gender, race and location is health systems' goal in all countries. This study aimed to determine inequality in healthcare services distribution and development level of cities in Guilan province.
Materials and Methods: This descriptive, cross-sectional study assessed the distribution state of 13 healthcare indicators in all cities of Guilan (n=16) in year 2011 and 2013. In order to collect data, the database of Statistical Center of Iran (SCI) was used as reference. The taxonomy technique was employed to determine the degree of development of different cities. In addition, indicators were weighed by Shannon’s entropy. Finally, TOPSIS was used to rank the cities in term of access to health sector resources.
Results: Taxonomy technique in 2 years showed that Rudbar, Rudsar and Lahidjan were of most developed cities and Talesh, Rezvanshahr and Amlash were the most under-developed cities respectively. After weighting indicators and according to Shannon entropy, the number of specialists and paramedics gained the most and the least weight, respectively.
Conclusion: Due to the inequality in distribution of health resources in Guilan province, attention to underdeveloped cities in this province should be a priority. To achieve equitable health resources in Guilan, it is recommended that the plannings be based on state of development of cities.

Background and Aim: Considering the scope of tasks and the role of teaching hospitals in the promotion of population health, it is important to consider their responsiveness as one of the three goals of health system. The aim of this study was to evaluate the level and relative importance of responsiveness domains in teaching hospitals from the viewpoint of households living in selected areas of Mashhad.
Materials and Methods: In this cross-sectional study, a valid questionnaire designed by World Health Organization (WHO) was used. From among the households of two selected areas of Mashhad, 561 families that had the background of referring to teaching hospitals were selected via multi-stage sampling. Based on WHO pattern, descriptive and inferential statistics were used for data analysis.
Results: About 50 percent of the respondents expressed the level of responsiveness as good and very good. Information confidentiality domain and the quality of amenities got the highest and lowest ranks from the respondents’ viewpoint, respectively. The highest and lowest importance belonged to the domains of quality care facilities and family and social support, respectively. 
Conclusion: Considering the relatively low responsiveness of different domains and also the existing gap between families’ priorities and performance of teaching hospitals, it seems necessary that policymakers pay more attention to patients’ priorities such as the quality of care facilities and the creation of appropriate educational content related to medical students. Also, periodic evaluation of responsiveness can be useful in promoting the responsiveness of teaching hospitals.

Background and Aim: Conditions, advantages and limitations of professional ethics have not been discussed. The present study aimed to determine the framework, dimensions and requirements of professional ethics in selected countries in order to review their experiences.
Materials and Methods: The present study was comparatively conducted in 2017. Considering inclusion criteria in designing study including purposeful and specified activity in terms of professional ethics, five countries of United Kingdom, Malaysia, Japan, Turkey and United States of America achieved the conditions to enter the study. For data analysis, comparative tables were used which included dimensional comparison obtained from professional ethics development study in the selected countries. 
Results: Medical and nursing associations and headquarters units in Ministries of Health, prepare appropriate utilization of professional ethics principles. Using temporary or permanent and regular committees in line units, also includes other characteristics of attention to the professional ethics concept in the selected countries. In Malaysia and Japan, professional ethics is taught in different courses and majors. 
Conclusion: Applying professional ethics concept requires information transparency and factors such as education, organizational structure set up and their establishments and institutionalizing must should be discussed more and to be localized on the basis of the countries situations.

Background and Aim: Thalassemia is a chronic disease which is extremely expensive, complex and debilitating. The management skill of thalassemia patients should be enhanced to minimize the risk of disease complications. The main purpose of this study was to develop personal electronic health records for thalassemia major patients.                                             

Materials and Methods: This is a developmental applied study which was conducted to develop a personal electronic health record for thalassemia major. First, a questionnaire was prepared to determine the data elements and was filled by Hematology and Oncology professionals in the country (110 persons). Then, based on the results of needs analysis, the system was designed using PHP programming language and MySQL database and was evaluated by 50 thalassemia patients who referred to the Thalassemia Clinic of Bu Ali Sina Hospital of Mazandaran University of Medical of Sciences during the second half of the month of Aban. Finally, a standard questionnaire of usability and user satisfaction assessment was distributed among them.   
Results: Usability evaluation of the system showed that patients evaluated the system at a good level with a mean rating of 7.91 (out of 9 points). 

Conclusion: The web-based systems can be used to help thalassemia patients to control injection and reduce the complications of the disease and to promote health. 

Background and Aim: Personal Health Record (PHR) systems play a key role in employing patient-centered care. Besides, the inclination to use Internet services has increased in recent years. The goal of this study is to describe the needed requirements for developing the proposed hybrid PHR model in a social network. 
Materials and Methods: Using a descriptive study, a hybrid PHR model was designed in this paper to be implemented in the social health network. Then, by using observation, introspection and questionnaire methods, the requirements of the proposed social network were listed. The elicited requirements were then analyzed by SPSS 16 using descriptive statistics (absolute frequency). Finally, the proposed system was described in the Software Requirement Specification (SRS) standard format. 
Results: The proposed hybrid PHR model has benefits of all existing PHR models and is most consistent with PHR definition (individuals control and manage their PHR). It is also applicable and reliable both for individuals and physicians. The results indicated that the proposed system had PHR capabilities as well as social network functionalities. So, the possibility of creating relations between individuals provided more benefits in comparison to other PHR models.    
Conclusion: By providing reliable information, the social health network can improve patient-physician relationships. As a result, the proposed social health network can make possible the utilization of web 2.0 and social network capabilities in the healthcare field as well as the benefits of PHR records and patient-centered care.

Background and Aim: Medication errors are preventable event, which may result inappropriate medication intake or damage to patients and, Medication management is a complicated process including multiple activities in order to improve patient safety. There are many documentations that indicate the considerable potential of information technology, especially mhealth in this area. The aim of this study was to review the mobile based medication management systems in order to extract the requirements for these systems development.
Materials and Methods: Four electronic databases (PubMed, Embase, Web of Science and Science Direct) were searched for papers regarding mhealth based medication management systems. After screening the abstracts and publications information a descriptive study was performed on 15 papers.
Results: In this study, 13 functional requirements were extracted and the user requirements was divided into six main groups. Also the technologies which was used in order to implement the functional requirements were extracted.
Conclusion: According to the current study, medication management systems using mhealth technologies are feasible for people with chronic diseases, elderly people and etc. but there is not any medication management system for visually impaired people. Although due to their disabilities they are at higher risk of medication errors and it is a research gap that should be considered in future works.

Background and Aim: The quality of healthcare services is determinant in patients’ improvement process, upgrading their satisfaction, ranking healthcare centers, and preventing patients’ repeated referrals leading to more costs for healthcare centers and insurance companies. The purpose of this study was to evaluate the quality of services -- from the perspective of patients -- given by the laboratories having contract with Iran Health Insurance Organization (IHIO). 
Materials and Methods: In this cross-sectional study, the opinions of 302 patients having referred to the laboratories in contract with IHIO in Tehran were surveyed with a researcher-developed questionnaire. Descriptive and inferential statistical tests were used to analyze and report the results.
Results: The sample included 43.5% males and 56.5% females. Most of the participants were married (71/3%). Based on the results, the patients' perception of the quality of laboratory services was 78%. Their expectation of services was 85%. The gap between perception and expectation of clients in all dimensions was statistically significant (p<0/001).
Conclusion: The gap between clients’ perception and expectation in all dimensions suggests that there is some room for improving the quality of laboratory services. The results of this assessment can surely affect the way IHIO treats with laboratories in terms of extending contracts and strategic purchase of services from these centers. In addition, patients' opinions will be important in improving the quality of services. 

Background and Aim: The emergence of Web interactive technologies has enabled interactive social networking services. The purpose of this research is to choose a model and present an architectural design for the social network of health at Shariati Hospital in Tehran.
Materials and Methods: At first, valid enterprise architecture frameworks were reviewed. Then, dimensions of the architecture frameworks needed for the social network of health were reviewed and six dimensions including of input, output, goals, views, abstraction, and system life cycle were selected. Architecture frameworks were prioritized on the basis of these six dimensions and the Zachman framework was selected. The extracted elements for these dimensions were evaluated by using a researcher-made questionnaire and experts’ opinion in the t-test. The questionnaire was distributed among 40 health-care information technology experts. After analyzing and verifying the dimensions and sub-indicators of each dimension, probable risks for the implementation of the health social network were identified based on interviews with experts and were approved by a panel of five experts.
Results: The Zachman framework was selected based on six dimensions as a suitable framework and potential implementation risks were identified.
Conclusion: The results showed that the proposed architecture model could be the basis for the implementation of this network in the country. Attention to extracted risks can minimize the failure of the implementation of the health social network.

Background and Aim: The quality of Electronic Health Records (EHRs) depends on the quality of its content and proper documentation. Determining the Minimum Data Set (MDS) to enhance the quality of electronic health records’ content and helping to improve the quality of health care provision to uveitis patients are essential matters. The aim of this study is to determine the essential MDS for uveitis patients’ electronic health records.
Materials and Methods: In this descriptive-analytical study, data collection tools for collecting the Minimum Data Set were library resources and internet-based database. The MDS was obtained through Likert scale questionnaire and was surveyed by 22 ophthalmologists and retina subspecialists.
Results: Among the elements of the survey, all cases with over 90% approval were considered as main elements. Regarding the importance of presented data elements, no significant difference was found between the responses of ophthalmologists who participated in this study. 
Conclusion: The Minimum Data Set of uveitis patients’ electronic health records can be represented by five groups of demographic information: patients’ clinical records, laboratory information, type of uveitis, treatment guidelines, and the information of ophthalmic pictures. A suggested model for manual systems and electronic medical records is available. 

Background and Aim: In the past studies, few researchers have addressed the simultaneous effects of human capital in health and education indicators on the economic growth of the country, and especially, provinces of the country. Therefore, the current study examined the simultaneous effects of human capital in health and education indicators on the economic growth in Iran s’ Provinces
Materials and Methods: This was an applied, analytical, descriptive study, and the research community consisted of the country's provinces. The data were collected through documentary-library research and from the databases of Iran Office for National Statistics, and Central Bank; afterwards, they were analyzed via unit-root and chow tests, using Generalized Method of Moments (GMM) and Eviews 9. 
Results: The results showed that each percent of rise in family health expenditure, fertility rate, and life expectancy increased the provincial economic growth by 0.033%, 0.71%, and 1.83% respectively. In addition, 1% rise in mortality rate decreased the provincial economic growth by 0.43%. Educational expenditure influenced the provincial economic growth by a coefficient of 0.08, and credit capital asset acquisition, by a coefficient of 0.048.
Conclusion: Human capital is considered a long-term investment in health and education sectors which should be an important priority on the agenda of provincial policymakers. 

Background and Aim: To provide effective care, health care providers need timely and appropriate information. Electronic records provide quick access and easy management of data. The aim of this study was to develop electronic health records for patients with hydatidiform mole and evaluation of completeness of medical records
Materials and Methods: This applied study was conducted in 2017. After verifying the minimum data set required for the system, data were extracted from patient records using a checklist and entered into SQL server. SQL server 2012 and Visual Studio 2013 to design electronic records and SPSS 20 for data analysis was used. Extent of data completion in patient records was also assesed.
Results: Data on the completion of paper records indicated that in 100% of cases, “address” item was filled in. The less completed data was related to carotene deficiency (%1.1). Our findings also showed that the eight most important items like age of first menstruation, first gestational age, interval between pregnancies, number of sexual partners, menstruation between pregnancies, contraceptive methods, social habits and radiotherapy, were not completed in all records.
Conclusion: Many of the important minimum data set for hydatidiform mole disease were either not completed or completed in limited numbers in paper records. By developing such health records, we can ensure better prevention and treatment, and regular follow-up for the patients and help them to save their time and costs.

Background and Aim: Workplace bullying around the world is a work-injury factor, a mental health alarm and a global disaster. The aim of the present study was to investigate the relationship between transformational leadership and workplace bullying among employees at Shiraz University of Medical Sciences taking into account the mediating role of organizational health.
Materials and Methods: The research method was descriptive - survey. Research instruments chosen for the purpose of this study included The multifactor leadership questionnaire as the standard instrument for measuring transformational leadership behavior Bass & Avolio with(0.79) reliability, Graham Lowe’s standard questionnaire of organizational health questionnaire with(0.79) reliability and for organizational bullying a researcher-made questionnaire with(0/83) reliability was used. The statistical population of the study consisted of 265 university staff who were selected by simple sampling method. The research hypotheses were analyzed using SPSS and Lisrel 8.8 softwares and descriptive statistics and path analysis.
Results: The results showed that the components of transformational leadership affected workplace bullying indirectly and negatively through the mediation of organizational health. In addition, among the components of transformational leadership, idealized influence had the highest indirect effect(-0/19) on workplace bullying.  Among the components of organizational health, vibrant workplace had the highest level of direct effect(-0/27) on workplace bullying.
Conclusion: A good leadership style creates a healthy organization and reduces workplace bullying. Therefore, organizations need to develop organizational health and provide training, especially to managers of organizations.