Index
Journal Index
Volume 9, Issue 3 , May and June 2012
Abstract
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نامه به سردبیر
Fatemeh Hadizadeh; Peyman Adibi
Volume 9, Issue 3 , May and June 2012
Original Article(s)
Farahnaz Sadoughi; Masoumeh Khoshkam; Sayedeh Raziyeh Farahi
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Hospital information systems (HISs) are computerized systems used as electronic tools for managing patient information. Usability is necessity for the success and acceptability of HISs and can enhance the quality of provided care. This study aimed to evaluate the usability of HISs in Hospitals ...
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Introduction: Hospital information systems (HISs) are computerized systems used as electronic tools for managing patient information. Usability is necessity for the success and acceptability of HISs and can enhance the quality of provided care. This study aimed to evaluate the usability of HISs in Hospitals affiliated with Mashhad University of Medical Sciences (Iran). Methods: This descriptive, analytical study was conducted in 2010. The population consisted of 110 users of HISs in 1 general and 2 specialized hospitals affiliated with Mashhad University of Medical Sciences. Simple random sampling was used to select the interviewees. Data was collected by Bhattacharjee's usability scale which includes usability, continued intention to use HIS, perceived usefulness and benefits, and user satisfaction. The collected data was analyzed using descriptive statistics and Spearman's correlation coefficient in SPSS. Results: More than two-thirds of the users (71.8%) were satisfied with HISs. In addition, 64.2% of the users had the intention to continue using the system and 78.0% of them had perceived the benefits of HIS and believed in its usefulness. However, the system could meet the needs and expectations of only 59.8% of users. Significant correlations existed between system efficiency and intention to continue using the system (P = 0.001), between intention to continue using the system and perceived usefulness (P = 0.001), and between user expectations and perceived usefulness (P = 0.001). Conclusion: User satisfaction, perceived usefulness, meeting user expectations, and intention to continue using the system are distinguished indices to determine the success or failure of HISs. The results indicated that hospitals affiliated with Mashhad University of Medical Sciences were successful in implementing HIS and improving productivity. Since HIS assessment is conducted to modify the system, it is necessary to further evaluate HIS and focus on the problems that lead to dissatisfaction. Keywords: Usability; Perceived Usefulness; User Expectations; Evaluation; Hospital Information System.
Original Article
Ahmad Shabani; Morteza Mohammadi Ostani; Hamed Forugozar
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Knowledge management is one of the most interesting and challenging issues of management in the new millennium. Educational and research institutions such as libraries and information centers are the most suitable places for the implementation of knowledge management programs. This study ...
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Introduction: Knowledge management is one of the most interesting and challenging issues of management in the new millennium. Educational and research institutions such as libraries and information centers are the most suitable places for the implementation of knowledge management programs. This study aimed to identify and rank the factors affecting the implementation of knowledge management in libraries of Shiraz University of Medical Sciences (Iran) based on the technique for order preference by similarity to ideal solution (TOPSIS) approach. Methods: In a descriptive survey during 2010-11, librarians of libraries of Shiraz University of Medical Sciences (88 persons) were assessed. Due to the limited size of population, sampling was not performed. A researcher-made questionnaire on the basis of Bukowitz and Williams's model was used to collect data. Face validity was confirmed by experienced professors and the reliability was estimated to be 0.80 using Cronbach's Alpha. The data was analyzed using descriptive and inferential statistics in SPSS. Results: All factors of Bukowitz and Williams's model (finding, using, learning, sharing, evaluation, development/maintenance, and removal of knowledge) were effective on the implementation of knowledge management in the studied libraries. Except learning and removal of knowledge, other factors were in good conditions. Based on TOPSIS approach, knowledge sharing was the most important factor while removal of knowledge had the least impact on the implementation of knowledge management. Conclusion: Implementing these programs in health environments, where knowledge sharing is important, would provide better services and facilitate learning, teaching, and research. Therefore, understanding effective factors and ranking them is very important. According to the obtained results, the model suggested by Bukowitz and Williams is a comprehensive model for successful implementation of knowledge management in academic libraries of Shiraz University of Medical Sciences. Keywords: Knowledge Management; Libraries; Bukowitz and Williams; TOPSIS Approach.
Original Article(s)
Amir Pouya Iravani Tabrizipour; Safar Fazli; Mohsen Alvandi
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Balanced scorecard (BSC) is regarded as one of the successful tools in performance measurement. However, it neither absolutely nor comparatively provides the weight of each perspective and indicators related to each perspective. In this study, we applied a fuzzy analytical hierarchy process ...
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Introduction: Balanced scorecard (BSC) is regarded as one of the successful tools in performance measurement. However, it neither absolutely nor comparatively provides the weight of each perspective and indicators related to each perspective. In this study, we applied a fuzzy analytical hierarchy process (FAHP) to weight the perspectives and BSC indicators in hospital. Methods: This applied, descriptive, cross-sectional study was carried out in Hasheminejad Hospital in Tehran (Iran) during 2011. First, we provided a list of performance measurement indicators with BSC approach. Paired comparisons were then made through field method and distribution of the standard analytical hierarchy process questionnaire, with the compatibility rate of lower than 0.1, among 7 experts. Afterwards, FAHP was used to obtain the weight of each indicator and each perspective. Finally, weighted accomplishment of each of them in 2010 was evaluated. Results: Among the BSC perspectives, society beneficiaries and services (28.11%) had a little superiority over the other perspectives. Moreover, among all indicators, patients and their relatives' satisfaction and also the learners indicator had the greatest importance in hospital performance. The total performance score in year 2010 was calculated as 95.88%. Conclusion: This study suggested a BSC-FAHP integrated approach to improve the performance measurement in the hospital. The obtained results may help managers and customers of health and medical care section to make appropriate decisions and to use suitable strategies in the future. Keywords: Performance Evaluation; Balanced Scorecard; Analytical Hierarchy Process; Hospitals.
Original Article(s)
Arash Ghodoosi; Heidar Ali Abedi; Akbar Mansouri; Ahmadreza Riaziat
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: The rapid increase in health costs across the world has forced governments to use insurance programs. Uncontrolled costs would reduce the financial ability of insurance organizations in providing services. Abuse of health insurance wastes 3-15% of the health budget annually. This study ...
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Introduction: The rapid increase in health costs across the world has forced governments to use insurance programs. Uncontrolled costs would reduce the financial ability of insurance organizations in providing services. Abuse of health insurance wastes 3-15% of the health budget annually. This study was conducted to determine cases of violating the rules and regulations of Medical Services Insurance Organization by contracted physicians in Isfahan Province, Iran.Methods: In this descriptive study, of 2752 cases of physician contracts, a sample size of 384 cases was selected using random sampling. Content validity and Cronbach's alpha (α = 0.75) were respectively used to confirm the validity and reliability of the data collection tool. After extraction, data was analyzed in SPSS.Results: Visiting patients using another person's insurance book (P = 0.02), using more than one sheet per visit (P = 0.008), and prescribing inappropriate medications (P = 0.024) were significantly more common among general physicians than in specialists. On the other hand, compared to general physicians, specialists were less committed to the determined fees (P = 0.01), more commonly visited patients in groups (P = 0.007), and accepted more limited number of patients under insurance coverage (P < 0.001).Conclusion: The results showed that less than 1% of service providers failed to comply with the rules probably due to lack of awareness. Therefore, insurance companies can provide information on the rules and regulations, replace insurance books with electronic health cards, make timely payments of claims, and hold retraining seminars on professional ethics with emphasis on the Islamic rules and the national law to improve the services provided and prevent violations of the law.Keywords: Insurance; Health Services; Legislation.
Original Article(s)
Shahin Mojiri; Alireza Rahimi; Zahra Bahrami; Mohsen Yaghoubi; Parvin Hematian
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Increasing volume of information in various sciences, such as medicine, has led to the use of various strategies to effectively provide students, researchers, and teachers with medical and paramedical information. The Iranian Ministry of Health and Medical Education has developed an online ...
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Introduction: Increasing volume of information in various sciences, such as medicine, has led to the use of various strategies to effectively provide students, researchers, and teachers with medical and paramedical information. The Iranian Ministry of Health and Medical Education has developed an online digital library, called Iranian National Medical Digital Library (INMDL), which provides access to databases of medical fields. However, it is believed that most researchers in Isfahan University of Medical Sciences still tend to use printed resources due to their insufficient familiarity with electronic databases. The aim of this study was to describe the knowledge of physicians about and their use of INMDL in teaching hospitals in Isfahan, Iran.Methods: This applied descriptive survey was carried out on physicians from 9 educational hospitals in Isfahan. The number of participants was determined based on the Morgan's sample size table. From the 500 physicians working in 9 hospitals, 217 individuals were randomly determined. Data collection tool was a questionnaire whose validity was confirmed by professionals. The reliability of the questionnaire was verified after a pilot study (α = 0.87). Finally, 127 questionnaires were completed and data was analyzed in SPSS18.Results: Most physicians had little knowledge about the e-journals and book databases available on INMDL. Moreover, the majority of physicians made very little use of INMDL. Among the existing resources, most use was made of e-journals while databases and e-books stood next. Education level was significantly correlated with the knowledge of physicians and their use of INMDL. 81 percent of physicians had little awareness to INMDL's e-books and 85.2 percent of physicians had very little use of INMDL's e-books. A strong correlation was also detected between the knowledge of physicians about INMDL and their use of it. Among the electronic journal databases and e-book databases, Science Direct and MD Consult were most frequently used.Conclusion: Medical librarians need to have an active role in informing and educating physicians about methods of searching for information in INMDL resources. In addition, as lack of time is a problem for physicians, educating them to use Alert and RSS services is necessary. Moreover, face to face training can be possible by appropriate medical librarians.Keywords: Awareness; Physicians; Iranian National Medical Digital Library; Hospitals, Teaching.
Original Article
Mohammad Hossein Tahari Mehrjardi; Hamid Babaei Mybodi; Ali Morovati sharifabadi
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Health services currently support physical and mental health of individuals and are a prerequisite for sustainable development in every community. However, such benefits cannot be gained unless balanced distribution of health and treatment facilities and equipments among various geographical ...
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Introduction: Health services currently support physical and mental health of individuals and are a prerequisite for sustainable development in every community. However, such benefits cannot be gained unless balanced distribution of health and treatment facilities and equipments among various geographical regions is ensured. This study assessed the status of development and rankings of Iranian provinces in terms of access to indices of health sector.Methods: This applied, descriptive, cross-sectional study surveyed all Iranian provinces (n = 30) in 2008. In order to collect data, online and printed literate was reviewed and the reports of the Ministry of Health and Medical Education and the Iranian Statistics Center were used as references. The taxonomy technique was employed to determine the degree of development of different provinces. In addition, indices were weighted by Shannon's entropy. Finally, technique for order preference by similarity to ideal solution (TOPSIS) was used to rank the provinces of the country in terms of access to health sector indicators.Results: Taxonomy technique showed 12, 9, and 9 provinces to be developed, semi-developed, and underdeveloped, respectively. Shannon's entropy introduced the ratio of the number of pharmacists to the population as the most important indicator. According to TOPSIS, the provinces of Semnan and Sistan-and-Baluchestan ranked the first and last (30th) in access to health services.Conclusion: In order to reduce imbalance, health policy makers and officials are recommended to consider the developmental rankings of the provinces while allocating resources.Keywords: Provinces; Iran; Health Status Indicators; Techniques; Taxonomy; Shannon's Entropy; Technique for Order Preference by Similarity to Ideal Solution.
Original Article(s)
Mohammad Reza Esmaeili Dooki; Hadi Sorkhi; Seyed Abbas Fatemi; Fatemeh Hosseinzadeh; Yadollah Zahedpasha; Ahmad Tamaddoni; Naeimeh Nakhjavani; Rahim Barari Savadkohi; Iraj Mohammadzadeh; Mohammad Reza Salehiomran; Mousa Ahmadpour Kacho; Abbas Hadipoor; Soheil Osia; Mahmoud Hajiahmadi; Ali Bijani; Hassan Mahmoodi Nesheli; Peiman Eshraghi; Kazem Babazadeh; Ali Mohammadpour Mir
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Medical records consist of documents evidencing a patient's health status at a moment of life. There is a close relationship between disease progress and daily physician orders issued in medical records. Each order in fact reflects the patient's medical status and his/her disease progress. ...
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Introduction: Medical records consist of documents evidencing a patient's health status at a moment of life. There is a close relationship between disease progress and daily physician orders issued in medical records. Each order in fact reflects the patient's medical status and his/her disease progress. In this study, while keeping the previous progress page in the records, a column of brief disease progress was included in physician order sheets to increase the quality of records and promote the education of learners.Methods: In this cross-sectional controlled interventional study, medical records of all patients admitted to super specialty wards of Amirkola Children Hospital during the first quarters of 2009 and 2010 were included. From a total of 3462 records, 150 records were studied each year. Each indicator of disease progress, which was recorded based on subjective, objective, assessment, and plan (SOAP) note, was given a score. Finally, if only three indicators were mentioned in the record, it was considered as poor. Scores 4-5 represented moderate and scores 6-7 were considered as good. The scores of the records were then compared using statistical tests including t-test, paired t-test, Pearson's correlation coefficient, chi-square test, Fisher's exact test, and Kappa coefficient. P values less than 0.05 were considered as significant.Results: The mean number of physician orders in records during the first quarters of 2009 and 2010 were respectively 9.15 ± 10.8 and 8.45 ± 6.80 cases. Good scores had the highest frequency in the new brief disease progress form. The highest average of results in the studied groups was observed in brief disease progress notes of 2010. Comparison of mean scores revealed statistically significant differences (P < 0.05).Conclusion: Adding a new column named "brief disease progressive note" in physician order sheets significantly promoted the recording of disease progress and reasons for medical orders based on SOAP note. Therefore, it is recommended to include this column in physician order sheets.Keywords: Medical Records; Progressive Note; Physician Order Sheet; Documentation.
Original Article(s)
Sedigheh Mohamadesmaeil; Mahrokh Nassehi Oskouei
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: With the increasing role of the Internet as one of the most important sources of information on the one hand, and the enhancement of its usability on the other, it is necessary for web designers and developers to be familiar with the criteria that make a website usable. Therefore, this ...
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Introduction: With the increasing role of the Internet as one of the most important sources of information on the one hand, and the enhancement of its usability on the other, it is necessary for web designers and developers to be familiar with the criteria that make a website usable. Therefore, this paper aimed to provide knowledge about the interactivity, changeability, and non-textual content of websites of Iranian hospital libraries.Methods: In an applied research, the interactivity and changeability of online libraries of Iranian general and specialty hospitals were evaluated. The tool for data collection was a 21-item researcher-made explanatory checklist based on the review of the available literature. The websites of 24 hospital libraries were evaluated by the checklist. In order to analyze research findings, descriptive (frequency and percentage) and inferential statistics were used. All analyses were performed in SPSS and Microsoft Excel.Results: Overall, 38% of both general and specialty hospitals were committed to interactivity and changeability criteria. Non-textual content criteria were met by 26% and 24% of the websites of libraries of general and specialty hospitals, respectively.Conclusion: Since only less than half of the required criteria were met, strategies need to be employed to improve the process of web designing.Keywords: Evaluation; Interactive and Changeable Views; Non-Textual Views; Libraries, Hospital; Internet.
Original Article(s)
Feizolah Akbari; Hossein Joudaki; Mahmood Mahmoudi; Ali Akbari Sari; Alireza Namazi
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Measuring the extent and nature of outsourcing in public hospitals affiliated with Tehran University of Medical Sciences (TUMS), Tehran, Iran was the aim of this study.Methods: In this cross-sectional applied study, we reviewed the relevant literature and interviewed with 5 experts to introduce ...
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Introduction: Measuring the extent and nature of outsourcing in public hospitals affiliated with Tehran University of Medical Sciences (TUMS), Tehran, Iran was the aim of this study.Methods: In this cross-sectional applied study, we reviewed the relevant literature and interviewed with 5 experts to introduce various indices of measuring the extent and nature of outsourcing. We recommended 6 simple indices. The data was collected from 14 hospitals affiliated with TUMS in 2007.Results: The extent of outsourcing in TUMS hospitals was 12% in average. Moreover, the private sector was in charge of 25% of employments. There were 124 contractual agreements between TUMS hospitals and other parties in 2007. A private institute was the other side of 90% of contracts. The other sides of 68% of contracts were recognized in a competitive space. However, 10% of the contracts had been revised during implementation.Conclusion: Although the extent of outsourcing was not considerable, the implementation process of outsourcing was acceptable.Keywords: Policy; Outsourcing; Contracting; Private Sector; Hospitals, University.
Original Article
Alireza Amanollahi; Farhad Shokraneh; Hafez Mohammadhassanzadeh; Mohammad Ebrahimi-Kalan; Ghazaleh Banani
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Most physicians consider abstracts to give a general idea about the full text of an article. Abstracts, as summative and informative parts, contain main information of papers. They also point out the content of papers to readers. The importance of abstracts leads journals to be stricter ...
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Introduction: Most physicians consider abstracts to give a general idea about the full text of an article. Abstracts, as summative and informative parts, contain main information of papers. They also point out the content of papers to readers. The importance of abstracts leads journals to be stricter about their structure and content. This study aimed to assess the abstracts of randomized controlled clinical trials (RCTs) indexed in PubMed according to Consolidated Standards of Reporting Trials (CONSORT) checklist.Methods: In this descriptive cross-sectional study, we assessed all 314 abstracts of RCTs affiliated to Tehran University of Medical Sciences (n = 249) and Iran University of Medical Sciences (n = 65) indexed in PubMed up to the end of 2010. Data was presented in frequency tables and bar charts using SPSS16.Results: Among the items considered in the checklist, only the intervention used in the 2 groups has been completely presented in the abstracts. Other items about the method of randomization, type and design of the RCT, and the number of people involved in the analysis have been reported weakly. The drug interventions were the most common reported interventions (68.2%). In addition, double-blind was the most common blinding method.Conclusion: RCTs were not presented in high quality reports. Therefore, training courses about qualitative reporting of RCT results seem necessary for medical researchers. In addition, editors of medical journals must provide necessary reporting guidelines for authors and reviewers to improve the quality of published researches.Keywords: Evaluation; Randomized Controlled Trials; Databases; Abstracts.
Original Article(s)
Seyed Jamaloddin Tabibi; Amir Ashkan Nasiripour; Ali Ayubian; Hossein Bagherian MahmoodAbadi
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Medical tourism marketing is currently known as a competitive and profitable industry throughout the world. It is considered as a modern field of developed tourism. Appropriate provision of information would increase the awareness of medical tourists about the capabilities of health services. ...
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Introduction: Medical tourism marketing is currently known as a competitive and profitable industry throughout the world. It is considered as a modern field of developed tourism. Appropriate provision of information would increase the awareness of medical tourists about the capabilities of health services. This study was conducted to evaluate the effects of information mechanisms on attracting medical tourists in selected hospitals of Tehran, Iran.Methods: In a descriptive, cross-sectional study in 2011, over 195 directors, administrators, matrons, quality promotion authorities, supervisors, and head nurses of 8 hospitals in Tehran were included. A valid and reliable (Cronbach's alpha = 0.88) 2-part questionnaire was designed to collect data. Data was analyzed using inferential and descriptive statistics in SPSS.Results: There was not a significant relation between information mechanisms and medical tourist attraction (P > 0.05). Among the variables of information mechanisms, only media advertising was significantly related with attracting medical tourists (P = 0.05). However, other variables including brochures, manuals, TV programs, electronic methods, and organizations responsible for tourism had no effects on attracting medical tourists.Conclusion: Since media advertising was the only effective factor in attracting medical tourists, it seems that international advertisements about the potentials of Iranian hospitals would help in attracting more medical tourists.Keywords: Travel Medicine; Medical Tourism; Information Science.
مقاله مروری نقلی
Soodabeh Vatankhah; Mohammadreza Maleki; Shahram Tofighi; Omid Barati; Sima Rafiei
Volume 9, Issue 3 , May and June 2012
Abstract
Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This review study evaluated management contract conditions in selected ...
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Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This review study evaluated management contract conditions in selected countries. We focused on services under contract, different forms of management contract, methods for monitoring contracts, effects of management contract on factors under study, and the payment system in management contract. Management contract is the most common type of privatizing management. In this method, the responsibility and control of a healthcare organization is granted to a person or a private organization. Contracting is used strategically to introduce market mechanisms while ensuring that essential public services are provided. Therefore, the government needs to recognize contracting as a powerful process, not just a cluster of independent transactions. This means that contracting initiatives must be regulated and monitored at the highest level of government by experienced and astute policy makers, economists and operational personnel. Keywords: Outsourcing; Hospitals, Public; Hospitals, Private; Management Contract.
Short Communication(s)
Farkhondeh Asadi; Hamid Moghaddasi; Azamolsadat Hosseini; Mohammd Dehghani
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: Ambulatory care is an inseparable part of health care system. It is commonly considered as the entrance of the patient to the health care system. High qualify ambulatory care has an important role in reducing mortality and morbidity rates. On the other hand, quality of information has an ...
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Introduction: Ambulatory care is an inseparable part of health care system. It is commonly considered as the entrance of the patient to the health care system. High qualify ambulatory care has an important role in reducing mortality and morbidity rates. On the other hand, quality of information has an important role in the quality and safety of ambulatory health care. It is hence necessary to properly manage information. Therefore, this research was carried out to evaluate the outpatient information management systems in hospitals affiliated with universities of medical sciences in Tehran, Iran.Methods: This descriptive study was performed in 2011 to assess outpatient information management systems (clinics and emergency departments). Data was collected using a self-made questionnaire whose content validity was approved. The reliability of the questionnaire was also examined by test-retest. Sample size was equal to society size (42 hospitals). The analysis of data was conducted based on descriptive analysis in SPSS10.Results: None of the evaluated outpatient information management systems employed qualitative review in order to improve the quality of collected data. In addition, about 62% of emergency departments and 78% of clinics did not perform any procedure to organize data within the records.Conclusion: The existence of a high quality and dynamic outpatient information management system is critical. Therefore, the processes and rules on data collection, storage, processing, and distribution in outpatient information management systems require more attention.Keywords: Information Management; Ambulatory Care; Medical Records; Information.
Short Communication(s)
Mohammadreza Hashemian; Mohammad Javad Alemokhtar; Akbar Hasanzadeh
Volume 9, Issue 3 , May and June 2012
Abstract
Introduction: The LibQUAL model measures 3 dimensions on a scale of approximately 22 aspects of services. The purpose of the present research was to evaluate the quality of services provided by libraries of Isfahan University of Medical Sciences using the LibQUAL model. Methods: In a descriptive research, ...
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Introduction: The LibQUAL model measures 3 dimensions on a scale of approximately 22 aspects of services. The purpose of the present research was to evaluate the quality of services provided by libraries of Isfahan University of Medical Sciences using the LibQUAL model. Methods: In a descriptive research, 368 users of libraries of Isfahan University of Medical Sciences participated. Data was collected by the LibQUAL questionnaire. Independent samples t-tests were conducted to analyze the data in SPSS. Results: There were significant negative gaps between minimum levels of services, perceived levels of services, and desired levels of services in all 22 aspects and all 3 dimensions of LibQUAL model. Conclusion: Constant evaluation of all aspects of the LibQUAL model and user education are essential. Keywords: Evaluation; LibQUAL; Libraries.
