Index
Volume 9, Issue 7 , December 2012
Abstract
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Original Article
Raheleh Samouei,; Tayebeh Tayebani; Mohsen Moslehi
Volume 9, Issue 7 , December 2012, Pages 951-957
Abstract
Introduction: Research is one of the major indicators of success of societies in various scientific,technological, and economic domains. University faculty members, in general, are of the most importantgroups with scientific and administrative responsibilities in this field. Therefore, addressing their ...
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Introduction: Research is one of the major indicators of success of societies in various scientific,technological, and economic domains. University faculty members, in general, are of the most importantgroups with scientific and administrative responsibilities in this field. Therefore, addressing their researchneeds and requirements is considered as a major aim.Methods: In this cross-sectional, analytical and prospective study, 119 faculty members of IsfahanUniversity of Medical Sciences, Iran, using a researcher-made questionnaire (α = 0.95) were participated.They were selected in proportion to their population and were invited individually to complete thequestionnaire. The data were reported based on descriptive statistics.Results: The obtained mean scores were 3.91 for social needs, 3.9 for organizational needs, 3.81 foreducational needs, and 3.93 for supportive needs. The highest reported needs were defining an appropriatebudget and providing enough free time for researching.Conclusion: The faculty members had various needs in the research field; however, they emphasizedmore on financial supports. Generally, universities should have regular and targeted programs for activerole of instructors in the research field.
Original Article
Sayed Hamid Raza Shavaran; Saeed Rajaeepour,; Iraj Kazemi,; Bibi-Eshrat Zamani
Volume 9, Issue 7 , December 2012, Pages 958-968
Abstract
Introduction: Universities and their faculty members are responsible for educating students for socialresponsibilities. If the faculty members are to contribute to the attainment of university and societal goals,they should trust their dean, colleagues, and students. This will facilitate the collective ...
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Introduction: Universities and their faculty members are responsible for educating students for socialresponsibilities. If the faculty members are to contribute to the attainment of university and societal goals,they should trust their dean, colleagues, and students. This will facilitate the collective efficacy of facultymembers. If faculty members believe in their collective abilities, the attainment of academic goalsbecomes feasible. The main objective of this research was to study the relationship between trust andcollective efficacy of faculty members in Isfahan selective public universities, Iran.Methods: This was a descriptive-correlation study. From all faculty members of University of Isfahan,Isfahan University of Medical Sciences, and Isfahan Industrial University a sample of 261 subjects wasselected through proportional stratified random sampling in 2011. Data gathering tools included thestandardized questionnaire of organizational trust and a self-administered questionnaire of collectiveefficacy, which their reliability coefficients were estimated 0.81 and 0.89, respectively. To analyze thecollected data, SPSS software version 16 was utilized and analysis was done through descriptive andinferential statistics including correlation and multiple regression.Results: The findings indicated that collective efficacy was affected by faculty members’ trust and itscomponents in all three universities. However, collective efficacy at University of Isfahan could bepredicted only through trust in students and colleagues. Trust in students affected the collective efficacy ofIsfahan University of Medical Sciences faculty members, while the collective efficacy of faculty membersin Isfahan Industrial University could be predicted through trust in dean and colleagues.Conclusion: Collective efficacy of the faculty members may be predicted through trust and its components.It is, therefore, suggested that university chancellors, college deans, and departments chairpersons attempt tocreate and maintain a space of trust for faculty members. This can be accomplished through encouragingcooperative culture, maintaining coordination among academic departments, and faculty empowerment.These measures would lead to the improvement of university performance in general
Original Article
Rafat Mohebi-Far,; Hossein Safari; Hasan Jafari,; Bahman Ahadinejad; Mahdieh Torka
Volume 9, Issue 7 , December 2012, Pages 969-976
Abstract
Introduction: Citizenship behaviors are behaviors which are not mentioned directly in the formal rewardingsystem of organization and often are forgotten and usually are regarded as voluntary; nonetheless, they affectthe activities of organization. Quality of work life is an important index which can ...
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Introduction: Citizenship behaviors are behaviors which are not mentioned directly in the formal rewardingsystem of organization and often are forgotten and usually are regarded as voluntary; nonetheless, they affectthe activities of organization. Quality of work life is an important index which can provide enough andbeneficial information for management from employees-related major issues and creates sense of ownership,autonomy, responsibility and security for them which may result in increasing productivity of employees.This study aimed to analyze the relationship between organizational citizenship behavior and quality of worklife in university hospitals affiliated to Qazvin University of Medical Sciences, Qazvin, Iran.Methods: This was an analytic cross-sectional study which performed on 117 physicians, nurses andpara-clinical and supporting staff who were selected randomly from university hospitals affiliated toQazvin University of Medical Sciences. Williams-Anderson and Casio questionnaires were used for datacollection and data were analyzed using SPSS version 11 and Spearman, chi-square, Student’s t-test andANOVA tests were employed.Results: Quality of work life had obtained higher mean score than organizational citizenship behavior.Among organizational citizenship behavior’s dimensions, the highest mean score was for altruism (0.89),and the least belonged to the civic virtue (0.78). There was a direct correlation between quality of work lifeand reverence, civic virtue and altruism. None of these relationships were statistically significant except therelationship between organizational citizenship behavior and quality of work life. Correlation coefficientbetween organizational citizenship behavior and quality of work life was -0.177. It means that there was anindirect significant correlation between organizational citizenship behavior and quality of work life (P < 0.05).Conclusion: Improving quality of work life will affect performance and productivity of employee andalso any improvement in each dimension of organizational citizenship behavior affects other dimensionsand creates a desirable environment for implementing tasks. Considering the adverse relationship betweenquality of work life and organizational citizenship behavior, hospital managements should implementappropriate procedures in order to make them paralleled.
Original Article
Habib Allah Doaei; Monireh Salehnia; Somayeh Ahmadzadeh-Jozi
Volume 9, Issue 7 , December 2012, Pages 977-988
Abstract
Introduction: Having a desirable image in a market can be considered as an asset for an organization.Therefore, using proper approaches, managers of such organizations must monitor and manage the imageof their organizations in order to achieve their organizational goals and their customer’s satisfaction. ...
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Introduction: Having a desirable image in a market can be considered as an asset for an organization.Therefore, using proper approaches, managers of such organizations must monitor and manage the imageof their organizations in order to achieve their organizational goals and their customer’s satisfaction. As animportant sector of every society, managers of hospitals also must try their best to induce a desirableimage of their organization in their customers’ mind. The present study aimed to evaluate the effect ofcustomers’ perception from human capital of organization on their mental image formation about hospital.Methods: It was a descriptive survey, and the population were the inpatients of one of the hospitals whichwas affiliated to Isfahan University of Medical Science in fall 2009. Data collection was done by aquestionnaire and its validity and reliability was confirmed by factor analysis and Cronbach’s alpha.Results: Knowledge and communication skills of employees affected the customer's image formation abouthospital (B = 0.594, P < 0.001). Results showed that knowledge (B = 0.622; P < 0.001) had more influencethan communication skills (B = 0.548; P < 0.001). Finally, the study presented ranks of influencing factorson image formation based on human resource groups (physicians, nurses, employees and staff).Conclusion: Customers’ perception of knowledge and communication skills of employees affected thecustomer's image formation about hospital; thus, for managing hospital and marketing services, managersof hospital must attempt to promot human resource to human capital.
Original Article
Masoud Ferdosi; Sayed Mohammad Ehsan Farahabadi; Maryam Mofid; Farzaneh Rejalian; Maryam Haghighat; Parnaz Naghdi
Volume 9, Issue 7 , December 2012, Pages 989-996
Abstract
Introduction: Hospitals are required to focus on core activities which are inevitable affair. The sensitivityof the monitoring and supervision mechanism as well as preserving and enhancing the quality ofoutsourced services prevent new problems in this area.Methods: This was a descriptive and applied ...
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Introduction: Hospitals are required to focus on core activities which are inevitable affair. The sensitivityof the monitoring and supervision mechanism as well as preserving and enhancing the quality ofoutsourced services prevent new problems in this area.Methods: This was a descriptive and applied study which was done by case study (pretest-posttest)method. Outsourcing nursing services of clinical wards (ENT and surgery) of Kashani Hospital wasstudied. Data were extracted from the questionnaire (internal customer's satisfaction), semi-structuredinterviews with officials and also survey of financial and administrative documents as well as recordsrelated to the topic. The validity of thee questionnaire was approved using the standard form of thesatisfaction in Isfahan University of Medical Sciences, Iran and its reliability was based on calculatingCronbach’s alpha.Results: The findings indicated an increased number of graduate nurses per bed to fulfill the main goal ofoutsourcing. However, achieving this goal was accompanied with increasing costs per bed and resulted inincreased total costs of the hospital after outsourcing. In addition, the intangible changes in internalcustomer satisfaction with the performance of non-governmental sector have been achieved.Conclusion: While outsourcing should bring about staff and patients' satisfaction and increase theefficiency and effectiveness, outsourcing nursing workforce strategy led to severe loss of efficiency.Therefore, the adopted strategy did not meet the productivity for the hospital
Original Article
Sayed Mohammad Ehsan Farahabadi; marziyeh Fattahi; Mehrzad Artang; Akbar Hassanzadeh
Volume 9, Issue 7 , December 2012, Pages 997-1005
Abstract
Introduction: One of the most important duties of manager is to organize and maintain enterprisesystems. Managers are responsible for the amount and type of employee commitment to the values oforganization. Committed and loyal workforces have significant impact on health service delivery in healthorganization. ...
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Introduction: One of the most important duties of manager is to organize and maintain enterprisesystems. Managers are responsible for the amount and type of employee commitment to the values oforganization. Committed and loyal workforces have significant impact on health service delivery in healthorganization. The purpose of this study was to identify average of three dimensions of commitment (i.e.affective, continuous and normative commitment) of disaster management and emergency medical staff.Methods: This cross-sectional study was carried out in 2011. The staffs of Isfahan Emergency Medicaland Disaster Management Center (Iran) were the study subjects. Sample size was estimated as 128subjects using simple random sampling with 0.2 as the accuracy of sampling. Data were collected usingquestionnaire that its validity and reliability had been tested in past studies. Data were analyzed by SPSSsoftware and application of Spearman correlation and analysis of variance (ANOVA).Results: The mean score of organizational commitment was 59.7. The score of affective commitment was69.2 (first rank), continuance commitment was 50.6 (third rank) and normative commitment was 56.4(second rank). The maximum score was 100.Conclusion: Due to the critical role of emergency medical staff in ensuring the health of people and savethem in case of accidents, it is essential for managers to concentrate on organizational culture and alsocontinuous commitment by activities such as increasing job security, creating positive changes inorganizational culture, providing appropriate training and orientation before the recruitment. Incentiveprograms with the aim of increasing organizational commitment in employees could be another solution
Original Article
Mohammad Hossein Yarmohammadian; Farrokh Mojahed; Reza Gholi Vahidi; Kamal Gholipour; Azad Shokri; Vahid Rasi
Volume 9, Issue 7 , December 2012, Pages 1006-1016
Abstract
Introduction: Discharge against medical advice (DAMA) may expose patients to an increased risk ofadverse medical outcomes. We conducted an intervention based on the factors associated with dischargeagainst medical advice for reducing DAMA.Methods: This was a pretest-posttest intervention conducted in ...
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Introduction: Discharge against medical advice (DAMA) may expose patients to an increased risk ofadverse medical outcomes. We conducted an intervention based on the factors associated with dischargeagainst medical advice for reducing DAMA.Methods: This was a pretest-posttest intervention conducted in Dr. Soulati Hospital in Urmia, Iran, in2011-2012. We analyzed the data extracted from the clinical governance office forms about self-discharge.After determining causes of discharge against medical advice (DAMA) according to data in 2011, wedesigned an intervention in clinical governance team to reduce the rate of self-discharges. Interventions likeeffective relationship among physician and patient, financial support in DAMA cases, and assessing patients’decision-making capacity were designed. Four months after implementing, we analyzed self-dischargesprevalence rate and result was compared with the previous year. Data were analyzed using the Excelsoftware and information presented by descriptive statistics.Results: The rate of DAMA in the study hospital was found to be 4.6% which decreased to 2.8 percent ofall the discharged patients 4 months after the intervention. Among patients who discharged againstmedical advice in this study, family or financial obstacle, patient’s healthy feeling, dissatisfaction withtheir care, dislike of the hospital environment, prolonged hospitalization, and patient judgment ofimprovement were the most important factor for their decision.Conclusion: Discharge against medical advice comes from many factors and information about thereasons for DAMA is necessary for identifying implementable strategies to reduce the likelihood andadverse health consequences of DAMA. Enhancement of doctor-patient communication, improvement ofhospital environment and social workers could reduce the DAMA rate. The need for a clearly documentedsystem or guidelines for assessing and managing such patients is highlighted.
Original Article
Tayebeh Tayebani; Ayatollah Sohrabi; Raheleh Samouei
Volume 9, Issue 7 , December 2012, Pages 1015-1023
Abstract
Introduction: Addiction treatment centers have been increased in the country. The therapist’s health isimportant for their contact with patients with an excessive damage caused this survey to study job burnoutof the therapists in the licensed addiction centers in Isfahan, Iran and its relevance ...
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Introduction: Addiction treatment centers have been increased in the country. The therapist’s health isimportant for their contact with patients with an excessive damage caused this survey to study job burnoutof the therapists in the licensed addiction centers in Isfahan, Iran and its relevance with individual andprofessional factors.Methods: This was a cross-sectional study done on 137 therapists in withdrawal addiction centers ofIsfahan, Iran in 2011 (34 physicians, 14 psychiatrists, 42 psychologists and 46 nurses). Data collectionwas done using Maslach Burnout Inventory (MBI) (α = 0.87). The subjects were selected through simplerandom sampling and the questionnaires were distributed among them. Frequency, percentage, standarddeviation, Student’s t-test, correlation coefficient and analysis of variance were used.Results: The results of this study suggested that the mean score of lob burnout in the survey samplecompared with the referent score was weak and the job burnout in the emotional exhaustion (13.79) anddepersonalization (4.44) dimensions was weak and in terms of decreasing personal efficiency (14.87)reported to be medium. A significant correlation was observed between the job burnout and variables ofjob background, consent of income, interest in job and attitude to the effectiveness of clinical work.Conclusion: Although weak, there was some burnout among the study subjects, so that the intensity in twodimensions of emotional exhaustion and personal efficiency reduction is worrying. Therefore, it is necessaryto distinguish the intensifier and reducer factors in individual, organizational and environmental dimensions.
Original Article
Ahmadreza Reisi; Susan Bahrami,; Somayeh Safdari; Somayeh Shafiei
Volume 9, Issue 7 , December 2012, Pages 1024-1031
Abstract
Introduction: Human resource is one of the most important resources of an organization. Since theattempt of anyone is depend upon his motivation and satisfaction, these are important prerequisites to dothe right things. The more the individual-organization fit, the more and the finer the job consequences ...
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Introduction: Human resource is one of the most important resources of an organization. Since theattempt of anyone is depend upon his motivation and satisfaction, these are important prerequisites to dothe right things. The more the individual-organization fit, the more and the finer the job consequences willbe. This study aimed to determine the relationship between individual-organization fit and job satisfactionof nursing managers.Methods: This was a descriptive-correlative study. The statistical population included nursing managers inuniversity hospitals of Isfahan, Iran. The method of sampling was census (n = 150). Data collection toolsincluded two standard questionnaires of individual-organization fit and job satisfaction. The content validitywas verified and the reliability of individual-organization fit questioner was 0.92’ and for job satisfaction itwas 0.86. For data analysis both descriptive and inferential statistics were used containing frequencypercentage, mean, standard deviation, Pearson correlation coefficient, t-test and multiple regression test.Results: The level of interest and job characteristics were higher than mean score and the personality, skilland knowledge level were lower than mean score. In general, person fit level was lower than mean scoreamong components of individual-organization fit. Moreover, components of organization fit were higherthan the mean level. Among job satisfaction components, opportunity component was higher than themean level and the colleagues, income, organization type and job component were lower than mean level.In general, job satisfaction components were lower than the mean level. Finally, there was a positive andsignificant correlation between individual-organization fit and job satisfaction. Multivariable regressionshowed that there was a significant correlation between individual-organizations fit and job satisfaction.Conclusion: Since the degree of individual-organizations fit and job satisfaction level was less than theaverage score in nursing managers which will eventually lead to lower efficiency and effectiveness oftheir performances and activities, the hospital managers must be careful in selecting human resources andgo along with the individual-organizations fit parameters and provide necessary conditions required forthe fulfillment of the organization objectives
Original Article
Alireza Jabbari,; Farzaneh Mahmoudi Meymand; Fatemeh Nezamdoust; Zahra Agharahimi; Leila Shojaei
Volume 9, Issue 7 , December 2012, Pages 1032-1038
Abstract
Introduction: In recent years, dental tourism had a growing trend. As a branch of medical tourism, indental tourisms people travel abroad to receive dental services which are with a higher cost in theircountry. This study aimed to identify potential of dental tourism in Isfahan, Iran.Methods: This was ...
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Introduction: In recent years, dental tourism had a growing trend. As a branch of medical tourism, indental tourisms people travel abroad to receive dental services which are with a higher cost in theircountry. This study aimed to identify potential of dental tourism in Isfahan, Iran.Methods: This was a qualitative study that was conducted in 2011 in Isfahan. Data collection was doneusing a semi-structured questionnaire with directed questions that was completed through interview. Formeasurement of the validity, the data of the qualitative study was checked with some participants toensure the acceptance rate (objectivity). Dentists who provided service for foreign patients during the pastyear were selected.Results: Out of 79 patients who were referred to dentists and participated in the study, 63.3% of themwere females. Reconstructive services were allocated the highest percentage (58.2) between the types ofservices received by the foreign patients. 81.8% were with Iranian nationality residing abroad. Potential ofdental tourism in seven categories were the demand conditions, urban advantages of Isfahan, manpoweroperating conditions, competitive conditions in the dental centers offering medical tourism, medicaltourism requirements, related and supporting industries and information strategies.Conclusion: Despite suitable capabilities of ecotourism, professional staff and competitive advantage inIsfahan, its position is not clear yet. To develop the dental tourism in Isfahan, It is necessary to strengthenrequirements for medical tourism, increase coordination of related and supporting industries, increaseinformation strategy and marketing.
Original Article
Lida Shams; Golrokh Atighechian; Sayed Mohammad Ehsan Farahabadi
Volume 9, Issue 7 , December 2012, Pages 1039-1046
Abstract
Introduction: Due to the fact that nurses constitute the highest percentage of hospital staff and quality ofhealth care is largely influenced by their performance, evaluation of the internal environment from theirperspective can greatly indicate the improvement and the strength points of the hospital. ...
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Introduction: Due to the fact that nurses constitute the highest percentage of hospital staff and quality ofhealth care is largely influenced by their performance, evaluation of the internal environment from theirperspective can greatly indicate the improvement and the strength points of the hospital. This study aimedto clarify nurses’ view regarding the status of the internal environment component.Methods: A quantitative-analytical study was carried out in educational, non-educational and privateselected hospitals of Isfahan University of Medical Sciences, Iran in 2010. The sampling method wasclustering method and inside the cluster, it was done proportionally. Finally, nurses were selectedrandomly. Inclusion criteria were being nurse with bachelor and master degrees. On this basis, the numberof sample was estimated equal to 384. Data were collected using standard questionnaire (WiseboardSix-Dimension Box Model) with Cronbach's alpha of 89.7. Data were analyzed using statistical tests suchas Pearson correlation, independent t-test and analysis of variance (ANOVA).Results: Considering the factors included in this study i.e. “purposes”, “structure”, “helpful mechanisms”“relationships”, “leadership”, “reward mechanism”, the weakness of all the hospitals in the rewardmechanism was revealed (educational hospitals = 22.6, non-educational hospitals = 24.0, privatehospitals = 25.4). The organizational structure was the weakness of non-educational hospitals and alsoable to improve in the other studied groups (educational hospitals = 19.88, private hospitals = 19.93).Conclusion: Systematic approach at the design and development of a fair compensation mechanism withrepresentatives of staff can have a significant impact on improvement of the current situation of studiedhospitals and also facilitates organization to achieve its goals
Original Article
Akbar Etebarian; Karim Azarbayejani; Saeid Salehizadeh; Amirhossain Honarmand
Volume 9, Issue 7 , December 2012, Pages 1047-1057
Abstract
Introduction: It has been experienced that performance improvement and promotion of human resourcesas the most valuable assets of an organization has the most vital role in its success. The aim of this studywas measuring impression of ACHIEVE (ability and skill, clarity, help, incentive, evaluation, ...
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Introduction: It has been experienced that performance improvement and promotion of human resourcesas the most valuable assets of an organization has the most vital role in its success. The aim of this studywas measuring impression of ACHIEVE (ability and skill, clarity, help, incentive, evaluation, validity,environment) model on functional promotion of staff.Methods: It was a descriptive study which included all the medical, paramedical and financial staff(n = 1201) of Dr. Shariati Hospital in Isfahan, Iran. Sampling was done through a stratified randommethod and data was collected using a researcher-made questionnaire. Cronbach’s alpha was calculated as0.841 and validity of the questionnaire was confirmed by experts (n = 186). In data analysis, one samplet-test, paired t-test, Hotelling’s T2 were used.Results: The results showed that seven factors introduced by ACHIEVE model had a significantrelationship with staff performance and productivity especially for incentive (motivation factor)(x = 4.28); however, organizational support (x = 4.26) and individual skill (ability) of staff (x = 4.22) werein next preferences.Conclusion: Motivation factor as the most influencing factor on the promotion of staff functioninfluenced on their performance.
Original Article
Mahmoud Keyvanara; Nahid Tavakoli; Raheleh Samouei; Fatemeh Tavakoli
Volume 9, Issue 7 , December 2012, Pages 1058-1065
Abstract
Introduction: The focus on social capital in recent years has been based on the effect of this capital onproducing and increasing the human capital and also improving the level of general health in the society.The social capital is discussed as a potential in successful social welfare programs and general ...
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Introduction: The focus on social capital in recent years has been based on the effect of this capital onproducing and increasing the human capital and also improving the level of general health in the society.The social capital is discussed as a potential in successful social welfare programs and general health; andfor the same reason, a specific place has been assigned to investigate and codify the social, physical andmental health indices. The purpose of this study was to identify the relationship between social capital andmental health among the social sciences students in University of Isfahan, Iran.Methods: The investigation was conducted using descriptive and correlation studies. Initially, theconcepts of social capital and mental health were identified using script studies and then the data werecollected and expressed. The relationship between students’ social capital and mental health wereanalyzed using SPSS software.Results: The findings showed an inverse statistically significant correlation between confidence,belongingness, affection, and trustworthiness with mental health. Based on the findings of the study, therewas a relationship between students’ social capital and mental health.Conclusion: One of the significant indices was the low level of communion, confidence, belongingness,affection and trustworthiness among students which is an indication of lower social capital among them
Original Article
Mahbobeh Janghorbani; Ahmadreza Raisi,; Sanaz Dehghani; Arefeh Mousavi
Volume 9, Issue 7 , December 2012, Pages 1066-1072
Abstract
Introduction: Global patient safety is the concern of all areas of the health care. In addition to the humansuffering in those inflicted unsafe care and services, it has a heavy economic cost. Due to the sensitivepatient safety in the operation rooms, the present study aimed to assess patient safety ...
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Introduction: Global patient safety is the concern of all areas of the health care. In addition to the humansuffering in those inflicted unsafe care and services, it has a heavy economic cost. Due to the sensitivepatient safety in the operation rooms, the present study aimed to assess patient safety in the operating rooms.Methods: This was a descriptive cross-sectional study that was conducted in Shahid Beheshti Hospital,Isfahan, Iran operating room in 2011. The data were collected through standard questionnaires for patientsafety friendly hospital census from 20 senior, middle and executive managers as well as operating roomstaff of Shahid Beheshti Hospital. In order to assess the level of patient safety, average score of 0-0.5represented a poor level of performance, 0.5-0.7 an average level and 0.7-1.0 showed an intermediate level.Results: Average score for rule and leadership was 0.7 ± 0.35. In community participation and interactionwith patients 0.56 ± 0.37, in evidence-based clinical services 0.73 ± 0.35, in safe and secure environment0.78 ± 0.37 which indicated the average, good, good, and good states, respectively. The average overallsafety score was 0.71 ± 0.36 and showed a good performance.Conclusion: Although the score for the level of safety was good, the organizational policies and programsin this area at present are not sufficient to achieve a higher level. Necessary investments in strategicplanning must be investigated in order to achieve 100% standards in the four domains
Original Article
Mohammad Hossein Yarmohammadian; Farhad Shafiepour Motlagh
Volume 9, Issue 7 , December 2012, Pages 1073-1080
Abstract
Introduction: The perceived lean services are definite type of the therapy services that patients’ needs areresponded based on information about how to receive services in hospitals and medical centers. Thepresent study aimed to determine the relationship between availability of patients’ ...
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Introduction: The perceived lean services are definite type of the therapy services that patients’ needs areresponded based on information about how to receive services in hospitals and medical centers. Thepresent study aimed to determine the relationship between availability of patients’ therapy informationmanagement infrastructures and perceived lean services to find suitable model.Methods: The study population included all the patients in the hospitals and medical centers of Isfahan,Iran (n = 103). Subjects were selected by available sampling method (2011-2012). This was a descriptivecorrelativestudy in which the data were collected through three researcher-made questionnaires:Questionnaire of availability to patients’ therapy information management infrastructures (33 items,α = 0.87), questionnaire of perceived lean services (12 items, α = 0.93) and questionnaire of patient’ssatisfaction (15 items, α = 0.89).Results: The results indicated the direct effects of information management infrastructures caused bycondition of perception for patients (0.34) and information management for outpatients (0.27) in additionto the direct effect of the outpatients (0.42) and direct effects of information management for reception ofpatients due to any additional time (0.33). Moreover, there was a direct effect of information managementfor patients’ medical documents and literacy (0.13). The comparative fit index (CFA) showed that themeasurement model fit the data very well with a goodness of fit index (GFI) of 0.9 and adjusted goodnessof fit index (AGFI) equal to 0.953, root mean square error of approximation (RMSEA) equal to 0.078, anda chi-square equal to 268.6 (P < 0.001).Conclusion: The therapy information management infrastructures must be prepared to enhance quality ofservices to patients.
Original Article
Asadollah Shams; Mojgan Mosaddegh; Saeed Afrough; Elham Asadi
Volume 9, Issue 7 , December 2012, Pages 1081-1086
Abstract
Introduction: Nowadays, more than ever we have forgotten that solving health problems depends uponwhat people should do for themselves. Helping people is a vital issue along with intelligent healthservices, against treatment services which make people depended, and are high-cost and less effective.The ...
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Introduction: Nowadays, more than ever we have forgotten that solving health problems depends uponwhat people should do for themselves. Helping people is a vital issue along with intelligent healthservices, against treatment services which make people depended, and are high-cost and less effective.The aim of the present study was to assess the philosophical principles of the prevention in primary healthcare (PHC) and the knowledge and belief of the directors of the health care in this regard.Methods: This was a descriptive-analytical survey. Research tools was a researcher-made questionnaire withthree types of basic, knowledge and attitude questions about 9 philosophical principles of PHC. Validity andreliability were approved by experts and Cronbach’s alpha (84%), repectively. Study population included384 individuals of top, middle and executive managers of Isfahan, Iran Health Institutions in 2002. Student’st-test, analysis of variance (ANOVA) and Pearson’s correlation tests were used.Results: The highest mean knowledge score of the nine philosophical principles of PHC belonged to "loveand motivation" (98.3 ± 41.1) and the lowest philosophical dimension score belonged to "equality andjustice" (65.7 ± 29.2). The highest average score of philosophical attitude was in "coordinate betweensection” (81.5 ± 23.0) and the lowest philosophical dimension belonged to "equality" (49.1 ± 12.8).Conclusion: The average score for all the categories of knowledge management was a little higher than80. The mean attitude score was 65. This result was not good for the system; because the attitude ofmanagers plays a key role in the run up to the principles of PHC.
Original Article
Masoud Ferdosi; marziyeh Fattahi; Samaneh Jafari
Volume 9, Issue 7 , December 2012, Pages 1087-1103
Abstract
Introduction: Studies of design location are done in order to respond better to the needs of the physicalspaces of the hospital. The present study aimed to improve workflow processes of emergency departmentthrough the study of designing the location in restructuring of the emergency department of Shariati ...
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Introduction: Studies of design location are done in order to respond better to the needs of the physicalspaces of the hospital. The present study aimed to improve workflow processes of emergency departmentthrough the study of designing the location in restructuring of the emergency department of Shariati Hospitalin 2011 as one of the largest hospitals in Isfahan Province, Iran that has to deal with emergency patients.Methods: This was a descriptive case study related to Emergency Department of Shariati Hospital in2011. Data were collected in 4 Parts, i.e. reviewing the duties and functions, workflows, challenges andexisting spaces and design changes. According to the clinical and supportive areas in emergency plans in2011, data were collected through standardized questionnaire and direct observations to codificationprocesses. Data were analyzed using Excel Software.Results: Out of six objectives of restructuring, setting up triage had the first priority and among processesand spaces, emergency patient admission process, toxicity admission process, children admission process,entrance, triage, critical and noncritical patient section, had the most fundamental changes, respectively.Conclusion: According to the accreditation standards, it is essential for hospital managers to payparticular attention to the building standards, which is one of the major causes of patient satisfaction. Theymay use the simple, comprehensive and applicable method of design location plans in hospitalrestructuring, process improvement, and develop building quality improvement program according toaccreditation standards.
مقاله مروری نقلی
Saeed Karimi,; Najmeh Bahman Ziari
Volume 9, Issue 7 , December 2012, Pages 1113-1122
Abstract
Health is a multi-core processing and is very important. On the one hand, many factors involved increating and sustaining it and is the result of the participation of all administrative units of a communityand on the other hand, has a significant impact on other sectors of a society. What is important ...
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Health is a multi-core processing and is very important. On the one hand, many factors involved increating and sustaining it and is the result of the participation of all administrative units of a communityand on the other hand, has a significant impact on other sectors of a society. What is important in thehealth care is equity. The present study aimed to review the fairness and justice of our health servicesduring the third and fourth development programs. This study conducted in 2012 by reviewing the libraryand internet to collect information about the subject. Then the research findings were organized andarranged. As was stated, although there are no shortcomings in terms of legal content and planning forexpanding equity in financial access, there are numerous problems and by ending the third and fourthdevelopment programs, there is no statistical analysis and annually documented reports to know to whatextent the goals have been achieved. Reviews showed that health sector policies could not significantlyimprove equity in financial access. However, we have made improvements to some extent but moreresearch is needed to find out the root causes of unsuccessful applications.Keywords: Equity; Health; Financial Indicators of Health; Development Plans
مقاله مروری نقلی
Alireza Jabbari; Raja Mardani
Volume 9, Issue 7 , December 2012, Pages 1104-1112
Abstract
Information and communication technology have made it easier to trade health services and the business israpidly growing. Health services under the General Agreement on Trade in Services (GATS) are tradedthrough four modes. Migration of health professionals, the 4th mode of trade in health services, ...
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Information and communication technology have made it easier to trade health services and the business israpidly growing. Health services under the General Agreement on Trade in Services (GATS) are tradedthrough four modes. Migration of health professionals, the 4th mode of trade in health services, has had agrowing trend due to demographic changes, aging populations and rising health care costs in high-incomecountries as factors that increase demand, and expanding exports, increase foreign exchange incomes,increase knowledge and skills of employees supply as factors encouraging supply. Although migration ofhealth professionals to countries has advantages, it can be a challenge too. This study reviewed theopportunities and challenges of migration of health professionals from the Asian countries. Trade in healthservices as one of most complex challenges of health system, its various types, and the current situation ofAsian countries dealing with the fourth type were studied and opportunities and challenges of migration ofhealth professionals were expressed. Studies showed that countries importing or exporting health services arenot faced with identical opportunities and threats. Migration to higher income countries has the opportunityto work and better conditions for health professionals and provides a source of income for the exportingcountry. However, lack of explicit policies in this area will lead to the depletion of the country of origin fromskilled labor which reduces labor and leads to loss of national wealth spent on educating the staff.
مقاله مروری نقلی
Mohammad Hossein Yarmohammadian; Hossein Ebrahimipour; Farzaneh Dousty
Volume 9, Issue 7 , December 2012, Pages 1123-1131
Abstract
Ever environmental changing and the rapid advancement of technology has forced the health careorganizations to accommodate in line with appropriate changes. In sectors like healthcare, there are manylegal restriction and clinical guidelines that practitioner have to comply with. Therefore, these featureslead ...
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Ever environmental changing and the rapid advancement of technology has forced the health careorganizations to accommodate in line with appropriate changes. In sectors like healthcare, there are manylegal restriction and clinical guidelines that practitioner have to comply with. Therefore, these featureslead to less freedom and authority to free core business process from non-value adding activities andreengineering of process for practitioners. Nowadays, flexible principle of business process management(BPM) is a strategy that successfully applies in many developed countries. BPM includes identifying thecurrent status of processes, modeling and determine effects of process’s reforms implementation. In manycontexts, this approach has been introduced as the third wave of reforms that is the effective method, andits aims are to eliminate previous methods defects and considering budget constraints and the legalrequirements. Through focusing on essential steps of process, integration and eliminating the non-valueadded steps, BPM provides the possibility of increasing the flexibility, quality and speed of processes. Inhealthcare organizations, employing BPM, via integration of electronic health record (HER) and hospitalinformation system (HIS), and guidelines, meet the above mentioned aims. In this paper, after briefdescription of process-oriented trend history, we introduced the BPM approach, and its aims andintervention scopes in healthcare organizations were described
مقاله مروری نقلی
Alireza Jabari; Gholamreza Sharifirad; Azad Shokri; Najmeh Bahman Ziari; Ayan Kordi
Volume 9, Issue 7 , December 2012, Pages 1132-1145
Abstract
The ultimate goal of the health care system of any country is to promote public health. Reformingprograms were required because of failure to respond to the needs and expectations of health in recentdecades. Rural family physician was a part of these reforms of the health system, which was implementedin ...
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The ultimate goal of the health care system of any country is to promote public health. Reformingprograms were required because of failure to respond to the needs and expectations of health in recentdecades. Rural family physician was a part of these reforms of the health system, which was implementedin 2006. The aim of this study was to evaluate the performance of the rural family physician programsince it was started. This review was done by searching in Google, Google scholar, SID, Magiran,Iran-doc with the following keywords: Family physician, rural family physician, family medicine, ruralfamily medicine. 32 related articles were extracted and analyzed. The objectives of family physicianprogram were classified in several sub-goals series including referral system, accountability, access, cost,coverage, priority-based health services, formation of health record, control the quality of services,satisfaction and attitudes of health team staff and service recipients and the family physician performancein achieving this goals. Generally, after a few years of implementation, the program has performedrelatively well but the referral system and presenting feedback from specialists, patients follow-up andcompleting health record was not implemented properly. Access was improved and unnecessary costswere reduced although good holistic health insight has not institutionalized yet.
مقاله مروری نقلی
Saeed Karimi; Fatemeh Rezaei; Ayan Kordi
Volume 9, Issue 7 , December 2012, Pages 1146-1151
Abstract
Introduction: The use of high-cost and high-tech magnetic resonance imaging (MRI) has expanded overthe past decade. A recently conducted research reported various causes with regard to their own countryand healthcare system included aging population and advances in diagnostic technologies which couldresult ...
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Introduction: The use of high-cost and high-tech magnetic resonance imaging (MRI) has expanded overthe past decade. A recently conducted research reported various causes with regard to their own countryand healthcare system included aging population and advances in diagnostic technologies which couldresult in diagnostic services to become more applicable in clinical arena. Increasing number ofradiologists, access to physicians and these types of services affect its use. This study aimed to determinethe level of magnetic resonance imaging service utilization in 2010-2011 for specialties, types of MRI andfund coverage.Methods: This was an analytical study. Information of various MRI types, prescribed MRI by eachspecialists and various fund of health insurance was extracted from the Isfahan Health Insurance, Irandatabase through census method during 2010 and 2011 midyears. Excel was used to analyze each group.Results: Over two midyears (2010-2011), total number of prescribed MRI increased about 177 MRIs.Neurologists and orthopedic specialists ordered the most scans (843 and 819 scans in 2011 and in 2012,respectively which was related to orthopedic specialists and then to neurologists) and were the mostfrequent users of CT/MRI scans. Abdominal scans (n = 1218) in 2010 and lumbar scans (n = 921) in 2011were the most ordered scans, respectively. The most prescribed MRI was related to governmentemployees fund (average number = 1472) and the lowest was related to self-employed insured fund(average number = 17).Conclusion: Increased number of performed MRI is rooted from different causes. Increased number ofMRI centers could cause an upward trend. Other effective factors in utilization these services would betime pressure for physical examination, professional uncertainty, patients' expectations to prescribe moredrugs and diagnostic services, lack of a proper payment system and inadequate payments to physicians
مقاله مروری نقلی
Faranak Shafiei; Farzaneh Farhadieh; Sayed Ali Taheri; Raheleh Samouei; Arsalan Pirasteh
Volume 9, Issue 7 , December 2012, Pages 1152-1157
Abstract
Introduction: With expansion of vocational role of nurses, they are responsible for the whole aspects ofhealth cares from legal and moral viewpoints. Therefore, they must be responsible for their actions andobserve the law as the main element of their duty. This study aimed to survey the level of staff ...
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Introduction: With expansion of vocational role of nurses, they are responsible for the whole aspects ofhealth cares from legal and moral viewpoints. Therefore, they must be responsible for their actions andobserve the law as the main element of their duty. This study aimed to survey the level of staff awarenessabout regulations for considering guild and vocational violations of staff affiliated to Medical Sciences inNour and Ali Asghar Hospital in Isfahan, Iran.Methods: In this cross-sectional study, the whole nursing staffs of Nour and Ali Asghar Hospital wereasked to complete the questionnaire, after measuring and analyzing the validity and reliability ofquestionnaire. Its data were analyzed using Pearson's correlation coefficient and Student’s t-test. Datawere processed by SPSS software.Results: In this survey, most of the responders were female (82.7%) married, (74%) bachelors (BScholders), were nurses (97.3%), had nurse organizational position (88.7%) and, were contractualemployment position holders (31.3%). Furthermore, the results showed that there was no significantassociation between the awareness of nursing staff to mentioned regulations and sex, material status,education level, organizational position and employment status; however, there was a direct correlationbetween the staff awareness and their record of services (P < 0.05).Conclusion: In present conditions, health care staff must be sensitive to their vulnerable profession.Nurses, while should obtain information from nursing advances, must render the best and safer care forpatients. In principle, the holding of in-service continuous instruction, with obtaining effective privilegesin promoting job position and gaining motive factors of different classes of personnel can be effective.
مقاله مروری نقلی
Amir Ashkan Nasiripour; Pouran Raeissi; Mohammad Reza Maleki; Mohammad Javad Akbarian Bafghi
Volume 9, Issue 7 , December 2012, Pages 1158-1168
Abstract
Introduction: The mixed marketing is an important issue in providing the healthcare that the healthcareprovider organizations need it to survive in the contemporary era and have more market shares, revenueand to increase customer service efficiency and effectiveness. The present study aimed to provide ...
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Introduction: The mixed marketing is an important issue in providing the healthcare that the healthcareprovider organizations need it to survive in the contemporary era and have more market shares, revenueand to increase customer service efficiency and effectiveness. The present study aimed to provide apractical model of the factors influencing the mixed marketing in Iranian public hospitals.Methods: This was an applied and analytical study. Considering the field of health care services, 7PService Marketing Mix Model of "Booms and Bitner" was used and the conceptual research model wasdetermined. The dimensions of conceptual model were in the seven dimensions that included theproduction (services), price, place, promotion, physical evidence, processes and peoples. Then, using thelibrary studies, the variables relevant to each dimension were collected. Data collection tool was aquestionnaire that regulated base on five-item Likert scale. The research community was formed frompublic and private hospital administrators in Tehran, and experts of Ministry of Health and MedicalEducation. Data analysis was done through Lisrel version 8.50 and SPSS version 18 and using exploratoryand confirmatory factor analysis.Results: The fit indexes of Lisrel confirmed and acknowledged the healthcare mixed marketing modelwith seven dimensions. The dimensions that had the greatest impact included the place with factor of 0.82and six components affecting it. The price with factor of 0.81 and eight components affecting it were alsoidentified. Meanwhile, other aspects of the research in terms of impact were identified: i.e. "services" withnine components, "promotion" with eight components, "physical evidences" with ten components,"peoples" with eight components and "process" with six components.Conclusion: Healthcare centers can use the mixed marketing service model with confirmed sevendimensions in marketing management through concentration on place and price.
Amir Ashkan Nasiripour; Mohammad Ali Afshar Kazemi; Ahmad Reza Izadi
Volume 9, Issue 7 , December 2012
Abstract
Introduction: Balanced scorecard is one of the most successful and widely used models of performance assessment in healthcare organizations, especially in hospitals. The model is a framework for designing a set of performance measures for organization strategies. The study was conducted aiming ...
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Introduction: Balanced scorecard is one of the most successful and widely used models of performance assessment in healthcare organizations, especially in hospitals. The model is a framework for designing a set of performance measures for organization strategies. The study was conducted aiming to yield a performance assessment model for Iranian social security hospitals with balanced scorecard approach. Methods: In this adaptive and descriptive research, 11 theory and practical models of balanced scorecard with successful experiences were studied. A model for Iranian social security hospitals was designed. A questionnaire was designed as a data collection tool. It was validated using expert's survey in Delphimethod. Reliability coefficient for this questionnaire was relatively high (Cronbach's alpha = 0.94). Independent t-test was used to identify significance of expert responses. Results: The mean score of experts opinion about the proposed model was 4.02 (out of 5) for mission statement and 4.5 for continuous improvement in healthcare quality and safety policy, 4.66 for optimization of current resources and facilities utilization, 4.66 for team working for satisfying ourpatients/clients policy, and 4.32 for responsible for environment and employee health and safety policy. The mean score was 11.66 for clinical perspective, and 11.5 for patient perspective, 11.66 for internal processes perspective, 10.78 for financial perspective and 11.46 for employee growth perspective. Totally, 27 measures were designed for these perspectives one of which was excluded. Conclusion: The model can be implemented in one or all the social security hospitals and also can be used for comparing the performance of the hospitals. Because of the dynamic nature of the balanced scorecard, the model is a flexible framework that could be adjusted by local situations based on differences in targets.
