نشریه مدیریت سلامت
پیاپی 33 (پائیز 1387)

In many countries, the medical records are important legal documents, essential not only for the present and future care for patients but also as legal documents to protect the patients and the hospitals. Medical record is a confidential document and always the patient's right to privacy must be regarded. This is a descriptive - cross sectional study. Study sample were 34 of teaching hospitals affiliated with Iran (9 hospitals), Tehran(16 hospitals), Shahid Beheshti (10 hospitals) Universities of Medical Sciences. The data was collected thorough a check list, presented by descriptive statistics on SPSS software. Regarding ratios of privacy and the release of patient information, in Iran, Tehran and Shaheed Beheshti Medical Sciences Universities were 61%,60% and 58 %, for request for the release of information, in 58%,56%,56%; for General Medico-Legal Principles 63%,49%,36%;and for Procedure for the Release of Medical Information in Legal Case were 72/59%, 73% and 81%; for Preparing a Medical Record for Court 52%, 50% and 53%respectively. Considering the importance information of medical record privacy, and due to extended application of medical records for authentication in legal cases, addressing on privacy principles is needed. Also majority of hospitals have dramatic differences with World Health Organization standards. Thus, we suggest more attention in privacy and release of patient information in legal cases and act for promotion policies regarding them.

Kiazen is an approach based on common sense that establish small, comprehensive and targeted changes by staff's common wise. Nowadays most successful organizations and companies owe their productivity and dynamicness to implementation of improvement systems such as kiazen. The present research was aimed to introduce and establish of kiazen operational model, and studying its effects on staff's performance in Fars Oil Industry(F.O.I) central policlinic. the present study is an interventional study, executed by applying an operational model in F.O.I central policlinic. We used pre & post test method to assess the effects of intervention, using performance questionnaire for 176 studied people in under study organization. Our findings showed that according to direct chief of studied staffs there is a significant difference between the five performance dimensions: work quality, cooperation, timeliness, innovation and reliability; before and after the implementation of the model(p<0.001); indicated the improvements of staff's performance in these dimensions. Although no significant difference were observed in two dimensions; work quantity (p=0.61) and work knowledge (p=0.66). simplicity and comprehensiveness of kaizen model and simultaneously its dramatic effects on improvement of processes and productivity of work environment has resulted in improvement of staff's performance in under studying organization. This improvement is independent from staff's age, gender, and education. We concluded that kaizen model is extendable to organizational levels, and could result in wide changes in individuals, organizations and even society.

Thesis commonly reflects student's research interests, which are formed in the university education courses. Formation problem in thesis is one of the most important subjects in these research documents. Limitations and situations govern in research scope causes author (researcher) to limited framework of topic as problem base in his or her research. Investigation of thesis content and their subject trend can help each auditor to identify student's interests, and make a good guidance for correct programming in future. Content analysis method is used in this research, and record unit are "subjects" or "thesis subjects". The bases for subject definition are areas extracted from American National Library of Medical Subject Headings. Three subject heading groups were used; "Information Science", "Administration", and "Health Care Economics and Organizations". Theses are distributed to three main subject groups according content analysis. "Information Science" with 89 theses had the most number of thesis, due to thesis distribution of two majors; "medical record" and "medical library & information science" in this subject. "Health Services Administration" with 67 theses topics in second. "Health Care Economics" with 41 theses topics was in third degree; 13 theses were not included in any of thesis subject groups, and finally each lied in a subheading group. The results show that some subjects were more regarding than others. "Medical library & information science", "staff management", "cost & cost analysis" in have the most numbers; due to: advisor specialization, lessons headings, and disregarding or no knowledge of modern and up to date subjects.

Today increasing growing of health information is results in applying of new technologies for suite manages and utilization of information technologies such as electronic health record. A growing capacity of information technologies in collection, storage and transmission of information has added a great deal of concerns since electronic records can be accessed by numerous consumers at various locations. Now considering Iran's new approach to make electronic health records, the basic question is "what is the appropriate model for their confidentiality principles? The present study is a descriptive investigation made in Iran in 2007. confidentiality principles of Electronic Health Record, gathered from comparative study that carried out about Australia, Canada and England countries. Then designed initial model. Final model information gathered by questionnaire and use of Delphi Technique. Rate under 50 percent eliminated from model and 75 percent and up added to model. The items from the pattern confirmed among 50 percent up to 75 percent and suggested items from participants, again put to votes. Offered model for our country emphasize on patient consent. no emphasis on the use and release of health information in marketing and purposes outside the care cycle without the patient's consent or any other people having an intimate relation with the patient, and the unavailability to his health information by the patient in certain cases. But in contrast to the selected countries, there is a reference in the suggested model to fines for disclosure of electronic health records, data ownership, and inclusion of information accessibility laws in all organizations, responsibility for inaccessibility to information, and finally the conditions for movement of data abroad. Comprehensive model of Electronic Health Records Confidentiality principles is Designed for Iran and Recommend approve and appliying of regulations with usage of proposed model for Protection of Electronic Health Information Confidentiality. Keywords: Confidentiality Principles, Information Confidentiality, Electronic Health Record, Confidentiality Model,

One of the most important challenges of our time is the need to have a system of disaster management to confront the natural and man made disasters. In order to set in place such a system in a country, there is an essential necessity to design a special organizational structure in the areas of disaster management. The main objective of this study was to design a structural model for disaster management in Iran. This is a comparative study with an applied proposed model. In planning this structure of disaster management, the study is based on institutional structures of United Stats of America, Japan, Australia, India, Turkey and Indonesia in comparison with Iran. The information used in this study has been researched both from first hand scientific and bibliographical sources; mainly from foreign sources like books, scientific magazines, official reports which have been obtained directly from databases in the related countries and domestic printed and official published documents. In planning the structural research model, the original model was based on comparative studies and situational analysis of related countries. This model was conceived using Delphi scientific technique and put for scrutiny by 30 of scientific scholars and professionals in the field of disaster management and then the final model was proposed. The results of studies in selected countries showed that: developed countries have an organizational structure for disaster management that is able to respond to natural and man made disasters in one centralized command structure with a structural pattern that enjoys a high degree of centralized complexity and formal structure. Meantime the results in most countries studied showed that the structure of disaster management is in the form of exclusive independent organization under the countries highest executive's authorities. Most countries attention to the whole system of organizing disaster management is focused on process of mitigation, forecasting, preparedness, response and recovery. The pattern designed in this study was also prepared based on the findings of this study's conclusion, like considering basic plan; a centralized unique organization for natural and man made disasters; a high level council in macro level and other levels with a need to categorize the delivery services in accordance with the conditions of Iran was proposed. Paying attention to Iran's vastness; variety of disasters and its degree of strength; necessity of existence of a prevailing plan, a need for a new organizational structure is felt as one of the countrie's essential needs in the field of disaster management. Use of a suitable and deserving structural model will lead to increase economic advantage, reduction of beurocratic barriers and speeding up disaster management related activities.

Today, in most of developed countries, there is a transition phase from bourocratic and official situation to entrepreneurship position. that is why identification and expansion of entrepreneurship related traits especially among managers, is very important. The main objective of this research was to study the relation between entrepreneurship and manager's personality traits health care organizations affiliated with Tabriz University of Medical Sciences. One-hundred sixty one employees at Tabriz universities health care organizations have been selected thorough cluster sampling method; and their points of views about their manager's personalities in case of entrepreneurship, have been assessed. Data collecting tools were standard questioners of the personalities traits (Moqimi-1382) with constant coefficient = 0.8; and entrepreneurship questioners of Zabihi & Moqaddasi (1385) with constant coefficient = 0.78. The data have been collected with self-responding completed questioners. In present research we found a significant and direct relation between manager's personalities traits and the organizations entrepreneurship (p<0.01 &r=0.65). Among manager's personalities traits, the best opportunities absorption has the most effect for the organization entrepreneurship (p<0.01 & F=23.17). Manager's personalities traits have positive and significant relation with the organization's entrepreneurship, and for expanding the entrepreneurship behavior in hospitals and health care organization, developing the absorption personality's traits among manager is necessary.

There are many reasons for an organization to increase its member's level of organizational commitment. Organizational commitment is one of the effective factors in human resource performance in hospitals. Organizational commitment, like other organizational behavior has been introduced in different aspects. First, organizational commitment is a new concept and it is totally different from dependence and job satisfaction. For example, nurses may like their job; however, they feel unsatisfied from the hospital they work, so they would look for another job. Or waiters (waitress) in restaurant may, have a positive feel about the work environment, but they would hate their job. Second, research shows that organizational commitment, with oncoming effects such as job satisfactions, presence, organizational behavior, and job performance and has a positive, and has negative relation with leaving job. Present study was aimed to evaluate Organizational commitment and job stress at Isfahan University of Medical Sciences (IUMS) teaching hospitals managers. This study carried out as a cross-sectional research. The studied population, were all the (IUMS) hospital managers (such as officers, nurses, and...) which have been selected with census method. The data collecting tools were two questionnaires related to measuring the stress and commitment level, their validity and reliability were confirmed by researcher. The questions have been design based on Likert method; and for presenting data descriptive and analytic statistics have been used. The average scores of organizational commitment was (67+13.7); equal for men and women, there was no significant relation between organizational commitment and sex; maximum level of the organizational commitment and age have no significant difference either; with a significant difference between manager's job experience and organizational commitment. The maximum organizational commitment found in those who have more job experiences. Also it showed that there was no significant difference between the type of management and the level of organizational commitment among managers'; and level of stress and sex with years of service; and between job stress and job experiences, type of management and type of hiring. Summary there was no significant difference between manager's job stress and organizational commitments. None of the organizational could be successful without their employee's commitment. Committed managers are more organized in their job and stay longer in their organization. Managers, also have to keep the employees committed and develop this behavior in them.

The aim of this study was the survey of medial students information needs. We expect this study would influences on the clinical education quality, the recognition of student's education needs and the education improvement in emergency and better management of patients by medical students, decreases patients hospital stay, and promotes patients satisfaction. We used direct observations and questionnaires as data collecting tools. Data were analyzed by descriptive statistics and bivariate, two-tailed correlation test, with significant level one percent. Findings revealed significant correlation between diagnosis, and treatment needs (P=0.000, Coefficient=0.576). The majority of the students report information needs as: laboratories test (84.3%), and radiologic reports (74.3%). The least were interested to cadaver's transfer (1.4%), and medico legal coordination (10%). A few organizational or management questions were asked such as: hospital policies, procedures and coordination issues. The students did not pay attention to legal issues. WE recommended initiating programs about importance of legal issues and organizational information in curriculum.