نشریه مدیریت سلامت
پیاپی 51 (بهار 1392)

quality of services provided to patients Is prominent in hospitals as a large and complex service organization and the most important service units within the health system، Patients can determine the quality of services provided. The aim of this study is assessment of service quality gaps in educational and therapeutic Imam Khomeini Complex in Tehran، by using the difference between patients'' perceptions and expectations from Services and then analysis and discussion of findings.

Reviews of 116 patients admitted in educational and therapeutic Imam Khomeini Complex in Tehran، were examined by using the six-dimensional SERVQUAL model in a cross-sectional method. Validity and reliability were confirmed by researchers. Samples were estimated using the Cochrane statistical formula and the data were analyzed Using an independent t-test، correlation test and ANOVA.

There was a negative gap in all dimensions of The quality of services provided. The most gap was figured (-2. 55) in the access dimension and the lowest gap (-0. 697) was in assurance dimension. Also، none of the variables، including gender، marital status، insurance، visit frequency، age and education، was obtained significant relationship with service quality gap (Pvalue>0. 05).

In any dimension، expectations of patients are not being met and can، by affecting on each side of expectations'' or perceptions'' dimensions affect on the other side، except in the access dimension. In general، there is much opportunity for improvement in the quality of services at this center.

Collaboration between researchers at domestic and international level is an extensive form of scientific collaboration emphasizing the importance and benefits of collaborative research. This study was aimed at investigating the rate of collaboration between researchers in Tehran University of Medical Sciences with their counterparts in other countries and institutions in the Web of Science publications. This was a survey using scientometrics indicators. The instrument of the study was the Web of Science in which the scientific products of Tehran University of Medical Sciences including 5781 records were investigated between 2006 and 2010. To determine the collaboration between researchers، collaboration coefficient formula was used. The authors’ collaboration coefficient mean was 0. 64 showing their high interest in collaborative research. Investigation into scientific products showed that the rate of scientific collaboration was lower at the international level (22%) than the domestic level. The results showed that the researchers in Tehran University of Medical Sciences had scientific collaboration with 69 countries. The lowest annual growth rate (3. 7) was related to international collaboration. Main partners of Tehran University of Medical Sciences were the USA، UK، and Canada، respectively. Based on the number of co-authors، the highest collaboration rate belonged to the documents with five to eight authors. This rate increased from 33% in 2006 to 45% in 2010. The findings indicated that co-authorship and collaboration in the period studied is on the rise for Tehran University of Medical Sciences suggesting researchers’ interest in scientific collaboration.

It is of prime importance to consider the pattern and geographical changes of a disease، in each community independently، to determine high and low risk areas. Mapping diseases is a set of statistical methods which attempt to provide precise maps by which the geographical distribution of a disease is estimated. In this study، Bayesian methods were applied to estimate the relative death rate of work-related accidents in Iran. For the purpose of this study، the data of work-related accidents of Iran in 2009 were analyzed. To estimate the parameters of the map، empirical Bayes method (Poisson-Gamma method) was applied using Winbugs 1. 4 software. Moreover، the Arc GIs 9. 2 software was used to set relative incidence of death and accident related maps. Regarding the estimates achieved by empirical Bayes method and applying Poisson-Gamma for the incidence of work related accidents in 2009، the maximum and minimum prevalence risk rate among men was 2. 991 in Markazi province and 0. 457 in Khorasan Razavi province، while they were 3. 848 in Semnan province and 0. 243 in Hormozgan province for women. Overall، the incidence of work-related accidents follows no specific geographical distribution pattern and in most provinces the pattern was different for men and women in Iran. By and large، the incidence of these events in the neighboring provinces of Tehran is more than the other parts of the country.

Regarding the importance of medical research، scientific mapping and social network analysis، the main aim of this article was to visualize scientific mapping of medicine in Iran in 2007 based on the two indices of degree and betweenness centrality of social network analysis. In this scientometric study، the population of the study included all medical scientific products of Iran in 2007 indexed in Science Citation Index (3967 documents). Network Workbench Tool (NWB) was used for calculating subject category co-citation، analyzing social networks and visualizing the maps. More than 37% of scientific products of Iran in 2007 belonged to medical categories. The most productive category was general and internal medicine and the most cited category was from pharmacology and pharmacy. These two categories together with biochemistry and molecular biology ranked the highest in degree and betweenness centrality. The strongest co-citation link was between general and internal medicine and public health، occupational and environmental health. Using the social network indices is effective in the analysis of scientific mapping of medicine. Highly productive and more cited subject categories have strong presence in scientific maps of subject category co-citation.

Organizational climate is a set of characteristics describing and distinguishing an organization from the other organizations. This climate is almost stable over time and may affect the prevailing behaviors in organizations. The purpose of this study was to assess organizational climate of libraries at Babol University of Medical Sciences. This cross - sectional study was conducted in 2011. The population of the study included all full time، temporary and would be full time staff of Babol University of Medical Sciences (25). A standard questionnaire for data collection as well as the questionnaire of O rganizational Climate (OCDQ-RS)، designed by Lille Sussman and Sam Deep، were used. The data were analyzed by descriptive and inferential statistics using T-test and ANOVA. The results showed that of the maximum score of organizational climate (160) the average organizational score of the libraries under the study was 112. 04. There was no significant difference in organizational climate of the libraries under study in school، hospital and central libraries. However، there was a significant difference in the males’ and females’ attitudes towards the prevailing organizational climate in the libraries (P = 0. 012 (. Among The eight indicators of organizational climate the highest average scores belonged to the indicators of disturbance or inhibition (16. 52)، intimacy (16. 32) and team spirit (16. 20) and the lowest average score was related to distance indicators with the average of 11. 24. Based on the findings of the study، library management and authorities have an important role in improving the organizational climate of libraries. They could provide management strategies to raise interest، creativity and motivation among employees.

The important role of labor productivity could be observed in Iran 4th and 5th Economic Planning. The literature shows the perception of productivity from the view point of employees engaged in industry / service procedures. Drawing on this perception makes an initial stage in increasing productivity. The main objective of this research was to identify and rank the effective factors on employees'' productivity in Shahid Sadoghi Hospital. This survey was analytical – descriptive in nature. The population consisted of all personnel in Shahid Sadoghi Hospital with the sample size of 145 persons. Two questionnaires were used for data collection. To analyze the data one sample test and multi- criteria decision making techniques were used. The demographic characteristics showed a high potential of personnel. With statistical tests and data processing techniques eight hypotheses were approved. Finally eight effective factors on personnel’s productivity were identified and ranked. The findings revealed that the managerial، organizational support compensation، mental and physiological working conditions and degree of freedom and liberty of employees to work were the most effective factors. TOPSIS technique was used to rank the relevant items. These factors could be used as the core of productivity cycle، and implementation of on job training for managers.

In Emergency Departments (ED)، seconds and minutes are vital for the patients. Therefore، a logical decision making is crucial to manage the patients’ waiting time. Simulation، a decision supporting technique، is used to analyze risk factors and strategies in decision making. The purpose of this research was to apply this method to reduce patients'' waiting time in the ED at Ayatollah-Kashani Hospital. The population of this applied- analytical study included the patients referred to the ED at Ayatollah-Kashani Hospital in Isfahan during May 2008. Having recognized the patients’ workflow، the researchers gathered the required data concerning the time of patients’ arrival and service delivery at various stations for 663 patients during 2 weeks. The data were used to design a simulation model for the ED using simul8 software. The validity of the model was verified through comparing the results obtained from the manual system with those from the simulation model which led to the formation of the finalized model. The results showed an increase in the waiting time when implementing alternatives 2، 9، 10 and 12 while a decrease was observed in other alternatives. In alternatives 6 and 13-17، the total waiting time decreased more than the other alternatives. The most amount of reduction was observed in alternative 15، so much so that the waiting time of receiving emergency services reduced from 112. 19 to 99. 24 minutes. This could be due to the placement of an intern student at Eye- Nose-Throat (ENT)، Neurology، and Orthopedic stations which caused reduction in the waiting time from 38. 89، 13. 31 and 12. 13 to 26. 54، 6. 58 and 5. 98 minutes، respectively. Since health care managers، especially in the ED، are mostly physicians not experienced enough in statistical analysis، it is essential to provide them instruments with which they can readily achieve scientific approaches to reduce costs and patients’ waiting time. Applying various research methods such as simulation can satisfy these goals.

The speed of service delivery in health care systems، particularly in emergency centers، is crucial to reduce mortality and disability rates. One of the indicators used to evaluate the emergency departments is patients’ waiting time for receiving diagnostic/treatment services. This study aimed to measure the timing indicators in the emergency department at Firoozgar hospital. This cross-sectional، observational study was conducted during April to September 2012. The study population consisted of all patients admitted to the emergency department at Firoozgar hospital. Workflow forms were used to collect data from five groups. Data were analyzed using Thematic Analysis. According to the findings، in emergency department، the average access times to first clinical visit، first nursing services، receiving lab tests، taking radiology images، and waiting time were found to be 3، 3، 170،125، and 305 minutes، respectively. The timing indicators of emergency at Firoozgar hospital were close to standard which could be due to the presence of emergency resident physicians and the disposition committee.