Journal of Health Management and Informatics
Volume:5 Issue: 3, Jul 2018

Hospitals should provide necessary conditions for the renewal of knowledge, skill and attitude through unlearning. Thus, the present study aimed to determine the relationship between antecedents and processes of unlearning and organizational innovation among the teaching hospitals of Hamedan.
This is a descriptive correlational study. The statistical population of the study included 1352 health personnel in four teaching hospitals of Hamedan. To select the administrative personnel, we used the total population; also, for physicians, and for the health personnel we used purposeful voluntary sampling and stratified random sampling, respectively. Based on the methods, 431 were selected as the subjects. Research instruments were unlearning researcher-made questionnaire and innovation scale. Data were analyzed through multivariate regression analysis and structural equation model using SPSS19 and LISREL 8.54 software.
The results indicated that organizational support and training, frequency of changes, and predictability of changes were the positive and significant predictors of the product, process and administrative dimensions. The group crisis was the negative and significant predictor of the product and administrative dimensions. Organizational memory was the positive and significant predictor of the administrative dimension. Individual processes, group processes, and organizational processes were the positive and significant predictors of organizational innovation.
Based on the effective role of organizational support and training, organizational memory and frequency of changes and predictability of changes on innovation in teaching hospitals, it is suggested that the administrators and authorities of the hospitals should accept new opinions of their personnel.

The family physician referral system has been determined as a major goal to economic, social, and cultural development in the field of health in Iran. The necessity of implementing this system has been explicitly stated in high-level documents. Hence, the aim of this study was to evaluate the overall performance of the referral system in Fars Province in 2015.
In this cross-sectional study, 20% of family physicians (75 doctors) were randomly selected; then, all patients of these physicians (1289 patients) in one work shift were studied. The data were collected in three parts containing the questions related to the physician and patients using data collection forms. Finally, data analysis was performed through SPSS, version16, using descriptive statistics and Chi-square test.
The results showed that 70.3% of the patients (906 patients) had used the referral system to visit specialists. Most of the referral forms had been completed correctly (63.6%). Most of the referrals (820 cases) were recognized as necessary (59.4%) and from the first level of referral, i.e. by the family physician (96.3%: 1241 cases). The patients aged 70 and over had the minimum self-referrals, whereas young people aged lower than 20 had the maximum selfreferrals (P=0.03). Also, more self-referrals were observed among highly educated patients (P=0.001).
Based on the findings, the most important problems of the referral system included self-referrals, incomplete referral forms, and unnecessary referrals. Self-referral could be solved through education, establishment of an electronic referral system, and legal measures. Also, educating doctors, making an electronic referral system, and using auxiliary staff and incentive measures can reduce the incompleteness of the referral forms. To reduce the patients’ unnecessary referrals, development of referral guidelines might be very effective.

The estimated human resources needed in the health care sector, especially physicians, have been discussed over the years. Supplying the targeted medical human resources is the key to improvement of health care in a country. The aim of this study was to determine the equity in distribution of physicians in the south of Iran before and after adjusting the needs.
In this study, data were gathered from the Statistics Center of Iran and Ministry of Health for the number of population and physicians, respectively. Birth and mortality rates were used for adjusting the needs. We calculated Gini and Robin Hood indices using the Excel 2013 software. In order to display the distribution of variables in graphical form, we used GIS software as well.
Gini coefficients for general and specialized physicians in 2011 were 0.18 and 0.31, while they were 0.13 and 0.38, respectively, in 2014. The equity in distribution of GPs was better than specialists during the study period. The results revealed a worse status after adjusting needs.
Because the health sector is affiliated to human resources, especially physicians, paying attention to their balance based on the people’s needs is essential. Therefore, the Ministry of Health should put it as one of its goals. Accurate estimation of the required human resources can help to reduce the cost of health care systems as well as those of households.

Unfair distribution of healthcare services is one of the most important issues all over the world. The present study aimed to determine the distribution pattern of available hospital beds and the accessibility pattern to hospitals in Shiraz.
This was an analytical study. At first, spatial distribution pattern of available hospital beds was determined using Moran’s Index (Moran’s I). Then, the accessibility pattern to hospitals was determined using Euclidean distance and network travel distance metrics. Allof the analyses were conducted using Arc GIS (10.3) software.
The results revealed that available hospital beds had a random and unbalanced distribution pattern in Shiraz based on Moran’s I (Moran’s I=-0.05). Besides, according the achieved standard service areas for the existing hospitals, calculated by using Network analysis tools, 65.47% of Shiraz population was underserved in terms of accessibility. Furthermore, assessment of accessibility patterns resulted from both types of applied distances, indicating that in most cases hospitals were located in the central parts of the city.
According to the results of the present study, distribution of hospitals in Shiraz was unfair. Therefore, policymakers are suggested to plan in order to increase the number of Shiraz hospitals. They are also recommended that they should give priority to establishing new hospitals in areas without standard accessibility over areas with standard accessibility based on the results of the present study.

Human resource is considered a valuable capital in management. In this study, the impact of organizational citizenship behaviors on achievement motivation of nurses was assessed.
The current study is a cross-sectional descriptive research which focuses on correlation. The statistical population of the study included all the nurses working in Medical University’s Hospital in Ilam Province in 2016 that included 315 participants and by using Cochran’s formula, the size of the sample equaled 179 participants. Sampling was done using stratified method with appropriate and random allocation. The tools used for gathering information in this study included a questionnaire of demographic information, Inventory of Organizational Citizenship Behavior of Podskoff, as well as the Achievement Motivation Questionnaire of Hermens. To determine the correlation between the variables, Pearson correlation coefficient was applied using SPSS software, version 19, and the confidence level was 95% for controlling the significance.
The mean score of organizational citizenship behavior indicated that the organizational citizenship behavior of nurses in hospitals of Ilam Medical University was at a medium level 75.77±6.1 from 120. The mean score of achievement motivation of nurses working in hospitals of Ilam Medical University 3.02±0.7 from 4 showed to be acceptable and high. Pearson’s correlation coefficient indicated a significant positive relationship among all the components of organizational citizenship behaviors and the achievement motivation of nurses. Pearson’s correlation coefficient showed that there was a positive and significant relationship between organizational citizenship behavior and the nurses’ motivation for improvement (P The significant impact of organizational citizenship behaviors on achievement motivation indicated the importance of this variable in improving the achievement motivation of the nurses and in turn the performance of the hospitals of Ilam Medical University.