ahmad ameryoun

Value stream mapping (VSM) is one of the most important and widely used tools for lean thinking to identify non-value adding activities and improve the service delivery process. The aim of this study was to design a value stream map to improve the sonography service process in a military hospital..

Methods :

Value stream mapping (VSM) is one of the most important and widely used tools for lean thinking to identify non-value adding activities and improve the service delivery process. The aim of this study was to design a value stream map to improve the sonography service process in a military hospital.

The results showed that on average, the waiting time for sonography was 42.6 minutes and the main service cycle time was 30.6 minutes. On average, the total time for each sonography procedure was 73.3 minutes. The most frequently waste in the sonography process was related to “correction waste”, such as unclear sonography orders, incomplete registration of sonography orders, and mistakes in specifying the type and organ of sonography by the referring physician. Finally, the possibility of sending a prescription for appointment scheduling and receiving responses through social networks (such as WhatsApp, etc.), precise scheduling and appointment booking, and training clinic physicians for prescription and strengthening information technology infrastructure were introduced as some of the main solutions..

cause of time wastage, and most of the patient's attendance time is spent waiting. Therefore, it is necessary to reduce patients’ waiting time with management measures such as queue management and appointment scheduling systems as well as the use of new technologies.

Considering the growing trend of cancer incidence and mortality in the world, regardless of the human development level, cancer control and prevention programs should be a high priority in health policies. Developing the national cancer control program is in line with these efforts. Therefore, the current review study was conducted to examine the dimensions of national cancer control programs and the strategies used in these programs. This study was conducted to investigate the dimensions of the national cancer control program of different countries. To find relevant articles, the authors searched keywords, such as National Program of Cancer Registries, Screening, Neoplasms, Cancer, and Cancer Control separately and in combination in databases, including Google Scholar, Scopus, PubMed, and Science Direct. Furthermore, the Persian equivalents of these keywords were searched in Sid, Magiran, and Civilica. Finally, full text articles related to the cancer control program in Farsi or English published from 2000 to 2020 were selected. 586 articles were identified, and finally, 19 were investigated. The dimensions of the national cancer control program differed among countries and they had used different strategies to implement the cancer control program. The National Cancer Control Program is the most logical means to achieve a significant degree of cancer control, even in cases with limited resources.

Management of cardiovascular disease (CVD), the leading cause of death in the world, is often associated with a variety of treatments and lifestyle modifications.

In this review, the authors sought to identify and summarize self-care related behaviors in persons with CVD based on Orem’s self-care theory. By applying this theory, healthcare professionals can involve patients in their own care in a holistic way that can improve health outcomes.

A comprehensive review was conducted using the Web of Science, PubMed, Magiran, SIDS, Scopus, CINAHL, and Google Scholar databases. The results were organized into themes based on the Orem’s Self-care model for patients with CVD.

A total of 1153 articles identified through databases. After excluding duplicated, unavailable or unqualified articles a total of 12 articles met all inclusion criteria and were included in this review and categorized into five major themes based on Orem’s self-care model for patients with cardiovascular diseases: basic conditioning factors and self-care agency, initiating and adhering to self-care activities, symptom recognition, and supportive nursing interventions and culture. The model suggests the patients should take responsibility for self-care behaviors; and nurses, peers, families and health systems can have a great impact on the level of self-care in these people with considering cultural factors.

Improving the well-being in people with cardiovascular diseases and reducing the related healthcare costs are achievable by promoting self-care behaviors based on culture, educational interventions, and monitoring the self-care over time as suggested by the model.

Cancer is one of the most important health challenges. The World Health Organization has established tools to reduce the risks and burdens of cancer for countries within a framework called the National Cancer Control Program. this study aimed to design a cancer management model in Iran.

In this comparative study, comparison tables were prepared based on the dimensions of the research objectives. Then the preliminary model of cancer management in Iran was designed. A questionnaire was set up to test the template and validate it. The opinions of 23 experts were used in two stages of the Delphi technique.

In the present study, effective dimensions for cancer management in Iran were introduced: primary prevention, screening, early diagnosis, treatment, palliative care, survivor support, manpower, registration, and cancer research. According to the findings of this study, to optimize the cancer management program in Iran, cancer prevention programs, screening stages, and cancer palliative care services should be covered by insurance. Cancer treatment is decided by a multidisciplinary team. Palliative care specialists should be trained. Other findings are discussed in the main article.

Modeling and localization of cancer management dimensions of successful countries in cancer control, provides the basis for the development of cancer health services management in Iran.

Improving the performance appraisal system in the armed forces health care system is one of the challenges for managers in this field. Therefore, this study aimed to develop performance evaluation indicators of nurses working in military medical centers in Iran.

The present study is an applied and multi-stage research that was conducted in three general phases during the years 2020-2021 in military medical centers of Iran. Participants included 36 experts in the field of nursing. Library study, purposive sampling, in-depth and semi-structured interviews, semi-open questionnaire, expert panel meetings, and the Delphi method were used to collect data. Data were also analyzed by qualitative content analysis and Graneheim and Lundman's proposed steps. The importance of the identified criteria was determined through a pairwise comparison questionnaire based on a 5-point Likert scale and by fuzzy hierarchical analysis method in Matlab software.

Based on the results of this study, 33 performance criteria for military nurses in four categories of special conditions competencies (10 indicators), military competencies (7 indicators), command and leadership competencies (4 indicators), and nursing's basic competencies (12 indicators) were identified by experts, and the importance of each was determined.

The study results showed that special conditions competencies and basic nursing competencies are more important than other groups in the military nurses' performance evaluation. Therefore, it is suggested that the identified indicators in this study can be used in macro-management decisions in the fields of education, training, and performance management of military nurses.

Receiving a quick response is not only one of the important factors affecting the satisfaction of emergency patients but also one of the indicators for evaluating the quality of emergency services. The aim of this study was to compare the selected national indicators of hospital emergency with the standards in a selected military hospital in Tehran. 

This descriptive-analytical and cross-sectional study performed in 2020 with random selection of patients referred to the emergency department of a military hospital in Tehran. Data collection tool was a researcher-made form whose validity and reliability were confirmed. Data were analyzed by t-test using SPSS software with α= 5%.

Results showed that the average waiting time to receive the service until the assignment was 267 minutes.  Also, the percentage of patients assigned within 6 hours, the index of patients discharged from the emergency department within 12 hours and the index of leaving with personal responsibility were in accordance with national standards and the average of the relevant values ​​was statistically significant (P <0.05).

According to the results of this study, the indicators were in good condition. Hospital managers should pay special attention to these indicators and study them periodically. Also, in order to avoid long waiting times and reducing costs, proper and optimal management of resources are seeming essential.

The occurrence of chemical events causes a lot of financial, life and environmental damages. The purpose of this study is investigating and analyzing chemical events in Fars province between 2008 and 2017, to provide solutions based on chemical defense for immunization and emergency response to consequences.

This research conducted with practical approach and descriptive method. The study population consists of experts with operational experience in response to chemical events in Fars province (including 29 cities). The study tool was a researcher-made questionnaire which its reliability and validity were confirmed. Analytical Hierarchy Process with Expert Choice software has been used to investigate chemical events in Fars province.

166 chemical events in Fars province during the period from 2009 to 2018 was recorded. Industrial unit fires, road transport accidents, and gas leaks and gas leakage from the gas distribution network were the most significant incidents. The type of chemical that caused the event, human injuries and the location of the event were considered as the main criteria. Capital damage, proximity to residential area, and environmental and natural resources damage were considered as sub-criteria. The most important chemical defense solutions include; preparing a database of all chemical industries and factories, prioritizing chemical facilities from a risk perspective, conducting training programs for emergency teams, conducting medical examinations of people exposed to chemicals, cleaning up contaminated areas, and preventing the spread of contamination. 

This research has shown that most events were not only preventable, but also severely predictable. One way of immunity and emergency response to events is their timely analysis to identify the causes, most of which are human error and the factors affecting it.

Medical tourism is one of the most important industries in the field of health care, which not only protects the interests of the national economy, but also guides the health and treatment process, including access to optimal, cheap and fast medical services. The purpose of this study was to investigate and evaluate the feasibility of influential components and suggest ways to develop the medical tourism in military and civilian hospitals in Tabriz, Iran.

This applied and hybrid study was conducted in two qualitative and quantitative stages. The research population in the qualitative section was medical tourism experts and authorities related to tourism in Tabriz hospitals and tourists referred to hospitals and medical experts in the field of medicine. Sample size in the qualitative phase was 10 people and in quantitative phase 7 people who were selected by purposeful sampling. Semi-structured interviews were used to collect data in the qualitative phase to reach the saturation level and in the quantitative phase the dimensional technique was used. Qualitative data analysis was performed using MAXQDA10 software and quantitative data were analyzed with MATLAB software. Data collection was performed over 2019. Experts approved the various stages of the design for validity and reliability.

 After conducting interviews and eliminating overlaps, 72 initial codes were obtained. The initial codes were then classified into 5 themes (quality of service, cost, medical staff, medical equipment, facilities and amenities) and 23 sub-themes. The qualitative phase results were then analyzed to determine significance using the dimensional collective decision-making method in six steps, the most important of which were sub-themes. 

 According to the goals of medical tourism development research in military and civilian hospitals in Tabriz, it requires paying attention to setting up IPDs and VIP rooms, proportional to the competitive price of patient origin, recruiting and training physicians and medical staff, using health technology assessment science (HTA) and facilitates the patient admission process to improve the quality of services and attract medical tourists. The development of medical tourism alongside services and urban facilities requires in-hospital factors and, above all, the quality of services in line with international standards, in-hospital welfare services, up-to-date medical equipment and trained staff and departments plus the role of skills. Linguistic communication is also very significant.

Admission to the clinic is a key process from the patient referral to the doctor until he/she hospitalizes in the wards. In the reengineering approach, with the aim of continually improving processes and improving quality, existing processes are replaced by new ones. The purpose of this study was to reengineer the admission process from the clinic of a military hospital in Tehran in 2017.

This was a qualitative case study that was conducted in a military hospital in Tehran from October 2017 to March 2018. Interviews were conducted with 12 staff and stakeholders involved in the admission process. Purposeful sampling was used for process owners and available sampling for patients. Data were collected through semi-structured interviews and focus group sessions. Edraw Max7 software and MAXQDA11 software were used for data analysis

Initially, the current admission process of the clinic was drawn up with 29 main activities, 14 procedure steps and 5 decision stages. Out of 109 codes extracted for the challenges in the process, seven general challenges (main theme) were taken: costs, deficiencies and disadvantages, training, inadequate utilization of the hospital information system, overcrowding, lengthy process and time taken. Finally, the process of charting the admission workflow diagram from the clinic was drawn with 29 main activities, 14 procedural cases, 3 decision-making steps, and elimination of the stopping and archiving phases, thereby reducing the new process time from 5 to 4 hours.

Reducing the admission process steps, increasing the process of action and reducing decision-making and eliminating the delays and archive lead to reduce the time and improved satisfaction and drawing of new flowcharts for the admission process. The new process is more agile and efficient, improving hospital admission performance and ultimately increasing productivity.

Emergency department (ED) in military hospitals due to its nature is one of the most critical healthcare centers for injured people at urban unrest. The aim of this study was an exploration of dimensions and components of ED preparedness in military hospitals for urban unrest.

This was a qualitative and content analysis study. The study population was the physicians, nurses, emergency managers of military hospitals with at least 15 years of work experience. Sampling was initially targeted with semi-structured interviews and continued with the snowball method until reaching the saturation (10 participants). Interviews were conducted between October 2018 and February 2018. Findings and conceptual model of the research approved by the experts for validation and reliability. Data analysis performed by MAXQDA10 software.

With the implementation of interviews, the 659 code recognized. After deleting the overlaps, 128 codes were obtained. In the next step, the extracted codes were classified into 7 dimensions (themes) and 31 components (sub-themes). The seven dimensions of preparedness included command and control, human resources plan, resource management, communications, protection and security, treatment and increasing capacity, respectively. Finally, the conceptual framework of military hospitals emergency preparedness for urban unrest retrieved and approved by the expert's opinion.

According to the conceptual model of the study, which consisted of 7 main dimensions (themes), the components of emergency preparedness were almost identical in most crises but differed in importance and prioritization. In the emergency preparedness model of military hospitals in urban unrest, there is a significant difference in terms of protection and security which, if weak, will have a significant impact on other aspects of preparedness. Since people's views and opinions aligned with military personnel in natural disasters, there are no significant challenges in terms of protection and security, conversely, in urban unrest, especially if it is accompanied by political issues, due to divergent opinions and other influential factors, there will be irreparable threats to the injured, staff, health centers, and continuing urban unrest.

Average length of stay (ALOS) is an indirect indicator of resource consumption and a measure of efficiency in hospitals. Therefore, managing the effective organizational aspects can provide opportunities for increasing revenues, reducing costs, improving patient clinical outcomes and quality of care, and increasing profitability. This study aimed to identify organizational factors affecting the ALOS. This was a systematic review using the PRISMA protocol to search literatures in international (PubMed, Google Scholar, Science Direct) and national (SID, Magiran, and MedLib) databases. According to the PICOS strategy, all published papers were retrieved in English and Persian languages until October 2017 using different combinations of keywords such as length of stay, stay length, stay lengths, hospital stay، hospital stays, organizational factors and the Persian equivalent keywords. Final selected papers were critically appraised with the CASP and PRISMA checklist. Finally, factors affecting ALOS were presented in comparative tables. A total of 127 publications were retrieved in the initial step. After screening, 12 full text publications were carefully reviewed. The most important organizational factors affecting the patient's ALOS were the ratio of nurse: patient, training of the physicians and nurses, the patient's discharge process, the presence of a physician in department, the number of para-clinical requests, inter-departmental coordination, time of the first treatment in the ward after admission, visit times, and admission days. These factors were categorized into four groups of process, service, organizational, and human resource factors. Process and management factors are considered the controllable variables of hospital management, therefore senior managers and decision makers in hospitals can focus on these factors to conduct policy interventions in order to improve productivity and the quality of services.

Today, most of the hospital revenue comes from insurers. The aim of this study was to investigate the amount and causes of insurance deductions of the Armed Forces Medical Services Organization (Sakhad) in a military hospital in Tehran, Iran. This cross-sectional study was performed in Tehran, Iran in 2015. All inpatient files with deductions which had contracted with the armed services medical insurance were collected using a database. Medical records and documents were screened using a checklist assessing the amount and reasons for the deduction, month, division and specialty of the physician. Data were analyzed using SPSS-19 software. A total of 11,992 inpatient medical records were studied, yielding a total of 3517 medical records with insurance deductions. The total amount of insurance deductions was 2,383,423,209 Rials (79,447.4403 USD). The highest amount of deductions per month, department, physician's specialty and causes were in June (14.45%), men's surgery (39.78%), orthopedics (40.76%), and consumables (48.30%), respectively. There was a significant difference in deductions mean score and month, department, physician specialty and causes variables (p <0.0001). Considering the significant confirmation of the difference in the mean of deductions and the study variables, personnel familiarity with insurance laws, and using a hospital data system can help prevent insurance deductions

Medical error is an important challenge for health systems. Developing reporting systems and addressing the obstacles to reporting errors is essential in order to improve the quality of health care services. This study aimed to survey the factors affecting the refusal to report medical errors from the nurses’ point of view using the Analytical Hierarchy Process (AHP) in selected military hospitals of Tehran, Iran.
This is a descriptive, analytical and cross-sectional survey conducted in 2017. Data were collected using a systematic review and then a quantitative phase. The research population included nurses from 3 military hospitals, of which 269 were selected using Cochran's formula. The data gathering tool was a researcher-made questionnaire. Data analysis was performed using descriptive statistics and hierarchical analysis process using SPSS21.0 and Expert Choice 10.0 software.
Based on the systematic review findings, the factors influencing the refusal of reporting on medical errors were classified into three groups of management, process and nursing factors. Results indicate the most important reasons for refusal to report medical errors are: managerial factors (with importance coefficients of 0.669), factors related to the nurse (0.224), and factors related to the process of reporting (0.888).
Due to the high weight of management factors in refusing to report medical errors, hospital managers, and especially nursing directors, should remove these obstacles by expanding the culture of encouraging reporting in the organization.

In-service training of nurses plays an indispensable role in improving the quality of inpatient care. Need to enhance the effectiveness of in-service training of nurses is an inevitable requirement. This study attempted to design a new optimal model for in-service training of nurses.
This qualitative study was conducted in two stages during 2015-2016. In the first stage, the Grounded Theory was adopted to explore the process of training 35 participating nurses. The sampling was initially purposeful and then theoretically based on emerging concept. Data were collected through interview, observation and field notes. Moreover, the data were analyzed through Corbin-Strauss method and the data were coded through MAXQDA-10. In the second stage, the findings were employed through Walker and Avant’s strategy for theory construction so as to design an optimal model for in-service training of nursing staff.
In the first stage, there were five major themes including unsuccessful mandatory education, empowering education, organizational challenges of education, poor educational management, and educational-occupational resiliency. Empowering education was the core variable derived from the research, based on which a grounded theory was proposed. The new empowering education model was composed of self-directed learning and practical learning. There are several strategies to achieve empowering education, including the fostering of searching skills, clinical performance monitoring, motivational factors, participation in the design and implementation, and problem-solving approach.
Empowering education is a new model for in-service training of nurses, which matches the training programs with andragogical needs and desirability of learning among the staff. Owing to its practical nature, the empowering education can facilitate occupational tasks and achieving greater mastery of professional skills among the nurses.

In‑service training of nursing personnel has a significant role in increasing the empowerment of nurses and promotion of the quality of health services. The objective of this study is to identify and explain the process of in-service training of nursing personnel in the hospitals affiliated with Baqiyatallah University of Medical Sciences in Tehran.
The present study employed a qualitative approach using Corbin and Strauss method (2008) in 2015, and examined the viewpoints and experiences of 35 nurses, nurse managers, and educational managers with the in-service education of nursing staffs. According to this method, comparisons, asking questions, flip‑flop technique, depicting personal experiences, and raising red flag were used for data analysis.
In this study, five major themes including unsuccessful mandatory education, empowering education, organizational challenges, weakness in the educational management, and educational-job resiliency were derived from the results. Unsuccessful mandatory education was the main concern of participants and empowering education was the core category derived from this study.
Empowering education emphasizes the practice-oriented and self-directed training. It is an applied education, is participation-oriented, facilitates job functions, and is based on exploration.

Aims: This study aimed to investigate the time management skills among military and civilian hospital's managers.
This was a cross-sectional and descriptive-analytical study conducted in 2015 on 240 senior, middle and first-line civilian and military hospital's managers in Kermanshah. The required data were collected using a standard questionnaire (Time Management) consisting of 6 dimensions and 40 items. The collected data were analyzed using SPSS v21.0 through a few tests, including Mann-Whitney, Kruskal-Wallis tests and Spearman correlation coefficient.
The results showed that among the time management dimensions, the highest and lowest means were, respectively, related to the prioritization of objectives and activities (with the mean of 1.79) and goal setting (with the mean of 1.56). Also, the results revealed that all the dimensions of time management skills in the Imam Hussein Military Hospital had higher means than the civilian hospitals and its means was greater than the average significantly.
Results showed that the studied managers were at a moderate level in terms of time management skills. Therefore, assessing the manager's time skills and behaviors in order to better understand the strategies used by them to manage their time and inform them about managing time can be suggested.

Hospitals to improve the quality of health care and reduce the time and cost in providing health care should follow a strategic plan. Implementing strategies in hospitals is not possible easily and managers of hospitals face with barriers for implementing them. The aim of this study is to identify barriers to implementation of the strategic plan in the military and civilian hospitals.
This cross-sectional study was performed on senior managers, middle and executive in three military and three selected civilian hospitals of kerman in 2014. The total number of samples was 25 persons that had been selected as census. the instrument used, was a questionnaire that consists of two parts, the first part includes demographic specification and the second, consists of 4 areas, the human, process, structural, and institutional factors. Data was analyzed with SPSS 21.
The results showed that barriers to implementation of the strategic plan in military and civilian hospitals is related to structural, human, processes and institutional factors respectively. There is no significant difference between the barriers to the implementation of the strategies in the military and civilian hospitals (P>0.05).
Structural factors, are the most important barrier in lack of strategies implementation in hospitals and managers should coordinates Structures with strategies in medical centers under their management.

Undoubtedly, the knowledge and skills of the employees lead to the survival of the organization. The purpose of this study is to investigate the important issues in designation and implementation of staff in-service training models to determine a framework for designing the efficient nursing continuing education models.
Methods & Materials: This study is a structured review based on Cochrane five-step protocols, in which18 qualitative articles from six English, and three Persian databases were extracted and analyzed using seven-step process of Noblit and Hare method in meta-synthesis without any limit of time. The English databases included “Science Direct, PubMed, Google Scholar, EBSCO, Proquest, and SAGE Journals” and Farsi databases were “Noormags, Iran Doc, and SID.” A standardized protocol along with specified criteria was used to study selection.
In the initial analysis of findings four themes were extracted: process for staff training, method for staff training, educational effectiveness, and specific model for staff training. The final analysis of findings showed that the models presented in the field of staff training can be generally divided into three categories: (a) Models that deal with the designation of processes and functions of staff training, (b) models that focus on the effectiveness of staff training, and (c) models that deal with
both aspects.
This study highlights the important role of effectiveness strategies as well as compatible training functions in designing the nursing staff in-service training models. In this way, the staffs motivate to participate actively in the organizational trainings.

processes re-engineering is one of the best ways that leads to reduce the time, costs and finally earn the satisfaction of stakeholders by reforming method of carrying out activities. This study aimed to reform approval process of research projects in clinical research unit of Baqiyatallah (as) hospital.
Material and This qualitative action research study was performed in 2015 in the research department of Baqiyatallah Hospital. The sample size included all process owners and partners. Data were included documents and interviews to identify bottlenecks. All work stages of status quo were recorded. After that, the streamlining process were also recorded using standard diagram optimized workflow. Results were analyzed with Excel 2007.
Process activities were classified in six parameter: decision, archive, delay, inspection, transportation, and operations. All current approval process were carried out by 83 activities. By implementing reengineering and simplifying it, were reduced to 63 activities.
Re-engineering and simplification of the process lead to reduce activity, saving time and reducing waste time researchers.

Timely access to cardiovascular health services is necessary to prevent heart damages. The present study examined inequality in geographical distribution of cardiovascular health services in Iran.
Present study is a cross-sectional study conducted using demographic data from all Iranian provinces (31 provinces) from 2012 census by the Statistics Center of Iran (SCI). The Gini coefficients of CCU beds and cardiologists were used to assess equality in access to cardiovascular health services in Iran. MS Excel software was used to calculate Gini coefficients.
The proportions of CCU bed and cardiologist per 100,000 population were 4.88 and 1.27, respectively; also the Gini coefficients were 0.129 and 0.045, respectively.
Descriptive statistics showed a skewness in distribution of pubic cardiovascular health services in Iran, though Gini coefficient revealed no significant inequality. However, equal distribution of CCU beds and cardiovascular specialists does not mean they are sufficiently available in Iran.

In today's world, having principle and targeted management is one of the progress and development factors of any organization. Effective use of time for each manager is the most important base for managing current affairs and controlling daily activities. The present study aimed to investigate and analyze the relationship between factors affecting time management among the senior, middle and first-line managers of the hospitals in Kermanshah in 2015.
This was a cross-sectional and descriptive-analytical study conducted in 2015 in ten hospitals of Kermanshah. The study population consisted of all senior, middle and first-line managers of the studied hospitals (N=240) which were selected using census method. The required data were collected using a researcher-made pair-wise comparison questionnaire. The collected data were analyzed using the DEMATEL technique through Matlab8.1.0.604 software.
The results showed that, from the studied managers’ viewpoints, the variables of goal setting and prioritization of objectives and activities were certainly affecting variables and located in the cause group. Also, the variables of planning, delegation, communication management, and meetings management were affected variables and located in the effect group. Furthermore, in the hierarchy of affecting and affected variables influencing time management, goal setting and meetings management with the coordinates (1.23, 1.23) and (1.06, -1.05) were identified as the highest and lowest priorities and were considered as the most affecting and most affected variables, respectively.
The results of the present study showed that among the studied variables influencing time management, goal setting was the highest priority and most affecting variable, and meetings management was the lowest priority and the most affected variable. It is recommended to increase the hospital managers’ knowledge about time management and the need for accurate goal setting through providing management and time management courses, and requiring them to develop a time management plan in order to improve their time management.

Hospitals, like other organizations in the community for survival and development are managers need creative and innovative. Breeding and training of such managers Appropriate demand shall provide the platform that its determination requires the understanding of factors affecting innovation and creativity of people is. Factors influencing creativity and innovation managers, both military and civilian hospitals in Tehran. Cross-sectional study method was conducted. Senior managers and middle managers in nine selected military and civilian hospitals in Tehran (90) The study formed. Data collection was conducted by questionnaire. Data obtained from 90 questionnaires, using SPSS software for analysis and comparison of mean scores obtained in different groups ANOVA was used. Results showed that the most organizational factors achieving points with 56.2 and the subsets of organizational factors, factors related to the reward system earned the highest score. The most important factors affecting innovation, hospital managers, and individual factors achieving points with 83.2 was identified among a subset of individual factors, factors related to science, knowledge and expertise manager earned the highest score. According to the results, providing a suitable environment and good for the field organization may encourage hospitals to create innovative managers. To create such an environment also reform the payment systems and designing a suitable payment system in hospitals, action seems necessary. Change the prevailing culture in hospitals and innovation become the norm and a positive value, the benefit is not empty.

Determining health research priorities helps policymakers to effectively make targets in health care systems. This research is a descriptive- cross-sectional study that has done in 2012, in order to determine priorities according to four main areas: Stewardship, Creating Resources, Financing and Delivering services in health care systems. Overall 26 priorities has been identified in four areas. Explore the role of private sector in the health system and a comparative study of payment system in another countries have the most means in health care research priorities. For efficient use of financial resources must do research based on health sector needs.

Today, decision making in the management of large organizations is of paramount importance that some researchers have identified the knowledge of organizational management as decision net and management as decision-making. All experts are aware of the importance of decision-making. This is a descriptive-analytic and cross-sectional research. The target group was the project, plan and budget deputy of the Baqiyatallah University of Medical Science. The Rational Rose software (2003 version) was used for analyzing and designing the system. In general, essential infrastructures were prepared for setting up the system. And managers as main users of the system notified that the management information system is one of their most essential needs. Discussion and as there are necessary infrastructures for applying IT in the university, and determining the minimum standards based on the advancing methods and analyzing the organizational systems through the scientific methods, providing software that are able to exchange information with each other are needed.

The success of every organization undoubtedly depends on an efficient monitoring&evaluating system. The lack of an effective hospital accreditation system not only will lead to increase the health care costs but also will put the health of population at risk. This research was a practical study in 2010-2011 and its intention was presentation of guidelines for hospital accreditation process in IRIN by reviewing it in the selected countries. This research was a practical–comparative study. GoogleScholar، PubMed، ScienceDirect, Google, SID data bases and also related books have used to gathering data. Sampling was purposeful and Canada, Farance, India, South Africa on America, Europe, Asia, Africa, were selected for study. And also have used comparative-analytic method for content analysis The study of hospital accreditation process in selected countries showed that Certification practicaly is different from accreditation. Certification usually is a mandatory process while accreditation is voluntary. Also hospitals accreditation perform by the national and independent organizations and the organizations that accredit hospitals and other health institutions, consist of all representatives involved in health care services. Although had done good actions at accreditation enrichment field by editing of new checklists by recent years in IRAN, but we can say that participation of all representatives in health care services is necessary for organize of accreditation process. Also licensing and accreditating, should be separated.