seyed saeed tabatabaee

Continuous improvement of the quality of the education system requires assessment of the performance of teachers in order to make more informed decisions regarding the improvement of teaching methods. The study aims to explore the educational performance of Mashhad health faculty members from the perspective of graduate students through a qualitative approach.

The study was conducted as a qualitative content analysis. The research population was post graduate students. Sampling was started based on the objective and continued until information saturation, i.e. no new information was received, in the form of theoretical sampling. It was used to collect data through face-to-face interviews. Immediately after conducting the interviews, the recorded voices of the participants were typed word by word in Word software and analyzed using MAXQDA10 software.

The functional challenges of professors from the point of view of postgraduate students were identified in four areas: structural, moral, scientific competence and communication skills in 10 subcategories (lack of time management, student abuse, lack of inclusiveness, not updating the curriculum, unavailability of faculty member, lack of specialized guidance, several teachers for one lesson, lack of expression, lack of knowledge, and lack of experience).

Updating educational curricula, more interaction between professors and students, using professors with executive skills and experience in related courses, strengthening communication skills and expression techniques, having patience and tolerance, and observing professional ethics can play an important role in the educational performance in faculty member.

Context: 

In recent decades, the tobacco epidemic has spread worldwide. The impact of tobacco control policies has been different among countries. This paper aims to explain how two countries, the United Kingdom (UK) and India, with different political, social, and cultural contexts, implemented theWorld Health Organization (WHO) Framework Convention on Tobacco Control.

Evidence Acquisition: 

A comparative study was done for tobacco control in UK and India in 2022. A review of literature in five databases, observational data and legal documents on tobacco use were undertaken. To identify and explain the factors that pose challenges to the implementation of tobacco control policies, country reports and health policy monitoring and research databases (in total, 27 papers and 16 reports) were reviewed.

Having different economic, social, and cultural backgrounds, a similar pathway to control the tobacco industry can be seen in UK and India. The factors that can explain the similar outcomes in two countries are the global pressure of WHO, increased awareness of people and policymakers, and a sense of urgency about the tobacco problem in both societies.

At different stages of tobacco control in both countries, various interest groups with different routes of political influence used veto opportunities to overturn political decisions in the policy process. Continuous analysis of interest groups and their status quo is necessary to restrict the tobacco industry in favor of public health. Governments should carefully recognize the stakeholders and stake challengers in the policy domain and balance their interests.

Globally, population growth and ageing are expected to increase the risk of vision impairment for more people. Eye disorders impose heavy social and economic burdens on communities through increased poverty, reduced quality of life, and decreased employment. Weaimed to calculate the economic burden of eye diseases in Iran.

Prevalence-based and top-down cost estimation methods were used with a sociological approach. Data were collected from the Northeastern Ophthalmology Center Institute for Health Assessment, and Evaluation, besides the 2017 census. Eye diseases were classified according to the ICD10. Data were analyzed using Excel 2016 software.

Survey data were collected from 19,113 patients with vision loss and eye disorders. The average cost of vision loss/eye disorders was estimated to be $250.3. The findings indicated that the economic burden of visual diseases was $2,844 million a year, with direct medical costs comprising 87% (66% of inpatient and 21% of outpatient) and direct non-medical and indirect costs estimated at 6% and 7%, respectively. Furthermore, 72.8% of direct medical costs was paid by insurance companies, 20.6% by patients, and 6.6% by the government.

Eye diseases and vision loss in Iran, as in other countries, are costly for the health system and society. Instituting effective policies and measures to address this rising burden should be a national priority. Another suggestion in this area would be to focus on preventive care and policies such as health education, highlighting the role of reorientation of health services and advocacy (for policies that promote eye health), where relevant.

The shadow of the coronavirus phenomenon over the nursing profession is considered as a serious threat to the health of nurses and the quality of nursing care for coronavirus patients. This study intended to measure the occupational fatigue/exhaustion recovery of nurses caring for COVID-19 patients in hospitals affiliated with Mashhad University of Medical Sciences.

This descriptive-analytical cross-sectional study of 203 nurses caring for coronavirus patients was conducted in 2021 using the census method. Data were collected using a 15-item Occupational Fatigue/Exhaustion Recovery (OFER-15) scale, and were analyzed by SPSS statistical software version 22 using independent t-test, one-way analysis of variance, and Tukey’s post hoc tests. The significance level was set at α = 0.05.

The majority of the nurses were female (51.2%), married (81.3%), and bachelor’s degree holders (86.2%). The mean occupational exhaustion score of the nurses studied was 60.20±6.13, indicating a high level. Likewise, the average score for chronic fatigue was 22.89±5.87, representing a high level. In contrast, the mean scores for acute fatigue and inter-shift recovery were 18.36±2.76 and 18.95±2.41, respectively, suggesting a moderate level. Nurses in the special coronavirus ward had a significantly higher mean score of acute fatigue than those in the general coronavirus ward (p=0.02).

Since the mean occupational exhaustion score among nurses caring for coronavirus patients was high in this study, it is recommended that managers modify the conditions and variables that contribute to fatigue, implement the necessary controls to reduce fatigue, and formulate a strategy to boost the productivity of nurses and the satisfaction of COVID-19 patients.

Crises are often unavoidable events that occur around the world. Hospitals play an important role in treating patients and preventing extensive injuries in times of crisis, requiring adequate preparedness. In order to design a proper planning system, it is essential to be aware of the challenges of hospitals during a crisis. The purpose of this study was to explain the challenges of hospitals admitting COVID‑19 patients in the city of Mashhad, Iran, from the perspective of their managers.

This study employed a qualitative approach, using the method of conventional content analysis and was conducted from May to July 2020. A purposive sampling method was used to recruit the senior managers of hospitals admitting COVID‑19 patients in Mashhad. The interviews were conducted face to face, with open‑ended questions following an interview guide based on semi‑structured questions, and continued until data saturation was reached. Data were analyzed using Atlas Ti software.

After the implementation of the interviews, first 665 initial codes were extracted from the data, and after removing the overlapping sequences, a total of 115 codes were obtained. Three categories (organizational challenges, extra organizational challenges, and challenges related to information domain), 13 sub‑categories, and 33 codes were extracted from the content analysis of the interviews. The main themes propounded in the field of challenges of COVID‑19 referral hospitals in Mashhad were organizational challenges, extra organizational challenges, and information domain challenges.

The results of this study showed that the hospitals admitting COVID‑19 patients in Mashhad faced many challenges. To improve the quality of services in postcrisis phase, replacing hospitals’ equipment, revising curriculums at medical universities, staff retraining, recruiting skilled human resources, and creating a supportive community context are necessary.

For sure, the COVID‑19 crisis will not be the last one, we have to be prepared for the bigger health crisis.

Considering the challenges that COVID-19 disease has created in human life, the study of its various dimensions is one of the topics of interest today. Considering the important role of nurses in combating this disease, in this study we examined the level of knowledge and job stress of nurses working in COVID-19 and non-COVID-19 wards and their relationship with each other.

 We assessed the awareness and job stress of 215 nurses working in COVID-19 wards and also 142 nurses working in other wards in Imam-Reza and Ghaem hospitals in Mashhad, using a researcher-made questionnaire as well as the JRTI questionnaire.

 The mean score of nurses' knowledge was 68.19 ± 17.44. The level of knowledge of nurses working in COVID-19 ward was significantly higher than nurses working in other wards (p = 0.002). The mean score of job stress in nurses was 58.82± 13.17 and there was no significant difference between job stress of nurses working in COVID-19 wards and nurses working in other wards (p = 0.134). There was a negative relationship between awareness and job stress of nurses (r = -0.14, p = 0.007).

Increasing the level of nurses 'awareness reduces their job stress, which shows the importance of increasing nurses' awareness about COVID-19 disease by providing appropriate training.

Leaving service by employees has many direct and indirect consequences and costs for the health system, and it is important to study and recognize it. The tendency to leave service is the best predictor of actual service left. In this study, we aimed to determine the organizational factors related to the tendency of non-governmental health workers to leave the service in the suburbs of Mashhad.

This descriptive-analytical study was performed on 323 health workers in 2018-2019. Data collection was performed by a researcher-made questionnaire included demographic characteristics, three dimensions of work environment, job demand, and social support. Research data were analyzed using descriptive and inferential statistics

The tendency to leave the service was about 64%. The mean score of work environment, job demand, and social support of organizational dimensions related to the tendency to leave were 45.95, 39.92, and 38.49, respectively. The results of multivariate regression analysis showed that with one unit increase in the scores of work environment, labor demand, and social support, provided that other variables are constant, the chances of leaving the service were reduced 0.923, ,0.899 and 0.876, respectively. (P <0.001).

In conclusion, clear job descriptions, appropriate salar,y and benefits considering to the type of work and workload, reducing ambiguity and role conflict, increasing job diversity, increasing authority, opportunities for advancement, supportive leadership can lead to increased job satisfaction and consequently, increase the tendency to stay and reduce the tendency to leave service.

Human resources are considered as a major component of the health sector.  this study estimates the number of midwives required in maternity wards in hospitals by using the WISN method.

This cross-sectional descriptive study was conducted in three hospitals affiliated to Mashhad University of Medical Sciences in Iran using the WISN method in 2019. The workload and the standard working time were determined through holding expert meetings; the timing methods were used to test and verify the standard working time; available working time was determined through holding meetings with personnel affairs experts, studying the relevant laws and regulations and personnel system information; and the actual workload was determined based on information management system and information registries. Microsoft Excel was used to analyze WISN data and Stata (version 19) was used to analyze statistical data.

10 factors related to midwifes’ available working time were identified. Annual available working time for midwives in the studied hospitals was 1378 hours per year. In this study, labor, delivery, recovery and postpartum, recovery after cesarean care, and new born cardiopulmonary resuscitation (CPR) were identified as the main activities of midwives. The results have shown that the Centre hospital and the educational hospital faced with 2 and 13 midwifes shortage, respectively, while the non-educational hospital had 2 surplus midwives.

The results showed that although both center and educational hospitals are faced with a shortage of midwifery staff, in comparison of working pressure, midwives in the educational hospital are under more pressure than the midwifes in the center hospital; so staffing in the educational hospital is a top priority. so workforce recruitment has a significant role in these hospitals.

Patient engagement is a concept that has gained special importance in medical care today, and is considered as a valuable goal in patient care. With the evolution of modern health from a disease-centered model to a patient-centered model, patient interaction has played an important role in improving the health care processes. This study aims to identify the factors affecting the patient's interaction with the physician.

This is an applied study with a qualitative-descriptive method. First, the information of patients who underwent angioplasty in 2019 was extracted from the hospital information system. Then, in-depth interviews with patients were conducted using a semi-structured interview guide. In the next step, we analyzed the data using qualitative content analysis with MAXQDA.

After analyzing data, we were able to extract 1072 codes. Then, we categorized the codes into two sub-categories of supply side (physician) and demand side (patient). We identified 11 factors affecting supply-side interaction (information, physician behavior, education, access, cost, responsiveness, patient perception of physician expertise and skill, managerial weakness, facilities, trust, and satisfaction with physician), as well as seven factors on demand-side (personal problems, patient questioning spirit, response from other sources, financial problems, lack of knowledge and awareness, advice from others, and self-medication).

It is expected that the patient's interaction with his/her physician after angioplasty could accelerate the patient's recovery process, prevent possible complications, and reduce costs. Recognizing the effective factors and designing appropriate interventions on the supply and demand side that can lead to improving patient interactions with physicians, and pave the way for promoting community health.

Nurses’ turnover reduces quality of health care and increases costs. Neglecting the nurses’ quality of worklife can lead to their turnover. The aim of this study was to determine the relationship between nurses’ quality of worklife and their intention to leave work in public hospitals in Herat, Afghanistan.

This was a descriptive-analytical study, investigating nurses’ quality of worklife and their turnover intention in public hospitals. We used census method, and all 258 respondents completed the standardized questionnaire on quality of worklife. Nurseschr('39') turnover intention was also measured by using an item. Meanwhile, we used descriptive statistics to present demographic variables. Meanwhile, Mann-Whitney test, Chi-square, and Spearman correlation coefficient were used to determine relationships between the study analytic variables. In this study, SPSS version 26 was used.

The quality of worklife and the intention to leave was at an average level. No relationship was found between turnover intention and demographic variables (p>0.05). Results from the Spearman correlation coefficient demonstrate a significant inverse relationship between turnover intention and some aspects of the quality of worklife including participation and involvement, job security, wages and salaries, career honor, and job stress. In other words, an increase in any of the aforementioned aspects results in a decline in intention to leave (P<0.05). The relationship between intention to leave and quality of worklife was inverse and significant (r=0.279, P=0.001).

Participatory management in decision-making, paying attention to salaries and benefits, and assuring nurses that they will not lose their job in the event of any socio-economic change can increase job satisfaction, and reduce their intention to leave work.

This study aimed to compare the performance evaluation of a selected hospital through weighting and not weighting the indices using a hybrid approach. This mixed-method study was conducted in a Specialized Hospital in Mashhad, Iran. In the group discussion sessions of the scorecard team, a list of performance indices was prepared in four perspectives using a balanced scorecard approach. The indices were selected using the Delphi method and measured in the hospital afterward. In the first method, the percentage of realization of each index was measured based on the expected value of the index in the hospital, and the overall performance score was obtained. In the second method, the weight of each perspective and index was calculated using the standard hierarchy analysis questionnaire, and the coefficient of the significance of each index and perspective was considered in hospital performance based on the expected quantity of the index. Eventually, the performance of the hospital was compared using these two methods. Based on the results obtained from the application of the weighting method, the processes and customer perspectives obtained the highest and the lowest scores, respectively. The score of the hospital’s performance in this method was obtained at 89.27%. However, in the method without weighting, the processes and financial perspectives obtained the highest and the lowest scores, respectively, and the score of the hospital’s performance was estimated at 82.63%. The score of perspectives and indices will be different when the significance of perspectives and indices are ignored, which results in an incorrect (downgraded) estimation of the organization performance.

Human resources play a highly important role in providing health services. The aim of this study was to determine the human resources required for the linear accelerator sector at Reza Radiotherapy-Oncology Center.

This applied analytical-descriptive study utilized human resources determination method based on workload indicator of staffing needs. Expert meetings were held to determine the components of workload and standard time. A survey was used to confirm the standard time of main activities, and interviews and personnel information system were used to determine the amount and factors related to available working time.  Furthermore, management system and registries were used to determine the annual workload. The data were analyzed using the Excel and SPSS software version 19.

Seven factors related to the annually available working time of employees were identified. Annually available working time for employees was set at 806 hours. Patient preparation, treatment, surgery, and case completion were identified as the main activities. The results of workload index calculations showed that the accelerator sector had a shortage of three people.

The results of this study showed that Reza Radiotherapy-Oncology Center is experiencing a shortage of professional staff in the linear accelerator sector. It seems that using the workload indicator of staffing needs method to determine and distribute the required human recourses is a necessary step for the optimal management of human recourses in specialized sectors.

Human Resources in the health sector not only is the most crucial source in health providing but account for nearly three-quarters of the health sectorchr('39')s costs. The purpose of this study was to estimate the required Human Resources of the CT scan department of the Reza Radiotherapy-Oncology Center based on the workload indicator of staffing needs in 2019.

This cross-sectional descriptive study used human resources determination based on staffing needschr('39') workload indicators. The method of conducting expert meetings was used to determine the components of workload and standard time. Also, Interviews and rules, and personnel systems were used to determine the amount and factors related to available working time, and to determine the annual workload, the hospital management system and observation of activity logs were used. Excel and SPSS19 software were used to analyze the data for determining the required human resources and timing data, respectively.

 7 factors related to staff annually available work time were identified. The available work time for CT scans staff was 1113 hours per year. In this study, imaging and simulation were determined as the main activities of the CT scans ward. The results of the workload indicator calculations showed that the CT scan section lacked 3 Personnel.

This study showed that Reza Radiotherapy Oncology Center is experiencing a shortage of professional CT scan staff, and the work pressure is (0.4). Therefore, CT scans are a top priority to provide the human resource.

Attracting and retaining physicians in rural and low-income areas are the most important challenges for health system policymakers, which affects the poor health status of the population living in these areas. The purpose of this study was to investigate the factors related to the willingness of the working physicians to stay in rural areas and evaluate them according to the recommendations of the World Health Organization.

This applied research was conducted using descriptive-analytical and cross-sectional method in 2019. The study population was 306 physicians working in rural health centers under the supervision of Mashhad University of Medical Sciences. They were chosen through the census method, and the data collection tool was a researcher-made questionnaire. Descriptive statistics, simple, and multiple ordinal regression models were used to analyze the data.

The results showed that the willingness of the working physicians to stay in rural areas of Mashhad was low (16 percent). Furthermore, there was a significant relationship among the importance of laws and regulations, the observance of educational dimension, laws and regulations, financial incentives and personal and professional supports with the willingness to stay in rural areas (p <0.05).

The use of adequate financial incentives commensurate with the expectations of employees and commensurate with the opportunity costs of living in rural areas, accompany with individual and job support for employees, can strengthen the effects of each dimension and ultimately the willingness to stay in rural areas.

Nowadays, patient safety culture is recognized as an important issue in providing high quality services for the patients around the world. Unsafe care and services can lead to mortality, disability, prolonged hospitalization and increased costs of treatment. Therefore, the present study aimed to identify the errors associated with the labels of pathology samples in Qazvin hospitals.

This descriptive-analytic study was performed on the basis of a census sampling and included samples obtained from the operating rooms of five educational hospitals in Qazvin University of Medical Sciences in 2018. A standard checklist was used to collect information. Our professors and pathologists determined validity and reliability of the checklist by Cronbachchr('39')s alpha of 0.89. Using SPSS 21 the results were analyzed by statistical indices.

Among 1164 biopsy samples, 6425 errors were detected. The highest error rates were related to lack of registration of the patientchr('39')s age (564 cases; 48.4%), lack of registration of the name of the of the patientschr('39') fathers (562 cases; 48.2%), and lack of recording the number of biopsies (558; 47.9%) and the lowest rates of errors included empty container (10 cases; 0.86%), lack of recording the number of specimens (14 cases; 1.2%) and lack of using appropriate fixative (16; 1.37 %) respectively.

Regarding the frequency of labeling errors in the pre-analytical phase in the pathology ward, use of bar code imprinted in the sample containers, lack of using paper applications, use of radio frequency chip technology, use of a re-checking system and improvement of communication in the operating rooms can result in reducing these errors.

Human resources planning is known as the most essential limitation in achieving health care quality in the world. The main component of health human resource planning is to determine the required staff. There are several methods for determining required staff in a health facility. In this regard, one of the most widely used methods is the workload indicator of staffing need (WISN) method. In 1998, the World Health Organization announced the WISN as a human resource planning tool for the rational distribution of staff at health centers at all levels. It has been used in some countries since then. There is a recommendation on the division of the workload components. According to the modified workload indicator of staffing need (MWISN), there are four kinds of workload component. The first one is common main activity accomplished by all employees of the job category and for which periodic statistics are regularly collected. Uncommon main activity is the second one performed by a limited number of employees of the job category and for which periodic statistics are regularly collected. Moreover, support activities performed by all employees of the job category but for which periodic statistics are not regularly collected. The last one is additional activities performed only by some employees of the job category and for which periodic statistics are not regularly collected. Following the new division of the workload components, the final formula for the estimation of required workforce requirements is modified. Therefore, the MWISN can increase the accuracy and precision of the measurement of the workload and determine the number of workforces required.

Hypertension is a major cause of noncommunicable diseases such as cardiovascular disease. Therefore, this study aimed to estimate the prevalence of hypertension in cardiovascular patients in Iran by meta‑analysis.

The search was carried out using authentic Persian and English keywords in national and international databases including IranMedex, Scientific Information Database (SID), Magiran, IranDoc, Medlib, ScienceDirect, PubMed , Scopus, Cochrane, Embase, Web of Science, and Google Scholar search engine without any time limitation until 2017. Heterogeneity of studies was assessed using I2 statistic . Data were analyzed using STATA 11.1.

In 66 reviewed studies with a sample of 111,406 participants, the prevalence of hypertension was 44% in Iranian patients with cardiovascular disease 67%(95%CI: 38%–49%) in women and 42% in men. The prevalence of systolic hypertension in cardiac patients was 25%, diastolic 20%, diabetes 27%, and overexposure 43%. The prevalence of hypertension was 44% in patients with coronary artery disease, 50% in myocardial infarction, 33% in aortic aneurysm, and 44% in cardiac failure.

Hypertension has a higher prevalence in women with cardiovascular disease than men, and it increases with age. Among patients with cardiovascular disease, myocardial infarction patients have the highest levels of hypertension. The prevalence of systolic hypertension in cardiac patients is higher than diastolic hypertension.

If organizational culture leads to stimulating organizational creativity, it will bring effectiveness and success to the organization. Therefore, the aim of this study was to determine the relationship between organizational culture and creativity of employees, taking into account the role of mediation of social capital in the development deputy of Mashhad university of medical sciences. This descriptive - analytical study was conducted in 183 employees of management development and resources department of Mashhad university of medical sciences that were randomly selected. The data collection tool was a standard organizational culture questionnaire (56 questions), employee creativity (60 questions), and social capital (28 questions). Data were analyzed using Structural Equation Modeling Method and with the help of the software Pls smart version two. There was a direct correlation between organizational culture and social capital (r=0.752) and between organizational culture and creativity of staff (r=0.464). Also, the social capital of the relationship between organizational culture and creativity of staff played the role of mediation. Organizations can help to increase creativity by agreeing on the values and beliefs in the organization and aligning individual and organizational goals, and planners cannot plan the criteria for increasing creativity of individuals regardless of organizational culture. If managers act to strengthen social capital, they can strengthen organizational culture in their organizations and create a suitable platform for creating a commonality.

Designing and implementing a model for estimation and distribution of required nurse is one of strategies to prevent unequal distribution of nurses within and between hospitals. The purpose of this research was to determine required features for hospital nursing staff estimation model.
We conducted a qualitative study using a Colaizzi analysis approach. We used semi‑structure and in‑depth interviews by purposive, quota, and snowball sampling of 32 participants (10 informed experts in area of policy making in human resources in Ministry of Health, 10 decisions making in employment and distribution of human resources in treatment and administrative chancellors of medical universities, and 12 process owners in hospitals). The data were analyzed using ATLAS.ti software version 6.0.15.
The ten following sub‑themes emerged from data analysis: Skill mix and task shifting, work measurement, legal support, stakeholder involvement in designing a model, considering the ward activity, considering type and extent of care patients required, model development by experts predominate in nursing process, considering the nurses availability, considering the capabilities and professional merits of nurses, fitness with social, cultural, and belief of people. The main themes were occupation analysis, planning and policy making, real workload, acceptability, nurses’ efficiency, and being a native.
Given that standardization of nursing staff estimation is announced as one of the challenges in reaching Iran’s 20‑year vision plan. Hence, design and implementation of a nursing staff estimation model in regard to identified features could be part of priorities in Ministry of Health in Iran.

Medication error is one of the quality problems in hospitals harming millions of people around the world every year. This study aimed to investigate the occurrence and reporting of medication errors by nurses in hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran.
This descriptive cross-sectional study was conducted on 530 nurses selected by simple and stratified random sampling in 2014. Data were collected using a survey consisting of four sections and 66 questions, scored based on a Likert scale (87% return rate). Data analysis was performed in SPSS Version 18 using descriptive statistics, ANOVA test, and chi-square test. P-value of less than 0.05 was considered statistically significance.
The most prevalent medication errors by nurses was early or late administration of medication (43.7%), which was attributed to individual factors by the managers in the viewpoint of the nurses (mean: 3.66.3). In addition, the occurrence of medication error might be due to the hospital ward patient overcrowding (4.29.07). No significant relationship was observed between the variables of medication error, the causes, and lack of error report with gender and nursing experience (P=0.6 and P=0.8, respectively).
One of the effective methods for prevention of medication error is providing teaching courses for nurses to raise their knowledge in this regard and aware them of the outcomes of wrong medication prescription.

Cancellation of surgical procedures is one of the biggest challenges in hospitals throughout the world and it is important as it increases patient's stress, expenses and wastage of time, and prolongs the duration of hospitalization of patients. The aim of this study was to review literature related to reasons of surgery cancellation in Iran.
This systematic review was conducted from March to Sep. 2014. The keywords including cancellation, delay, postpone, cancelled surgery, surgery operation and Iran were searched in international search engines including Pubmed, Scopus, ProQust and Google scholar and Persian indexing websites of SID, Magiran and Iranmedex. All articles related to cancelled operations in Iran, written in English or Persian (from Jan 1, 2004 until Sep 31, 2014) were collected. Then, those articles which contained any of the selected keywords in their titles or abstracts were compiled, and others were excluded. At last, a check list including title of article, time and location of study, sample size and location and cancellation cause was designed for final assessment.
A total of 646 records were found in 7 selected databases of which 13 articles met the criteria for inclusion in this study. The main cases of surgery cancellation were related to operating room and hospital, anesthesia, patient's non-clinical problems, the surgeon and clinical problems.
Adoption of strategies for on-time initiation of surgical procedures, identification of patient's underlying problems and the appropriate process of hospital admission can be effective in reducing the rate of cancelled operations.

Due to the changing environment of hospitals and the necessity of providing services for patients in the shortest possible time and at an acceptable quality and cost، it seems to be necessary to utilize the maximum intellectual capacity of the organization to enhance agility in hospitals. The aim of this study is، in fact، to investigate the relationship between organizational intelligence (and its components according to the Albrecht model) and organizational agility in hospitals of Mashhad University of Medical Sciences. This descriptive study was conducted in 2013 on 408 hospital employees seleced through stratified sampling method. To collect data on organizational intelligence، the Albrekht standardized questionnaire was used and to gather data on organizational agility، a questionnaire designed based on Goldman model was employed. For data analysis and hypothesis testing، the SPSS software version16، Pearson correlation، t-test، Anova، and regression techniques were applied. The results of the study showed that there was a significant relationship between agility in hospitals and organizational intelligence (components: Appetite for change، heart، knowledge deployment، performance pressure، strategic vision، shared fate، and alignment and congruence). The determinants of agility were mainly strategic vision، performance pressure، and a lignment and congruence. The results of the study showed that dynamic strategic planning in hospitals and developing educational programs of organizational intelligence aiming at employees'' and managers'' awareness could lead to an increase in the agility level of hospitals and provision of effective services for patients.

Purchasing hospital equipment is one of the most important decisions made by managers and health professionals. Gray systems theory is an approach to deal with issues under uncertainty conditions where decision makers are facing a small number of unspecified data. The purpose of this paper is to apply the gray theory for the purchase of anesthesia machine. This study was a survey in which mathematical analysis was used. Data collection devices included documents، interviews and questionnaires. In order to solve multiple criteria decision making in uncertain conditions، a model based on gray system theory was used. Data analysis was performed using Excel software. The findings show that among anesthetic equipment bought by public and private hospitals، brand A is superior to other brands. However، the gray possibility degree for the other brands is significantly different from brand A. In addition to helping to purchase anesthetic equipment for hospitals، the results of this study are also useful for companies manufacturing medical equipment to evaluate their situation in terms of the studied criteria and take appropriate measures to develop their strengths and improve their weaknesses.

one of new and unique tools for survival of organizations among their competitors having comprehensive knowledge of all the environmental factors affecting the organization, means organizational intelligence, that with its measurement Strengths and weaknesses of the organization are identified and can affect the performance of organization and in this way, they help to organization in the measurement and evaluating progress in achieving its goals. This descriptive analytical study was performed in 12 general hospitals affiliated to Mashhad University of Medical Sciences in 2012. Study samples were 375 employees who were selected through stratified sampling method. The study Tool of data accumulation was Albrecht organizational intelligence standard questionnaire and checklist of hospital performance indicators that was determined by the Ministry of Health. To determine score organizational intelligence was used the five-point Likert scale. Data were analyzed by SPSS v.16 using Statistical tests and Pearson correlation coefficient (P=0/05). we found that there was a significant positive relationship between hospitals’ organizational intelligence and all the performance indicators of the exception of “Bed occupancy ratio”, “Ratio of surgeries to operation beds” (P<0.05), and organizational intelligence had the highest correlation with indicators of Bed Turnover Interval (r = 0.739) and the average length of patient stay (0.691). it seems that attention and planning to strengthen and increase organizational intelligence can be effective in improving the performance of hospitals.

Medication error underreporting by clinical staff prevent identification of type and intensity of medication errors, and addressing strategies. Most investigation of barriers to medication error reporting comes from public hospitals. This study aimed to explore the issue as perceived by nursing staff in private hospital. A sample of 97 nurses from a 180-bed private hospital situated in Mashhad City (Western Iran) was surveyed. A literature-based questionnaire consisting of 16 questions asking the reasons for medication error underreporting from the nurse’s perspective was used as the survey tool. The content validity of the survey tool was explored by using nursing experts’ opinions. The reliability of the tool was examined using test-retest method. Data were summarized using descriptive statistical methods. The factors contributing to the medication error underreporting were ranked based on their importance scores, and clustered into three major ranking categories: very important, moderately important, and slightly important. T-test and ANOVA were used for comparison of the medical error factors between the demographic groups. Fear of legal involvement, fear of losing job, and fear of the consequences of error were identified as the three major factors contributing to medication error under reporting. Age, work experience, working department, type of shift work and marital status were significantly we found to be influential on reporting medication errors. According to our results, factors related to the potential consequences of reporting constitute the major concern of nurses in reporting. This observation that is corroborated by numerous previous findings emphasize the importance of developing rational and blameless climate for honest reporting of un-intended medication errors and taking the advantages of these reports for improving patient safety.