نشریه مدیریت اطلاعات سلامت
سال دوازدهم شماره 6 (پیاپی 46، بهمن و اسفند 1394)

Human resources are one of the factors most effective on the success or failure of an organization and service motivation is a factor which affects the quality and quantity of activity of an organization. The present study aimed to determine the motivating potential score (MPS) of medical record staff of training hospitals in Isfahan, Iran, over the years of 2011-2012.
This was an applied and descriptive survey. The statistical population of the study included all staff of the medical records departments of training hospitals in Isfahan. The participants consisted of 127 individuals selected by conducting a census. The data collection tool was Hackman and Oldham’s Job Characteristics Scale. The content validity of the scale was confirmed by experts and its reliability was approved through calculation of Cronbach’s alpha (α = 0.84). The collected data were analyzed using descriptively statistics (frequency percentage, mean, standard deviation, and etc.) and inferential statistics (MANOVA, Fisher's LSD) in SPSS software.
This study results showed that the MPS index with the score of 40.665 was at a medium level among medical record staff. There was a significant difference among hospitals in terms of mean MPS according to the unit of service in the medical records department.
Findings showed that occupations related to medical records have been designed in a way that can provide an average degree of working motivation for individuals. Therefore, the improvement of MPS requires a high degree of efforts by managers at all levels of hospitals, universities of medical sciences, and especially, human resources.

Employee empowerment is a process that requires appropriate conditions in the organization. The application of information systems in the health sector as a pragmatic approach and critical element in empowering employees provides the possibility of enhancement of the capacities and development capabilities of human resources. The purpose of this study was to investigate the relationship between the application of hospital information systems (HIS) and psychological empowerment of hospital staff.
This was a descriptive correlational study. The statistical population consisted of 304 staff members of Vali-asr Hospital in Tehran, Iran, who were associated with HIS in 2015. The sample size was determined using the Morgan and Krejcie table. The sample consisted of 170 individuals selected through stratified random sampling. Data were collected via two researcher-made questionnaires. The reliability and validity of these questionnaires were approved by specialists and using Cronbach's alpha coefficient (α = 0.93), respectively. Normality of data was approved by Kolmogorov-Smirnov test. To analyze the data, descriptive statistics, the Pearson correlation coefficient, and linear regression were used in SPSS software.
The results of the Pearson correlation and linear regression analysis showed a significant positive correlation between HIS use and each component of psychological empowerment (P = 0.001, R = 0.567, R2 = 0.322).
A significant positive relationship was observed between HIS and psychological empowerment of hospital staff. HIS has an effective role in the development and empowerment of human resources in all aspects including increased knowledge, improved performance quality, reinforcement of decision making skills, and staff profession development, increased employment opportunities, and increased self-management responsibility. The development of information technology in the health sector requires the modification of the structure and improvement of appropriate cultural, communicative, and organizational infrastructure.

The healthcare sector is one of the areas affected by information technology (IT). Due to the importance of IT in hospitals and factors affecting its use, the present study was conducted to investigate the human factors affecting the use of IT among managers of university hospitals in Shiraz, Iran.
This applied and analytic study was conducted in 2014 in 7 university hospitals of Shiraz selected through simple random sampling. The statistical population included 119 senior, middle, and operational managers of these centers. The study subjects consisted of 91 individuals selected through convenience sampling and Cochran’s formula. The data collection tool was the Technology Acceptance Model Questionnaire. The validity and reliability of the questionnaire were confirmed in previous studies. Descriptive statistics were used to determine mean and standard deviation and inferential statistics (independent t-test, ANOVA, and the Pearson correlation coefficient) were used in SPSS software to analyze data.
No significant difference was observed in the mean score of using computers among managers and supervisors in terms of gender, age, work experiences, and education level. There cognition and learning had a significant relationship with attitudes toward using IT. However, no significant relationship was observed between decision making and this variable.
Human factors, particularly their determining dimensions including cognition and learning, are among the most important factors that influence the use of IT. Therefore, it is recommended that, before implementing programs related to IT, individuals be informed about its benefits and capabilities so that they gain appropriate understanding and receiving the necessary training.

Today, medical software are used in different aspects of healthcare varying from simple data processing to collection and interpretation of physiological information and education of nurses and physicians. To ensure use of medical software, they must be constantly evaluated based on specific criteria. Since there is no organized evaluation system and comprehensive criteria for evaluating medical software in Iran, the present study aimed to codify and present a conceptual evaluation model for anatomical pathology software.
This was an applied and descriptive study. The research population included pathology anatomical software evaluation models. The research environment consisted of libraries and the internet. This study was performed in 2014. The sample volume of was equal to the research population volume (5 evaluation models). The second checklist was developed through studying the literature. The validity of the checklist was approved through determination of content validity by studying the literature and obtaining feedback from scholars. The reliability of the instrument was approved through test-re-test. The collected data were analyzed through comparative analysis using evaluation models of anatomical pathology software.
The results presented two different groups for evaluating anatomical pathology software capabilities; general criteria and specific criteria. The general evaluative criteria were classified into 3 categories including security, user friendliness, and interoperability. The specific criteria were divided into 7 categories including admission-discharge-transfer, test ordering, following the specimen, recording and reporting of results, obtaining reports, quality control, and accounting management. Based on these findings, the evaluation instrument (the checklist) and its method of evaluation were presented.
The model presented in this research encompasses various dimensions of anatomical pathology information system and the appropriate method for its evaluation. The strengths of the evaluation model compared to other evaluation models were the separation between general and specific criteria, specified target users for each relevant subcriterion, the clarity of specific criteria in more detail, and validation of the evaluation model by experts in this area.

The number of systematic reviews and meta-analyses published in Iran has increased significantly in recent years. Writing these articles based on internationally accepted guidelines is one of the most important factors effective on their structural quality. This study aimed to assess the abstract of Iranian systematic reviews and meta-analyses indexed in Scopus.
This study was an applied, descriptive survey. The study sample included 247 abstracts of Iranian systematic reviews and meta-analyses indexed in Scopus until the end of 2012. In this study, the quality of the abstracts was evaluated using a checklist and organizational affiliation and the articles’ publishing progress were identified through the analysis of Scopus.
Compliance with the checklist criteria was generally poor in abstracts. The objective criteria obtained the highest compliance rate (98.8%) and the registration criteria obtained the lowest compliance rate (1.6%). The results showed the growth in quantity of articles in time. Tehran University of Medical Sciences with 131 reviews was the most productive organization and Baqiyatallah University of Medical Sciences and Isfahan University of Medical Sciences with 23 and 22 reviews, respectively, were the next in the ranking.
The present study showed that the abstracts’ quality was not desirable. Therefore, training authors on review writing and greater attention by editors and judges during the adjudication process seems essential.

Due to the use of information technology in libraries and information centers, librarians are faced with many challenges in terms of their roles and needs; hence, they require continuous training to cope with these challenges. The aim of the present study was to determine the effectiveness of in-service training courses for librarians working in libraries at the Isfahan University of Medical Sciences, Iran, between the years 2012 and 2013 based on Kirkpatrick’s model.
This applied research was conducted through a survey. The study population consisted of 70 librarians working in libraries at the Isfahan University of Medical Sciences in 2015. Due to the limited number of librarians, sampling was not performed. The data collection tool was a researcher-made questionnaire based on Kirkpatrick’s model. The validity of the questionnaire was confirmed by experts in the field of Education, Library, and Information Management and its reliability was approved using Cronbach's alpha (α = 0.88). Data were analyzed using both descriptive and analytical statistics (independent one-sample t-test and ANOVA) in SPSS software.
From the librarians’ point of views, the effectiveness of the training courses was above average (3.7) in all four levels and in total; however, effectiveness in two levels of reactions and learning was higher than the other two levels. There were no significant differences between the views men and women and library and information sciences (LIS) educated librarians and non-LIS educated librarians in terms of effectiveness of training courses. There was no significant relation between librarians’ occupational background and their perspectives on the effectiveness of training courses expect in the learning level.
Librarians believed in-service training courses to be effective in all four levels of reaction, learning, behavior, and results. This is due to accurate needs assessment, using experienced teachers and adequate training equipment, and appropriate working environment for applying the course material.

Today, in the era of information, the main parameter for scientific assessment of countries, and academic centers is their contributions to the development of science and technology. This study was conducted to evaluate scientific outcomes of Ardabil University of Medical Sciences and its faculty members until the end of July 2014.
In a descriptive study on bibliographic information, all documents affiliated to Ardabil University of Medical Sciences (280 essays) in Scopus database were collected. Then, the contribution to academic production was evaluated through the number of citations to each document, type of authorship according to first or corresponding author, H-index, target journal, and collaboration with other institutes.
Ardabil University of Medical Sciences was illustrated with 3 addresses which contained 280 essays. The number of essays had increased from 1 in 2000 to 56 in 2013. Most essays and the most cited papers were published in 2013. The highest number of the essays were original articles (n = 45) and lowest number were editorial letters (n = 1). The H-index of the university was equal to 19 at the end of July 2014.
The increase in the number of essays from 2000 to 2013 shows the increase in scientific outcomes in Scopus database. Despite the high growth in scientific outcome during the studied period, the rank of Ardabil University of Medical Sciences among other institutions and universities affiliated to the Iranian Ministry of Health is not desirable. Thus, it seems that the greater attention of university authorities is necessary to increase the level of scientific production.

Iranian academia has recently experienced an increase in the number of its funded papers, and their citationadvantage over unfunded papers has been approved. However, this improvement and advantage is only meaningful whencompared to other countries. Thus, in order to determine Iran’s status among its counterparts, the present study investigated andcompared the status of research funds absorption in Iran with that of the three most prolific Islamic Middle Eastern countries,Turkey, Egypt, and Saudi Arabia.
This fundamental research was conducted through a citation and publication analysis approach. The statistical populationconsisted of all valid papers from prolific Islamic countries. The study sample was selected through purposive sampling and 174965academic papers indexed in the Science Citation Index Expanded during 2008-2011. Data were collected on 25 of October 2012 andanalyzed using descriptive statistics (mean, frequency, and percentage) and inferential statistics (chi-square, independent t, ANOVA,Welch’s t-test, Brown–Forsythe test, and Games- Howell test) in SPSS and using Excel software.
The countries’ funded researches were significantly less, though superior in citation performance compared to unfunded papers.Saudi Arabia outperformed the other nations in terms of the portion of its funded papers. In the unfunded papers group, no statisticaldifference was observed among the nations in mean citations, except Iran which outperformed Turkey. In the funded papers group, all thenations had similar citation levels. However, the mean citation of Iran was significantly lower than the other countries.
Funded researches seem to fail to achieve a considerably high visibility and, thereby, a competitive advantage for theIranian academic production. The findings illustrate the necessity of elimination of deficiencies in Iran’s academic system,especially research fund allocation and distribution mechanisms.

It is clear that if the discharge process takes less time and the patient leaves the hospital bed earlier, the length of hospitalization, and consequently, the waiting time for admission decreases. Therefore, the method of use of treatment facilities is somewhat improved. The hospital discharge process, from when the discharge authorization is issued until the patient leaves the hospital, is a bottleneck in hospital procedures. The aim of this study was to reduce the waiting time for patient discharge from hospitals in Alzahra Hospital in Isfahan, Iran.
This was an empirical and descriptive-analytical research in which the data collected in the summer of 2010 was analyzed using the queueing network model. The required data consisted of the time of starting and ending each activity related to the discharge process, from 10:15 am on 10 selected days (related to 200 patients). The collected data were recorded in the related table. The required parameters for the stochastic distribution were estimated by the mean of the collected times. Statistical distribution of duration between discharge and different services were analyzed using Kolmogorov-Smirnov test in SPSS software. Evaluation of services provided in the discharge process, areas of improvement in procedures, and reduction of time spent on different procedures was conducted through analysis of the related queueing network.
The analysis of the discharge process procedures showed that the main factors affecting average waiting time were patients’ financial problems, unnecessary activities, and delay in writing the medical record abstract and insurance confirmation.
Using the queuing network model, scenarios on improving the discharge process and reducing the waiting time are proposed, which are applicable in many other hospitals.

A strategic plan provides the context for improving organizational performance by accurate, extensive, and in-depth identification and analysis of interior and exterior environments. This study was performed to develop and execute a strategic plan at the Medical Sciences Universities of Iran.
This analytical and cross-sectional study was performed in 2012-2013. The study population was selected through systematic random and quota sampling and consisted of the vice-chancellery of health of 13 medical universities. In the selected universities, all managers and experts were interviewed trough census method. The data collection tool was a researcher-made questionnaire including 8 individual and organizational questions and 6 questions on the formulation, implementation, evaluation, and effectiveness of strategic plans. The validity and reliability of the questionnaire was confirmed. The data were analyzed in SPSS software using the related statistical tests with the significant level of α > 0.05.
From the point of view of 267 managers and experts, the participation level of administrators and managers in the formulation of a strategic plan was 2.9 ± 1.4, from a total of 5 scores. The level of informative content and objectives of the strategic plan was 2.8 ± 1.3. The level of assurance of managers and experts was 2.6 ± 1.22. The level of alignment of the strategic plan with the operational plan was 3.2 ± 1.2. The level of evaluation and revision of the strategic plan was 2.3 ± 1.2. The level of its effectiveness was 2.5 ± 1.1. There was a significant difference between the formulation, implementation, evaluation, and effectiveness levels of the strategic plan and university types (p > 0.05).
This study showed that the level of alignment of the strategic plan with the operational plan was average, and the rest of the factors were lower than average. Therefore, it is recommended that in the future revision of the strategic plan, intervention programs be designed and implemented.

Hospitals are often considered to be the forefront of countering incidents, some of which result from a wide range of incidents including industrial accidents, natural outbreaks of disease, and regional accidents called chemical, biological, radiological, and nuclear (CBRN) accidents. This study was conducted to assess the level of preparedness, capacity, and capability of responding to CBRN incidents in teaching hospitals of Isfahan, Iran.
This descriptive study was conducted in 2013-2014. The statistical population consisted of 43 managers, matrons, educational supervisors, emergency supervisors, and head-nurses in teaching hospitals (12 hospitals) of Isfahan. The participants were selected through census sampling. The data collection tool was a checklist translated by the researcher and its content validity was verified by facts and concepts provided in valid sources and by university professors and experts.
Except hospital A, which had a specialized emergency room for CBRN accidents, no other hospital was prepared to deal with CBRN incidents. Using the checklist, hospital A obtained the a good score in terms of preparedness and planning, employing decontamination team, warm decontamination zone, warm decontamination system, decontamination triage, and patient decontamination. It obtained a relatively good score in terms of security and access control, and medical monitoring of staff. It also acquired an average score in in hazard declaration and recovery. However, it did not obtain a good score in training and exercise, and personal protective equipment.
None of the studied hospitals had the necessary capacity and capability to counter CBRN incidents. The emergency ward of hospital A, however, was assessed to perform well in terms of preparedness and response (score: 67%).

Governments’ tendency toward operating budget is because this process results in the reformation of budgeting systems, and thus, assists countries’ economy. Iran has also prioritized the changing of traditional budgeting to operating budgeting to increase the efficiency and effectiveness of organizations. The aim of this study was to investigate the possibility of stabilizing operational budgeting in Isfahan University of Medical Sciences, Iran, based on the PESTLE model.
The present research was an empirical, descriptive research. The statistical population consisted of 250 financial managers, accounting experts working in finance departments, and finance expert working in Isfahan University of Medical Sciences in 2015. Data were collected using a researcher-made questionnaire the validity of which was approved by experts through face validity. The reliability of the questionnaire was confirmed using Cronbach’s alpha (α = 81%). The PESTLE model consists of the 6 political, economic, social, technological, legal, and environmental dimensions. Each dimension was evaluated separately. Data were analyzed using descriptive statistics [frequency distribution table (percentage), mean, and standard deviation) and inferential statistics (univariate t-test, bivariate t-test, and ANOVA) in SPSS software.
The stabilizing operating budget was possible in Isfahan University of Medical Sciences in the political, economic, social, technological, legal, and environmental dimensions. Mean political, economic, social, technological, legal, and environmental dimensions were 3.8, 3.6, 3.5, 3.8, 3.9, and 3.8, respectively.
The results showed that the stabilizing of operation budgeting is possible in the mentioned university. In the environmental dimension, circumstances are desirable for establishing and implementing operation budgeting. However, in the social dimension, more cultural activities are necessary to prepare the minds of experts and other engaged staff to be more cooperative in modification of this approach.

One of the most important factors affecting the future survival of organizations is identifying and meeting the increasing needs and demands of patients in order to provide high quality health care services. The aim of this study was to identify factors affecting the selection of Milad Hospital, Iran, by patients based on combined marketing factors.
The present analytical and cross-sectional study was performed in the inpatient wards of Milad Hospital in 2013. Data collection was conducted using the Yaghoubi and et al. Questionnaire. The validity of the questionnaire was approved by specialists and its reliability was approved using Cronbach’s alpha (r = 0.85). The statistical population consisted of patients referring to inpatient wards of Milad Hospital. Using the formula for determining sample volume, a sample sized of 421 patients was determined. Sampling was performed using stratified random method. Data were analyzed using one-sample Kolmogorov Smirnov, independent-samples t-test, and ANOVA in SPSS software.
Among the seven dimensions of marketing, the service and process dimensions with mean scores of 18.58 and 6.27, respectively, were the most and the least important reasons for selecting a hospital. Moreover, specialization, appropriate quality of services, type of insurance coverage, skilled physicians, reputation of the hospital, recommendations of relatives and physicians, and sophisticated equipment played a leading role in hospital selection.
Patients make different choices in different situations, but multiple competitive advantages can result in an increase in frequency of patient referral to a medical center.

Today, health tourism is an important and growing phenomenon in the world. Iran has been one of the most active centers of health tourism in the region. Due to the important role of the health tourism industry in the global economy and the capabilities of Yazd Province, Iran, in this industry, the purpose of this study was to identify and evaluate barriers to the development of health tourism in this province.
This empirical survey was conducted in 2014. The statistical population of this research consisted of 10 experts who were familiar with the health tourism industry in Yazd Province. The data collection tool was a questionnaire. The reliability and validity of the questionnaire were confirmed by experts in the field of health tourism and through a review of literature similar researches. First, the barriers to development of health tourism were identified through literature review. Then, using the Shannon entropy, the importance of each barrier was identified and they were ranked using multi-objective optimization and Fuzzy VIKOR methods. Data analysis was performed using Excel software.
The barriers of high costs (0/0561) and limited advertisement (0/0462) were of the highest and lowest importance, respectively. Demanding regulations, health requirements of local community, and lack of human resources (nurses and doctors) were the most important obstacles to the development of health tourism in Yazd Province, respectively.
In the present study, the barriers to health tourism in Yazd Province were identified and strategies to eliminate these barriers and attract more health tourists were presented.

To cope with novel changes, organizations must think beyond environmental compatibility and seek to take advantage of potential opportunities. A paradigm for this is the enhancement of organizational flexibility, speed, quality, and agility. Human resources are the most important tool for enhancement of organizational agility and the most valuable asset of each organization and country. Thus, the aim of this study was to determine the impact of predictive capabilities on human resources agility in the Isfahan Blood Transfusion Center, Iran.
This was a prospective descriptive study. The study population consisted of managers, officials, and experts in the Blood Transfusion Center in Isfahan and 3 other disaster-prone provinces (Kerman, Bushehr, East Azerbaijan Province, Iran) with a minimum of 10 years of experience (161 individuals). The subjects were selected through simple random sampling method. First, the theoretical and scientific background was studied through literature review. Then, the main study components and variables were identified, and using the supervisor’s and advisor’s feedback, a questionnaire was developed in 4 phases through the Delphi method. Face validity of the questionnaire was approved by experts and its reliability was approved using Cronbach's alpha (α = 1). Data were analyzed using t-test, regression test, and Kolmogorov-Smirnov test in SPSS software.
The rate of impact of strategic predictive capabilities on crisis management was 31% and on human resources agility was 89%. The rate of impact of human resources agility on crisis management was 60%.
All elements of strategic predictive capability had significant impact on human resources agility.