مجله مدیریت بهداشت و درمان
سال هشتم شماره 2 (پیاپی 24، تابستان 1396)

Allocation of human resource properly can have an effective role in the hospital emergency departments cost performance. This research has been conducted to provide the optimal solution on staff leveling for emergency department of hospitals.
This research is an applied research and deploys from analytic analysis. The population of study include patients referred to a given emergency department on Imam Reza Hospital in Tabriz at a period of three months in 1393. After analyzing the current patient workflow, required data concerning the patients’ inter-arrival time, cycle times in different stations gathered for 900 patients during three weeks. Based on such data, simulation models designed using the Arena software features and finally the model verified and validated. Then proposed linear programming model based on minimizing patients’ average stay time, helped to calculate optimum staff leveling.
Result of sensitivity analysis on DTDT, show that if operational budget of emergency department increased 10%, 20%, 30%; The LOS leads to 359,337,308 minutes. In the lower budget, this correlation is apparent and significant.
Simulation results revealed that increasing on the number of physicist has the most priority on extra investment. Also, the proposed simulation model helped the operating managers to get more sense on the effects of the relevant controllable factors to total efficiency on the emergency department; in simulated framework, without operational experience, examine intended scenarios and comparing results then select best solutions.

Ever-increasing development of quality-oriented and customer orientation in health services, through continuous feedback of patients expectations and continual recovery of service presentation, is possible. Patient satisfaction can impact on compliance with suggested treatment and therefore impact on health outcomes.
this correlation-descriptive study of 405 bedridden patients was done at 3 hospitals that are depending to Tehran medical sciences Islamic Azad University that were selected according to the available sampling. Information collecting tools was a questionnaire including of two parts demographic and questions measuring service quality (SERVQUAL).
The highest quality of hospital service in the perceptions of the reliability dimension was with 17.5 averages and the lowest percentage was related to tangibility dimension with the average of 12.84. The highest average of hospital services quality in the expectation part was related to Empathy dimension with the average of 21.12 and the lowest percentage was related to tangibility dimension with the average of 17.23. The gap between patients’ perceptions and expectations at hospitals depending to Tehran medical sciences Islamic Azad University equal to -19.9 units. The lowest gap with -2.52 unit related to service Assurance dimension and the most gap with -4.6 units related to Empathy expectations.
For promotion of treatment health service quality, it’s necessary to establish a balance between services presenting and patient expectations. Suitable quality control is was to decrease of quality gap.

The current research study aims to examine the effect of human and technical factors on establishment of the operational budgeting at TUMS. To achieve this goal, after studying and reviewing the findings of the previous studies which had been carried out in theoretical research, the desired framework was proposed.
The research methods, in terms of research objectives and data collection, were practical and descriptive, respectively. In the survey, 92 participants consisting TUMS managers and financial officers were selected as the sample of statistical population. Sampling method was the population census. For data collection, in addition to the library studies, a survey questionnaire, which its validity confirmed by the experts and confirmatory factor analysis and its reliability approved through Cronbach's alpha method at the level of 80 percent, was used.
In order to analyze the conceptual framework for hypotheses assessment, one-sample t-Test, and for Prioritization of dimensions, Friedman test were used.
The findings indicate that human and technical factors with t=7/56 influences on establishment of the operational budgeting at Tehran University of Medical Sciences.

using internet of things on health related departments is one of the most important technological efforts for enhancing medical centers performance like hospitals; while applying it improves social justice in health related areas.
This is a practical research and descriptive- correlative in methodology. The statistical community includes 400 doctors and nurses among which 196 samples were chosen through random classified sampling; collecting data was done by questionnaires of using health related internet of things and organizational performance. The statistical analysis includes structural equations technique through LISREL8.54 and multiple regression analysis.
Findings: The findings indicated that collecting vital signs and the parameters of chronic and incident diseases ,continuously and in period, supervision , remote services, information management, intelligently sending contents to user, inter-organizationalintegration, environmental activity effect on organizational performance 0.42, 0.31, 0.36, 0.47, 0.43, 0.29, 0.21 and 0.24, respectively.
using internet of things, according to the above mentioned variables, is one of the most important technological outcomes that effects on health related organizational performance in Tehran Shahid Rajaee Hospital directly.

The most important issues in the process of implementation is stakeholder analysis and identify their interests to effective implementation. This study intends to examine policy content of family physicians and referral system from the medical perspective as the main stakeholders the project.
This cross-sectional descriptive-analytic study was conducted in 2013. Data collection using the questionnaire developed by the researchers based on version 02 family physician instructions that its validity and reliability were tested. Data were analyzed with SPSS software.
Over 60% of sample were female and aged less than 40 years. They also were under 5 years of experience and more than %50 of physicians were working in the line (health teams).
Establishing referral system in the country is a huge revolution in the delivery of health services. To implementation of this, and access to health services costs associated with the management. Infrastructure and health reforms in other sectors including health information systems, and training of related human resource, improve culture of the society, guidelines related to the payment system and how service delivery is required.

Today, not only is the capability of quick and on time use of information and technological knowledge a big challenge for organizations, but also is the first priority that creates advantage for it. Technology intelligence is the process that provides the necessary awareness for decision making in the field of technology and helps in acquiring competitive advantage for the firm by gathering and analyzing information and technological knowledge.
This is a descriptive research and its statistical society is all the Iranian companies in the second Iran Pharma exhibition in Tehran in 1395 (193 companies). The questionnaire of this research was distributed among all the participants in the exhibition and 98 correct questionnaires were received. Content validity of the questionnaire was confirmed by the experts and its reliability was calculated using Cronbach's alpha. SPSS software was firstly used to analyze the data and then Smart-PLS software was used for structural equations modeling by least partial squares.
The results of this research, technology intelligence had a positive impact (β=0.774) and significant (T=18.742>1.96) on the competitive advantage of pharmaceutical companies. Besides confirming the model, the results show that the technology intelligence variable has been able to take 59.8% of the changes in these companies by a impact coefficient of 0.774.
According to the findings of this research, it can be said that by utilizing technology intelligence and also its significant positive impact on competitive advantage, one can see the acquisition, improvement, and promotion of competitive advantage in an organization.

hospital service's outsourcing is a key strategy towards is improvement the quality of services. The aim of study was determine the quality of services in outsourced and non-outsourced clinical laboratory of educational hospitals in Ahvaz, 2016.
This is a cross-sectional study. In this study 643 patients were selected randomly. Data were gathered by SERQUAL questionnaire. This tool included 22 questions and 5 dimensions including tangibility, reliability, responsiveness, assurance, empathy about services quality.
services quality in outsourced clinical laboratory centers was significantly higher than non-outsourced clinical laboratory centers (P=0.001). The mean of waiting time to receive services and sampling time of patient was 37.29±28.08 and 4.48±1.6 min respectively. The mean of waiting time in outsourced clinical laboratory was significantly lower than non-outsourced clinical laboratory (P=0.001).
the results showed that outsourcing strategy had positive relationship with services quality of clinical laboratory units. Also, waiting time to receive services in outsourced clinical laboratory centers was lower than non-outsourced clinical laboratory centers.

The speed of environmental and organizational changes has made training and updating of human resources, especially managers, very important. Nowadays, this importance is doubled due to the sensitivity of the occupations in the hospitals. Therefore, it is important to identify and prioritize the educational needs of hospital managers.
This research is applied in terms of purpose and descriptive survey method. The statistical population of this study consist of all other managers of the hospital of the rest of the country, of which 190 are. Using Morgan's table, 123 people were selected as the sample size (92 men and 31 women), and they were selected by stratified random sampling from the statistical population. The data gathering tool was a questionnaire whose validity and reliability were confirmed by standard methods. To analyze the data, one-group t-test and Friedman test were used.
The results of a single-group t test showed that different levels of hospital management required different technical, human and perceptual training indices. According to Friedman's test, the priority of these needs varies.
The three levels of managers (excellent, middle, and supervisor) need all three levels (technical, human, and perceptual), but higher level executives are more concerned with perceived needs, and managers are at the level of technical supervision, while all three The managerial level has prioritized the educational needs of the human being. Also, the priorities of these three groups are different.