مجله مدیریت بهداشت و درمان
سال نهم شماره 1 (پیاپی 27، بهار 1397)

The philosophical dimensions of lean management in health section, and especially in hospitals which could renew their function and contribute to their development in providing improved services are of particular importance.The present study aims to investigate the effect of waste control, lean techniques and visual systems on lean management in hospitals of Shahid Beheshti University of Medical Sciences (SBMU).
Considering the results, the present case study falls in the applied category. The research populations were managers at different levels of senior, middle, and operational in the SBMU teaching hospitals. The data were obtained through researcher-made questionnaire that its validity confirmed by a group of elite scientific and executive experts in the field of lean management and its reliability calculated 82 percent using Cronbach's alpha.
The obtained findings revealed that all the three factors of waste control, lean techniques, and visual systems significantly loaded on the lean management. The results of the conducted factor analysis on the basis of goodness of fit indices NFI=95%, GFI=92%, and RMSEA=0.052% verified fitness of the model.
Considering the effect of waste control, lean techniques, and visual systems on lean management in the teaching hospitals, examining hospital infrastructures and the use of self-assessment system for feasibility of lean execution could be effective in establishment of lean management in hospitals.

The doctor is a health care provider which is depreciated due to, work, accidents, environmental pollution and age and increases the demand for health services; many factors have an impact on the demand for health services; this study attempts to measure the impact of 18 of the most important ones.
The model used is the Generalized Logit and ANN. The population includes those who referred to Shiraz and Arsanjan hospitals in 1994. The sample consists of 100 patients and 100 patient patients (non-patient) and data Collected through questionnaires.
Findings: The results of model validity tests including fit of Goodness (Pearson and Deviance index), Parallel Regression, Maximum likelihood, and Newton-Raphson Algorithm indicate that the validity of the model is up to 84% confidence. According to the results, increase of 1% in visit, 2% of demand for services is reduced. The initial health and beliefs has the same interpretation of visit. An increase of one percent in premiums caused a decrease of 3.11% and increases one unit in health index, decrease of 1.3% and a one year increase in age, increase of 10%, and daily consumption of one cigarette, increases 0.04% in demand Health care.
According to the results, health, insurance, education and awareness of body anatomy have the greatest impact and smoking and job have the least impact on the demand for health care. With increasing age, education, insurance coverage, awareness and income, the demand for treatment increases. On the other hand, over time, education, awareness and per capita income are rising, so, the demand for these services will increase in the future.

the optimum is under the pharmacy location, rapid access of patients to the medical service has proportional distribution and facilitate the pharmacy, the problems of citizens access to these centers to follow. The main objective of this study was to evaluate how the current distribution of the causative of the Pharmacy and determination of the best location for the new establishment of pharmacies.
this study was applied in terms of the purpose and nature of the procedure and, in terms of analytical descriptive. The steps are fitted in place during the fining of Pharmacy overnight of layer preparation day contains information for each element, the classification of information based on the values of each layer and the combination of all of the information layer and apply the final analysis model of the ANP and the final maps. Also, the data include both distance and access and twelve under the criterion.
a study of computation and azanjam, the highest weight to the criterion of "forming a RADIUS service and fitted the least weight to the criterion" distance from military centers. In the studied area of 13.36% with a degree or higher to be the establishment of new centers and 21.5% is appropriate
The results show that the current location of most day-care pharmacies in Urmia is not proportional to the population of the region. Due to the overlapping of the range of pharmacie's services, especially in the central area of the city, organizing in these areas and transferring some of the existing units to other areas that are lacking is necessary, and in the northern and eastern parts of the city, according to the final map, the establishment of new centers is required.

Accreditation is a comprehensive and supportive model for assessing hospital performance. The present study aimed to assess the methodology of scoring hospital accreditation standards in Iran.
This research is a qualitative study in 2017. The main scope was to interview the experts in the area of policy and accreditation of hospitals in Iran. Accordingly, semi-structured interviews were conducted with 25 experts and hospital accreditation assessors. A framework analysis was used to analyze qualitative data.
In this study, six subjects were identified as the key factors influencing the hospital accreditation method. Standards Classification, Scoring, Weighting, Overall Score Ranking, Role of Assessors, Evaluation Method. In the current method, the overall score did not determine the difference between hospitals. Weighting was not clearly specified. The executive steps which were guidelines of implementation were scored. The decision making methods of the assessors were not the same, and the assessments were mandatory and not carried out by an independent organization.
In the area of classification of standards and the method of scoring and weighting in the current accreditation evaluation, there needs to be changes. Required measurable elements in the accreditation standards will be eliminated. The precondition for entering the accreditation process will be to obtain the necessary permits before accreditation. It is suggested that the Likert scale be used for scoring. It’s recommended that the weight of patient safety standards must be considered more.

One of the most important determinants of organizations success is the presence of manpower committed to organization their careers. On the other hand, in recent years, empowering human resources has been used as a way to create efficiency and productivity. In this respect, purpose study was to investigate the relationship between empowerment and organizational commitment and professional commitment of nurses in Milad hospital
The method of collecting this descriptive-survey and applied study was questionnaire (Validity and reliability was evaluated with a formal approach and Cronbach's alpha test (0.932)). Population was 807 Nurses and sample according to Cochran formula was 261 Nurses. To analyze the hypotheses, inferential tests were used.
In the significance level less than 0.05, nurse's empowerment with organizational commitment and professional commitment has a positive and significant correlation (correlation coefficient is 0.908 and 0.797). Also, nurse's empowerment and their dimensions, organizational commitment and its dimensions, and professional commitment in Milad Hospital are higher than average (3). And the mean of these variables is not significantly different in age groups, education, gender and experience.
Considering the relationship between nursing empowerment, organizational commitment, and professional commitment among the nurses in Milad Hospital, it can be concluded that efforts to improve nurse's ability can be a valuable strategy to improve organizational commitment and professional commitment.

Patients with doctors and nurses have the most relevance in hospitals. The relationship between doctors and nurses with the patient should be such that the patient is encouraged to continue medical care and loyalty to the hospital.
The present study was descriptive-survey in terms of method and applied in terms of purpose. In this research, a questionnaire was Boquiren et al based on Behavioral Medicine Behavioral Model, Wolf et al Nursing Behavior, and Delourt et al loyalty of Patients, were used for collecting data. The statistical sample of this study was 194 patients in Sina Hospital. Data were analyzed by descriptive statistics and inferential statistics such as Pearson test and regression test.
According to the results of the regression test, 95% confidence level (less than 5% error), the behavior of medical personnel dimensions in the professional of physicians 'behavior (p = 0.00), emotional behavior of physicians (p = 0.00), professionalism of nurse's behavior (p = 0.013 ) And emotional behavior of nurses (p = 0.00) were significantly correlated with patient loyalty.
If hospital managers focus on the strengthening and effectiveness of the behavior of their medical staff in their professional and emotional dimensions and by applying different educational and motivational approaches in order to improve and adapt to patient's needs, significant results are expected in relation to patient's loyalty to hospitals in the long run.

The work-family conflict, dubbed the "incompatibility between work and family roles", emanates from the pressures inherent in the incompatibility of family and professional roles. The present study aims to investigate the conflict between work and personal life of people with working hours.
Therefore, in view point of the nature is a descriptive-survey method, based on this, for measuring the concepts of research, the standard questionnaire of conflict between work and life has been used. The reliability of the questionnaire was evaluated using Cronbach's alpha, which is 0.838 and is in the desired level. For data analysis, one-sample t-test was used in SPSS21 software.
the research indicate that there is a high degree of conflict between work and personal life The factor of the time conflict between work and personal life with the mean of15/93 is the highest conflict and the variable of conflict on the basis of stress or pressure with the average of 15/63 in the second and finally the factor of conflict on the basis of behavior with an average of 14/87 third place in the controversy of work and Life is dedicated to them
It is suggested that time management and stress management courses be provided by the organization to the employees. Considering the material and spiritual rewards, paying attention to the health and support of employees can increase the amount of their commitment and job satisfaction

Increasing the quality of labor is one of the most important factors in improving labor productivity. Also, improving the quality of labor can be achieved through improving the labor health. Accordingly, this study examines the two-way relationship between health and labor productivity in Iran.
This research is doing a causal-analysis by using Toda - Yamamoto and Johansen-Juselius methods over the period of first quarter of 1996 to fourth quarter of 2016 for the country of Iran. Also, the level of significant is 5 percent.
There is a two-way relationship between health and labor productivity. Also, one percent increase in privet health expenditure, increases the labor productivity by 0.67 percent. Accordingly one percent increase in the labor productivity lead to 1.48 percent increase in privet health expenditure.
Given the significant cross positive impact of health on labor productivity and vice versa, it is recommended that policy makers with increase health, improve labor productivity and also, with increase labor productivity, improve laber health.