مجله مدیریت بهداشت و درمان
سال یازدهم شماره 3 (پیاپی 37، پاییز 1399)

The success of hospitals in providing patient satisfaction depends on many factors. The role of employee's commitment to organizational behavior in patient’s satisfaction in hospitals is important.

The present study is a methodological research in Tehran University of Medical Sciences, which aims to design a questionnaire for assessment of the employee's commitment to organizational behavior which was carried out in two phases. In the first phase we developed items pool based on a review of literature and expert’s views. In the second phase we evaluated content validity and face validity of items, and finally the reliability assessment of the instrument.

A questionnaire was developed based on a review of literature; an 80-items pool was formed. By interviewing experts, and omitting the overlap items, the number of items was reduced to 40 items. In the next stage, content validity, face validity and reliability of the items (α = 0.859) were proved, and the number of items were reduced to 17 items. Finally, we allocated 12 items (from 17 items) to be assessed by heads and colleagues. We also found that patients were able to evaluate the employee's commitment to organizational behavior through 5 items (from 17 items).

An assessment tool contain 17 items was developed for assessment of the employee's commitment to organizational behavior, taking into account the views of service providers and patients.

The efficiency and effectiveness of health systems and the amount of health insurance coverage are considered as one of the main components in the development of countries. Empowerment of people in the health system has been introduced as one of the effective and efficient solutions by the World Health Organization. The purpose of this study is to model effective strategies for empowering people in the health insurance system of Iran.

This research is applied in terms of purpose and descriptive-analytical in terms of method and is a qualitative research in terms of tools. In this study, using the tacit knowledge of experts and the method of content analysis, the causal relationships between strategies affecting the empowerment of individuals / insured in the health insurance system were identified. Due to the ambiguity and uncertainty in the statements of experts, the developed method of cognitive numbering has been used for modeling.

Based on the indicators of effectiveness, impressiveness and centrality, effective strategies on empowerment of individuals in the health system were evaluated. Local organization capacity strategy with a score of 2.62 with the highest impact index, rights protection strategy with a score of 2.67 with the highest impact index and participation strategy with a score of 4.91 with the highest centrality index. FCMapper and Pajek software were used to draw and determine the amount of indicators.

Implementation of empowerment approach in health insurance organization of Iran has different dimensions among effective strategies that modeling causal relationships between them can play an effective role in proper implementation of this approach.

This study was conducted to promote the rationality of public policy-making through stakeholder participation in the codification of public policies. Accordingly, the main issue of study is the pattern of factors affecting the stakeholder’s participation in the process of public policy codification in the Iranian Food and Drug Administration of the Ministry of Health and Medical Education.

This study is qualitative-quantitative research. At first, the stakeholders of (IFDA) were identified through interviews. Then, 18 experts in public policymaking, managers, and experts working in the (IFDA) were interviewed by using the DEMATEL method, as a result of which the relationship between the stakeholders and the severity of their effects on each other was determined.

16 stakeholders of (IFDA) were identified. The results show that in terms of effectiveness and impressibility (D-R) of the governing board with a value of 0.906 was the most influential beneficiary and final consumer with a value of -1.971 was the most impressible stakeholder and also, in terms of the importance of stakeholders (D + R), the Ministry of Health, with the value of 5.322 has the most importance and insurance organizations with the value of 3.216 have the least importance.

By considering the important stakeholders such as the Ministry of Health and the governing board, as well as influential stakeholders such as the final consumer, and by considering the relationship and intensity of stakeholders with each other, the basis of policymakers to involve stakeholders in the policy-making of (IFDA) has been set.

Reengineering of systems and processes for selecting committed and specialized human resources as the main capital of the Health Organization based on general and specialized competencies using progressive administrative and selection laws in this type of government organizations in Iran, which is mainly challenging. Unique in various political, economic and social spheres, along with the requirements of health advocates, is possible. Therefore, the purpose of this study is to explain the model for the selection system so that it can be qualified (specialized and committed) to be employed in health-oriented organizations.

This research has been done in terms of exploratory research in an exploratory mix, in the field and using the data theorizing strategy of the foundation (qualitative part) and survey (quantitative part). For statistical calculations, the method of structural equations with partial least squares approach (PLS-SEM) has been used. The open test method was used to analyze the data obtained from the interview. Criteria of Z, R2, F2 and Q2 have also been used to evaluate the structural.

The results of data analysis show that the selection model includes components of using new tools, efficient in collecting information about job applicants. In order to fully implement the selection model, it is necessary to amend some of the rules and regulations and regulations used in the selection and to reform the qualification criteria of applicants in health-oriented organizations in three dimensions: organizational, social and individual. In this study, the factor loads of all observable variables, with the exception of one case, have a factor load greater than 5%, and the measured Krubnach alpha values for all codified variables are more than 7%. All calculated values for T statistic are greater than 1.96.

The process selection model is based on ethical and scientific principles to determine and monitor the praise of accrual competence as the most important dimension of excellent health quality along with other specialized skills. This model is so dynamic and quantitative that if punished if a person replaces you without using it in order to establish the model, it is necessary to design and establish an information management system for selection and review of selection and administrative rules and regulations.

Organizations to develop and succeed need the knowledge, capabilities, and experience of human resources in a highly competitive global market. In knowledge organizations such as health organizations, is essential existence of performance evaluation system to maintain and grow tacit knowledge. The purpose of this study is to identify the most important dimensions and appropriate indicators for evaluation the performance of knowledge workers.

This study was a narrative review articles and reports on the knowledge workers health system between 2010 and 2020. In order to access related scientific documents, electronic search in both Persian and English using the keywords performance evaluation, performance evaluation system of knowledge workers, Scientific (SID), Iran Medical Sciences Articles Database (Magiran), Iran Medex article database (Iran Medex), PubMed, Science Direct, Inter Science, Ovid, Pro Quest.

The search results in different sites, including 7 articles in Persian in the field of evaluating the performance of knowledge workers, have been paid a survey variable such as independence, creativity and self-control by considering the results-based management and educational and research activities.

In the health system as a knowledge-based organization, managers must plan to implementation an optimal knowledge performance evaluation system. Thus fit model should be design to evaluation performance of knowledge workers, so that in addition an effective management of service delivery processes better health care quality outcomes.can be achieved.

In previous studies, little attention has been paid to the simultaneous effect of health expenditures and good governance on health indicators. In this regard, in this study, the effect of health expenditures and good governance on the health index of Mena countries during the period 2002 to 2019 has been investigated.

The present study is descriptive-analytic of applied type. The statistical population includes the countries of Mana. The method of data collection is library and the data required for the research have been collected by referring to the World Bank database and world government indicators.The data were analyzed by using unit Root, Cao and Generalized Torque tests using Eviews 9 software. In this study, weighted average of six indicators of self-esteem and accountability, political stability and lack of violence, government efficiency, order quality And regulations, rule of law and corruption control as a good governance indicator, as well as infant mortality rates and mortality rates for children under the age of 5 were used as indicators of health.

The results showed that health costs had a positive and significant effect (coefficient -1.32) on the mortality rate of children under 5 years and a positive and significant effect (coefficient -1.2) on the death rate. And infant mortality as a health index has the health index of selected countries. Also, good governance index has a negative (non-significant) effect on health status in selected countries. The results also showed that the weak institutional structure in Mena countries weakens the impact of health expenditures on the under-5 mortality rate (coefficient - 0.13) and (-0.12) on infant mortality rate as a health indicator.

Health in the government leads to improved public health and the lack of government health despite increasing public health spending not only improves public health but also leads to the loss of public resources.

Unsafe health services are still a widespread global problem. Although significant progress has been made in the last decade, there are still numerous shortcomings and the rate of harm inflicted on patients is unacceptably high. Since the evaluation of medical centers leads to improved performance, increased health, reduced accidents and ultimately increased patient satisfaction as one of the most important stakeholders of these centers, the existence of evaluation criteria is essential. No study was found to introduce and prioritize these criteria.

By reviewing the most important methods of evaluation of healthcare centers, criteria related to patient safety are extracted and their importance is determined using the opinion of experts and through entropy method.

The findings of this study led to the establishment of a database of patient safety management criteria that the health and infection control criteria in all evaluation methods have been mentioned. Finally, the mentioned cases were grouped and prioritized to 19 criteria that the criteria of medical facilities and patient monitoring and patient safety management gained the most important position from the perspective of research experts by gaining weights of 0.0987 and 0.0855, respectively.

In the evaluation methods and studies, different criteria in the field of patient safety management have been presented, the collection and review of which provide a suitable context for the establishment of a comprehensive evaluation method. Therefore, the results of this research can be used for self-assessment, comparison of different centers and thus improving performance.

Social undermining affects the proper performance of authorities of clinical wards. This study seeks to a model to overcome social undermining on the authorities of clinical wards in Isfahan hospitals.

The present research is an applied research in purpose and in terms of data gathering is a qualitative research based on grounded theory. In this study, the data obtained from semi-structured interviews with 16 authorities of clinical wards of Isfahan hospitals. In qualitative data analysis with open axial and selective coding, 16 main categories, 39 sub-categories and 79 concepts were obtained. Content validity and validation of the model were confirmed by experts and calculating the Lawshe index.

The phenomenon of social undermining of clinical authorities is caused by factors such as lack of mental health needs of employees, organizational jealousy, perception of organizational injustice, accountability. Strategies such as creating a learning organization, promoting justice-oriented thinking, facilitating organizational interactions, platforming of individual organizational citizenship behavior and hospital’s autonomy are effective in overcoming social undermining and organizational health and human resources productivity. Personality factors, economic conditions, social factors, extra-organizational laws and organizational factors affect the implementation of strategies.

The relationship between clinical wards authorities’ social undermining factors, overcoming strategies and its implementation outcomes was presented in a paradigm model based on grounded theory.