نشریه مدیریت سلامت
پیاپی 17 (پاییز 1383)

The objective of the research was an anology of the Knowledge level of hospital heads, administrators, directors of nursing of statistical indicators in Ardabil public and private hospitals by a comparative survey method, in a way that it would help them to use quantitative data in the best and most effective way.

In 1999(1377) 34 staff members of ardabil public hospitals, including, administrators managers and directors of nursing and 3 employees including administrator, manager and director of nursing of private hospitals were evaluated using a questionniar. In this study the random sampling was not.

The comparison of average awareness through T test showed that there is a meaniful difference, between the chief executires of public and private hospitals in the awareness of hospital ststistical indicators (P<5%), but there was nomeaniful difference between the administrators of public and private hospital in their awareness of hospital statistical indicators. Implementing the same T test to the directors of nursing in both public and private hospitals showed a significant difference between them (P<5%). When comparison was made between chief executives,administrators, and directors of nursing by variation analysis, the difference between them was not significant. Most of the hospital chief exectives in public as well as private ones help Ph.D or were Medical doctors 91.7% and only one person(8.3%) in public hospital didn't have a master or a Ph.D.

The results of this survey showed that hospital chief executives, administrators and directors of nursing of both public and private hospitals in Ardabil had low awareness regarding hospital statistical indicators, It seems that the people in charge in hospitals use the hospital statistics minimally run their business effectively and smoothly and donot have a scrutinizing attitude toward statistical data.

Information documented in the medical records includes demographic Factors, history, examination and treatment. Information documented in the health record file has impressive Effect on the quality of care and treatment of patients. The pieces of information concerning patients who need operation are completed in special operation sheet htat should be exact, on time and complete.

The present study was carried out by a cross-sectional method during the spring of 2003 to compare the completion of special operation sheets among two medical teaching hospitals (Imam Khomeini and Motahari) affiliated to Uromia University of Medical Sciences. In this study special operation sheets of 200 files in every hospital (total 400 files) were reviewed. The collected data were analyzed by SPSS program and using Chi square and T tests.

the proportion of items completed on the pre- operation care sheet, anesthesia sheet, operation report sheet and recovery room sheet subsequently %66, %42, %79 and %65 in the hospitals. Overall special operation sheets in Imam Khomeini hospital were more complete than Motahari Hospital (%69 versus %59).

Low proportion of sheet completion in the hospitals studied necessitates the use of electronic record systems, recruiting medical records university graduates, encouraging efficient personnel and having workshops to upgrade the completeness and accuracy of documentations of information in files.

In recent years attempts have been made in many provinces to automize hospitals. In this respect sporadic attempts , using different software packages in different hospitals has been the main cause of varius data input which is not worth keeping. The applicability of medical Records software packages to research were surveyed in Medical University hospitals which had a mechanized system in their Medical Records Department.

This study was done in a cross - sectional method. Due to the limited number of research population sampling method was not applied, instead with an aid of a cheek list and direct visit to the hospitals, data were collected and analyzed by descriptive statistical methods.

Usage rate of Medical Records software packages in most of the University of Iran's Medical Hospitals was very low 40% , and low 40% at most of the hospitals of University of Tehran..40% and lower at most of the Shahid Beheshtees University hospital 30% in all hospitals and low in overall evaluation of the hospitals Understudy 55%.

Low exploitation rate of medical records packages in Medical recods department indicate that the available packages do not have the necessary capabilities to meet the demands of medical records department's needs.

The core requirement of successful and innovative organizations is doing right things and doing things right. Nowadays organizations are to perform excellently strategically and operationally so that they can face the current and future world challenges. Performance measurement is one of the ways in directing organization to the right targets and avoid diversity in practices. The effective performance measurement will result in accountability and responsiveness, thus making it possible to maximize the utilization of limited available resources. In this paper some of the dimensions and frameworks for performance measurement are presented and reviewed. Then a conceptual framework has been recommended for determining performance dimensions and indicators.

In this paper after reviewing a brief history of performance measurement, and the characteristics of traditional models of performance measurement, including BSC and model in hospitals founded by National Health System, and Canadian hositals and RDF model of Montreal University, a model used on Denmark, quality indicator rojects in U.S, and the framework were studied. Literature Review: Following a brief history at performance measurement, and performance measurement frame works and models at performance in health core settings and hospital including Base model in hospitals founded by national health system, Canadian hospitals and RDF model, of Montreal university, a model used in Denmark, Quality indicator, projects in U.S, and the from work for the evaluation at NHS performance and the performance dimensions in each frame work were studied.

Reviewing models and frameworks based on the available foundations indicate that each of them has strengths and weaknesses. One of the reasons is the multiplicity of hospital functions and health policies. Yet in measuring hospital performance non of the functional areas should be ignored. There fore when reviewing the internal affairs of the hospitals, organizational, and theoretic specifications of hospitals should be fully understood to have a comprehensive analyses of the hospital performance. At the end of the study a conceptual frame work is presented on the account of patient centered strategies of hospitable whishes necessitate data measurement, performance processes, organizal structure, and most important organization results, so that we can come up with a lanead and complete view of a hospital performance.

Challenges relating to expense and quality has induced an atmosphere in a way that decision makers at all levels are investigating objective data to evaluate healthcare organizations. Since medical records document the care of the patients, and are considered to be the first yard stick to evaluate the care rendered to the patients, His essential that they follow certain rules and regulations, so that the quality of services offered by this department be computable with and durable to evaluative standards.

In this descriptive comparative study, standards of medical records in the United States, Australia, and Canada were gathered and compared with the Iranian standards, via fax, internet and email.

Research findings show that the Iranian Ministry of Health and Medical education has taken in to consideration the minimum standards relating to medical records policies and procedures. All countries under study except Iran had standards for education and professional development. Iran is the only country that the use of computer and other technological gadgets were used without defining their objectives for use.

With a glimpse at the importance of the role that standards play in facing the challenge of expense and quality in today's health care system, It is essential that medical records as part of the system, abide by a standard and follow on efficient system. But due to constraints and shortages in standards prescribed by the ministry, a national movement in standardization of different medical records with the help of experts in this field seems essential.

Management is the art and scienal of the efficient and practical use of human resources in planning, organizing, directing, controlling and allocating resources to reach the organization's objectives. The objective of this survey was to study the performance of mid level managers in regarding their role in planning, organizing, directing, communicating and supervising and health leadership of care treatment networks in kohkiloye and BoyerAhmad Provi.

This was a cross sectional study. To collect data, two 36 item close ended questioneer were used to survey the oppinion of 432 network and hospital staff towards the performance of their administrators. Data were fed into the computer using InFo-EPI software, Descriptive statistical methods including, mean, standard deviation, abundant distributive tables were applied. To compare the performance of network centers, one way ANOVAtest was used. The questioneer included five choice marks always, usually, sometimes, seldom, rarely and never ranking form zero to forty. Below two point average manager was regarded as poor and un acceptable and above two point average was considered as favorable managers.

In hospitals studied Sadjad hospital in Yasoj with the average and standard deviation of (2.6 ± 1.2) and Shahid Beheshti hospital in yasoj with an average and standard deviation of (1.69 ± 1.22) and |Shahid Rajaii hospital in Gachsaran with an average and standard deviation of (1.69 ± 1.33) were considered unfavorable in all managerial aspects. Among health care networks, studied, Kohkiloye province health center with an average and standard deviation of (1.03 ± 2.88) rated as favorable by the staff in all managerial aspects. Shahid Alizadeh health center in Gachsran with an average and standard deviation of (1.69 ± 1.26) and Shahid Damideh health center in Yasoj with an average and standard deviation of (1.65 ± 1.24) were considered unfavorable in all managerial aspects. Overall management performance of the health center networks with an average and standard deviation of (2.1 ± 1.32) was considered to be favorable.

Despite the favorable performance of directors of the health care networks, holding training and educational courses to improve the performance of health care directors seems unquestionable.

Breast cancer is the most common type of female cancer in most countries, and also the most important of cause death among women in away that 6 to7 woman out of 700 are inflicted by it . Considering that one of the best models used in studying the behavior in health education in the prevention and control of diseases , particularly Female cancer at is health belief model , the present study was conducted aiming to use the health belief model in adopting preventive behaviors for breast cancer among female teaches in Birjand in 1383.

In this cross - sectional study 280 female teachers from 4 guidance schools, and 4 girl high schools were surveyed randomly. Data colleting instrument was structure questionnaire based on variable of health belief model (comprehended interests, comprehended barriers comprehended intensity, comprehended sensitivity, and signs for action and conduct) . The results were analyzed by SPSS software T, X2, one way tests, and Pearson correlation coefficient were used.

The results show that female teachers have good sensitivity and intensity and feel themselves at risk of cancer. Teachers have mean knowledge about the sings and complications of breast cancer but as the age rases the teachers' knowledge about this case lowers.

Providing needed education about breast self - examining in the form of group education , in - service programs and group discussions for teachers not only increases their knowledge , but will also promote girl students , level of knowledge , attitude of cancer.

Considering the significance of mental health as an inseparable part of human health, and in view of its high prevalence and severe long disabling effect, and the role that people's knowledge and belief have in utilizing mental health services, this research was performed with the purpose of studying the effects of mental health education on the awareness, belief and attitude of high school girl students at pre-university phase, in the year 2001-2002 in Tehran.

In this quasi-experimental study, Tehran's 7Th educational district was selected for the study. With the application of randomized cluster sampling method, 150 high school girl students from two pre-University phases were chosen. Samples were evaluated at two stages, before the implementation of the educational program and after, by using a questionnaire including the awareness level of mental problems (anxiety, depression), their attitude towards mental problems, self-concept and existing variables. The results were analyzed, using paired T test, one way variance analysis and Schaffer test.

Results of paired T-test between the mean score of knowledge, components of health belief model and self concept scores of students indicated significant difference before and after educational program implemented (P<0.0005).

Mental health education has a positive effect on knowledge, beliefs, attitude and self-concept of people. This study is considered to be a beginning to more future research in this field