نشریه مدیریت سلامت
پیاپی 26 (زمستان 1385)

Customer- centered principle in the new management theories is considered as a main direction in today's organizations, because with customer's satisfaction inside and outside of the organization, established its efficacy to organizational productivity. Honoring program as one of the reforming programs in the country has been done with customer satisfaction as its concreted bases. The aim of this study is to evaluate the honoring program comparing to customer-centered principles and fundamentals. Presented paper has been developed as literature review using the library and internet sources, and recording and analysis direct, wide, and object authors experiences in governmental organizations. In addition to explain the objectives of honoring program, and presenting it as a customer-centered approach for country -wide official reform, we tried to clear the importance of inside costumer (employees) satisfactions, and empowering and motivating them as a prerequisite to accomplish and adapt with costumer centered principle. It is necessary to pay attention to such studies, because of being new subjects and using it in countrywide. Literature review: Most of the studies showed that human recourses is the most problematic issue in the official system due to the subject because of lack of motivation, economical problems and their needs, conservative aspects of job and undesirable work relations. In system and method section, it has been pointed to the less costumer honoring and quality management attention to the customer honoring is the share point for all these studies, in the approval law about costumer honoring, providing the customer benefit's is Poirier on the organization's and the service providers, which the satisfaction of the organization has been challenged because of the matter. Customers honoring program is a customer centered approach due to administration system reform in country, it is a must to put the inside customers in the first place by empowering, supporting and make motivations for the service providers with the practical and scientific management, so that with gaining their satisfaction, the continuing quality improvement achieve and therefore, the outside customer's satisfactions also would achieved.

Information systems in health care providing systems with collections, analyzing, and dissemination of data provide areas for usage of the information in term of improving the society's health. This study has been designed to evaluate health information system from the administrators and providers of the health system points of views. This is a descriptive, cross - sectional study carried out in1383 (2003). At first administrators and expert's points of views in teaching health centers, public hospitals, district health centers, chancellor headquarters, and medical faculty collected by questionnaires and then data have been analyzed by SPSS 12. Health administrators and experts suggested that two main areas: decision making and planning are proper usages of information. Health administrator's 41% and expert's 43% answered correctly to the descriptive statistic questions, 53% of health administrators and 39% of experts have used the information in past two weeks. About 70.8% health administrators and 40.8% of experts have collected simultaneously their needed data. Given to the organizational information system place, and its critical roles in making right policies, creating a coordinative and integrated information system, and expert empowering to use data correcting, is considered a necessary priority.

Reorganizing the governmental administrative systems is one of the major policies of the Islamic Republic of Iran. In the recent years, the Iranian Ministry of Health as well as medical science universities has taken various actions approaching improvements in their administrative systems. The study aimed at to determine the level of achievement the goals of administrative reform program among medical universities. In this descriptive-analytical, applied and cross-sectional study, group A of type 1 medical universities, including Tehran, Iran, Shaheed Beheshti, Mashhad, Isfahan, Tabriz, Shiraz and Ahwaz Universities were studied to assess their success in targeting administrative system modifications in accordance with the 3rd Economical, Social and Cultural Development Plan of the Islamic Republic of Iran. Study period was from March to September 2005. Data sources were the Ministry of Health and the Management and Planning Organizations as well as their affiliated institutions. Actions taken by the universities to implement the modifications were assigned scores and classified into two groups of general and specific. These actions were set up as 182 criteria and analyzed descriptively. Results obtained showed that average performance score of the studied universities was 75.8%, which confirms a moderate/borderline level of performance. Re-engineering of administrative processes automation and development of organizational structures have the most impact on implementing the general activities reform plan. The general activities reform plan had a better improving effect on the administrative reform plan compared to the specific activities reform plan. Binary comparison of the universities revealed that there is no significant difference between their performances regarding the administrative reform plan. Although studied universities were imperfect in achieving to goals of administrative reform plan, their performance look likes to national average performance other governmental organizations. Regards continuation of administrative reform plan in the 4th Economical, Social and Cultural Development Plan, persistent efforts are needed to accomplish objectives defined in the administrative reform plan. Obviously, strong enthusiasms as well as cooperation of the concerned organizations i.e. the Ministry of Health are needed to provide proper resources and facilities for implementing the reform plans., School of Management and Medical Information Sciences, Iran University of Medical Sciences.

The hospital is known as the biggest and the most costly performing unit of health care systems; therefore, paying attention to efficiency of cost is very important. Survey the technical efficiency in hospitals is the objective of this paper. This study estimate technical efficiency in hospitals of Iran University of Medical Sciences by Data Envelopment Analysis, in 2000 to 2004. Efficiency of hospitals estimated with input-oriented form of DEA-VRS by Deap 2.1 software. Data obtained by forms center of Statistics University. The DEA results indicate that: 1-There is a potential to raise technicalefficiency 10 % in hospitals; 2-constant return-to-scale (CRS) is prevalent in production process; 3-hospital services have suffered extra production factors especially human resources. Deletion of extra human resources can be reduced health care and hospitals expenditures. Finally recommended for future studies some factors such as quality of performance services and satisfaction of patients to be consider. Keywords:

Evaluation is considered as an integrated and administrative activity, because using measurable information is followed by improvement in administrative activities. Given the importance of hospitals evaluations this research is aimed and carried out to determining current methods for public and private Tehran's hospitals evaluation methods from chief executives points of views and headquarter. This is a descriptive cross sectional study by research community including 70 persons 35 hospital's chief executives including heads, managers, matrons of hospitals and 35 ministry of Health authorities and headquarter's experts and Tehran county located universities health chancellors working on hospitals evaluations. The mean collecting information tools were a valid and reliable questionnaire and interviews and documented reviews. The collected data using EPI INFO and SPSS software processed and by t-test and X² tests analyzed and presented by descriptive and analytic statistics. Ten percent (7 persons) were agreed with composition, timing, and scoring methods for current evaluations. Twenty percent (14 persons) believed that current evaluations would result improvement in efficiency and effectiveness of hospitals performances and 22.9% (16 persons) believed that current evaluations would achieved Ministry of Health targets. Twenty percent (14 persons) agreed to joining public and private hospital evaluation forms and 18.6% believed that evaluation methods would be effective for establish medical tariffs. Generally public hospitals and authorizes, headquarters experts of Ministry of Health and health chancellors of Tehran's medical sciences universities did not agree with current hospital evaluations method, and willing to change evaluations methods and presenting a proper paradigm.

Urban growth with increase in population has resulted in an increase in amount of waste. Today getting rid of this waste especially in hospitals has known as one of the most significant environment challenges in all developed and developing countries. Improper hospital waste management in many of countries like Iran causes disposal of hospital waste without considering environmental and technical issues causes harmful effects on human and the environment. Therefore managing of hospital waste is one of the most complicated problems for government in all countries that involves many expenses. The study aimed at decreasing the amount of infectious waste by using a quality model. In this study, we performed a quality improvement model to interfere generation of waste in a public university affiliated hospital in shiraz- Iran. In this study, we tried to decrease the amount of infectious waste by using this model. Hospital waste was weighted in two stages, before and after performing model. The descriptive statistics was used to compare the results of two phases. Prior to accomplishing this model, the daily average of waste production was 813 kg for infectious waste and 83 kg for non-infectious wastes that contains kitchen wastes only. Total amount of daily medical wastes in inpatient wards was 594kg (3.4 kg per occupancy bed-day). Therefore, infectious waste was 90.7% of the total amount of hospital waste. After accomplishing the model, it decreased to 57.6%. Using the quality improvement model, infectious waste production has been decreased by 33.1%. Therefore, hospital can use the quality model to decrease their infectious waste production.

hospitals are considered one of the sources to produce the wastes in cities. The most of the hospitals waste are hazardous waste. If the separation, collection, transportation, and disposal of that waste have not done properly, then not only it has side effects on hospitals employees and patients, but also it will affect badly on human and the society indirectly. Based on this fact the hospital wastes management (in Bookan, Mahabad, Saqqez,and Myandoab-eastern) will be investigated. This research had carried out based on a checklists, and direct observations in the year 2004. The research community is the public hospitals of above-mentioned cities. Our research findings showed that despite of waste separation, the process has not been 100% completed. In some cases, they were mixed. In 75% of cases the transportation have been done by trowel and 25% by cart, 50% of hospitals had incinerators, but based on the observations the performance of quality was not desired. In 25% of cases, infectious wastes were separated, and in 25% of cases, wastes were delivered to other hospitals to burn. The cooling systems were not available for any cases and in all hospitals the waste disposal have been done 50% with other municipal wastes, and 50% were buried separately. The direct and continuous supervision up and on hospital waste management is a very important issues and it is of all authorities responsibilities to pay attention more often.