نشریه مدیریت سلامت
پیاپی 9 (تابستان 1380)

Efficiency and effectiveness of the services of the organizations such as medical records departments depends on a dynamic management. The major objective of this study is to compare the management of medical records departments of general teaching hospitals affiliated to Iran, Tehran, and Shahid Beheshti Universities of Medical Sciences. In this descriptive, cross-sectional case and comparative study, the major variables are: planning, organization, implementation, and evaluation. Managers, experts, and heads of the four major units of the hospitals were examined. The results indicated that the managers of medical records units with an average of 2.53, their rate of management usage in the department estimated in a high level. But, the experts and the heads of the wards with the averages of 1.75 and 1.38 have estimated in a low level. The involvement of the medical records managers of IUMS in planning was highest, the involvement of the same managers of IUMS in organization and implementation showed highest, and involvement of these managers at SHBUMS in evaluation was in highest level.

The peresent research is of the sectional descriptive-analytical type. Using questionnaires as the tool and in the framework of open and closed questions, the research is concerned with an investigation into the views of medical record authorities at all hospitals of three Iran, Tehran and Shahid Beheshti Universities of Medical Sciences, in 1378 (1999-2000) in the city of Tehran, with respect to the necessity of the presence of consultant. The research results show that (69.8%) of the population of study (authorires of medical records) have a positive view to the necessity of consultants' Presence, and their fields of study. There is also an indirect coorelation of (r=-0.375) between the views and the manner of Knowing the consultant. Investigation on the view with respect to work experience, also shows an indirect correlation of (r=-0.205) Results of the present research regarding the areas of problems for medical record authorities are indicate that (52.9%) of such authorities mostly face problems in the field of disease coding. In evaluating the opinions with respect to the organization to establish a consultation center for medical record authorities, the first priority goes for the Deputy's office of Treatment Affairs of the Ministry of Health. Authorities of medical records have announced that they are inclined that the consultant be present at their work lication, and to announce their consulation views in writing. In a polling of medical record authorires regarding the characteristics which a consultant should have indicate that the consultant should gave closed and regular relation with university centers, and be a member of the academic board.

The present study, Descriptive - Analytical in nature, addressed the leadrship styles in the hospital affiliated with Shiraz University of Medical Sciences. All the hospitals affiliated with the University (13) compiised the study population. The attitudes of the middle managers (13) and their immediate employees (315) were studied through four questionnaires. The data was analyzed By chi-square, t-test, pearson correlation coefficient and other statistical procedures. The analysis of the data revealed the following

1- The middle managers and their employees showed a strongly positive attitude toward faire style of leadership. 2- There was a positively significant relationship between the performance of hospital managers and the employee leadership styles they applied. 3- Employees' job Satisfaction was the highest in the hospitals with Faire style of leadership. Finally, a suitable model of leadership was designed and tested by the researcher.

The present research done in a survey method aims at estimating the amount of pharmacology students' and assistants' accessibility to requierd articles through the libraries of Iran pharmacology colleges. During a one month period, bibliographic information of 882 articles that were needed by the participants were gathered. Statistical methods used were descriptive- analytical in which t-test was used to measure the variations. Results showed that 54.8% of the participants used medline to do their research, and also 46.5% of them did the search to accomplish their thesis papers.78.95% of subjects prepared the articles through their own college libraries. The means of the accessibility to articles'fulltexts in the libraries were estimated as : tehran pharmacology college (32.4%) , shahid beheshti pharmacology college (15.86% ),isfahan pharmacology college (18.7%), tabriz pharmacology college 17.80 percent, shiraz pharmacology college 3.37% and 0.99 percent for sari pharmacology college. It was also specified that the mean of access to articles' fulltexts was 28.88% through colleges in cities which was less than the amount of access through Tehran pharmacology college(32.49C). The outcomes also indicated an increase (38.74%) in the average of access of people under im·estigation who searched through the libraries of Iran's pharmacological colleges. The accessibility percentage through pro quest medical library cds was (4.19) Yhi_c it was (20.7) for ADONIS CDs. Finally . the results showed that the average of access to articles' fulltexts :r:rough the libraries of Iran pharmacology college , pro quest and ADONIS CDs was (-+8.82) percent.

Organizing the human resource aspects, and also creating a suitable & compact structure in Educational & Medical Centers ha:- ahvays ~een one of the mai:1 goals resource in Educationa: & IvIedical Centers related to IUI'IS, in compare with standard functional criteria. This descriptive study ,vas performed by designing some question forms" (Quizes), and also by using available document, such as descriptive structure. At first, after producing the necessary information, an standard critetion sample was develoned to shmv the emplovment situation of each center individually. and 1 .• .I .I' main jobs (key jobs) to suppo!"tive jobs are not compatible, according to standard levels.

The reserch studied Medical Record Managers VIew of the use of Computer-based Patient Records (CPR) in the hospitals affiliated '.vith Tehran, Iran and Shahid Beheshti Medical Universites. It was a descriptive study and the data was gathered through a questionnaire by the researcher and an instructed person. The respondants included 41 medical records. The results showed: 1- Half of respondants in Shahid Beheshti and Iran medical university hospitals are familiar with ADS9, and 2. few number of them in Tehran medical university are familiar with MedRec program. 2- A few number of respondants in 3 medical university hosDitals studied~ update their Knowledge of CPR progress from(Shahid Beheshti 21.4%. Tehran). easy access to sources such as periodicals and information networks, especially internet and encouraging them are recommended. 3- The cost of CPR running and Jack of an agent resDonsible for giving advice on CPR design, installation: operation and support are major problems. - Instructing medical and paramedical staff: especially medical records and administrative departments in CPR technology as needed. Computerizing different departments in hospitals and connecting them to med:cal records department on a schedule.

Abstracts and indexes are the most important instrument in health information systems. There are some organizations that produce these tools which cover some part of users needs on this abilities and make them indexes or abstracts. For the university students and their teachers knowing new topics and the improvment in their specialize branches and for researchers knowing of the last Scientific researches and avoid of repeat them are important and to reach this information being familiar with these sources is important. This research tries to consider of amount of essay which porduct in medical record in indexes of Excerpta Medica, Index Medicus and Hospital Health and Administration Index Based in lecture related to medical record. The Methodology of this research is statistical method. This research shows that index medicus will cover more essay information of the others such as Hospital Health and Administration Index and Exerpta Medica, because of from 1185 essay which rese~rched, 400 of them related fo Hospital Health and Adminstration, and 462 of them covered by Index Medicus and 323 of them covered by Excerpta Memdica. Also it Showed that Index Medicus have the most title of topic between them. In the end recommanded that Index Medicus for medical record is more useful for medical Record users because covers and has more information about medical records.

In Health care system, it is not easy to explain what quality means and how it measures. No doubt, quality is an important criteria for distinction between desirable and undesirable level of health care. Today health care organizations face to new market place pursuit of quality and ability to change, have become essential. Total Quality Management(TQM) is a philosophy and a methodology that assists organizations to manage change and to set their own agenda for dealir.g with the external pressures. Transforming organizational culture is a slow process and TQM provides guidlines for transition. To be truly effective it requires organization wide and is benefits for external and internal costumers. In this article, authors describe the concept of TQM and Focus-PDCA method, and demonstrate how this strategy can be Put effectively in health care organizations.