نشریه مدیریت سلامت
پیاپی 34 (زمستان 1388)

Earthquake is one of the commonest natural disasters; and sometimes the most dangerous event in the world. In Iran, because of being on Alp-Himalaya earthquake belt, earthquake is common. In earthquake events, hospitals are as the first centers that their providing suitable and timely healthcare are determinant and can save lives and reduce mortalities. Also, having knowledge about hospital programs against natural disasters has an important role in decreasing damages. This study was aimed to determining TUMS hospital executive manager's knowledge and performance; and their hospitals preparedness against earthquake events, and their relationships (2005-2006). This is a cross-sectional, analytical-descriptive study; explores all TUMS public hospital executive manager's -teaching and non-teaching- knowledge and performance and their hospitals preparedness against earthquake events. A checklist, questionnaires, and observation method were used for data collecting; gathered data were analyzed using SPSS 11.5 software and correlation (Spearman correlation coefficient) tests. In all studied dimensions, average overall knowledge, performance of hospital executive manager's and average overall their hospitals preparedness level to confront earthquake events were (47/52%), (56/69%) and (49/54%), respectively. Manager's performance and their hospitals preparedness against earthquake events have been improved by increasing their knowledge, but only there was statistically significant relationship between manager's knowledge and their performance(P= 0.016). Hospital executive manager's knowledge, performance and their hospitals preparedness to confront earthquake events showed very low. Given the significant relationship between manager's knowledge and performance, it is important to develop and implement short term educational courses for hospital them to improve their performance to confront earthquake events.

The competitive condition of the world is such that the organizations make quality improvement, increase customer's satisfaction, reduce costs and increase productivity. Existence of such environment cause the variety technique and approaches such as total quality management, re-engineering, value engineering, lean production and Six Sigma. Six Sigma as the newest program of quality management helps organizations toward increasing customer's satisfaction and financial saving. The objective of this research was to shorten the stay of orthopedic patients who had to undergo a surgical treatment in Firoozgar teaching hospital, based on training DMAIC cycle to project team. Present research is a cross sectional-longitudinal study. The time period of the project was estimated to be seven months. Length of stay data before training (three months) and after training (four months) collected by patient's dossiers and analyzed by Minitab software, using t-test. The mean of length of stay before training DMAIC in a sample of 200 patients was 7/915 days and after training was 6/375 days. Using the mean comparison indicated that there is a significant relationship between training DMAIC and the mean of length of stay (p-value<0/001). For use of Six Sigma methodologies in quality improvement of hospital services, training is so important. Six Sigma training emphasis on tools learning and DMAIC process that it facilitates the implementation Six Sigma in organizations. ô°û 11 / يپ°û 43 / ى·}پَ 7831 Keywords: Six Sigma, DMAIC cycle, Training, Length of Stay

The quality work life is regarded as a global concept for organizational development and manpower management, and its provision and improvement is considered the main key to the success of any organization. The improvement of the quality work life is in fact considered a skill for the betterment of organizations by senior directors. To improve the management's productivity of hospital by increasing of the quality work life of the managers. The present research is carried out in descriptive, cross-sectional method. The study population are the directors of the hospitals of the Social Security Organization of Tehran Province (N=10). The data gathered using two questionnaires, of which the 29-questions questionnaire related to the quality work life based on the quality work life components. (Tatel, Casio, Morton, and the American Management Association, and the 21-item questionnaire were a questionnaire on productivity prepared based on Hersi and Goldsmith Model, scored based on Likret 5-score scale. In order to evaluate the consistency of questionnaires, the alpha method of Cronbakh was used. The alpha coefficient of Cronbakh was 0.86 and 0.89, respectively. The data was analyzed using SPSS software package and Spearman Correlation Coefficient). Among the quality work life components, including materialistic and educational components, democracy in organization, participation in decision making, job design, and work space in organizations, the component of work space was located at the highest position, with an average of 3.72, and job design at the lowest point, with a coefficient of 2.90. Participation in decision making, with a correlation coefficient of 0.858 (P-value=0.002) showed the highest correlation with the quality work life from the statistical point of view, and materialistic privileges with a correlation coefficient of 0.358 (P-value=0.310) showed no correlation (P-value>0.05). On the other hand, given the averages obtained for productivity components, the component of job identification with an average of 4.4 was at the top and performance feedback with an average of 2.3 at the lowest point. The component of capacity, with a correlation coefficient of 0.664 (P- value=0.36), showed a positive and meaningful correlation with the productivity component. Based on the hypothesis put forward, only the component "democracy in organization", with a correlation coefficient of 0.665 (P-value=0.036), showed a positive and meaningful correlation with productivity. There is a significant correlation between the quality work life and the productivity of the management of hospitals of the Social Security Organization of Tehran Province. Productivity could be improved through adopting logical principles and procedures such as encouragement.

The evidences suggests that Iranian hospital managers do not apply a standard device for assessing leadership performance, and identifying strong and weak points to devise the executive plans required to improve leadership. The present study was aimed to promote the application of self-assessment system through measuring leadership performance at the Khorramabad hospitals, to increase the use of leadership potentials as the most important factor to improving the quality of hospital services. The present study is a descriptive, cross-sectional research. The study population including of Khorramabad hospitals, as well as middle and senior managers. The workshop method and the Simply Better Standard Questionnaire, having the needed reliability and validity, was used for collecting data.. Among teaching, private, and social security hospitals, one of each group was included in the research thorough simple sampling method. The data are presented by descriptive statistics. The mean scores of studied hospitals: teaching, social security and private in "organizational leadership," dimension were 26%, 32% and 21% respectively; in " citizenship and public responsibility," dimensions were 29%, 39% and 18% respectively, and in "creativity, risk, and innovation" dimension were 26%, 32%, and 22% respectively. According to our findings, the teaching hospital and the private hospital have both started permanent improvements in a few number of their leadership dimensions. The social security hospital, however, has showed a permanent improvement in a wide spectrum of its leadership dimensions. Since leadership proves to be a driving force for other factors to maintain quality, it is suggested that hospitals take actions to document their leadership processes, compile the indices to measure their achievements, constantly make the indices permanent, and identify the strong and weakness points, and grounds for improvement, and conduct improvement plans.

Teams as the fundamental units of organizations and lever keys are considered for improving the function of organization. For promoting the productivity and acquiring the satisfactory staffs and clients, organizations use working teams. Some organizations are highly dependent teams. Hospital is also one of these organizations, in which establishing cooperation between the members of team can play a role to accelerate patient's life saving operation and his/her improvement. This article aimed to determine and evaluate the effects of effective factors on efficacy of surgical work team's efficacy from employee's point of views in training hospitals. This study is a descriptive- survey research. Research population was surgical teams of Isfahan teaching hospitals. These teams were made of 6 groups of nurse, aides, and experts in surgery theaters, experts in anesthesia, nurses, anesthesists and surgeons. So, used sampling approach was classified sampling approach. 189 persons of members of surgical teams were selected randomly. Data collecting tools was a researcher made questionnaire, with Lycert scoring. External and content validation was confirmed by of guide and advisor professors, and its constancy was provided by primary study using Cronbach's alpha 0.94 coefficients. Our finding showed that team size, team task fitness, existence of definite goals in team, team, and norms in the efficacy of surgical work teams meaningfully affected more than average: and team cohesiveness, team composition, evaluation of function and the effect of remuneration in team and organizational support of team on the effectiveness, were less than average. By considering that surgical teams were complicated and incongruous one, team composition and team cohesiveness did not affect the efficacy of surgery teams. With multivariable regression analysis, team norms with 74. 5% had the highest amount effect on the efficacy of surgery teams. With promoting team norms, organizational support, and existence of clear goals in teams, the efficacy of surgical teams increase. Also perspectives of members of hospital surgery teams in terms of education, service background, position, hospital, age, and team size and sex, were similar about the effects of mentioned factors.

The recent advances in medical sciences and information technology (IT), health care organizations turned to the competitive environments and consumer-driven ones. So for successful at expand and continue their activities; they increasingly need to HIM professionals. In this environment exist many opportunities for HIM professionals, but this opportunities are only useable for people who have multi-skills and readiness to dealing with new changes. This research was aimed to examine medical record staffs in Tabriz Medical University Hospitals. This is a cross-sectional study on 60 managers (12), and staffs (48) of MRD of 12 Tabriz University Hospitals. They completed questionnaires in four categories. To analyze the data, we used SPSS software. The majority of respondents (73%) were female; mean of years of years of practice was 8/6 years. The most important skills of MRP needed sorting at 3 categories: General skills: ability to use computer - speed activity with high accurate - responsibility - "self- learning" - change management; Communication skills: ability to communicate with managements, patients, and physicians; Professional skills: reporting - analysis data - documentation - familiar with HIS - retrieval information -correct coding. In responding to changes occurred at HIM workplace and need to new skills these strategies are needed: The new and suitable definition from the structure of MRD in hospitals; revising and updating of academic education; taking course for training; and changing management works from paper medical record to HER.

An assess performance is a systematic and comprehensive process about comparing organizations activities and process with achieved results based on EFQM model. Assessing performance process allows organization to identify clearly strength points and designing plans for improvement. Hence, the purpose of the present research was to compare self assessment results based on European Foundation for Quality Management with two approaches of questionnaire and Performa on human resources management at Isfahan University of Medical Sciences (IUMS). This research was descriptive - cross sectional study, carried out at human resource management of (IUMS) in academic year 2006-2007. Study population is 32 staff managers and their deputies selected by census sampling. Data collecting are a standard questionnaire; and a designed Performa based on EFQM model, and collected data were analyzed using SPSS and EFQM software. Total score of assessment human resource management(IUMS) based on questionnaire and Performa were 550and 516 respectively; and scores percentage for each nine factors were as follows: Leadership 65 and 61, Policy 80 and 75, employees results 50 and 43, employees results 30 and 29, community results 60 and 55, and key performance results 50 and 52 percent. Through EFQM model, we can identify strength points and area for improvement that help organization and activities to focus on most benefits area for organization and intervention and changes are followed.

one of common methods for scientific activity assessment is scientometric; this is possible with citation databases like Web Of Science (WOS). This is a descriptive-applied study. Data were selected via searching in WOS. The research society of the study was 625 records. Most records of Iran University Medical Sciences have published in 2006; and surgery subject area had highest hits. Immunology subject area had highest co-authorships. Although co-authorship among authors of this university has dramatic results, scientific products is very low, therefore research policy-makers should consider this aspect.