فهرست مطالب
نشریه مدیریت اطلاعات سلامت
سال هفتم شماره 4 (پیاپی 16، زمستان 1389)
- تاریخ انتشار: 1389/12/28
- تعداد عناوین: 25
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صفحه 497مقدمهطراحی و اجرای حداقل مجموعه ی داده ها (Minimum Data Set) در مراکز درمانی مقدمه ی مدیریت اطلاعات بیماری است و ارتقای کیفیت مراقبت و کنترل آن را به دنبال دارد. MDSپیوند به عنوان مجموعه ی گسترده ای از واژه ها و تعاریف پذیرفته شده قلمداد می شود و با فراهم آوردن یکی از مهم ترین ابزار های مدیریتی برای تصمیم گیری در صنعت سلامت متضمن دسترسی به داده های بهداشتی دقیق و بدون ابهام بیماری ها است. از این رو پژوهش حاضر با هدف مطالعه ی حداقل مجموعه ی داده های نظام مدیریت اطلاعات پیوند اعضا در کشورهای کانادا، مالزی و استرالیا و ارایه ی راهکار مناسب برای ایران انجام شده است.روش بررسیپژوهش حاضر از نوع کاربردی است و به صورت تطبیقی در سال 1388 انجام شده است. ابتدا MDS پیوند موجود در کشور بررسی شد، سپس MDS پیوند در کشورهای منتخب به عنوان کشورهای پیشرو در سیستم ثبت پیوند از طریق متون و منابع الکترونیکی مورد مطالعه قرار گرفت. مرحله ی تحلیل داده های MDS پیوند در کشورهای منتخب، با استفاده از جداول تطبیقی و تعیین وجوه اشتراک و افتراق مجموعه ی داده ها انجام گردید و در نهایت با توجه به نتایج حاصل، مجموعه ای از فرم های ثبت پیوند اعضا برای کشور طراحی و پیشنهاد گردید.یافته هاحداقل مجموعه ی داده های پیوند اعضا در قالب 23 فرم به صورت سه دسته (فرم های ثبت گیرنده ی پیوند، فرم های ثبت اهدا کننده ی عضو، فرم های پیگیری مراقبت های بعد از پیوند و فرم اهدا کننده ی زنده و مرگ مغزی) طراحی و پیشنهاد گردید و مورد تایید صاحب نظران واقع شد.نتیجه گیریبه منظور ثبت کلیه ی داده ها و بررسی ها و گزارش گیری آتی با مشخصه های متفاوت، باید فرم های مختلفی جهت ثبت داده ها در فرایند اهدای اعضا طراحی شود تا دقیق ترین اطلاعات به واسطه ی تکمیل این فرم ها وارد بانک اطلاعاتی شبکه ی فراهم آوری اعضای پیوندی شود و مورد استفاده قرار گیرد. MDS پیوند در قالب فرم های طراحی شده، منجر به کنترل هزینه ها و ارتقای مدیریت پیوند در کشور می گردد. همچنین مطالعات بقا، میزان اهدا و اطلاعات مورد نیاز برای بررسی های علمی و سیاست گذاری های کشوری بر اساس این اطلاعات ممکن می باشد.
کلیدواژگان: داده ها، مدیریت اطلاعات، پیوندها، مطالعه ی تطبیقی -
صفحه 707مقدمه
امروزه مدیران آموزش عالی با مشکلاتی نظیر فشارهای مالی، تغییرات سریع محیطی، رقابت با سایر مراکز آموزش عالی برای دستیابی به رتبه ی علمی و پژوهشی بالاتر، جذب دانشجویان مستعدتر و اعطای استقلال بیشتر به اعضای هیات علمی روبرو هستند و برای غلبه بر این مشکلات می توانند از نوآوری در برنامه های درسی، ارایه ی خدمات پشتیبانی و فرایند یاددهی- یادگیری کمک بگیرند. این مقاله درصدد بررسی نوآوری اداری و تکنیکی در دانشگاه های علوم پزشکی و غیر علوم پزشکی بوده است
روش بررسیدر این پژوهش توصیفی- تحلیلی، جامعه ی آماری شامل کلیه ی اعضای هیات علمی دانشگاه های دولتی استان (1830 نفر) بود که با روش نمونه گیری طبقه ای تصادفی 480 نفر در سال 1389 انتخاب شدند. ابزار تحقیق شامل پرسش نامه ی استاندارد Hongming و همکاران بود که روایی آن با استفاده از روایی محتوایی و صوری و پایایی آن با استفاده از محاسبه ی ضریب Cronbach’s alpha (92/0 = r) تاییدگردید. تجزیه و تحلیل داده ها با استفاده از نرم افزار 18SPSS و در دو سطح آمار توصیفی و استنباطی صورت گرفت.
یافته هامیانگین نمرات نوآوری اداری و نوآوری تکنیکی در دانشگاه های دولتی استان، کمتر از سطح متوسط بود و فواصل اطمینان نشان داد که به احتمال 99 درصد میانگین نمرات نوآوری اداری بین 17/4 و 5/4، نوآوری تکنیکی بین 47/4 و 8/4 و نوآوری سازمانی بین 3/4 و 6/4 بوده است. از طرفی بین میانگین انواع نوآوری سازمانی در دانشگاه ها بر حسب مشخصات دموگرافیک تفاوت معنی داری مشاهده شد، به طوری که نوآوری اداری در دانشگاه علوم پزشکی اصفهان بیشتر از سایر دانشگاه های دولتی استان و نیز این نوع نوآوری در اعضای هیات علمی با سابقه ی کار 1 تا 10 سال بیشتر از 11 تا 20 سال بوده است. از طرفی نوآوری تکنیکی دانشگاه صنعتی بیشتر از سایر دانشگاه های دولتی استان بود. این نوع نوآوری در اعضای هیات علمی با مرتبه ی دانشیاری کمتر از سایر اعضا بود و نیز نوآوری تکنیکی در اعضای هیات علمی با سابقه ی کار 1 تا 10 سال بیشتر از 11 تا 20 سال بوده است.
نتیجه گیریدانشگاه ها باید به گونه ای مدیریت و رهبری شوند که نوآوری به عنوان یک فرهنگ و بخش طبیعی فعالیت های روزانه درآید و به عنوان دانش افزوده برای همه ی اعضای هیات علمی و دانشکده مطرح شود. توانایی تسریع در انتشار و تبدیل این دانش به سرمایه که محرکی برای بهبود آموزشی می باشد، امری ضروری است.
کلیدواژگان: نوآوری سازمانی، سازمان و مدیریت (بهداشت و درمان)، دانشگاه ها
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Page 506IntroductionOrganizational justice is a variable that predicts many organizational variables. One of these variables that have an important role in many organizations today is organizational citizenship behavior. So this study aimed to study the relationship between organizational justice and organizational citizenship behavior among medical record staff in selected hospitals of Isfahan in 2008.MethodsIn this descriptive correlation study, medical record stuffs were included. Data collected using two questionnaires: organizational justice, and organizational citizenship behavior questionnaire. The questionnaires reliability was supported based on Cronbach Alfa. and questionnaire validity confirmed by specialist view of point. Data analyzed by SPSS software.ResultsMean score of organizational justice among hospital stuff in Isfahan was 40.9+/-18.1.between hospitals in Isfahan. The highest and lowest score was related to distributive and interactive justice, respectively. There was no significant relationship between organizational justice and conscientiousness, altruism, sportsmanship. There was a significant relationship between organizational justice and civic virtue, courtesy and organizational citizenship behavior (P<0.001).ConclusionSince the score of organizational citizenship behavior and organizational justice among stuff of selected hospitals were moderate and the score of interaction justices was weak. Therefore, hospital managers should provide the backgrounds of creating and improvement of perceived justice among staff.
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Page 516IntroductionMedical tourism as one of the dimensions of tourism is helping in sustainable development and dynamics of the economy. Considering the low cost and high income of the industry and its role on strengthening country health structures, many developing countries focused their attention on the industrial sector and planning for it. The purpose of this research was to investigate effective factors in developing of medical tourism from manager's view point of selective hospital in Tehran and prioritizes them.MethodsIn this descriptive cross-sectional research 17 managers (hospital manager, Quality manager, and nursing manager) from Hashemi Nejad, Dey, Heart Center, Sarem, Laleh, Parsian, Baghiatallah hospital in Tehran were enrolled in 2008-9. Data was collected by a two-part questionnaire. It was completed by managers after confirmation of its academic validity and reliability by an 87 percent reliability Cronbach's alpha test. Effective factors in developing of medical tourism were prioritized in 4 indicators including, public infrastructure development strategy, human resources development strategy, information systems development strategy and marketing, product development strategies Data were analyzed using the SPSS-16 software and descriptive analytical statistical tests.Results70.6% of managers working in the private sector, 64.7% of women, 41.2% of nurse managers and 33.3% of managers have been familiar with medical tourism less than a year. There was significant relationship between the development of medical tourism and effective indicators in developing (P < 0.05). The most influential factors in the development of medical tourism from the opinion of managers were public infrastructure development strategy, human resource development strategy, information system development strategy and marketing, product development strategy, respectively.ConclusionFor the development of medical tourism industry it is suggested that government should consider all effective factors by designing a comprehensive and coordinated program in this regard.
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Page 525IntroductionThe process of knowledge transfer and exchange (KTE) in fact is a process of utilizing knowledge gained from research to practice. Appropriate exploitation of research results is guaranteed by good management of the research. The research aimed to evaluate the situation of KTE in current research centers in Isfahan University of Medical Sciences, and review its strengths and weakness in this field.MethodsThis descriptive– analytical and cross-sectional study was carried out in 2010. First a KTE briefing workshop was held for officials and experts from research centers and deputy of school, about how to complete the questionnaire. The self questionnaire, prepared earlier in Tehran University of Medical Sciences, was completed by research centers. Findings were analyzed using Excel software.ResultsThe results were presented in four sections of a research cycle i.e.: the question of research (research priorities), knowledge production, knowledge dissemination and evidence based practice. Knowledge production by acquiring 63% of total score had the highest score and research question or setting of research priorities and having close relationship with stakeholder's with 30% of the total scores had the lowest score.ConclusionResearch centers need to obtain more efficient relationship with their stakeholders to identify and prioritize research topics. Doing granted research (particularly from sources outside the university) makes closer contact with the stakeholders and the use of research achievements is somehow guaranteed. Therefore KTE can promote transfer of research outcomes to every audience properly.
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Page 533Introduction
The Framework Convention Tobacco control (FCTC) is designed by World Health Organization (WHO), in response to the globalization of the tobacco epidemic, in 2003. All treaty signatories including Iran adopted to perform it during 3 years. This study was performed to design a model for evaluation of the implementation of this treaty in Iran.
MethodsThis study was a qualitative study which was held in 2008. We have interviewed with 265 policy makers, stakeholders and community members. After extracting first and second level codes and changing them to the third level codes, main concepts obtained.
ResultsTotally 72 third level codes collected. The main concepts classified in 12 total groups as well. Then by considering these groups the evaluation model was designed.
ConclusionRegarding the obtained concepts and model, in Iran, treaty evaluation should perform in various levels and considering all the objectives.
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Page 546Introduction
Evaluation of human resources requires proper indicators for its performance measurement. In fact, compiling indexes consider as the basic source of information evaluation. The aim of this study was to compiling the basic human resources indicators in health system to provide enough information to evaluate human resource management in this sector. This work developed by designing a conceptual framework to compile and classify the indicators.
MethodsIn this descriptive/ applied study, which carried out in 2006-7, the research sample was human resources office of University of Medical Sciences in Isfahan. To implement various stages of the scientific projects a conceptual framework for the project was designed and according to it the indicators was compiled using IPPO model and validation of the method was performed using concentrated discussion groups.
ResultsThe designed indicators were categorized in seven groups, including input, process, output, efficiency, effectiveness, productivity and outcome. Total indicators in this index were 60.The final score of University Human Resources Department was 1042 that had been allocated 63% of the total score.
ConclusionIndicators considered as the most important tools in monitoring and evaluation activities of units of human resources in organizations. Hence, compiling indicators, as a human resources information system evaluation tool at different levels of health system is the most important tasks of managers and experts in this field.
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Page 556IntroductionNowadays we face with the globalization and increasing development of communication in all aspects. As a result, researchers and specialists should proceed to more communication and scientific collaboration and co- authorship, because a specialist can hardly overcome all problems in research process. The main object of this paper is to identify collaboration rate among researchers in IUMS medical and paramedical national seminars.MethodsIn this survey, scientometric methods were used. Statistical population was all articles that attended IUMS medical and paramedical national seminars during 2003-2007. The number of articles was 1751 and researchers were 3697 ones. Data gathered via two checklists (planning by specialists) which validity was approved by experts of Library and Information field and analyzed in a excel database.ResultsGreatest number of titles of articles (522 titles) with 1350 authors and mean number of 2.59 authors per article were observed in 2003. Minimum number of titles of articles (209 titles) with 474 authors and mean number of 2.27 authors per article were observed in 2006. Mean of authors per article was 2.11. "Reza Eshaghi" with 13, "Giti Sadegheyan" and "Hossein Hejazi" with 12 and "Ehsan Habibi" with 11 articles were the most proliferated authors among researchers who attended to mentioned seminar during 2003-07. The mean of collaboration rate among researchers in this study was 0.22.ConclusionSpirit of cooperation among the groups of authors was low, so, identifying the activist majors and researchers can help others to get familiar with them and utilize their experience through scientific collaboration.
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Page 566IntroductionRapid development of information technology, extent of information, media variety of information and the growing information needs, made librarians to keep pace with these developments in order to respond quickly, accurately and with the quality to needs of users. Planning education for librarians depends on the accurate needs assessment studies and the purpose of this study was needs assessment of in-service training courses for librarians.MethodsThis is a survey- descriptive study among 180 librarians of Isfahan State Universities who were selected through census methods. Data collection was carried out through self administrated questionnaire which validity and reliability was confirmed by experts and calculating Cronbach's alpha (0.82), respectively and finally 142 questionnaires returned. Data analysis conducted by SPSS software.ResultsThe highest level of in-service training needs was in the fields of: methods of information searching on the Internet, principles of librarian's communication skills and familiarity with databases and search them and research method in Library and Information Science.ConclusionThe priority of providing training in libraries should be allocated according to the above mentioned findings and these courses with rich educational content, instructors and specialists and continuously should be performed and evaluated in libraries.
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Page 577IntroductionManagement is one of the most important factors for life, development, growth or death of any organizations including hospitals. The power is of one of the main concepts that by focusing on the fundamental and theoretical efforts considered as an important factor at all levels of management and human resources. Managers who know the sources of power and are using them, have more effective management and better performance. By using manager's power sources, participation of employees can increase. The main objective of this study was to survey the relation between cooperation of employees and managers power sources (reward, obligation, legal, specialty and being reference power) in selected general hospitals of Isfahan city in 2009.MethodsIn this descriptive- analytical and practical study 140 employees from four hospitals (Al Zahra, Amin, Kashani, Esabne Maryam, Noor) were studied in 2009. Sample and hospitals were selected randomly. Two questionnaires of power resource and employee's cooperation were used in this study. For analyzing the relation between cooperation score of employees and manageres's power resources score, T-test and Pearson correlation were also used.Result“Power of specialty” by mean score of 60.89 was the most effective factor on employee's cooperation. Next ranks were respectively legal, being reference, obligation and reward power. Employee's cooperation with a mean score of 62.99 was higher than the average. But in test of hypothesis, these differences did not show any significant.ConclusionIn this study the effect of power sources on employee’s cooperation was related to expertise resources, law, authority, obligation and reward, respectively. Despite dramatic differences in the results of descriptive research, there were no significant differences between employee's cooperation and manager's power sources.
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Page 586Introduction
Since human resources in organizations are the most important factors of effectiveness and efficiency, identification of the factors affecting the performance and response of personnel, including intraorganizational changes in management levels is very important. Therefore the goal of this research was to determine the effects of organizational changes on employee's reaction of head quarter of Isfahan University of Medical sciences.
MethodsIn this survey study, 100 out of 700 studied people were selected by random stratified sampling method based on Morgan Table. Data collected using questionnaire of employees reactions against changes and questionnaire of acceptation to change job which validity(face and content) and reliability was approved by experts and measuring of Cronbach’s coefficient alpha(0.76 for reactions against changes and 0.84 for job change).Obtained data analyzed using SPSS software and descriptive and inferential tests (test Kendal).
Results70% of studied population were in 30-39 years age group and had equal men and women distribution. Mean of work experiences was 12.6 years and 54% of them were formal employee. The scores obtained from job change questionnaire were between 5-25 and mean score of job change acceptation was 14.42.The scores obtained from reactions against changes questionnaire was between 24-6 and mean of denying, resistance, exploration and commitment reactions were 14.12,16.32, 13.9 and 12.15.There was no significant relationship between age, sex, organizational position, work experiences and employment type with job change and reactions of deny, acceptance, resistance, exploration and commitment. There was positive correlation between age, commitment, type of employment and acceptance of job change.
ConclusionResults of research indicate there is a kind of indifference among employees towards the organizational change which may be due to organizational culture, lack of adequate information, lack of involvement in the process of change and lack of proper training. Also, people who have job security (formal engagement) showed more commitment reaction than the other staff.
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Page 594IntroductionInsurance considered as the main financial resource of hospitalsBut hospitals have disagreement with insuring organizations in some financial cases and usually they do not received all their insurance claims. The aim of current research was to review the causes of deductions in insurance bills in Seyed Alshahada hospital and suggest some suitable approaches.MethodsIn this descriptive cross-sectional retrospective study, prescription information and records of patients referred to Seyed Alshahada Hospital (AS) in the second six months of 2007 were studied and information of patients with special diseases was extracted from. Sampling method was census records and during the study 4983 clinical prescriptions, 27238 paraclinical prescriptions and 3392 hospitalized case were investigated. Data was collected using a checklist which validity was confirmed by insurance experts and management specialists and analyzed by statistical and descriptive scales.ResultsThe highest prevalence and causes of deductions in clinical prescriptions was related to insurance organizations Komite Emdad (62%) due to confounding date. Next Rankings were Nirouhaye Mosalah, Tamin Ejtemaei and Khadamat Darmani insurances. The highest prevalence and causes of deductions in paraclinical prescriptions was related to insurance organizations Komite Emdad (45.3%) due to lack of prescriptions. Next Rankings were Nirouhaye Mosalah, Tamin Ejtemaei and Khadamat Darmani insurances.The highest prevalence and causes of hospitalization records deductions was related to Tamin Ejtemaei (74.4%) due to lock exorbitant. Next rankings were Khadamat Darmani insurance, Komite Emdad insurance and Nirouhaye Mosalah insurance.ConclusionMost causes of outpatient deductions had direct correlation with organizational mistakes derived from hospital staff. In this field, educating physicians, nurses and other staff holding up in patients bill procedure seems to be necessary. On the other hand, the main cause for inpatient files as it was mentioned was due to extra demands, which did not count resources lose. Transparency of the deductions would reduce the disagreement between hospital and insurance organizations.
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Page 601Introduction
The purpose of this research was to evaluate the Performance of the hospitals’ managers affiliated to Medical University of Isfahan by Data Envelopment Analysis (DEA) method. Also since some attributes of performance are qualitative, Analytical Hierarchy Process (AHP) method was used also to quantify the data.
MethodsThis research was practical in purpose and descriptive-analytic in method. The research population was 29 hospitals’ managers affiliated to Medical University of Isfahan University in 2008.Primary data collected from the existed documents in care deputy of medical University of Isfahan. Data analysis has been done by DEA & AHP methods using Expert Choice and DEA-Excel Solver software.
ResultsIn this research the efficient managers are determined along with their return to scale (RTS). The variable returns to scale and output oriented model of DEA has been applied in the research. And also the optimal situation compared by in this situation, that showed the most variation between these situations was about ratio of revenue to cost. The efficiency, Optimal Multipliers and slacks are determined.
ConclusionIn this research the efficient managers and their score were determined. Between 29 managers 15 managers was determined as efficient ones. RTS for more managers are decreasing or constant. Indicators such as Lack of hard work indices, the number of expert resources and number of resources were treated as inputs. Indicators such as performance form Score, bed occupancy, last time payments and ratio of revenue to cost were selected as the output.
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Page 612Introduction
Industrial lifestyle considered as one of the main problems of humanity, because it result in reduced mobility and activities of people. Leisure time and the ways which is spent is a novel concepts which had been found its true meaning in accordance with rising various technologies and industrialization of societies. Nowedays, recreational sports with sports-related leisure time considered as the most appropriate and perhaps necessary ways of spending leisure time.The aim of this study was to determine the way of spending leisure time among Isfahan librarians with emphasis on the role of physical education and its relation to health.
MethodsIn this descriptive survey study librarians from public, academic, professional and institution libraries of Isfahan were included in 2008.Data was collected using a questionnaire containing 35 questions about physical activity, depending on type, leisure and health. The validity and reliability of the questionnaire was approved by health education and social medicine experts and calculating Cronbach's alpha(0.86), respectively. Data analyzed by SPSS software and descriptive statistics
ResultsThe most leisure time activity among librarians was watching TV and the lowest was going to the cinema and theater and doing individual work. 58% of them had no leisure time on Friday and have healthy recreation. The most important problems for not to do exercise was physical exhaustion due to job involvment (%29.8) and the least was expensive exercise equipment (%2.9). The highest priority for growth and development of exercise in departments was allocated to compulsion circular in stuffs (32.7%).
ConclusionPlanning, organizing and increasing motivation for useful and healthy spare time of academic librarian need the support of administrations. An important responsibility of directors in each organization is to recognize different condition, situation and tastes. Also it is essential to lead academic people to spend their leisure time in a healthy and useful way by cultural educations.
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Page 622IntroductionHuman behavior and activity are resulting from their motives or needs. Managers could timely and properly satisfy the needs and motivation of their stuffs by understanding and predict their real motivations and needs. This study was conducted to identify factors affecting staff motivation of public and private hospitals in Isfahan.MethodsIn this descriptive – analytical study 248 employees of public and private hospitals in large cities of Isfahan, in all occupational categories of medical, paramedical, nursing and administrative support were enrolled. Research tool was a questionnaire containing 51 questions in three categories of material, intellectual and organizational factors. The validity and reliability of the questionnaire was confirmed based on the viewpoints of behavioral sciences experts and Cronbach’s alpha coefficient(0.82), respectively. The data in descriptive and inferential statistics analyzed using SPSS software.ResultsMean of material, intellectual and institutional factors in public hospitals were 4.30, 4.34 and 4.17 respectively. Mean of material, intellectual and institutional factors in private hospitals were 4.18, 4.12 and 4.08 respectively. Mean of motivational factors (material, intellectual and institutional) in public and private hospitals was different significantly (P<0.05).Mean of motivational variables were different in studied population according to their average occupational class, employment status and qualification (P<0.05).ConclusionHospital staffs in private and public hospital have different motivational priorities. The spiritual elements were more important in employee of public hospitals than private ones. Therefore managers must understand these differences in various employees and attempt to motive them.
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Page 625IntroductionThe family physician program has been implemented with the effort of the country's officials since 2005in the villages and towns with populations under 20,000 people to performe comfortable and convenient access to health services.The aim of this research was to study knowledge and attitude of rural population toward the family physician program in rural regions of Shahr-e Kord.MethodsIn this descriptive analytic survey, 1100 individuals under the program of rural family physician in Chaharmahal va Bakhtiari Province were selected by multistage sampling method. Data collected using a self-adminstrated quesstionnare which validity and reliability was confirmed by health education and social medicine experts and calculating Cronbach's alpha, respectively. Obtained data analyzed by SPSS software in two categories of descriptive and inferential statisticsResultsMean age of studied population was 34.23 years. Knowledge of participants regarding family physician program was poor, moderate, good and excellent in 30.9%,53.5%,14.5% and 3.1% of cases, respectively. Their attitude was very good,good,moderate and poor in 0.5%,25.5%,64.4% and 9.1% of cases, respectively. There was a negative significant relation between knowledge and age and positive relation between knowledge score and education. There was a positive significant relation between attitude score and age.ConclusionResults indicated that rural population did not have the appropriate knowledge to the family physician, as well as their attitude was also moderate.. These results confirm the need for more education in improving and increasing their appropriate attitude.
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Page 637IntroductionJob burnout results from the reaction to the chronic psychological stress and it mainly occurs in care services. It may lead to consequences such as job cost, reduced performance and fatigue. This study aimed to investigate the nursing administrators and chief executive officers job burnout in three areas of depersonalization, fatigue and emotional exhaustion and its relation to some demographic features in university hospitals of Isfahan.MethodsIn This cross- sectional study 198 nursing administrator's (metron, supervisor and head nurse) and chief executive officers were enrolled in the first semester in 2010. Data collected using modified native Maslach & Jackson's job burnout questionnaire. Its Cronbach’s alpha was 86%. Data analyzed by SPSS16 software using descriptive and inferential statistics such as Kruskal- Wallis, regression, and chi-square tests.Results166 of the participants filled out the questionnaire. The participants were ranked from the highest rate of job burnout to the lowest in the following order: head nurses, supervisors, administrators who were a supervisor and a head nurse, metrons and chief executive officers. There was significant relationship between mean of job burnout and organizational status, sex and age in that head nurses had the highest mean and metrons had the lowest. However, there was no significant relationship between job burnout and marital status, educational level, the time and number of shifts, employment status and years of work in the current, position. There was significant relationship between emotional exhaustion and organizational status, so that head nurses had the highest and metrons had the lowest mean. There was no significant relationship between depersonalization and organizational status.ConclusionRegarding the different levels of job burnout, it is necessary to adopt new policies for prevention of this phenomenon. The recognition of the problem, understanding the need to support, taking part in problem- solving activities considered as the most important factors in preventing the administrator's job burnout.
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Page 649IntroductionJob satisfaction considered as an important factor in increasing productivity, workers belonging and attachment to the work environment and improving the quantity and quality of work.The aim of this study was to determine job satisfaction levels in medical record staff.MethodsIt was a descriptive analytic study. Due to the limited number of medical records staff in health education centers in Kermanshah University of Medical Sciences in 2006, 42 individuals were selected randomly by proportional counting method.Collecting data has done by using of Smith job satisfaction questionnaire (JDI) which was designed in dimensions of work in current jobs, facilities and working environment, salary and benefits, supervision, relationships with colleagues and improve their job by attitude measuring Likert scale. Data analyzing has done by using of descriptive statistics and SPSS software.Results71.4 percent of medical records staff were satisfied with their job and 28.6 percent dissatisfied. There was significant correlation between job satisfaction of staff and job satisfaction in current job, aspects of supervision, partners’ relationship, upgrading and promotion, salary and benefits and work conditions.ConclusionAbout 75% of medical records staff were satisfied with their job. Satisfaction with various aspects such as job satisfaction, supervision methods, relationships between colleagues, promotions, salaries and benefits and workplace conditions improving job satisfaction.
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Page 658IntroductionHospitals, like most executive agencies have scarified the importance of policy, planning and supervision with their executive actions. With their errors, they waste the resources and remain away from development and competitive arena.So during recent years the Ministry of Health and Medical Education as well as other areas, in order to make rational government size, strengthening accountability of the system and efficiency of the health services, has considered the strategy of supply sources from outside of the Organization on its agenda.. Therefore in this study outsourcing of medical records services unit was evaluated from different angles.MethodsIn this descriptive applied before-after study, the medical records unit of Kashani Educational Center was evaluated. Data collected by a questionnaire (internal customers), a check lists (Process Evaluation Unit, medical records defects, fulfill the requirements of 88 bylaw), semi- structured interviews with officials and by checking of financial and administrative documents and records related to the topic.ResultsThe findings indicated decreased medical cost per case and files defects in 4.5% and 37% of cases and improvement in unit processes in 37.4% of cases, after outsourcing the medical record unit. Other results of outsourcing medical record unit were 59% increase in customer satisfaction and 70% fulfillment of the requirements of 88 by laws.ConclusionKeep patients information is one of fundamental principles of patient privacy rights, and combined private sector presence and the above mentioned fundamental is important point in outsourcing in this section. Success in promoting private sector efficiency, reduce unit costs and increase customer satisfaction and improve service quality indicates that if the legal principles implemented, outsourcing of this unit could be considered efficient and effective.
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Page 669IntroductionThe profits of executable referral system process are including: decrease the staff and equipment and saving in expenses and tools, appropriate division of sources for the best use of them and prevention of put patients to unreasonable expenses. In this course, the purpose of present study was to determine the effective factors on executable amount of referral system process in public hospitals of Isfahan city from the point of view of people, until can surmount it by obtain to this purpose, and health system can use from these profits.MethodsIn this descriptive– analytic and measurable study, people who refer to public hospitals of Isfahan province were studied in 2008.Five hospitals affiliated to Falavarjan, Shahin Shahr, Shahreza and Nayyyn health centers and five public hospitals in Isfahan city selected by clustering method and 400 patients referred to selected hospitals selected by simple sampling method. Data collected by a self-administrated questionnaire which validity was confirmed by experts and its reliability was 85 percent.ResultsAwareness and satisfaction was higher in urban population and motivation in non-urban communities.51.9% of people covered by Tammin Ejtemai insurance and 89.09% of those who covered by Khadamat darman insurance have refered for first level of services.Mean of knowledge of client from referral system in studied hospitals was not different significantly.Mean of client satisfaction and motivation of the referral system in studied hospitals was different significantly (P<0.05).ConclusionThe most important factors in referral system in realization of its process from the perspective of urban population were awareness and satisfaction and from the perspective of rural population was motivation. So investing in promotion of these factors can be sure that the system will work more useful. So by investment for improvement of these factors, we can be sure that this system will perform more useful than the other time.
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Page 679IntroductionPurchasing scientific journals take a large amount of university library budget. So choosing journals with a scientific validity that response to universities needs is so important. This Article aims to have a survey on usage rate of Isfahan University of Medical Sciences users on public, environmental and occupational health journals to confirm core journals via Bradford Scattering law and compare them with the ISI Journals list.MethodsThis is a padding descriptive research that had a bibliometric survey on Isfahan University of Medical Sciences Electronic journals that presented in Iranian National Medical Digital Library (www.inlm.org). Research society was consisting of 191 electronic journals. A checklist was used for data collection and research findings presented by descriptive statistics in Microsoft excel.ResultsThe findings showed that the core journals of this university in public & environmental health course were Social Science and Medicine, Patient Education and Consulting and Preventive Medicine journals. The most widely used journal by users of the university in this field, in 2008 was not in ISI journal citation reports and most prestigious journal in the ISI in this category was in 32nd place rank of using.ConclusionThe results indicated the little familiarity of the university users with electronic resources in the health field. But we can expect that establishment of training course and electronic collections presentation can help electronic resource cognition in users and increase using them.
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Page 689IntroductionToday, with increasing emphasis on learning organizations, knowledge and learning are considered important factors in organizations and having updated knowledge and information have become an unavoidable necessity to continue the life and stability of these organizations.Hence this study was conducted to study the relationship between learning organization & leadership styles educational departments’ chairpersons at Isfahan University of Medical Sciences.MethodsIn this descriptive- correlative study, from 594 faculty members, 203 members were selected by stratified sampling method. Research instruments were two questionnaires of learning organization and multi- leadership styles which validity(face and content) and reliability was confirmed by experts and through measurement of Cronbach’s alpha coefficient (r1=0.92r2= 0.85), respectively. Collected data were analyzed by SPSS16 software and through descriptive and inferential statistics tests.ResultsThere was a significant relation between learning organization indices and transformational leadership, transactional leadership and laissez-faire leadership. Mean score of learning organization with multi- leadership styles based on years of employment, studies and age was not different.ConclusionPresence of different leadership styles among the directors of departments’provided an appropriate admission for use of the components of learning organization at the university and having the leadership styles of managers make communication and greater participation of members, managers and other sector groups in university activities.
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Page 695IntroductionUsers of medical record information in accordance to relying on data and health information, they demand quality. Proper storage, maintenance, and archiving of old medical records forms for different purposes has led to lack of enough storage space and retention problems for health services organizations. The objective of this study is to assess the effectiveness of medical record information by different users and the length of storage and retention time at Alzahra academic medical center.MethodsThis research is an applied, descriptive cross sectional study. The research population included all medical records (about 6000 medical records) of patients which have been demand by users in the first half of 2008 and selected by Census sampling method. Research findings was collected in the form of checklist by referring directly to the Medical Records Department Center and extract data from documents and user requests information about the patients file. Validity of this instrument was confirmed by experts. Data analyzed by SPSS software and descriptive analysis tests.ResultsThe most requests for medical records information was made by the patient themselves in 36.4% of cases; followed by law enforcement agencies at 27.8%, insurance companies at 23.1%, and quality assurance committees at 1%. The requests time frame for of medical records information after discharge was one year with 73.3%, and 94% after 3 years of patient discharge. From the point of view of request time frames, the oldest request was made 14, 11, 11, 1, 15 and 13 years after the patient discharge respectively. The most requests for medical record forms from the patient chat were discharge summary, operating room report forms, and echocardiography report forms. From the point of view of disease code, the most requests for medical records was related to injuries and related disabilities and poisoning and overdose cases at 30% and 1% for eye diseases.ConclusionThese study results showed that utilization of medical records information decreases over the time and it is not cost effective to keep about 95% of primary files for more than three years. In addition, 95% of disease information regarding to psychological and behavioral disorders, congenital anomalies and malformation and chromosome aberrations have been requested over seven years after creating the file which can be kept separately, Therefore, the results of the study suggests that health services managers and policy makers should adjust the time frame for storage and retention of medical records in their temporary and permanent archiving methods according to the utilization patterns of their users and customers as far as possible.
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Page 715IntroductionCompulsive Internet Use Scale (CIUS) is a newest and prestigious questionnaire in the diagnosis of internet addiction. The goals of this study was to investigate the reliability and validity (psychometric properties) of Persian version of CIUS in internet users of Isfahan's universities.MethodsIn this descriptive and Cross- sectional research 400 Isfahan university students were enrolled by quota sampling method. Studied population completed demographic questionnaire, Persian version ofCIUS, Internet Addiction Test (IAT) and Young Diagnostic Questionnaire (YDQ).Finally, to determine the cut off point, all studied subjects were interviewed clinically based on diagnostic criteria for Internet addiction (DSM- IV- TR). After collecting and scoring the questionnaires, the psychometric features of the questionnaire analyzed using factor analysis, discriminative validity, internal consistency (Cronbach’s alpha), split half, and ROC Curve by SPSS15 Software.ResultsFactor analysis revealed three factors for CIUS. It has good internal consistency (Cronbach’s alpha = 0.89), split half (r = 0.89), discriminative validity (r = 0.68) and concurrent validity (0.78,0.81).The best cut off point for this questionnaire (CIUS) was 37.ConclusionCIUS has acceptable psychometric properties and this is a valid and reliable instrument that may be used in research on Internet addiction.
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The goal of this article is review on case study methodology as a comprehensive method for theorizing in field of health and evaluating its applications. The method of this article is review and description of case study as a comprehensive study and in macro level as an integrated and combined strategy intend to explain goals of the method, definition of CASE, how to select it, conceptual framework and phases in case study methodology. According to review and analysis of literature about case study methodology, it is concluded that case study methodology is neglected in health management and planning research. Considering advantages of this method, it is recommended to do further study and application of it to theorizing and evaluating as well as solving the problems in health system.