نشریه مدیریت سلامت
پیاپی 49 (پاییز 1391)

Pre-hospital emergency services in Iran need to move towards evidence-based services. The aim of this study was to evaluation the physiological early warning scoring system (PEWS) for transport management of internal patients.

This is a cross sectional study. The study populations are internal patients that transport by pre-hospital emergency of Semnan province. Physiological early warning scoring system is used as the data collection device. Data were analyzed by the use of descriptive and Pearson correlation coefficient and by SPSS19 software.

The mean of the physiological scoring was 2. 38±2. 42. About 28. 9% of those transports to hospital did not need to emergency treatment، and there is statistically significant relationship between physiological early warning scoring and need to pre-hospital emergency attains of patients.

The Use of the physiological early warning scoring system suitable means for pre-hospital transport management for internal patients. But in identifying patients، who have no immediate need for emergency services، is faced with the challenge. Therefore، definitive statement about the use of this tool requires more studies in this area.

Maintaining and providing the health care are of the proprieties of each health system. Therefore، those involved in health sector should always do their best to provide high quality services. Increasing the efficiency of health system is one of the issues emphasized by the policy-makers. This study was aimed to compare between Iran and the Selected Countries on the Efficiency of expenses in Health Sector by Data Envelopment Analysis (1998 -2008).

In this applied descriptive study، the Data Envelopment Analysis (DEA) Method was used to determine the efficiency of Iranian health sector and the other selected countries (N: 40).

The findings revealed that the health sector in Iran had a technical efficiency of 77. 2% during the period of 1998-2008. Iran held the 16th rank among all countries under study.

The technical efficiency of the health sector in Iran is about 70% of the optimal level. As the mere increase in the expenses of the health sector cannot lead to improvement of health indices، health policy-makers should increase the efficiency of these expenses by means of appropriate policy making and implementation of these policies. Developing public insurance، improving life style، making organizational modifications، and paying more attention to the preventive measures can result in raising the efficiency of these expenses.

Access to trustworthy health information is one of the most important factors in nursing care. It is important that the nurses be assured of both importance and quality of information resources to access reliable health information. This study was conducted to assess different methods nurses and nursing students apply to access information resources and to assess the inhibiting factors in this respect. This descriptive and analytical study was conducted among 412 nurses and nursing students in hospitals affiliated to Semnan University of Medical Sciences and Social Security Organization of Semnan in 2011. A valid and reliable questionnaire was used for collecting data which were then analyzed by frequency distribution، mean، standard deviation، Mann-Whitney and Kruskal – Wallis tests and Chi-Square. The nurses appeared to have greater tendency than nursing students to use their colleagues’ and patients’ information. They showed less tendency to use information of printed textbooks in clinical decision making. There was a significant difference between demographic profile of the participants and the use of different information resources (p <0. 01). Moreover، there was a significant difference between nurses and nursing students in using different information resources and the inhibiting factors reported (P <0. 01). The results indicate that nurses and nursing students are more inclined to use traditional information resources such as the information given by patients، relatives or personnel. This might be due to different reasons one of which might be lack of skills to use hospital libraries. The findings suggest that h ealth information l iteracy is a major challenge in the nursing community، and information system professionals can undoubtedly facilitate the use of quality information in this regard.

Nowadays، organizations deal with complexity، ambiguity and dynamics and are consequently under the influence of environmental factors requiring suitable behavior. O ne of the important factors in organizational survival is the success in achieving the goals. In the current study، which was an attempt to identify the human factors of religious attitude and job stress a prediction model of success was designed. In this descriptive analytic study، fuzzy neural networks approach was applied to overcome the complexities inherent in the study of organizational success. Moreover، MATLAB software was used to design a fuzzy prediction model. A questionnaire for data collection and MATLAB software to design fuzzy prediction model were used. It was found that the optimal number of the type of membership function was five. The low error rate (0. 000003) showed that the ANFIS model was suitable for the prediction of organizational success. The results showed that religious attitudes and job stress were the determining factors affecting organizational success. The results indicate that there is a direct and significant relationship between religious attitudes and organizational success. However، stress، at its intermediate level، has the most positive effect and at its low or very high level (s)، leads to a reduction in organizational success.

Today، the universities leadership to adapt or adjust with complex and unknown phenomena are need until in its shadow، organizations to conduct by appropriate. The purpose of this research was to study the extent of application of cybernetic model indices at Isfahan University of Medical Sciences. A Research method was descriptive-survey that population consisted of all faculty members of Isfahan University of Medical Sciences in the 2009-2010 academic year. To do sampling‚ 207 faculty members were selected randomly and using stratified random sampling. To collect data (about seven hypotheses with regard to model Cybernetics indices (control، tight & loose coupling، interaction، decision making، hierarchy، leadership، equilibrium) by a valid and reliable researcher-made questionnaire of cybernetic model. Data were analyzed using two levels descriptive statistics (frequency، percentage، mean and standard deviation) and inferential statistics (one variable t-test). Since the mean each the seven components is higher of the intermediate (3)، Isfahan University of Medical Sciences in organizing its activities in usage extent from model of Cybernetics is the appropriate place. The results also suggest that the university، have a tendency to this model and the highest of tendency in relationship with hierarchy indice with mean 3/66. Since the university managers has not embarked on according to certain model of Cybernetics to organize university activities‚ like that concluded that in case of developing a model for management in the conceptual framework of Cybernetics from university managers can expect that they have more ready for use development of Cybernetics model in your organization space.

Knowledge management has become a significant determinant of future organizational survival. Knowledge management is a conscious strategy of getting the right knowledge to the right people at the right time. The Identification of key success factors and an effective decision approach thus can facilitate decision making on knowledge management implementation. In this study، it was attempted to identify of factors and indexes of effective implementation of Knowledge management in Hospitals and to investigate their relationship with introducing a conceptual model and using confirmatory factor analyze technique. This research is divided into two parts. The first part of the study is exploratory and involved a review of the literature and discussion with expertise to identify indexes. The second part involved the survey and included developing final questionnaire and structural equation modeling was used to analyze data. Managers، vice-chancellors and physician that responsible of different departments of private and public hospitals in Tehran formed the population of this research. The data were analyzed by LISREL software results show that all of four factors including process capability، structural-cultural capability، technological capability and managerial capability are important and managerial capability is mediating other factors. Furthermore، among indexes، clear objective for initiating knowledge management project، information technology infrastructure on hand، establishing a specific team in charge of knowledge management implementation، participation and support from senior administrators are the most effective. Regarding results، all factors are important in effective implementation of knowledge management in Hospitals and a simultaneous attention to them can lead to success. Whereas previous research in Iranian enterprises showed that this organizations had an unequal growth in technological factors regardless of other factors.

The family Practitioner and referral system is one of the main programs of the 4th social and economical development plans in health sector. Client satisfaction is a basic index in payment mechanism and performance monitoring process in family practitioner program. This study aimed to determine factors effective in the satisfaction of insured rural population of Sabzevar University of Medical Sciences. This cross-sectional study was conducted in rural population of Sabzevar in 2011. Data were collected by a valid and reliable questionnaire and were analyzed using independent t-test، ANOVA، Pearson Correlation coefficient and simple linear regression. In the 8 aspects surveyed (care and reverence، safety and welfare، trust and belief in performance، waiting time، usefulness of actions، payment costs، paramedical unit performance and on time accessibility)، the highest and the lowest levels of satisfaction were observed in payment costs، trust and belief in family practitioner performance، respectively. The correlation between sex، age، job، and marital status، and satisfaction rate was not significant. However، the relationship between residence، education، type of center and satisfaction of family practitioner was significant. Based on linear regression model، there was a significant correlation between patient satisfaction with family practitioner، residence، education، and the type of the center rendering services. The results show that higher level of education، place of residence، and delivery from urban health centers may lead to more client satisfaction.

Evaluation of financial performance of organizations is regarded as an important financial function of managers since this allows them to make the right decisions and maintain the organizational productivity and control. The aim of this study was to assess the financial performance of medical universities in Iran employing financial ratio analysis. This was a cross-sectional descriptive study. Qualitative and quantitative data analysis techniques were used. Content analysis and Delphi panel qualitative data collection techniques were applied to enrich our understanding of the financial statements and ratios in medical universities in Iran. Additionally، a questionnaire was used to collect quantitative data on the financial statements and ratios of all 38 medical universities. The sampling method used was purposive، and for data analysis standard deviation variation، mean central tendency and frequency were used. Financial ratios (12)، grouped in two categories of liquidity ratios، activity ratios and productivity of resources، were identified. The most important financial ratios were: quick ratio (mean=2. 53)، current ratio (mean=3. 58)، collection period ratio (mean=114)، operating income، divided by total fund (mean=0. 44)، budget productivity (mean=0. 79) and the assets return rate (mean=0. 84). The results indicate that the mean of liquidity ratios in medical universities in Iran was higher than the other sectors. This was due to the inappropriate year-end allocation of annual funds by the government. The other findings on activity ratio and operating cash flow ratio indicate lack of financial resources management regarding the assets conversion and resources and capitals combination within the universities studied. This shows that medical universities in Iran have not used the authoritative power of the board of trustees. We recommend further research on the development and standardization of financial reports in accordance with the type of services، disposable incomes، trade، and financial regulations in medical universities.