Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
Evaluating the Performance of the Medical Records Departments of Mashhad medical University teaching hospital (1381)
7
13
FA
A
Hajavi
H
Haqani
F
Akhlaqi
U
Mehdi Pur
Introduction: Supervision over main and complementary parts of planning and their evalvation, comprise the planning cycle which emphasizes on the qualitative as wellas quantitative procedures being carried out. Pervision makes the necessary reforms on the input, while evaluation takes care of midterm and longterm plans and procedures. The objective of this study was to evalvate the fonetion of medicalrecords department at Mashhad school of Medicine in 1381. Methods: This is a cross - seetional descriptive survey study.Data collection was done through four check lists using Interviewond observation methods. Indesigning the check lists. Likret criteria was used to evaluate the checklist questions. Findings: Non of the hospitals understudy bene fited from a M.R.A graduate. Medical Record department at Imam Reza hospital scord 94% (55.29) While Hasheminejad hospital scord 50 (29.41) the results of the surrey showed that the medical recods of Mashhad theaching hospitals with the average seove of 71.77 (42.42) had average performance range. Results: The results of the study showed that this is highly important that spcial instructions be written for very unit of Medical Records department, for job description, on the job training courses exployement of medical records graduates, resover provision, equipment and suitable envorinment, and also periodic evalution of the function of medical records departments for the improvement of the department.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
AComparative study of the organizational superiority model in Health care at selected countries proposing a model for Iran
14
19
FA
A
Barati Marnani
B
Nabilo
Introduction: Quality has a sixty years old historical heritage in health care establishment. Most countries use organizational superiority models an approach to execute total quality management, which in turn would lead to improved work performance and drastic change in organizations. The present study is to view the organizational superiority model in selected countries and come up with a model for Iran. Methods: This cross-sectional comparative study was conducted in 1381-82 (Iranian calendar) 2003- 2004, in order to design a superiority model of organization for Iranian Health care sector. Data collection was done in two stages using a questionnaire. The validity and reliability of the questionnaires was evaluated by comparing the superiority model of organizations in America, England, Canada, and Australia a suitable model was designed for Iran. This model was put in to test by 25 experts using Delfi model, and then the final model was eventually ready to be presented. Findings: The highest score in American model was given to the role of "leadership" in English model to "client, feed back" and in Australian model to "leader ship and innovation" and in Canadian model to "employee focus". The main criteria in the final model after applying Delfi test were: leadership, Strategic planning, "client approach, corporate culture, data analysis, Processes, resources and organizational performance. Results: Strengthening administrators, enriching corporate culture, promoting creativity and learning, rendering services based on need assessment and client's expectations, along with the client's satisfaction should be taken into consideration.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
ASuitable Model for National Cancer Registery System of IRAN
20
29
FA
AR
Zohoor
F
Ebadi
A
Barati Marnani
F
Sadughi
Introduction: In the new millennium people face many serious challenges in health care, including an upward trend in non contagious diseases. Cardiovascular diseases, cancer, and diabetes have had a bigger share respectively. Since cancer mostly develops (come on ) in later life considering the young population of our country and an increase in life expectancy, there is an anticipation that the development of this disease would be on the rise with great momentum. Despite promising trend in improving many aspects of health care and treatment in the last decade in our international standard. Effective practical research specially in etyology, materialization of preventive measures, screening programs in the country's healthcare and treatment policy and the evaluation of the efficiency of their strategies would materialize when the national cancer registration policy is established and it's data are collected and completed to date. The purpose of this comparative cross sectional survey was to study the national cancer registration system of England, Denmark, Malaysia and Iran Propose a suitable model for Iran in the year 2003-4. Methods: foreign and domestic specialists, as well as library and internet were consulted then the national cancer registration system of England, Denmark and Malaysia were evaluated. Taking into consideration the economical, cultural and geographical condition of the country. A model was suggested with the help of Delfy approach . Athree phase model trial was projected For the first and second phase a question was prepared and the third stage of this trial was carried out in session with the participation of specialists to evaluate. The third model and after analytical work, the final model was presented. Findings: Research findings the reduction of costs reveal that in order to optimize cancer registration and including data elements, registration criteria, information gathering process, classification and control mechanism of the current national cancer registration should be reevaluated, the results of comparison of proposed model is shown in two diagrams. Results: Strengthening administrators, enriching corporate culture, promoting creativity and learning, rendering services based on need assessment and client's expectations, along with the client's satisfaction should be taken into consideration.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
The Patient Service quality in the Emergency Departments
30
36
FA
F
Asgari
H
Mahjoub
M
Jamali
H
Khanjani
SR
Vahabi
M
Amani
N
Zamani
Introduction: Time restraint, heavy workload, limitation of diagnostic procedures and Urgency in selecting treatment Method are among the remarkable features of working in emergency units. These points, along with other particular problems in a selected emergency largest referral unit in Glean/province were our driving force to document the weaknessess by using statisties and information and propose a strategy to improve the quality of health care rendered to patients. Methods: In a cross-sectional study conducted within a month period, the quality health of services rendered to all referrals in emergency units expect, infant emergency unit, gyneochological and obsterics (O.B.G), and psychiatric cases were studied, Acriterian based questionnaire was designed to be completed by the observer, then data were tallied statistically by computer. Finbings: The number of referrals to the emergency department whilst the study was being conducted amounted to 2815.Or on the average (84 daily).59.2 percent personally referred, 40.8 percent were referrals from other centers or offices, 42.3 percent were hospitalized and 57.7 percent were treated as outpatients. The mean time spent for each diagnostic and treatment procedurals was as follows: The average time spent by trainers was 29 minutes, the time patient entered the unit until he was actually admitted took 55 minutes, record filling was 16 minutes, prescripitonal procedures 16 minutes, transfer time to the other departments 18 minutes, the time the emergency patient entered the ward (after diagnosis and treatment procedurals) till he got the prescription 118 minutes, lab results took 97 minutes. EKG results 11 minutes, sonography results 48 minutes, C.T scan from reqursting to return the result took 27 minutes. During Shahrrivar month in 1381, orthopedic and surgical wards had the most admissions (39.1and 28.8 respectably). Resident aids in the screening room at the emergency department were mostly anesthesists an surgeon aids all inal only 10.2 percent of the sceener's field of specialty matched the referees' cases. The average CPR and death cases in emergency unit was 2.5 and 2 respectably. Early diagnosis in 34% of the cases were correct and 5.4 percent were wrong. 42.8% of cases the final dignosis was determined by only one sign or indication. In 15.1% of the cases, there existed an ambiguity in the patient's diagnosis. The most crowded referral time estimated to have between 4 to 12p.m (49.4%). Results: considering the results, the procedures which hinderd the work flow in the selected center include: diagnositic tests, making decisions on admission, orders, filing procedures. Other shortcomings of the selected center are lack of adequate space and great number of emergency referrals, inconsistency of the aid's major field of study to the referrals actual medical complaint, and the absence of documentation of final diagosis in some cases.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
Study of Daily Bed Occupancy Costs And Performance Indexes in Selected Hospitalat of Iran University of Medical Sciences in 1381
37
44
FA
F
Ebadi
H
Ansari
A
Rezapoor
Introduction: Due to resource limitations in health sector, optimal utilization of resources Which Commonly accounts for 50 to 80 percent of government's expenditure in health sector is one of the objectives of decision makers in hospitals, By and large hospitals have the most highly trained health personnel, therefore it necessitate to consider the cost effectiveness of health care industry in hospitals, and the appropriateness of policies in order to boost productivity. Methods: This was a cross sectional study conducted in 3 hospitals (Firoozgar, Firoozabadi, Shohade- Hafte-Tir and Ali Asghar) in 1381. For the Purpose of data collection, information sheets were used. The information was then converted in to meaningful indexes to facilitate analyses. Findings: On the bases of research findings, performance indexes in hospitals under study were far from the designated performances envisioned by the third development plan of the health ministry (P<0.05). In a way that in the third development plan hospital bed occupency must be 70%, average length of stay 4.2 days, bed turnovel, 67 times, and the average bed occupancy internal was determined to be 2.3 days. Yet indexes in hospitals under study on the average were 57%, 6 days, 31 times, and 4.5 days respeetably. The cost of bed occupancy with assumed epical costs in selected hospitals was 713000 Rials daily. High rates of bed costs occopancy, the average length of stay the average interval of stay, the low index bed occopancy and bed turnovers in hospitals under study inefficiency and ineffectiveness was an indication of use of hospital resources. Firoozabadi hospital scored higher in performance in exes and Firozgar hospital in bed occupancy costs among hospitals under study. Results: Because of the high rate of bed occupancy cost and ineffaceability in performance indexes, low efficiency and effectibility, administrators and decision makers had better try to identify the important elements in rising costs and reduced ward efficiency in hospitals and come up with plan to boost productivity.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
AComparative Study of Iso-Standards and Research Elements in Used Master Theses of School of Management and Medical Information Science
45
51
FA
AF
Hoseini
F
Montajab
Introduction: Because of the Scientific nature of Universities and their potentials, they have longly been Functioning as the cradle for research projects. Every individual in order to be graduated is to submit an acceptable research work which will Lead to an academic endeavour in different scientific disciplines. Methods: In this descriptive survey, 87 M.S. Theses of the School of Management and Medical Information Science, have been studied in respect to their conformity to Iso 7144 and research elements. The selected disciplines included Medical Records Education, Medical Library and Information Science and Health Services Admininstration for the period of 2000 to 2002. The data collection method was observation, and the data were gathered by a chechklist and the Findings have been demonstrated in tables and diagrams. Findings: The results indicate that: - In all the Theses, The arithmetic mean of Iso Standards application is 77.69% and that of research elements is 66.91% - The arithmetic mean of Iso-Standards application in Medical Library and Information Science Theses is 79.88%, that is, it is more than that of other two disciplines under study. - The arithmetic mean of research elements in Theses is 69.45%, it is more than that of two disciplines under study. - The Iso-Standards in the "Tittle" Section with 99.62% and "Main Text" section with 82.65%, have been more than other than sections. - The research elements in the "Introductory statement" section with 93.69% and in "data analysis" section with 88.84% have been more than the elements other in Sections. - The results of the comparison between this research and other researches done in this area, show that the Level of comformity to Iso-Standards and research elements have increased in recent years. Results: Considering that Theses are significant research sources and have a great role in the exchange of information, it is recommanded that, (1) The existing standards and Criterion be seriously and steadily taken in to consideration and (2) The national standards for writing Theses be prepared in accordance with Iso-Standards and research elements, with emphasis on implementing them in Medical Universities on the country.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
Survey in to the Impact of Fee for Service Plan on Nurses' Work Output
52
59
FA
A
Ebadi
M
Hadad
M
Sirati
AA
Karimi
Introduction: From long time ago man has played a key central role in the organization's system. The objective of management is to attract, maintain , and enrich competent man power. Designing and systematizing Fair salary and wage payments is one of the most important factors in meeting this objective. Methods: A descriptive cross - sectional study with the objective of studying the impact of fee for service on nurses' work output and a proposal of a favorable model was conducted on a sample population on consisted of 255 nurses, and 52 head nurses holding degrees ranging from higher national diplomas ( 2year degree) to masters in nursing with at least one year clinical experience. Aquestionnair was used as a testing instrument for collecting data. The variables under study in the work output include nursing care, job satisfaction, workload, employee relationship, degree of reglligence, and malpractice treatment. Nurses and head nurses' point of view about the effect of present fee for service policy on these factors were tested . Findings: The results indicate that only 34% of nurses and 44.6% of head nurses believed that the current method of fee for service plan would have an impact on the improvement of nurses' workout . One the other hand 82% of these head nurses believed that with the current method of fee for service plan, the objectives of the plan also can not be covered. Results: Carrying out the present model of fee for service plan does not have a consider all impact on the improvement of the nurses' work output , and if optimistically speaking it would cause them to remain in the organization it is there fore recommended to use " a fair share view and open door policy" as a compromised reform Model instead of the current model.
Iran University of Medical Sciences
Journal of Health Administration
2008-1200
7
18
2005
1
1
Qualitative Research Parallel to Quantitative Research
60
67
FA
H
Karimi moonaghi
Introduction: Inadequate knowledge of new approaches in research, as in qualitative research can lead to disuse or abuse. Therefore, introducing different aspects of qualitative and quantitative research can clear up The ambiguity surrounding them which would play an effective role in applying these methods in research. For these reasons, this study was conducted. The purpose was: introducing and comparing the features of qualitative and quantitative research in different aspects. Methods: Library and electronic resources, correspondence with the international research organization was also another way for gathering information, and the relavant materials were selected After studying all materials the related content and information were selected. Findings:qualitative research like quantitative is a precise method of survey. In the qualitative research, information about phenomena are presented in the form of explanation and description, even though in some cases statistics and numbers are used, the main goal of qualitative research is to develop synthesizing concepts and creating theory, while quantitative research tries to test a hypothesis. Data collection in qualitative research mainly include observation and interview, but, in spite of quantitative research, special strategies are used. Data analysis in qualitative research is inductive and in the quantitative research is diductive. Another major difference between these methods is about the role of researchers. The qualitative researchers are in close interaction with the participants, but quantitative researchers try to control and measure the variables. Sampling methods of these approaches also differ. Results: Qualitative research is different from quantitative approaches from the point of view of the subject matter, goals and applications, data collection techniques, number of the samples, sampling procedure, and data analysis.