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Introduction: Nowadays, tatal quality management is welcomed as the common language and enlightening means of all organizations trying to modify their prior approaches by implementing this management system. However, the in formation systems with all their faults have caused some problems in implementing this high quality system consequently, favourable or considerable results are achieved. 

Methods: This paper was done as a library and internet research lay the review of literature. It was attempted to show the role, importance and mechanism of providing a eorrect information system if different stages of total quality management from the beginnig up to the end. Furthermore, the significance and provision of correct information system in all 9 stages of FOCUS-PDCA were discussed. Review of literature: The related studies mostly reveal that the main reason for unfavourable outcome of total quality management in the failure either in data collection or in the presenttion of the results. Thus, the real nature and efficiency of this management system is not totally revealed.

Conclusion: FOCUS-PDCA is a suitalle strategy under the topic of total quality management which encourages. Personnel to Think systematically. Morover, considering the prinaples of TQM, the real promotion of procedures is facilitated by the provision of information. Hence, along with the implementation of total Qulality Management, the modificalion of information systems should be considered simultaneously. The modification of the information systems is required during the procen of promotion at the end. Of it. Modification is the only assisting means to demonstrate TQM and its output in a precise system. When the output, folloswing the procen, is explained by statistical and reliable data, one can discuss whether the procen of promotion is effective and in compliance with the needs of the clients.

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Introduction: Health information systems have designed in order to manage health information fluency for improving healthcare quality. It is necessary to conduct continues evaluations to do epidemiologic researches and manage health information systems, enhance quality and decrease costs. Unfortunately there isn’t a framework for that foeus on the measurement methods and indicators in our country.Objective of this research is defining steps, study design methods, data sources and indicators of health information systems evaluation.

Methods: This research was cross sectional-description and conducted in 2004. At first studies books in library, and searched on internet to find related information. After that then we categorized developed indicators by Canada and England according their importance. Thereafter we sent a 20 keys questions questionnaire to review for 30 peer reviewers. Although the Questionnaires gived to 35 persons, but it full by 28. These persons were teaching staff in universities and specialists in health information systems. Selected indicators as the most important indictors were which over75% sight selected them high and very high degree. After gathering questionnaire, results analyze by SPSS. Results: There are six steps to evaluate health information system. They include Agree why an evaluation is needed,? Agree when to evaluate? Agree what to evaluate, Agree how to evaluate? analyze and report,?Assess recommendations and decide on actions. there were 13 study designs for health information systems evaluation. finaly indicators provided in three contexts. accountability, performance enhancement and knowledge development.

Conclusion: It is necessary to consider human aspects and knowledge development more over economics and financial aspects.conducted evaluation of health information system is based on the accountability that conducted with randomized Controlled trial and qualitative the best evaluation is conducted when use some evaluation methods with considering these indicators.

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 Introduction: Users of Hospital Information Systems use these systems, round o`clock and as such perceive their problems better than others. Investigating views of users are very critical in development of performance of the systems and should be effective in their development. The aim of this study was to investigate the users' views about Hospital Information System in teaching hospitals (Mashhad University of Medical Sciences).

Methods: This is an applied research with descriptive cross-sectional method. The sample subjects are recruiting through convenience sampling method. Three sectional valid and reliable questionnaires designed for data gathering consisting of: user interaction, quality of system, and quality of information. SPSS software was used for data analysis.

Results: Our findings showed that there is some slight satisfaction of 67.5% of users of the quality of function, 57.5% of quality performance, and 53.2% of quality information of system. Totally most users (70%) were slightly satisfied with hospital information systems.

 Conclusion: According to the study findings there are some problems in hospital information systems of Mashhad teaching hospitals. These problems consist of performance incompatibility between user needs and system which leads to has decrease of satisfaction of users to the system.

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Introduction: To take informed consent for treatment is one of the essential rights of each patient. All healthcare centers must complete consent forms. In spite importance to get informed consent forms, there isn't adequate paying attention to complete these forms. This research is aimed to review the completeness of consent forms in IUMS's teaching centers.

Methods: In a descriptive, cross-sectional research we reviewed the completeness of consent forms using a questionnaire. We selected 330 consent forms of inpatient patients in treatment-teaching centers from IUMS by a stratified random sampling method. Data were collected through observations and consent forms survey. In order to providing information we used descriptive statistics by SPSS. 

Results: Our findings showed that there were incompleteness for patient's family and first names in informed consents forms in 7.2% (24 patients), and for of patient's addresses 71.5% (234 patients). There weren't any sign or finger print in 1.2% (4) forms. In 5.4% (18) forms was bad handwriting. 2.4% (8 patients) patients didn't have legal age while they singed form consent, and 3.6% (12 patients) forms singed by consanguinity and casual relatives. In emergency conditions there were for 86.6% (74 patients) family name and first name recorded while in non emergency conditions 94.7% (235 patients) were recorded. Also forms were confirmed by witnesses in 77.6% (66 patients) in emergency cases while in non- emergency cases it was 59.9% (147 patients). It was applied another form as acquaintance (exemption) in 96.1% (76patients).

Conclusion: Goal of getting consent forms is providing the best decision-making for patients. Because importance of getting consent form for patient and treatment centers, it is necessary to reception personnel training to acquire knowledge about consent forms and their completeness.

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Introduction: User satisfaction is a key factor for the success of any information system. Evaluation of hospital information systems HIS is valueless without analyzing users' satisfaction. The purpose of this study was to survey the viewpoints of nurses, secretaries and paraclinic users about the usability of HIS in selected hospitals.

 Method: This cross-sectional study was conducted in 2009. A questionnaire, based on the international standard ISO 9241/10, was used to evaluate the usability of HIS. Initially, all hospitals in Tehran with HIS and companies providing the systems were identified. Then, a hospital from among the hospitals, supported by each company, was randomly selected. Finally, the usability of HIS was assessed from the perspective of nurses, department secretaries and paraclinic users through the standard questionnaire of IsoMetric. The collected data were analyzed by SPSS using descriptive statistics and one sample t-test.

 Results: The findings show that HIS usability was favorable from the perspective of nurses. However, it was perceived less desirable by paraclinic users.

Conclusion: The difference in viewpoints suggests that users' job affect the rate of their satisfaction. It is recommended that system providers pay special attention to the needs of paraclinic users, when designing HIS.

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Introduction: Organizational health, influenced by various factors, can affect the effectiveness, efficiency, and profitability of the organization. This study investigated the relationship between organizational healths (and its seven-fold dimensions) and the performance indicators at teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS).

Methods: This descriptive, analytical and applied study was conducted in winter 2011. There were 300 employees randomly selected from among the research population who were the staff of teaching hospitals affiliated to TUMS. The instruments were the checklist of performance indicators and a standard questionnaire of organizational health the validity of which was obtained through opinion analysis of seven experts and its reliability was measured by Cronbach’s alpha (88%). Data analysis was carried out using SPSS software and descriptive statistics including absolute frequency, relative frequency, mean, standard deviation, and Spearman correlation test.

Results: No significant relationship was found between any of performance indicators and either of the dimensions of morality, scientific emphasis, consideration, and support of resources. Significant relationship was, however, observed between construction of organizational health and indicators of the total number of occupied bed days, total number of those admitted the performance of the rotating beds, and the crude mortality rate (P≤ 0.05). The respondents evaluated the organizational health as very high (3%), high (68%), and normal (28%).

Discussion: To enhance organizational health, managers should be inclined to accept criticisms and offers provided by the staff and the clients.

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Introduction: Servant leadership, a newly developed concept of leadership, emphasizes on increased services to others, as well as a holistic attitudes toward people, individual development and shared decision making. The servant-leadership philosophy focuses on: servant leader, training staff and developing services in the society. This research aimed to study the relationship between servant leadership and its four dimensions (service, humility, trust and agapao love) as independent variables and job involvement as a dependent variable, among the staff of teaching hospitals affiliated to Kurdistan University of Medical Sciences KUMS

Methods: This was a descriptive – analytical study conducted in 2010. The population included 151 staff of teaching hospitals affiliated to KUMS. Data were collectedthrough Servant Leadership and Job Involvement Questionnaires and were analyzed using SPSS software, descriptive statistics and spearman correlation test.

Results: There was a significant and positive correlation between servant leadership and its four dimensions and job involvement among the staff of teaching hospitals affiliated to KUMS (r=0.343). The mean scores for servant leadership and job involvement were 2.56 and 2.78 out of 4, respectively.

Discussion: The high correlation between servant leadership and job involvement and a moderate correlation between servant leadership and job involvement suggest that managers should always be pioneers in serving customers inside and outside their organizations and consider this as their major responsibility.

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  Introduction : 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).

  Methods: 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).

  Results: 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 16^th rank among all countries under study.

  Discussion: 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.

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Introduction: Hospital Emergency Departments (ED) face different problems affecting their performance. Deficiency of inpatient beds, inability to access suitable care, noisy and overcrowded places, etc. lead to prolonged waiting time, increased length of stay and low service quality. The main purpose of this study was to improve patient flow processes in emergency departments.
Method: The population of this descriptive- applied study included unlimited number of patients who referred to the ED of the selected hospital. Colored Petri Net was used to model patient flow processes and CPN Tools software was employed to simulate and investigate different improvement scenarios. Input data for the simulation model were obtained through timing during data collection period. Patients’ waiting time, length of stay, and resource utilization were defined as performance measures. Four improving scenarios (B, C, D, and E) were defined and their effects were investigated to improve processes.
Results: According to simulation outputs, scenario B led to 45% decrease in waiting time for the specialists while the other scenarios had no positive (decreasing) impact on waiting time. Scenario E was the most effective one in decreasing the length of stay for patients at different ESI levels. Scenarios E and D had positive effect on resource utilization.
Conclusions: Selection of the best scenario depends on the mission of ED, i.e. to save patients’ life. Therefore, a scenario which is the most effective one in saving life must be chosen even if it is expensive. Although it is expensive, scenario E is preferred to scenario D due to its improved outcome. Scenario D is the second best scenario, compared to the other two scenarios, because it is less expensive.

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Introduction: Spite of many studies conducted on digital libraries, there are a few studies on the evaluation of this type of library. The present study was an attempt to determine similarities and differences between Tehran University of Medical Sciences Digital Library against the Structural Standards of an academic digital library.
Methods: This was an observational study in which the data was collected by a check list developed by the researcher. The check list was constructed by evaluating the best digital libraries in 2010 from Digital Library Federation point of view, facilities in an academic libraries and a literature review. Then, TUMS Digital Library was compared with all components in the check list to determine the similarities and differences. Finally, descriptive statistics (average and percentage) were presented using SPSS software.
Results: The study showed that TUMS Digital Library just met 22.3 percent (8 components) of the standards including university news, electronic journal, staff name, Email, telephone number, databases, physical library work time, address and membership in the library.
 Conclusion: It seems that the reason for calling this library a Digital Library is just based on possessing several electronic resources and TUMS digital library does not conform with a standard digital library. However, besides having features of a traditional library, a digital library should have special characteristics which will be discussed in this study.

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Introduction: Open access movement is a global initiative for providing free access to scientific journals and preprint of papers. Free access materials are in digital forms, continuous, and free from any restrictions. This study was carried out to identify the use of open access resources in school of Allied health of Tehran University of Medical Science.

Methods: This study was a descriptive survey. The population of the study consisted of 165 post graduate students of school of Allied health of Tehran University of Medical Sciences. Data collection was performed by aquestionnaire validity and reliability of which were confirmed.

Results: Findings showed that 16.5% of students had high and very high level of use, 22.5% had moderate level of use, 28.3% had low level and 32.7% did not use open access materials at all. Also there was a significant relationship between students’ use and grade and field of study.

Conclusion: The results indicated that the students’ use of open access resources and databases were lower than expected and the materials were not commonly used by the members of academic community.

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Introduction: Today, it is widely accepted that workerforce efficiency plays an indelible role in the economic growth of a country. This research study investigated the effect of public and private health expenses on workerforce efficiency in provinces of Iran.
Methods: This research was conducted, using data provided by Iran Statistics Center in 2004-2014. The data were selected on the basis of the panel data method. To this end,          Romer’s indogenous growth model, MG econometrics technique, PMG, FED were evaluated and based on Hausman’s test, the appropriate model was chosen. The based on cointegration panel method and through FMOLS and DOLS estimates, the long-term relationships were derived taking cross-sectional correlation. Finaly, PMG causal test was performed.
Results: Based on the findings, both private and public health expenditures had a positive and significant effect on workerforce efficiency in the provinces of Iran, and effectiveness of public health expenditures was higher than that of the private sector. Moreover, the results of the PMG causality test indicated that there was a long-term causal relationship between public and private health expenditures toward workerforce efficiency.
Conclusion: To increase the efficency of workerforce, the government should try harder to improve its investment on health in less developed provinces.

 

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Introduction: Informal, under-the-table, payments are paid to individuals/ health care organizations as cash or non-cash through informal channels. This study aims to identify the amount of informal payments in Shiraz University of Medical Sciences.
Methods: This descriptive study was conducted in winter 2014 and winter 2016 (before and after the Health Reform Plan). A questionnaire and telephone interviews were used to collect data which were then analyzed by using SPSS and Excel software.
Result: The average informal payment to physicians, nurses, service staff, security guards, and other employees were 11.1%, 22.2%, 22.2%, 0%, 0%, respectively.
Conclusion: According to the results, the Health Reform Plan, in general, has significantly reduced informal payments (P <0.01) in Shiraz University of Medical Sciences.

 

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Introduction: The pharmaceutical industry of each country shows the capability of that country in providing health for the society. Medication has always been one of the most important pillars of health due to its effects on health. As a result, production, distribution, and pricing are a special priority of governments. Therefore, the medication subsidized currency allocation policy was formulated and implemented in order to guarantee patients' access to drugs in the conditions of currency shortage and international sanctions against Iran. The objectives of the present study were to analyze the policy of subsidized currency allocation to medication and to present political alternatives in Iran.
Methods: The present study is a retrospective health policy analysis using a qualitative research method. Data were collected by using semi-structured interviews with key informants through analyzing policy and legal documents. We also analyzed the data by using framework analysis. To categorize and analyze the findings, we used MAXQDA 11 software.
Results: Results showed that contextual factors, including situational, structural, cultural, and international factors had an impact on all policy-making  processes of  currency allocation for medication. Four political alternatives for the allocation of subsidized currency for medication, we proposed: 1) removing the policy of subsidized currency and paying the exchange rate difference to insurance companies; 2) announcing a new rate for the subsidized currency; 3) paying the total exchange rate difference (selling half of the currency to pharmaceutical industries and the rate difference to consumers); 4) releasing a part of medication currency.
Conclusion: Challenges and negative consequences of subsidized currency have gradually emerged. Before modifying the policy of subsidized currency, the requirements should be reviewed. Developing a detailed and step-by-step road map  via  the participation of influential and interested institutions is  necessary to modify this policy.

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Introduction: “Information and Communication Technology (ICT) governance” was introduced in developed countries in the late 1990s and replaced ICT management. In addition to the separation of the ICT responsibilities between different units/levels, ICT governance allowed universities to develop mechanisms for monitoring ICT decisions in line with the University's vision, mission, and strategic goals through the distribution of the decision-making rights to various stakeholders. This study aimed to investigate the ICT management challenges in the university under study and explore the need for ICT governance.
Methods: This is a qualitative-descriptive case study conducted in the three stages of preparation, identification, and analysis and prescription in one of the universities of medical sciences in Tehran (from November to December 2021).  Semi-structured interviews based on judgmental purposeful sampling and FGDs were used for data collection, and qualitative content analysis in ATLAS-ti software was used for data analysis.
Results: Structurally, the only macro-policymaking body in the ICT field is the ICT council, which is inefficient in providing general direction and standards. In terms of processes, it lacks a mission and a long-term plan, and it has failed to integrate the university and ICT decisions, as well as steering decisions toward the university's goals. In terms of relational mechanisms, it hasn't been able to create a unified procedure in the implementation of ICT policies by creating a common language between ICT and the owners of the main processes in the university.
Conclusion: To get out of the current situation, the university needs serious changes in the ICT structure and the university users’ approach to ICT. These changes require the adoption of an indigenous ICT governance model tailored to the current and future problems and needs of the university toward full integration.

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Introduction: Hypertension is one of the most common cardiovascular diseases worldwide. Self-care ability in patients with hypertension can be influenced by various factors, such as health literacy. The aim of this study was to determine the relationship between health literacy and self-care ability in patients with hypertension.
Methods: This cross-sectional descriptive correlational study employed a convenience sampling method to investigate 120 hypertensive patients referred to medical centers in Sanandaj, Iran, between November 2018 and February 2019. The inclusion criteria included age between 30 and 75 years, diagnosis of hypertension by a specialist, and diagnosis of hypertension at least six months ago. A demographic characteristics checklist and standard hypertension self-care questionnaires (HSCALE) and Adult Health Literacy Assessment (HELIA) were used to collect data. Data were analyzed with SPSS version 16 software. A significance level of 0.05 was considered.
Results: The mean and standard deviation of patients' self-care scores and health literacy were 56.1 ± 8.6 and 117 ± 25.2, respectively. There was a positive and significant correlation between the mean scores of self-care and health literacy (r = 0.409, P = 0.001), with health literacy scores increasing in line with a rise in self-care scores.
Conclusion: Considering the observed relationship between health literacy and self-care, it seems necessary to perform educational interventions aimed at promoting the health literacy of patients with hypertension.