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Therapeutic activity may be accompanied with unpleasant consequences like any other activity. Hospitals are the central providers of therapeutic services. These services are provided organized, continuously and reliably in the hospitals. If we regard health as the final product of therapeutic activity in the organization, so-called hospital, so we should call hospital infection as the side effect of this organization. Hospital infection is naturally a multi-dimensional phenomenon. Humans are infected by it and suffer from it and human financial capital is spent for its treatment. Being contagious, it is probable that the infection be passed from one patient to another or to the staff in hospital (in therapy centers).It may take a social dimension. At last as a threatening factor, hospital infection requests the safety, smartness and organized cooperation of therapy and management specialists. Regarding its complicated dimensions, this problem must be considered as a major point by therapy staff, managers and officials of therapy centers.

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objective: To determine the relationship between hospital management and indexes of efficiency at teaching hospitals affiliated with Iran University of Medical Sciences in 1999. Methods: The study was descriptive - analytical and cross-sectional in nature. Data was collected by two questionnaires. Ten teaching hospitals affiliated with Iran University of Medical Sciences comprised the study population(365). Hospital directors, managers, matrons, department heads, and a number of senior staff, selected randomly, responded to the questions to obtain a general standard. The attitudes of experts in hospital management and faculty members were included. Bed occupancy rate was used as an important criterion in the study. Finding(s): The study revealed a considerable deviation from the existings standards. Conclusion(s): Bed occupancy rate plays a crucial role in increasing hospital efficiency, influencing other indexes of efficiency.

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Objective: This research was carried out in the first half of the year 1999 to review the performance of Alzahra Hospital in Isfahan and to compare it with the existing standards.

Methods: A descriptive - comparative method was used in this research. Data was collected by observation, interview and a check list. The four utilization indexes, including bed occupancy rate, the average length of stay, and turnover were calculated and compared against the existing standards.

Findings: The percentage of bed occupancy in the study hospital was 55.5% coming close to the country's average rate of 58%. Nevertheless, this rating was quite far from the world's standard (85%). The average length of stay (5.5), complies with the world standard.

Conclusions: Raising bed occupancy rate, and what it involves calls for long term, and comprehensive planning. This up rating requires an increase in the inpatient admissions and what it entails, which consequently results in the increase in the bed performance rate.

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Objective: To determine the attitudes of the graduates working in the department of mediccal records toward the relationship between educational programs, and employment in the hospitals affiliated to Iran, Shahid Beheshti, and Tehran universities of medical sciences.

Methods: The research sample society includes the graduates of associate and bachlor's degrees, working in the department of medical records, Samples of comprised 131 individuals, of whom 53 were undergraduates, and 78 graduates. The data was compiled by questionnaires and personal visits made to the hospitals. 

Finding(s): 29% of the subjects were engaged in the filing unit, and 6.1 % in the administration. Approximately, half of the subjects had less than 2 years of work experience, and those with more experience were mostly working in the administration unit. These peaple considered factors such as "work experience" and "the combination of theoretical education and work experience" effective regarding the quality of conducting medical records. In addition to these, 76% of the subjects believed that their scientific and practical knowledge is not evaluated. In regards to the effectiveness of core courses of associate degree program, the priority was as follows: physiology and anatomy (52%), mecical terminology books I & II (51.9%), and disease coding (55.4%). The ratings for the basic and specialized courses of bachelor's degree were medical terminology III & IV (43.8%), and disease coding III and IV at 57.1 %.

 Conclusion(s): The results of the study indicated that the existing coursework for associate and bechelor's degrees need to be revised.

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Objective: To determine the efficiency of general teaching hospitals affiliated with Kermanshah University of Medical Sciences in the spring, 2000. 

Methods: The study was cross - sectional in nature. Taleghani and Imam Khomeini teaching and treatment centers comprised the sample population. Data was collected through special forms. Indexes of efficiency were calculated and presented by charts.

 Findinges: Active beds at Taleghani and Imam khomeini hospitals are 100% and 93%, respectively. Bed Occupancy Rate is 63% at Imam Khomeini Hospital and 55% at Taleghani hospital. Bed day cost to Rls. 253,963 at Taleghni Hospital and Rls. 297,946 at Imam khomeini Hospital. Other indexes of efficiency were also computed.

Conclusion(s): Hospitals may not be able to function effectively unless special attention is devoted to the indexes of efficiency.

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Objective: To study hospital infection control system (organization and operations) at hospitals affiliated with Shiraz University of Medical Sciences and to provide guidlines.

Methods: The study was descriptive - analytical and cross-sectional in nature. Hospital managers, nurses, control committee staff of the Central Infection Control Commission of Fars province comprised the subjects of the study. Data was collected by questionnaires, interviews, and observations.

Finding(s): A low percentage of nurses (15.38%) were in charge of infection control and the rest (84.62%) were involved with other activities. Nurses scored the highest (61.53) in terms of their roles in infection control, and hospital managers ranked the second (53.84).

 Conclusion(s): Considering the crucial role hospital infection control plays, necessary workforce, including enviornment health experts and epidemiologists should be employed.

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The present study, Descriptive - Analytical in nature, addressed the leadrship styles in the hospital affiliated with Shiraz University of Medical Sciences. All the hospitals affiliated with the University (13) compiised the study population. The attitudes of the middle managers (13) and their immediate employees (315) were studied through four questionnaires. The data was analyzed By chi-square, t-test, pearson correlation coefficient and other statistical procedures. The analysis of the data revealed the following findings: 1- The middle managers and their employees showed a strongly positive attitude toward faire style of leadership. 2- There was a positively significant relationship between the performance of hospital managers and the employee leadership styles they applied. 3- Employees' job Satisfaction was the highest in the hospitals with Faire style of leadership. Finally, a suitable model of leadership was designed and tested by the researcher.

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The mportance of Implementing Managerial Skills in Hospital Administration The goal of the present study was to emphasize the importance of managerial skills in hospitals and health services administration. In order to achieve the above goal, health care organizations were analyzed from efficiency and effectiveness point of view. The importance of managerial skills in governing such organizations have been discussed in this paper. The content of the present paper leads the reader to the conclusion that involvement of specialized managers in hospital administration, and upgrading their professional skills are vital to the survival of health care organizations. 1- * .( Correspondmg Author) 2- Instruc 'Jr, M.S in Health Services Administration, Faculty of Research, Islamic Azad Uneverslty, 1ehran. Management And Medical Information

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The present article introduces the law of the modern system of management of governmenttrun hospitals, enacted by the Ministry of Health and Medical Education in 1994, and the amendment enacted in 1999. A brief discussion on the law and its achievements and shortcomings are included, along with suggestions to improve the law.

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To assess the efficiency of Farabi eye hospital between 1999 and 2001, this study, as a sectional descriptive survey, was performed in Farabi eye hospital to compare the statist performance of different wards of the hospital with other hospital indicators. The results showed that delivered services in various clinics, surgical operations, paracl services and financial performance indicated an increase in trend. Although bed turn ov~ had increased, bed occupancy rate and average Lenght of stay showed no increase. Mortalil and patients' satisfaction showed desirable quality. Excluding the decline in university financial support and limitation of human resc supply from hospital inputs as well as the educational activities from its output, the incr delivered sevices, while keeping the desirable quality, indicated that Farabi hospital's effie was promoted. Bed occupancy rate was not sufficient to estimate the efficiency of hospital and il necessary to be used with the statistics on hospital's different wards and other ho, indicators.

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There is constant danger of patients admitted into the hospital acquiring infection while in the hospital. Such infections are known as Hospital Acquired Infections(HAI) or Nasocomial Infections. Appearing of hospital infections is one of important health care quality indicators. These infections, annually impose many costs on secondary, tertiary and primary health care sectors, the patients themselves. and those who care for them. This research was performed by Department of Health, with aim of providing a more comprehensive assessment of the nature, distribution and magnitude of costs resulting from HAIs. The study has estimated costs incurred by HAIs to the secondary, tertiary and primary health care sectors, community care services, patients, informal carers and NHS. In addition to costs, also has estimated benefits of preventions.

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Introduction: The present Study entitled " Assessment of effective factors for job motivation of line personnel in hospitals affiliated with Shiraz University of Medical Sciences" was carried out in year 2001. Regarding To importance of manpower in heath care systems and that manpower is the most valuable source of hospitals, motivating this source for more efficiency and effectiveness is very important.
Methodology: this research was a Cross- Sectional study and specific objectives were appointment of motivation factors priority from personnel' sidea and comparison among these factors with a view to job and demographic variations. Data was collected by questionnaire. Sampling was systematic random form and sampling ratio was about 10 percent.
Results: After collection of data, among nine motivating factors, three factors all gained more than 80 percent of motivating score and selected as the most important factors. These. factors were "Good Communication and work Relations" "Suitable Salary and Benefits" and "Organizational Security and Justice" .Significant relations between motivating factors and some demographic factors acquired.
Conclusion: According to psychological and organizational behavior principles and regarding to result, The first three factors hadn't been met and personnel had too need for them.

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Introduction: The core requirement of successful and first- in- class organizations is doing right things and doing things right. Recent organizations should be able to have excellent performance from strategic and operational point of view so that they can face the current and future world challenges. Performance measurement is one of the ways for directing organization to the right targets and avoiding diversity in practices. The effective perfOlmance measurement will result in accountability and responsiveness and make it possible to maximize the utilization of limited and available resources. In this paper some of the dimensions and frameworks for performance measurement are presented and reviewed then a conceptual framework has recommended for determining performance dimensions and indicators. Methodology: This article has writed based on literature review method.
Literature review: In this paper after presenting scant history of performance measurement and characteristics of traditional models of performance measurement, following models have been introduced Balanced Scorecard in Trusts Hospitals in National Health System and The Ontario Hospitals Association, The resultants and determinants framework (RDF), Danish model, Montreal university, The experience of the "Quality Indicator Project" (QIP, USA), The NHS Performance Assessment Framework (PAF), WHO framework.
 Conclusion: Reviewing models and frameworks based on suggested principles indicate that every one have strengths and weakness, but in hospital PM should be considered all performance areas. So that, when performance is reviewed, theoretical and organizational features of hospital should be understood. In the end of this paper the conceptual framework is proposed that, in addition of focus on customer/patient oriented goal and strategies, measures performance of input, structural and managerial systems, output and organizational outcome and present a comprehensive and balanced picture of hospital.

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Introduction: Overcoming the existing crisis in the hospitals without considering the patients needs and their satisfaction is impossible. The level of hospitalized patients satisfaction with different units is one of the important criterions for evaluation of the quality of hospital services.

 Methods: The present study was carried out by a cross-sectional method during the spring of 2002 for evaluation of hospitalized patients satisfaction with provided services in different units of hospitals (Shafa, Bahonar and Kerman Darman) affiliated to Kerman University of Medical Sciences. The statistical population of this research includes patients over fifteen who have been hospitalized in the internal and surgery wards of the above hospitals for a minimum period of 48 hours. According to the pilot study, the minimum required sample size were 564 patients and for more confidence, 600 patients were interviewed in the releasing time. Study tools were prepared on the basis of the standard questionnaires of the Ministry of Health and Medical Education and Isfahan and Shahid Beheshti Universities of Medical Sciences. The collected data were analyzed by SPSS program and using Chi square and T tests.

Finding: About 59% of patients were satisfied with the hospital services. Among the different units, the highest level of dissatisfaction was shown for the patients' nutrition and hygienic conditions of their rooms and the highest level of satisfaction was shown for the clinics and nursing units. The results indicate no relationship between satisfaction with different hospital units and the patients' age, level of education, duration of hospitalization and marital status. 

Conclusion: Solving the problems resulting in patients dissatisfaction requires the administrators commitment and effort. Hospital administrators should consider the patients' needs and expectations to acquire their satisfaction and encourage them to cooperate in their own treatment and care process and help the hospital to achieve its objectives.

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Introduction: Training, in each organistion, may be offered III different forms including in-service education. In-Service education in hospitals is increasing important because of the dynamic of medical Sciences.

Methods: This research was done as a quais i-experimental study, to evaluate a retraining program offered to promote the knowledge of medical record practitioners of a social security hospital in Estahan in fall 1382. There were 30 subjects whose knowledge level was measured by a questionnaire before and after the retraining program. Face validity of the questionnaire was confirmed and its reliability was measured by a pretest and a post - test. The first part of the questionnaire included personal details and the second part consisted of 30 questions related to the subject content offered in the program. Data analysis was done by parametric and non parametric tests with the aid of SPSS soft ware.

Findings: The Percentages of correct mowers, given by the subjects in the pretest and posttest, were 50% and 78%, respectively. The personnel's with an educational background, related to medical education, showed higher scores both on the pretest and the post test. The scores of medical practitioners of Shariati hospital, on both tests, were lower than those of the other two hospitals, Qarazi and Fatemehalzahra.

Conclusion: Considering the significant effect of this retraining program on promoting the knowledge level of the practitioners, it seems essential to offer such a program for all medical record practitioners.

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Introduction: The objective of the research was an anology of the Knowledge level of hospital heads, administrators, directors of nursing of statistical indicators in Ardabil public and private hospitals by a comparative survey method, in a way that it would help them to use quantitative data in the best and most effective way.

Methods: In 1999(1377) 34 staff members of ardabil public hospitals, including, administrators managers and directors of nursing and 3 employees including administrator, manager and director of nursing of private hospitals were evaluated using a questionniar. In this study the random sampling was not.

Findings: The comparison of average awareness through T test showed that there is a meaniful difference, between the chief executires of public and private hospitals in the awareness of hospital ststistical indicators (P<5%), but there was nomeaniful difference between the administrators of public and private hospital in their awareness of hospital statistical indicators. Implementing the same T test to the directors of nursing in both public and private hospitals showed a significant difference between them (P<5%). When comparison was made between chief executives,administrators, and directors of nursing by variation analysis, the difference between them was not significant. Most of the hospital chief exectives in public as well as private ones help Ph.D or were Medical doctors 91.7% and only one person(8.3%) in public hospital didn't have a master or a Ph.D.

Results: The results of this survey showed that hospital chief executives, administrators and directors of nursing of both public and private hospitals in Ardabil had low awareness regarding hospital statistical indicators, It seems that the people in charge in hospitals use the hospital statistics minimally run their business effectively and smoothly and donot have a scrutinizing attitude toward statistical data.

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Introduction: The core requirement of successful and innovative organizations is doing right things and doing things right. Nowadays organizations are to perform excellently strategically and operationally so that they can face the current and future world challenges. Performance measurement is one of the ways in directing organization to the right targets and avoid diversity in practices. The effective performance measurement will result in accountability and responsiveness, thus making it possible to maximize the utilization of limited available resources. In this paper some of the dimensions and frameworks for performance measurement are presented and reviewed. Then a conceptual framework has been recommended for determining performance dimensions and indicators.

Methods: In this paper after reviewing a brief history of performance measurement, and the characteristics of traditional models of performance measurement, including BSC and model in hospitals founded by National Health System, and Canadian hositals and RDF model of Montreal University, a model used on Denmark, quality indicator rojects in U.S, and the framework were studied.

Literature Review: Following a brief history at performance measurement, and performance measurement frame works and models at performance in health core settings and hospital including Base model in hospitals founded by national health system, Canadian hospitals and RDF model, of Montreal university, a model used in Denmark, Quality indicator, projects in U.S, and the from work for the evaluation at NHS performance and the performance dimensions in each frame work were studied.

Result: Reviewing models and frameworks based on the available foundations indicate that each of them has strengths and weaknesses. One of the reasons is the multiplicity of hospital functions and health policies. Yet in measuring hospital performance non of the functional areas should be ignored. There fore when reviewing the internal affairs of the hospitals, organizational, and theoretic specifications of hospitals should be fully understood to have a comprehensive analyses of the hospital performance. At the end of the study a conceptual frame work is presented on the account of patient centered strategies of hospitable whishes necessitate data measurement, performance processes, organizal structure, and most important organization results, so that we can come up with a lanead and complete view of a hospital performance.

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Introduction: Overcoming the existing crises in hospitals without considering the patients' needs and their satisfaction is impossible. The rate of inpatients satisfaction with different units is one of the important criterion for the evaluation of the quality of hospital services. Methods: The present study was carried out in a cross-sectional method during the spring of 2002 for the evaluation of inpatients satisfaction with services provided in different units of different hospitals (Shafa, Bahonar and Kerman, Darman) affiliated to Kerman University of Medical Sciences. The statistical population of this research include patients over 15 who had been hospitalized in the internal and surgery wards of the above hospitals for a minimum period of 48 hours. In the study, the minimum required sample size was 564 patients but for more assurance , 600 patients were interviewed at discharge time. The instrument for showing patient satisfaction was a standard questionnaires of the Ministry of Health Education , Isfahan and Shahid Beheshti University of Medical Sciences. Collected data were analyzed by SPSS software using Chi square and T tests.

 Findings: About 59% of patients were satisfied with hospital service. The highest level of dissatisfaction was shown in the patients' nutrition and hygienic conditions of their rooms and the highest level of satisfaction was shown for the clinics and nursing units. The results indicate no relationship between satisfaction with different hospital units and the patients' age, level of education, duration of hospitalization and marital status.

 Results: Solving the problems resulting in patients' dissatisfaction requires the administrators, commitments and efforts. Hospital administrators should respectand value the patients' needs and expectations, get their satisfaction and encourage them to cooperate in their own treatment and care process, and help the hospital to reach its objectives.

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Introduction: Creative and innovative hospital administrators are needed for the of hospitals survival and success It is necessary toidentify the influential factors affecting administrator's the if such administrators are to be trained.

Methods:This cross-sectional study was carried out during the spring of 2004. The research population included 66 senior managers including hospital administrator hospital manage horsing supervises in cluding hospital administrator pospital mana, hursing supervisors of 22 hospitals in Esfahan. Data were collected on the basis of a questionnaire wichits validity and reliability were confirmed. The collected data were analyzed by SPSS program using Kolmogorov - Smirnov, Mann-Whitney U,Kruskal Wallis, analysis of variance and T tests.

 Findings: The most important influential factors on administrator creativity were organizational elements with mean score of (16.25 ± 2.35). The most important influential factors of manager's innovation were personal factors with mean score of (17.87±3.10).

Results: Designing an appropriate reward system is required to improving hospital administrator's creativity. Also, hospital administrators should improve their professional capacity through education and training.

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Introduction: Integrated and goal - oriented productivity attempts as well as decision making for next action can be considered as a leading approach for organizations which will in turn result in to competitive advantages. This research was done to assess Social Security Organization Hospitals in Tehran according to The National Productivity Model.

Methods: This cross- sectional descriptive research was done in two Social Security Organization hospitals with ISO certification. Data collection was done using a self-assessment questionnaire of the national productivity model based on nine criteria of the model in the hospitals.

Findings: According to the findings Alborz hospital has had the higher score in leadership criterion (46.1%), policy and strategy (50.6%), and processes (61%). Panzdah khordad hospital has had the higher score in employee criterion (47.39%), partnership and resources (49.5%), customer results (46.1%), employee results (39%), society results (40.6%), and key performance results (56.5%). The total shows that Panzdah khordad hospital scored 471.56 and Alborz hospital 439.55, respectively.

Conclusion:The result , as the first practical experience in health care field , showed that the model is quite applicable to benchmark and supervise hospital performance with a focus on continuous quality improvement. There fore, it is remmended to the Ministry of Health to use the criteria of the model for grading and formal assessing of hospitals.