[A comparison of efficiency and effectiveness of Karaj Shahid Rajaie Hospital before and after decentralization: 2012]

Introduction: decentralization is known an improve process and Promotion of health system and Inevitable part of wide reforms to promote equity, efficiency, quality, Economic justification. Administrative assignment is a method for Decentralization of government. The aim of this study was Comparison of Efficiency and Effectiveness of Karaj Shahid Rajaie Hospital before and after decentralization

Methods: this study was analytical and Comparison. Undertaken work cross - sectional. The data were collected via the questionnaire and Data collection form. After of data collection of before and after decentralization analysis was carried out with the SPSS 19 software and Statistical methods used are descriptive and analytical statistics [Mann-Whitney U]

Results: after of decentralization inpatient beds 4.8%, occupation beds 3.6%, percent of occupation Bed 0.3%, numbers of discharge of those 3.4% rate of rotation of the hospital bed 1.3% was increase . Numbers of inpatient in the after decentralization 3.3% and numbers of outpatient

16.5% increased hospital costs with inflation 2012, 19% decreased and hospital total revenues was increase overall of 6.5% .hospital infection rates in the after decentralization, 0.06% increased employee satisfaction average before of decentralization was mean and after decentralization was high. There are significant differences [P <0.0001], inpatient satisfaction average before of decentralization was low and after decentralization was mean. There are significant differences [P<0.0001]

Conclusion: efficiency and Effectiveness of karaj Shahid Rajaie Hospital after decentralization was Improvement, therefore Politicians and managers of health system should good infrastructure for the use of this mechanism in order to health system reform, especially public Hospitals

[Comparison of direct and indirect nursing care time in 8-hour and 12-hour shifts]

Nurses are the largest and one of the most important groups of health care providers. The quality of health care mostly depends on the quality of direct and indirect nursing care. Measuring the average nursing care time is an objective measure for assessing the quality of patient care. The goal of the present study was to compare the time being devoted to professional - nonprofessional activities by nurses in 8 hours and 12 hours working shift in Shahid Modarres teaching hospital in Tehran. A descriptive- comparative study was conducted on 30 nurses [27 female, and 3 male] working in medical and surgical wards of Shahid Modarres teaching hospital in Tehran. The nurses were working 8 and 12 hours shifts and in rotating schedule. Data were collected by direct observation of nurses' activities, using a checklist with list of direct, indirect and nonprofessional nursing activities. The reliability of the checklist was assured by calculating inter observers' agreement [The duration of time which nurses spent for each activity was recorded. Data were analyzed using SPSS and Wilcoxon test. The findings of the present study revealed that, nurses working 8 hour shift duration, spent 64.99% of their time on professional and 35.3% on nonprofessional activities [41.21% on direct nursing care, 23.78% on indirect nursing care, 22.53% on personnel affairs and 12.5% on administrative activities]. Nurses with 12 hour shift duration, spent 65.59% of their times on professional activities and 33.92% on nonprofessional activities [41.57% on direct healthcare, 24.02% on indirect healthcare, 20.94% on personnel affairs and 12.98% administrative activities]. Nurses working in both 8 and 12 hours shift spend most of their times for professional activities [direct and indirect healthcare] and devote less time to nonprofessional activities [administrative and personal affairs], and these activities are independent of their shift duration

[Factors determining satisfaction with family practitioner program from the perspective of rural insurance card holders affiliated with Sabzevar university of medical of sciences 2011]

The family Practitioner and referral system is one of the main programs of the 4[th] 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

[Perceived social support among hospital personnel and its influential factors: a case study]

Increasing productivity in an organization requires providing various conditions; important of all is human factor. Social support is known as a psychological factor in workplace that effect on productivity of human factor. The purpose of this study is to determine the rate of perceived social support among hospital personnel. In order to do this research 120 of employees of a selected hospital in Isfahan were surveyed using a self-report questionnaire. A convenience sampling method was used to select the samples. The questionnaire measured demographic information of employees and their perceived social support by coworkers and managers. The questionnaire was validated using the experts' judgment. A Chi-Square test was used to test the relationship between the demographic information and the perceived social support. The findings indicated that the employees' perceived social support by coworkers [with the mean of 3.34 +/- 0/48 on scale of 1-5] was higher than the perceived social support by managers [with mean of 3.19 +/- 0.4]. The Chi -Square test also showed a significant relationship between perceived social support and age and work experience of the employees [p<0.01]. The employees perceived social support by managers is not at the ideal level in the investigated hospital and for increasing the productivity level in this organization it is necessary that managers to take new policies under consideration. Meanwhile establishing a stronger relationship with employees can potentially increase the employees' efficiency

Evaluating the client satisfaction from family physician program [FPP] in health centers

Today, satisfaction is a concept that has an important role in health services. If it is evaluated properly, it can be very helpful to improve and enhance the activities. This study has been done in rural areas of Tehran to evaluate the client satisfaction from family physician program [FPP] in health centers. This is a cross-sectional and descriptive-analytic study. Sampling was randomly and systematically done and data was gathered by a questionnaire and face to face interview. Data was analyzed by inferential statistics. Satisfaction of 172 clients [70%] was evaluated in good range and there was no significant relationship between sex and the level of satisfaction. But between age and satisfaction was a significant relationship. [p=0.007 and R=-K].197] Between the level of education and satisfaction, there was a reverse non-significant relationship. [p=0.332 and R=-.062] The client satisfaction level varied among different districts. There was no significant relationship between level of satisfaction, location and type of assurance. In general, the level of client satisfaction was good. It seems that health centers should preserve the present situation and promote services by new client demands

[Correlation between emotional intelligence and communication skills in managers in educational hospitals of Qazvin]

The existence of an organization depends on communications and this is an area that managers spend most of their time on. Recognition of communication skills accompanied with its implementation is among the essential parameters of successful management in any organization. To determine the correlation between emotional intelligence and communicational skills among managers of educational hospitals in Qazvin. This was a cross-sectional study performed on 78 managers of educational hospitals in Qazvin in 2008. Data were gathered by completing the Shearing's Emotional Intelligence Questionnaire [EIQ], Berton's Communicational Skills Questionnaire, and the demographic characteristics questionnaire using Likert's scale for scoring the questions. Data were analyzed using descriptive statistical indexes, Pearson's correlation coefficient, independent t-test and one way ANOVA. Our findings showed that there was a significant positive correlation [r=0.026] between the managers' EI and feedback skills. No significant relationship was found between the EI and speaking-listening communicational skills. Also, based on data obtained in our study, there was no significant relationship between the managers' EI and their demographic traits including age, gender, job experience, management experience, and educational level. Managers' EI could be considered as an important factor in improvement and development of communicational skills in any organization

Occupational stress among rural health workers in Mashhad district, northeast Iran

This study explores the level of Occupational Stress and main sources of occupational and personal stress among Rural Health Workers [RHW] of the health network of Mashhad district. The first part of the Occupational Stress Inventory [OSI] [called the Occupational Roles Questionnaire [ORQ]] was used to measure the Rural Health Workers occupational stress [N=172]. A number of extra questions were also added to measure their specific sources of stress. The questionnaires were distributed among RHW in a meeting held in the Health District Center in the city of Mashhad. The mean score of stress for the investigated subjects on OSI and all of its dimensions was within the normal range. On some dimensions such as role overload and role ambiguity however, about 40% of the Health Workers had middle to sever stress. Type of employment, distance of the village to the nearest city, number and combination of Health Workers in rural health clinics showed to have a significant impact on the RHW stress as well. As the RHW Job is concerned, role overload and role ambiguity are the main sources of stress, which may have an adverse effect on the quality of their services. Type of employment, distance of the village to the nearest city, number and combination of Health Workers at the health center also put pressure on RHW that need to be taken under consideration in planning for improving RHW quality of work Life

Management development in health care setting: a training model for hospital managers

This study was conducted to design an on job-training model for the managers of the Iranian Social Security Organization [ISSO] hospitals and any other similar setting. A five dimensional model [i.e. knowledge, ability, managerial skills, personality attributes and attitudes] with 187 components was designed. The model was validated through seeking the view of experts and a field test. For the field test, a survey was done on 31 ISSO hospital managers to explore their views on the structure of the model and its components. The managers were asked to score each component on a five- point Likert scale as they thought it would affect their job per- formance. The model with 5 dimensions and 165 components was verified in the field test, and 104 out of 165 components of this model got high, 52 medium and nine low mean scores for influencing job performance of the managers. These findings reveal that most of the components selected in this pro- ject are justified to be included in the model. It also reflects the managers' needs for any formal and informal training program in future. The needs of hospital managers at work go far beyond the knowledge and skills, which they have gained, via formal education in school. Therefore, in designing a training program for this group of professionals one should consider a multi-dimensional model in which "knowledge, ability, managerial skills, personality, and attitude dimensions" are all taken under consideration

[Border hospital readiness in handling border relater crises in Kermanshah Province, Iran, 2007]

Helping the injured at the time of crisis is one of the duties of hospitals; therefore, they should plan and be prepared prior to any crisis. The present research was designed to measure the readiness of Kermanshah Province hospitals located near the western boarder of Iran to handle border related crises. The readiness of the three border hospitals in Kermanshah Province, e.g. Az-zahra [in Gilanegharb], Shohada [in Sare-Pole - Zahab], and Hazrat Abolfazl Abbas [in ghasre-Shirin] was evaluated using a checklist on the following six aspects: 1] crisis management information systems, 2] commandership terminal, 3] crisis-related training, 4] organizing hospital manpower, 5] having adequate facilities and equipment, 6] maneuvering and practicing. The data were gathered through interview, observation and using available statistics. According to the findings, hospitals scored [average] on crisis management information systems, commandership terminal, crisis-related training, and organizing hospital manpower, [good] on having adequate facilities and equipment, and [weak] on maneuvering and practicing. The findings also revealed that readiness was fairly good in Shohada hospital, average in Hazrat Abolfazl Abbas hospital and weak in Az-zahra Gilanegharb [hospital in general, readiness to deal with crisis in all three hospitals was evaluated as average]. Despite adequate facilities available for the investigated hospitals, they are not well prepared to handle border related crises in Kermanshah Province and it is essential to take necessary steps in this respect

[Comparison of hospital based cancer registry of Iran and the United States of America]

Cancer research is one of the essential activities for its control and treatment. Hospital based cancer registry system is an information system designed to collect, organize and analyze data on cancer. The objective of the present study was to compare hospital based cancer registry system in Iran with that in the USA. This research was a comparative study. Studied population included all the health care centers of Tehran, Shaheed Beheshti and Iran medical sciences universities having a pathology laboratory. The findings indicate that [Pars] software program is mainly used in pathology, while [ADS-9] program in medical record departments of the hospitals .Furthermore, requested information about cancer cases was mostly by researchers and students and the least by the hospital heads, cancer committees and physicians councils. 4-8% of cancer information from the pathology departments was demanded by hospital managers, pathology committees, physicians, researchers and students. 60% of cancer information from [medical record departments] was reported to the drug and care deputy of the medical sciences universities to which the hospitals were affiliated. 56% of cancer information from the pathology departments was reported to the health centers outside the hospitals. The hospital based cancer registry system in Iran is imperfect and limited in scope as compared to the registry system in the U.S. The cancer registry in Iran only records demographic information of patients and the type of tumors. Learning from the hospital based cancer registry of the U.S.A can help to improve the hospital cancer registry based system in Iran

survey of accidents in 0-14 old year children in the city of Tabriz, Iran

The current study investigated the types of accidents and their effects among 0-14 year old children during the months of Ordibehesht-Mordad of 1990 in Tabriz, Iran. A total of 717 patients were randomly selected from the patients admitted at two hospitals. A questionnaire was used to interview the subjects or their family members present at the hospital. Results indicated that automobile accidents were most common among 5-9 year old children, while burns, cuts, and amputation of fingers more frequently occurred among 1-4 year old children. The end result of these injuries was mostly broken or deformed limbs, cuts, and even death.%3.9 of the children died at the hospital