Designing a model for trauma system management using public health approach: the case of Iran

Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring [BIS] to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level

[ relationship between job rotation and performance of environmental health unit staff in the health centers of Shahid Beheshti University of Medical Sciences]

One of the methods of service training and development of human resources is job rotation and systematic interchange of the employees; but there are few researches about it in Iran health care organizations. The main goal of this research is to study the correlation between job rotation and the performance of the environmental health employees of health centers, affiliated to the Shahid Beheshti University of Medical Science. The current study is descriptive and correlative type and was conducted in 2011 in three health centers of North, North-West and East of Tehran. The study sample composed of 42 environment health employees of the health centers which were selected by random-classification. The data were collected using collection forms and performance evaluation forms, based on detailed monthly statistics of employees [number of visits, suspended, off suggestion, group training, chlorine and iodine measurements and water sampling]. The data were consequently analyzed by Mann-Whitney test and the Spearman correlation methods in SPSS software. The averages and standard deviation of performance in employees who recently experienced job rotation and those who didn't were 87.13 +/- 18.9 and 82.73 +/- 22.6 [out of 100 scores], respectively; thus, no significant correlation was found between job rotation and performance of environmental health employees [p =0.178]. This lack of correlation was found between job rotation and performance items, as well. In this study, performance of the environmental health employees in health centers was independent of their job rotation status, but it has been suggested that job rotation is one of the goals for increasing performance of the health center employees. It seems that with respect to the findings of this study, less usage of job rotation and stability in job activities can be effective in improving performance of the employees.

[Estimating outpatient waiting time: a simulation approach]

Providing a simulation model for understanding process and patient flow in outpatient clinics and estimating patients' waiting time. This was a descriptive study. In this study outpatient clinics of general teaching hospitals in Tehran were grouped according to statistical distribution of patients' arrival time and a sample of each group was selected. Then the data of arrival time, service time and flow of patient at clinic for 357 patients were collected. At last a simulation model of outpatient clinics was provided and validated. Simulatoin model outputs showed that the mean patient waiting time for examination by novice resident was about 58 minutes, for experienced resident was about 52 minutes and for attend was about 53 minutes. Review of examination process with simulation model showed that about 42-62 percent of patients' waiting time for examination was before physician arrival at clinic. There were no statistical differences between new and follow-up patients' waiting time and waiting time for primary and complementary examination by residents and attend. We found that the time gap between patient admission and arrival of physician was the most important factor in rising outpatient waiting time. Efforts to lessening this time will decrease total waiting time for examination about 60 percent

comparative study on community-based disaster management [CBDM] in selected countries and proposing a model for Iran

To compare CBDM in various selected countries in order to design a model for Iran. A descriptive-comparative study was conducted in six steps in which few countries have been chosen based on their contribution to issues such as policy making, planning, coordination, and control. The related information then was assessed. The results show that in order to achieve a successful disaster management, there is a need for the participation of the community in various disaster management cycle, although the type of this contribution may differ according to the characteristics of each specific country. This paper proposes a model emphasizing on contribution of community in the local level in the villages and neighborhood areas