نشریه راهبردهای مدیریت در نظام سلامت
پیاپی 2 (زمستان 1395)

Hospitals as major energy consumers can manage their energy consumption by intelligent interventions. Therefore, this study aimed to determine the amount of energy consumption of Water, Electricity, and Gas, and their association with functional indicators in teaching hospitals of Shiraz University of Medical Sciences from 2009 to 2011.
The present study was descriptive and cross-sectional in design which analyzed energy consumption and functional indicators from the beginning of 2009 to the end of 2011. The sample consisted of 7 teaching hospitals affiliated to Shiraz University of Medical Sciences. Data were collected from the departments of consumption pattern reform and statistics and recorded in the data collection form developed by the researcher. Data were entered in SPSS16 and analyzed using descriptive and analytical tests such as Pearson correlation test.
The average consumption of water, electricity, and gas per occupied bed days were 0.09 m3, 2.78 kWh, and 1.56 m3, respectively. Also, statistically significant and positive relationships were found between the amount of water consumption and the number of active beds (P = 0.009) and occupied bed days (P = 0.007).
Energy consumption in teaching hospitals of Shiraz is lower than similar domestic studies and in some cases more than foreign studies. More active beds with lower productivity increase energy consumption. Hospitals can reduce energy consumption and their costs with more efficient use of resources.

Clinical Governance is a Framework in which health care provider will be responsible for continuous quality improvement. This study aimed to identify implementation challenges of Clinical Governance in the area of risk management.
This is a descriptive-qualitative study. We used Content Analysis method for data analysis. Study environment contained 7 teaching hospitals, and the study population included the hospitals staff engaged in Clinical Governance implementation. Using purposive non-randomised sampling, 18 participants were selected. A semi-structured face-to-face interview was used for data collection. Content Analysis method was used to conceptualize, interpret and analyze the texts and maxQDA software for data analysis.
Our research findings presented two main themes as cultural factors and lack of resources.
Promoting management as well as empowering health care providers could act as a key factor in addressing problems related to the implementation of risk management in health care environments.

Appropriate relationship between physician and patient can increase patient's trust and prevent from their confusion and repeated visits to different doctors. Therefore, the purpose of this study was to determine the dominant pattern of physician-patient relationship among outpatients referring to Shahid Sadoughi Hospital.
This research was an analytical and correlational study carried out on 300 patients referring to Baghaeipour Clinic. The data collection tool was a standard questionnaire including 10 general items and 19 attitude questions. SPSS16 software was applied for data analysis; Chi-square test, Pearson and Spearman correlation coefficients were used in this regard.
Based on the findings of this study, the most dominant pattern of physician-patient relationship was guidance-cooperation pattern (% 57.5) followed by mutual participation (% 37.8), and active-passive (% 4.7) patterns. The type of physician-patient relationship pattern had a significant relationship with the physician's specialty (P = 0.002).
Considering that the most effective pattern of physician-patient relationship was the mutual participation relationship pattern, increasing patient's awareness and encouraging them to get more involved in the process of treatment can facilitate better access to health.

Hospital wastes are considered as a serious threat for public health. Hospital waste management may help to control disease transmission and have remarkable economic advantages. The purpose of this study was to assess the hospital's waste management in Isfahan, Iran in 2014.
Data of this descriptive and cross-sectional study were collected through a check list for surveying hospital waste management. Validity of checklist was confirmed by analysis of face validity and field expert's opinions. Cronbach's alpha of 0.80 was calculated. Data were then analyzed using descriptive statistics in Excell software.
In the studied hospitals "Elimination" dimension was inappropriate while the "Human resources involved in waste management" dimension was estimated relatively appropriate. Other dimensions were estimated as appropriate. Infectious wastes consisted of about 10.89 % of the total wastes in hospitals and the average of waste generation for each bed was 3.67 kg per day. There was no environmental unit in the studied hospitals and only one of them did not have waste management unit.
Despite the fact that waste management status in hospitals under study was relatively appropriate, but given the importance of the issue, it is essential to improve the current situation especially in some aspects of waste management.

Quality of working life and mental health is one of the important factors affecting organization's performance. The aim of this study was to investigate the relationship between the quality of working life and mental health in clinical staffs of the selected educational hospitals of Yazd.
This cross-sectional and analytical study was carried out from 2015 to 2016 in 3 hospitals of Yazd. In total, 350 clinical staffs of these hospitals participated in the study. Stratified random sampling was performed. Data were then collected through Walton's quality of working life questionnaires (1973) as well as Goldberg and Hiller's mental health questionnaire (1979), SPSS 22 software and AMUS were further applied to analyze data.
Quality of working life affects mental health with regression coefficient of- 0.14. Among the obvious components of mental health and quality of working life, belief in the rule of law with a coefficient of 1.90 and depression symptoms by a coefficient of 1.37 had respectively the greatest impact in calculation of mental health and quality of working life. However, physical incompatibility with coefficient of 1.00 and valid beneficial social work with a coefficient of 0.04 had the lowest effects, respectively.
According to the study, modification of working life quality can lead to better mental health and improve clinical staff performance.

The operation of the organization could be increased by organizational culture and commitment. Most basic tools for the development of the entrepreneurial is culture based on the concepts of entrepreneurship. This study was aimed to examine the relationship between organizational culture and organizational commitment and also organizational culture with organizational entrepreneurship.
This study is a applied and analytical research. From a sample of 150 employees from 2 hospitals selected in Shiraz in 2015-2016. We demonstrated model using structional equation modeling with the help of questionnaire tools. The required data were gathered using 3 valid questionnaire Denison organizational culture (2000) and Margarate Hill organizational entrepreneurship (2003) and Allen and Meyer organizational commitment (1990) being analysed thorough statistical software of Lizrel for Structural Equation Model and SPSS16 for descreptive statistics.
Our results showed a positive significant relationship between organizational culture and organizational commitment inaddition to organizational culture and organizational entrepreneurship. And also there is less significant relationship between organizational commitment and organizational entrepreneurship.
Based on the findings it can be concluded that the implementation of appropriate strategies for improving the organizational culture could increase theire commitment and also participate in their entrepreneurship.Among the components of the organizational culture, mission component has the highest corralation with entrepreneurship and organizational commitment and it could be involved in creating them.So to increase the level of continuance commitment and entrepreneurship, hospitals staffs should invest more in culture, spcially in mission sub-component.

Family is first organization that the person enter it, as for useful role family functioning in the normal family especially when a family member needs help for adaptation with environment and society, normal functioning of family have a helpful role, therefore the aim of this study was to evaluation family functioning. So, the aim of this study was to comparison of functioning of families with and without intellectual disable children.
This Case-control study conducted in 2015. This is a cross-sectional analytical study that population consisted of 86 families with and without intellectual disability children living in Ahvaz. Data collection by demographic and family functioning (FAD) questionnaire. Data analysis by SPSS 21, and analytical data were carried out by using t-test and Mann-Whitney tests.
This finding show that significant difference in mean between two groups in items of problem-solving and emotional fusion does not exist. There was also no significant difference between the two groups.
Mentally retarded child can affect a family functioning. Family members should try to set the conditions for accept the terms of outcome and the child's family environment with a disability to have better personal and social life do not help.

The literature indicates that organizational justice is a predictor to several other organizational parameters one of which is job satisfaction. The aim of this study, therefore, was to study the current status of social justice in Birjand University of Medical Sciences and to enquire into its relationship with job satisfaction.
This is a descriptive, correlational study. The population was all the staff of Birjand University of Medical Sciences in 2015. Kerjsy and Morgan’s table was used to calculate sample size whereby 205 individuals were selected using stratified random sampling method. To collect the data, Niehoff and Moorman’s Organizational Justice Questionnaire (20 items and 3 sub-scales on distributive, procedural, and interactive justice) and Kendall Smith and Hulin’s Job Satisfaction Index (70 items) were used. The collected data were nalyzed in Spss16 using Pearson correlation test, t-test and ANOVA at the significant level p In this study, 83 (40.5 %) were male and 122 (59.5 %) were female. The results showed that organizational justice and its dimensions (distributive, procedural, and interactive justice) correlated significantly with job satisfaction (p The results indicate that organizational justice and its components correlate significantly with job satisfaction of employees. Also, job satisfaction can predict job satisfaction. Hence, it is recommended to academic leaders to attend for organizational justice so that this will lead to improved job satisfaction of employees.