سید سعید طباطبایی

Continuous improvement of the quality of the education system requires assessment of the performance of teachers in order to make more informed decisions regarding the improvement of teaching methods. The study aims to explore the educational performance of Mashhad health faculty members from the perspective of graduate students through a qualitative approach.

The study was conducted as a qualitative content analysis. The research population was post graduate students. Sampling was started based on the objective and continued until information saturation, i.e. no new information was received, in the form of theoretical sampling. It was used to collect data through face-to-face interviews. Immediately after conducting the interviews, the recorded voices of the participants were typed word by word in Word software and analyzed using MAXQDA10 software.

The functional challenges of professors from the point of view of postgraduate students were identified in four areas: structural, moral, scientific competence and communication skills in 10 subcategories (lack of time management, student abuse, lack of inclusiveness, not updating the curriculum, unavailability of faculty member, lack of specialized guidance, several teachers for one lesson, lack of expression, lack of knowledge, and lack of experience).

Updating educational curricula, more interaction between professors and students, using professors with executive skills and experience in related courses, strengthening communication skills and expression techniques, having patience and tolerance, and observing professional ethics can play an important role in the educational performance in faculty member.

Considering the challenges that COVID-19 disease has created in human life, the study of its various dimensions is one of the topics of interest today. Considering the important role of nurses in combating this disease, in this study we examined the level of knowledge and job stress of nurses working in COVID-19 and non-COVID-19 wards and their relationship with each other.

 We assessed the awareness and job stress of 215 nurses working in COVID-19 wards and also 142 nurses working in other wards in Imam-Reza and Ghaem hospitals in Mashhad, using a researcher-made questionnaire as well as the JRTI questionnaire.

 The mean score of nurses' knowledge was 68.19 ± 17.44. The level of knowledge of nurses working in COVID-19 ward was significantly higher than nurses working in other wards (p = 0.002). The mean score of job stress in nurses was 58.82± 13.17 and there was no significant difference between job stress of nurses working in COVID-19 wards and nurses working in other wards (p = 0.134). There was a negative relationship between awareness and job stress of nurses (r = -0.14, p = 0.007).

Increasing the level of nurses 'awareness reduces their job stress, which shows the importance of increasing nurses' awareness about COVID-19 disease by providing appropriate training.

Leaving service by employees has many direct and indirect consequences and costs for the health system, and it is important to study and recognize it. The tendency to leave service is the best predictor of actual service left. In this study, we aimed to determine the organizational factors related to the tendency of non-governmental health workers to leave the service in the suburbs of Mashhad.

This descriptive-analytical study was performed on 323 health workers in 2018-2019. Data collection was performed by a researcher-made questionnaire included demographic characteristics, three dimensions of work environment, job demand, and social support. Research data were analyzed using descriptive and inferential statistics

The tendency to leave the service was about 64%. The mean score of work environment, job demand, and social support of organizational dimensions related to the tendency to leave were 45.95, 39.92, and 38.49, respectively. The results of multivariate regression analysis showed that with one unit increase in the scores of work environment, labor demand, and social support, provided that other variables are constant, the chances of leaving the service were reduced 0.923, ,0.899 and 0.876, respectively. (P <0.001).

In conclusion, clear job descriptions, appropriate salar,y and benefits considering to the type of work and workload, reducing ambiguity and role conflict, increasing job diversity, increasing authority, opportunities for advancement, supportive leadership can lead to increased job satisfaction and consequently, increase the tendency to stay and reduce the tendency to leave service.

Human resources are considered as a major component of the health sector.  this study estimates the number of midwives required in maternity wards in hospitals by using the WISN method.

This cross-sectional descriptive study was conducted in three hospitals affiliated to Mashhad University of Medical Sciences in Iran using the WISN method in 2019. The workload and the standard working time were determined through holding expert meetings; the timing methods were used to test and verify the standard working time; available working time was determined through holding meetings with personnel affairs experts, studying the relevant laws and regulations and personnel system information; and the actual workload was determined based on information management system and information registries. Microsoft Excel was used to analyze WISN data and Stata (version 19) was used to analyze statistical data.

10 factors related to midwifes’ available working time were identified. Annual available working time for midwives in the studied hospitals was 1378 hours per year. In this study, labor, delivery, recovery and postpartum, recovery after cesarean care, and new born cardiopulmonary resuscitation (CPR) were identified as the main activities of midwives. The results have shown that the Centre hospital and the educational hospital faced with 2 and 13 midwifes shortage, respectively, while the non-educational hospital had 2 surplus midwives.

The results showed that although both center and educational hospitals are faced with a shortage of midwifery staff, in comparison of working pressure, midwives in the educational hospital are under more pressure than the midwifes in the center hospital; so staffing in the educational hospital is a top priority. so workforce recruitment has a significant role in these hospitals.

Patient engagement is a concept that has gained special importance in medical care today, and is considered as a valuable goal in patient care. With the evolution of modern health from a disease-centered model to a patient-centered model, patient interaction has played an important role in improving the health care processes. This study aims to identify the factors affecting the patient's interaction with the physician.

This is an applied study with a qualitative-descriptive method. First, the information of patients who underwent angioplasty in 2019 was extracted from the hospital information system. Then, in-depth interviews with patients were conducted using a semi-structured interview guide. In the next step, we analyzed the data using qualitative content analysis with MAXQDA.

After analyzing data, we were able to extract 1072 codes. Then, we categorized the codes into two sub-categories of supply side (physician) and demand side (patient). We identified 11 factors affecting supply-side interaction (information, physician behavior, education, access, cost, responsiveness, patient perception of physician expertise and skill, managerial weakness, facilities, trust, and satisfaction with physician), as well as seven factors on demand-side (personal problems, patient questioning spirit, response from other sources, financial problems, lack of knowledge and awareness, advice from others, and self-medication).

It is expected that the patient's interaction with his/her physician after angioplasty could accelerate the patient's recovery process, prevent possible complications, and reduce costs. Recognizing the effective factors and designing appropriate interventions on the supply and demand side that can lead to improving patient interactions with physicians, and pave the way for promoting community health.

Nurses’ turnover reduces quality of health care and increases costs. Neglecting the nurses’ quality of worklife can lead to their turnover. The aim of this study was to determine the relationship between nurses’ quality of worklife and their intention to leave work in public hospitals in Herat, Afghanistan.

This was a descriptive-analytical study, investigating nurses’ quality of worklife and their turnover intention in public hospitals. We used census method, and all 258 respondents completed the standardized questionnaire on quality of worklife. Nurseschr('39') turnover intention was also measured by using an item. Meanwhile, we used descriptive statistics to present demographic variables. Meanwhile, Mann-Whitney test, Chi-square, and Spearman correlation coefficient were used to determine relationships between the study analytic variables. In this study, SPSS version 26 was used.

The quality of worklife and the intention to leave was at an average level. No relationship was found between turnover intention and demographic variables (p>0.05). Results from the Spearman correlation coefficient demonstrate a significant inverse relationship between turnover intention and some aspects of the quality of worklife including participation and involvement, job security, wages and salaries, career honor, and job stress. In other words, an increase in any of the aforementioned aspects results in a decline in intention to leave (P<0.05). The relationship between intention to leave and quality of worklife was inverse and significant (r=0.279, P=0.001).

Participatory management in decision-making, paying attention to salaries and benefits, and assuring nurses that they will not lose their job in the event of any socio-economic change can increase job satisfaction, and reduce their intention to leave work.

There are different soil-pile-structure interaction models that can affect on the response of offshore wind turbine structures. In this research, we tried to estimate the response of wind turbine offshore structures under tree different soil-pile-structure models which includes fixity level length with 2, 4, 6 and 8 times of pile diameter, stiffness matrix and independent springs and compared with more advanced and complete model of non-linear Winkler beam model. Results show the model of fixity level length with 8 times of diameter gives the best result among other models for axial loads in structural bracing elements and can be used as simplified pile-soil-structure interaction for wind turbine offshore structures.

Human resources play a highly important role in providing health services. The aim of this study was to determine the human resources required for the linear accelerator sector at Reza Radiotherapy-Oncology Center.

This applied analytical-descriptive study utilized human resources determination method based on workload indicator of staffing needs. Expert meetings were held to determine the components of workload and standard time. A survey was used to confirm the standard time of main activities, and interviews and personnel information system were used to determine the amount and factors related to available working time.  Furthermore, management system and registries were used to determine the annual workload. The data were analyzed using the Excel and SPSS software version 19.

Seven factors related to the annually available working time of employees were identified. Annually available working time for employees was set at 806 hours. Patient preparation, treatment, surgery, and case completion were identified as the main activities. The results of workload index calculations showed that the accelerator sector had a shortage of three people.

The results of this study showed that Reza Radiotherapy-Oncology Center is experiencing a shortage of professional staff in the linear accelerator sector. It seems that using the workload indicator of staffing needs method to determine and distribute the required human recourses is a necessary step for the optimal management of human recourses in specialized sectors.

Human Resources in the health sector not only is the most crucial source in health providing but account for nearly three-quarters of the health sectorchr('39')s costs. The purpose of this study was to estimate the required Human Resources of the CT scan department of the Reza Radiotherapy-Oncology Center based on the workload indicator of staffing needs in 2019.

This cross-sectional descriptive study used human resources determination based on staffing needschr('39') workload indicators. The method of conducting expert meetings was used to determine the components of workload and standard time. Also, Interviews and rules, and personnel systems were used to determine the amount and factors related to available working time, and to determine the annual workload, the hospital management system and observation of activity logs were used. Excel and SPSS19 software were used to analyze the data for determining the required human resources and timing data, respectively.

 7 factors related to staff annually available work time were identified. The available work time for CT scans staff was 1113 hours per year. In this study, imaging and simulation were determined as the main activities of the CT scans ward. The results of the workload indicator calculations showed that the CT scan section lacked 3 Personnel.

This study showed that Reza Radiotherapy Oncology Center is experiencing a shortage of professional CT scan staff, and the work pressure is (0.4). Therefore, CT scans are a top priority to provide the human resource.

Attracting and retaining physicians in rural and low-income areas are the most important challenges for health system policymakers, which affects the poor health status of the population living in these areas. The purpose of this study was to investigate the factors related to the willingness of the working physicians to stay in rural areas and evaluate them according to the recommendations of the World Health Organization.

This applied research was conducted using descriptive-analytical and cross-sectional method in 2019. The study population was 306 physicians working in rural health centers under the supervision of Mashhad University of Medical Sciences. They were chosen through the census method, and the data collection tool was a researcher-made questionnaire. Descriptive statistics, simple, and multiple ordinal regression models were used to analyze the data.

The results showed that the willingness of the working physicians to stay in rural areas of Mashhad was low (16 percent). Furthermore, there was a significant relationship among the importance of laws and regulations, the observance of educational dimension, laws and regulations, financial incentives and personal and professional supports with the willingness to stay in rural areas (p <0.05).

The use of adequate financial incentives commensurate with the expectations of employees and commensurate with the opportunity costs of living in rural areas, accompany with individual and job support for employees, can strengthen the effects of each dimension and ultimately the willingness to stay in rural areas.

Due to the complexity of loads applied to wharves and piers because of their special application as mooring and berthing structures, their design always has many challenges. These structures have a large mass, and the piles and pile caps connections must sustain large inelastic deformations during major earthquakes which force-based design method cannot consider properly. So this study was undertaken to evaluate the full seismic performance of a typical synchrolift wharf located at Hormozgan province with performance-based design method by a series of static pushover analyses for three different hazard levels in accordance with ASCE/COPRI 61-14 code requirements and local seismicity. Soil-structure interaction, material overstrength, and site-specific response spectra were used to determine the displacement demands. The results reveal that using conventional force-based design method leads to the unreliable deck as well as uneconomical pile foundation designs.

It is realized that the economy of many littoral countries, including Iran, is dependent on the marine developments; therefore, the construction of port structures as the point of berthing, mooring, and repair of marine vessels has boomed in recent years. Hence, there has been significant research on the design of port and harbor structures, which leads to the development of performance-based design method as a highly reliable way for seismic design of these structures. Seismic actions may cause uncontrolled damages to wharves and piers, resulting in huge economic losses to the country. Iran is also one of the most seismically active zones and contrary to the seismic design of waterfront structures which still leaves much to the designer’s judgment, there are several published codes for performance-based design of building structures. So in this paper, the state-of-the-art ASCE/COPRI 61-14 code requirements on seismic design of wharves and piers has been studied along with the performance-based design method.

Developmental dysplasia of the hip (DDH) includes a wide range of abnormalities of the hip that can emerge at any time including embryonic period, infancy, or childhood. The purpose of this study was to examine the clinical and radiographic outcomes of patients with DDH, treated with adductor tenotomy and closed reduction.

The study was retrospectively performed on 30 children (33 joints) with DDH,who were treated with adductor tenotomy, closed reduction and SpicaCast in Ahvaz Razi Hospital during 2015-2017. Inclusion criteria were patients diagnosed with DDH and below 2 years of age. Exclusion criteria were connective tissue diseases, secondary dislocation due to previous infection and acetabulum dysplasia in the context of specific syndrome. After the operation, the patients were evaluated for the severity of injuries associated with dislocation or subluxation of hip joint and hip joint congruity. Theradiographic results were studiedbased on Severin, Tonnis grading, McKay and acetabularindices.

The preoperative mean acetabular index of36.54 ± 3.27 degrees significantly dropped to postoperativeof 27.06 ± 2.15 degrees. According to McKay criteria, 90.9% of the patients had excellent and good therapeutic results after the surgery. According to Tonnis criteria, 93.9% of patients were in Class I and II after the surgery. Moreover, in radiographic evaluations,96.9% of the patients were in Class Ia and Ib  based on Severin criteria.In 1 patient (3.03%), osteonecrosis of the head was found, in 2 patients (6.06%), walking and lameness impaired walking, and in 3 patients (9.09%), sitting was reported. All patients were female in this study.

According to the clinical results and evaluations of this study, closed reduction along with adductor tenotomy can be used as an appropriate technique for the treatment of patients with DDH at an early age.

If organizational culture leads to stimulating organizational creativity, it will bring effectiveness and success to the organization. Therefore, the aim of this study was to determine the relationship between organizational culture and creativity of employees, taking into account the role of mediation of social capital in the development deputy of Mashhad university of medical sciences. This descriptive - analytical study was conducted in 183 employees of management development and resources department of Mashhad university of medical sciences that were randomly selected. The data collection tool was a standard organizational culture questionnaire (56 questions), employee creativity (60 questions), and social capital (28 questions). Data were analyzed using Structural Equation Modeling Method and with the help of the software Pls smart version two. There was a direct correlation between organizational culture and social capital (r=0.752) and between organizational culture and creativity of staff (r=0.464). Also, the social capital of the relationship between organizational culture and creativity of staff played the role of mediation. Organizations can help to increase creativity by agreeing on the values and beliefs in the organization and aligning individual and organizational goals, and planners cannot plan the criteria for increasing creativity of individuals regardless of organizational culture. If managers act to strengthen social capital, they can strengthen organizational culture in their organizations and create a suitable platform for creating a commonality.

The concept of lean management refers to the elimination of waste and creation of value in an organization. The aim of this study was to determine the effect of lean management on improving surgery ward processes in a private hospital in Tehran.

In this case study, the level of patients’ consent and their voluntary discharge both before and after the intervention were investigated. Spaghetti chart methods were used to implement lean management. All clinical, administrative, and paraclinical wards of a private general hospital in Tehran from January 2014 to July 2016 were studied. The data were collected using patients’ consent analysis questionnaires and researcher developed forms, and they were analyzed through descriptive statistics in Excel software.

The use of Spaghetti chart reduced the path in the process of discharging male patients was by 55%, 224 meter (from 408 to 184 m), and female patients by 41%, 224 m (from 546 to 321 m). The implemented interventions included the transfer of the Insurance Unit from the third floor to the ground floor and the transfer of the Discharge Unit from the first floor to the ground floor. The implementation of interventions reduced the frequency of voluntary discharge by 0.8% (from 6.8% to 6%), and it increased patients’ overall satisfaction by 8%.

Lean management in the hospital leads to the elimination of waste from the process of service delivery and the flow of activities performed. It is necessary to study the hospitals status quo, draw a picture of the forthcoming goals, determine the future status of the lean hospital management, and consequently, draw a map to move towards the lean hospital.

Hip fracture in the elderly is associated with a high mortality rate, imposing considerable burden to healthcare system. This study aimed to evaluate the functional score of Harris Hip Score (HHS) in elderly patients with intertrochanteric fracture treated by bipolar hemiarthroplasty. This study was conducted on 40 patients (mean age of 78.21 years) with unstable intertrochanteric fracture after surgery using cemented bipolar hemiarthroplasty. The cases were assessed in terms of radiographic and clinical evaluation. Harris Hip Score (HHS) questionnaire was filled for all the patients. Four patients had incomplete follow-ups and 5 patients had deceased. The HHS score was excellent for 6, good for 14, fair for 7, and poor for 4 patients. The mean HHS was 85.12 (good). Performing surgery with cemented bipolar hemiarthroplasty in older patients with unstable intertrochanteric fracture would lead to acceptable clinical and functional results with earlier ambulation, and HHS score of 85.12 .

Acetabular dysplasia is a well-known cause of early osteoarthritis of hip which may appear at any time (perinatal, breast-feeding and childhood). The aim of this study was to evaluate the clinical and radiographic outcomes of children with de-velopmental dysplasia of hip (DDH) after undergoing open reduction, capsulorrhaphy and Pemberton osteotomy procedures.
This study prospectively conducted on 13 patients with DDH who attended to Razi Hospital at Ahvaz Jundishapur University of Medical Sciences at Ahvaz, Iran, from April 2012 to March 2015. Inclusion criteria were children with age range of 18 months to 8 years and acetabular index≥ 40 degree. Exclusion criteria were the age less than 18 months or above 8 years, connective tissue diseases, secondary dislocation due to previous infection, and acetabular dysplasia with specific syndrome. All patients were evaluated before surgery and at least one year after surgery in terms of clinical evaluations, dislocation or subluxation of hip, congruity of hip and radiological out-comes according to grading systems of McKay, Tonnis grading system, Severin classi-fication and acetabular index, respectively. All patients underwent open reduction, capsulorrhaphy, and Pemberton’s osteotomy in single-stage surgery and if necessary femoral shortening was performed.
Ten patients (12 hips) were evaluated. Of those, 4 patients (40%) had right hip involvement. The mean age score was 38.92±12.37 months (range: 24-65 months). Acetabular index showed significant reduction after surgery in compare to before sur-gery (P= 0.002). According to Tonnis grading, 91.6% of cases were in I-II classes. Moreover, 66.6% of cases at clinical examinations of McKay criteria had excellent and good results after surgery. According to Severin radiographic findings criteria, 83.2% of cases were in I-III classes after surgery. There was statistically significant improvement in patients according to different grading systems.
In conclusion, Pemberton osteotomy could be an effective procedure and also in conjunction with other surgical procedures for the treatment of patients with DDH who presented in higher age and late.

Cancellation of surgical procedures is one of the biggest challenges in hospitals throughout the world and it is important as it increases patient's stress, expenses and wastage of time, and prolongs the duration of hospitalization of patients. The aim of this study was to review literature related to reasons of surgery cancellation in Iran.
This systematic review was conducted from March to Sep. 2014. The keywords including cancellation, delay, postpone, cancelled surgery, surgery operation and Iran were searched in international search engines including Pubmed, Scopus, ProQust and Google scholar and Persian indexing websites of SID, Magiran and Iranmedex. All articles related to cancelled operations in Iran, written in English or Persian (from Jan 1, 2004 until Sep 31, 2014) were collected. Then, those articles which contained any of the selected keywords in their titles or abstracts were compiled, and others were excluded. At last, a check list including title of article, time and location of study, sample size and location and cancellation cause was designed for final assessment.
A total of 646 records were found in 7 selected databases of which 13 articles met the criteria for inclusion in this study. The main cases of surgery cancellation were related to operating room and hospital, anesthesia, patient's non-clinical problems, the surgeon and clinical problems.
Adoption of strategies for on-time initiation of surgical procedures, identification of patient's underlying problems and the appropriate process of hospital admission can be effective in reducing the rate of cancelled operations.

Patient safety is one of important indicators in quality control of health services and Medical errors, especially medication errors are the most common causes of the safety-threatening, therefore this study was conducted to assess the rate and type of nurses medication errors. This study was Descriptive – analytical and sectional that carried in a private hospital in Mashhad. In this study population census was used and the entire population was considered as the sample. A researcher – made questionnaire was used for data collection. The validity and reliability of the questionnaire were confirmed. The collected data were analyzed using descriptive statistics and T-TEST and ANOVA in SPSS, version 15. Three errors, giving medication to the patient without physician prescription, no attention to complications due to medication errors and giving medication sooner or later, Respectively with The highest frequency and giving Past the expiration date of the medication to the patient, Giving the wrong medication to a patient and not giving prescribed medication to patient Respectively with The lowest frequency are Among medication errors. the nursing managers must to reduce medication errors more attention to raises holding in service classes for nurses, reform of nurses processes and their attitudes promotion towards the importance of patient safety.

Due to the changing environment of hospitals and the necessity of providing services for patients in the shortest possible time and at an acceptable quality and cost، it seems to be necessary to utilize the maximum intellectual capacity of the organization to enhance agility in hospitals. The aim of this study is، in fact، to investigate the relationship between organizational intelligence (and its components according to the Albrecht model) and organizational agility in hospitals of Mashhad University of Medical Sciences. This descriptive study was conducted in 2013 on 408 hospital employees seleced through stratified sampling method. To collect data on organizational intelligence، the Albrekht standardized questionnaire was used and to gather data on organizational agility، a questionnaire designed based on Goldman model was employed. For data analysis and hypothesis testing، the SPSS software version16، Pearson correlation، t-test، Anova، and regression techniques were applied. The results of the study showed that there was a significant relationship between agility in hospitals and organizational intelligence (components: Appetite for change، heart، knowledge deployment، performance pressure، strategic vision، shared fate، and alignment and congruence). The determinants of agility were mainly strategic vision، performance pressure، and a lignment and congruence. The results of the study showed that dynamic strategic planning in hospitals and developing educational programs of organizational intelligence aiming at employees'' and managers'' awareness could lead to an increase in the agility level of hospitals and provision of effective services for patients.

Anterior cruciate ligamant (ACL) injuries are the most common sport injuries of the knee joint. These injuries are commonly associated with other intraarticular lesions. The purpose of this study was to search for other intraarticular lesions in the MRI of the patients with torn ACL. Subjects and Between April, 2012 until March, 2013, 150 MRIs token from patients with torn ACL were collected and reported by another radiologist and the number of intraarticular structure injuries were reviewed. The most common lesion was joint effusion (80%). Other lesions were medial meniscus tearing (74%), lateral meniscus (23%), PCL buckling (8%), Tibial articular surface fracture (6%), Femoral articular surface fracture (4.8%), soft tissue edema (9%), Lateral collateral ligament injury (22%). There was 12% difference between two reports. Results of this study suggest that ACL injuries are associated with other knee pathologies and there are 12% inter-observer variation in interpreting MRI scans of these patients.

Purchasing hospital equipment is one of the most important decisions made by managers and health professionals. Gray systems theory is an approach to deal with issues under uncertainty conditions where decision makers are facing a small number of unspecified data. The purpose of this paper is to apply the gray theory for the purchase of anesthesia machine. This study was a survey in which mathematical analysis was used. Data collection devices included documents، interviews and questionnaires. In order to solve multiple criteria decision making in uncertain conditions، a model based on gray system theory was used. Data analysis was performed using Excel software. The findings show that among anesthetic equipment bought by public and private hospitals، brand A is superior to other brands. However، the gray possibility degree for the other brands is significantly different from brand A. In addition to helping to purchase anesthetic equipment for hospitals، the results of this study are also useful for companies manufacturing medical equipment to evaluate their situation in terms of the studied criteria and take appropriate measures to develop their strengths and improve their weaknesses.

one of new and unique tools for survival of organizations among their competitors having comprehensive knowledge of all the environmental factors affecting the organization, means organizational intelligence, that with its measurement Strengths and weaknesses of the organization are identified and can affect the performance of organization and in this way, they help to organization in the measurement and evaluating progress in achieving its goals. This descriptive analytical study was performed in 12 general hospitals affiliated to Mashhad University of Medical Sciences in 2012. Study samples were 375 employees who were selected through stratified sampling method. The study Tool of data accumulation was Albrecht organizational intelligence standard questionnaire and checklist of hospital performance indicators that was determined by the Ministry of Health. To determine score organizational intelligence was used the five-point Likert scale. Data were analyzed by SPSS v.16 using Statistical tests and Pearson correlation coefficient (P=0/05). we found that there was a significant positive relationship between hospitals’ organizational intelligence and all the performance indicators of the exception of “Bed occupancy ratio”, “Ratio of surgeries to operation beds” (P<0.05), and organizational intelligence had the highest correlation with indicators of Bed Turnover Interval (r = 0.739) and the average length of patient stay (0.691). it seems that attention and planning to strengthen and increase organizational intelligence can be effective in improving the performance of hospitals.

The hospitals and medical centers’ staff are always exposed to stressful working conditions that threat their physical, psychological and social health but also reduced organizational efficiency and lead to exorbitant costs for individuals, organizations and the entire society. The spiritual intelligence play an important role in enhancing capacity and various pressures, so the purpose of the present study was to determine the relationship between the spiritual intelligence and burnout in staff of Imam Reza hospital of Mashhad. Methods and materials: This cross-sectional study conducted in 2013 on 246 employees of Imam Reza hospital in Mashhad who were enrolled in a simple random sampling design. Were applied to gather the related data, The King Standardized spiritual intelligence questionnaire as well as Maslash Standardized occupational burnout questionnaire. The collected data were analyzed through Spss16, t - test, Anova and Pearson correlation coefficient. The error rate of %5 was considered acceptable. Spiritual intelligence in staff was at moderate to high and job burnout was moderate. There was found a significant negative Correlation between the spiritual intelligence and occupational burnout in the staff of Imam Reza hospital (r = -0.239 & p-value = 0.001) Systems’ managers can identify and improve the components of spiritual intelligence of their staff through various approaches such as improving the training systems as well as providing the contexts in which the spiritual intelligence of their staff can be developed.

Pediatric emergency department is a high risk area, and a wide range of imaging errors is probable. The aim of this study was to proactive risk assessment of the MRI process in the pediatric emergency department of Ghaem teaching hospital in Mashhad. This descriptive study was performed in Ghaem hospital, Mashhad during 2013. Failure modes and their effects were identified with Healthcare Failure Mode and Effect Analysis (HFMEA) using a mixed method (quantitative - qualitative). The UK community practice model and an approved model by the UK National Health System were used to classify failure modes and failure mode causes, respectively. The theory of inventive problem solving was used to determine solutions for improvement. 43 failure modes were identified for 13 sub-processes of the six-step MRI process. Four failure modes were considered as high risk (hazard score≥8) and were transferred to the decision tree. The frequency of failure modes were as follow: 40.42% communication errors, 23.40% clinical errors, 17.02% prescription errors, 6.38% patients and their relatives errors, 10.63% equipment errors and 2.12% other errors. Of 68 failure mode causes, the most common causes were related to the communication factors (23.5%), and the least common causes were related to the organization factors (2.9%). The HFMEA method was efficient in identifying failure modes, determining failure mode causes and proposing improvement strategies for the MRI process. Training and auditing were considered as two main tools for optimizing the MRI process in the pediatric emergency department of Ghaem hospital.