فهرست مطالب فرزانه دوستی

In recent years, many organizations have been searching for the best method to estimate the number of required staff in their organizations. However, since the basis of these methods is forecasting, their results are likely to be challenging, especially in healthcare organizations. Recently, approaches to estimating required staff based on real workload have become very popular in many organizations. In this research, the required number of family health care providers in outskirt comprehensive health service centers has been calculated using the WISN method.

The current survey is a qualitative-quantitative study. In the first stage, effective and important factors for estimating the required personnel in organizations were obtained by reviewing related articles. In the second stage, through the holding of focus group meetings, the micro-activities of the process of providing services by health care providers were extracted. In the third stage, by using the WISN, the difference and the ratio of the available to the desired staff were obtained, and finally, the norm of health care providers required in comprehensive health service centers was calculated.

In the first stage, from the review of related articles, four implicit factors that should be taken into consideration while analyzing the results of using WISN as factors affecting the number of required personnel were obtained. In the next step, the analysis of the results of the focus group meetings led to the identification of 16 main activities, nine supporting activities, and nine additional activities of health care providers. In the third step, by using the standard of main activities, group and specific allowance, ratio, and difference of WISN were obtained. This ratio was more than one and the difference was positive, indicating the lack of staff and the pressure of work on healthcare workers working in outskirts comprehensive health service centers.

Article reviews show that much research has been conducted in the field of hospitals to estimate the required staff. Unfortunately, despite the great importance of the health sector, the distribution of personnel is still carried out using the ratio of area population. Therefore, the necessity of conducting more studies in this broad and important field is evident. The data was collected from the country's ten regions or poles of medical sciences universities. Therefore, the obtained information can be used to estimate the required number of healthcare workers countrywide, taking regional differences into account.

Among various late 20th century schools of thought which have addressed the rapid deterioration of nature and the environment, Ecofeminism stands out. The term was first coined by the French writer Francoise d’Eaubonne in her 1972 book Feminism or Death.She was almost the first one to viewdomination, gender and the environmentin connection with each other. According to Ecofeminism, a dominating ideology equally treats women and the culturally inferior, andthe naturally inferior such as animals and the environment. In other words, similar patterns are at work to undermine the essence and identity of both.Thus,Ecofeminism has philosophical, theological, sociological and ecological concerns on one hand, and political and pragmatic concerns on the other. One can identify Ecofeminism schools and branches based on their political thought and praxis; however, what they all have in common is questioning dominant power structures that have equally subjugated woman and nature over time in different sociocultural and political contexts. Freed from gender/ecologic domination patterns,uto/dystopias and their hazards thus turn into main subjects of contemporary Ecofeminist subjects through a self-deconstructive approach.One should, however, admit that Ecofeminism’sfundamental philosophical and methodological flaws, most significantlyaccording to its critics, pure essentialism. The present paper intends to reframe Ecofeminismthrougha study of some contemporary artworks in the genre,rereading its deemed essentialism and sexism.

This paper examines Kamila Shamsie’s Home Fire (2017) as a faithful transposition of Sophocles’s Antigone into a contemporary novel that addresses the diasporic subject’s encounter with sovereign politics of life and death in the post-9/11 backlash against Muslims. A survey of the notion of the embodied subject as set in the complex network of power relations and biopolitics in the diaspora space where new forms of bio- and necro- power (as expounded by Postcolonial thinker Achille Mbembe) are at work towards enforcing subjugation of diasporic bodies forcefully synthesises with the question of belonging, the right to soil, and post-mortem identity in Shamsie’s Home Fire. For Aneeka Pasha and other British diasporics, burial of British citizens by birth in the British soil is a natural and legal right, whereas to the representatives of the Islamophobic State, the diasporic subject’s rights to soil is as evanescent as their liminal identities. Just like Polyneices in Antigone, the dead body of Parvaiz – a remorseful ISIS member seeking a way back home to rest in peace – functions beyond the biological borders of his body and proves to challenge the body politic of the state and question their necropolitical decisions.

One of the strategies of the the health system is (participation of) private sector and relying on the market. Lack of attention to the obstacles and challenges of Outsourcing Health Services to the Private Sector may lead to failure and irreparable damage to the health system. The present study aimed at identifying the challenges of Outsourcing Health Services to the Private Sector. This study was done in the form of qualitative research using a content analysis method conducted in a cross-sectional manner in late 2016. To this end, sampling was a purposive type and it continued until the data saturation was fulfilled.  The participants consisted of 16 experts, managers and Quality improvement experts of hospitals  Data collection  was conducted through in-depth interviews. Content analysis approach was used to data analyzing with regard to validity, reliability, and consolidation capabilities of data. Findings were included seven main challenges: Economic issues (4 sub-theme), Structural problems (12 sub-theme), Manpower challenges (7 sub-theme), Responsibility and accountability (4 sub-theme), planning challenges (7 sub-theme), Efficiency (5 sub-theme) and private companies (7 sub-theme).  There are many challenges in Outsourcing Health Services to the Private Sector and Solv them can be a step in achieving  improve the quality of health services. Structural problems were the major issues raised by interviewees. It is suggested, administrators before Outsourcing, in order to avoid any more of these challenges

General Health System Policy Statement by the Supreme Leader of the Islamic Republic of Iran are the basis for any correction in the health system and the health insurance system. Hence, this study design and implemented with the aims to identify and prioritize practical solutions for attaining article 9 of General Health Policy Statement that is about quantitative and qualitative development of health insurance. The present study is a mix-method (quantitative and qualitative) that was done in two part in 2018. In the first part, by reviewing the literature and reviewing the upstream documents, Different interventions for quantitative and qualitative development of health insurance was extracted. In the next part, based on the findings from the literature review, the panel of experts was held and expert opinions about the interventions were obtained. Finally, interventions were ranked and prioritized by expert’s opinion. According to the findings of the study, in order to achieve the objectives of article 9 of the general health system policy, a total of 34 interventions were selected by experts who should be considered over the next 5 years. One of the most important interventions is the developing of a basic package of unit services for the benefit of people from compulsory insurance, the creation of an independent insurance system for the purchase of services, the implementation of multilayer social security system document, the creation of stable financial resources for insurance, the redefinition of the payments system appropriate to different levels and etc. The quantitative and qualitative development of health insurance in the first phase requires the creation of a comprehensive and consistent database of all insured persons. The modification of payment systems and the design and developing of basic and complementary packages can also help to improve the insurance situation. Although achieving these aims requires more interaction between the Ministry of Co-operation, Labor and Social Welfare and the Ministry of Health, Medical Education and Training.

Quality of life is one of the key concepts of sustainable development. Social capital, on the other hand is considered both as an important variable affecting the success of development programs as well as a social determinant of health. Therefore, this study aimed to explore the relationship between quality of life and social capital among the community health service staff in Malayer city. In this cross-sectional study, conducted in 2017, a sample of 186 participants were selected using stratified sampling method. A standard questionnaire including questions on demographic information (N=5), quality of life (N=36) and social capital (N=36) was used to collect data which were then analysed using one-way ANOVA, Pearson correlation coefficient and independent t-test in SPSS 20. According to the findings, the mean scores of social capital and quality of life were 119/13 ± 3/34 and 68/4 ± 16/71, respectively. There was a positive significant relationship between social capital and the general health (r=0/22, p=0/003), mental health (r=0/24, p=0/001), social functioning (r=0/25, p=0/000), physical functioning (r=0/38, p=0/001), role limitations due to physical pain (r=0/25, p=0/001), role limitations due to mental problems (r=0/20, p=0/007) and vitality and happiness (r=0/23, p=0/001). There was a low but not significant positive relationship between physical pain and social capital (r=0/14, p=0/06) According of the findings the level of social capital can effectively improve the quality of life. It seems that enhancement of social partnerships and collaborative activities, development of social relationships, and reinforcement of a sense of security and trust among employees can improve the quality of life.

Integrated information systems، new approach of service delivery and interactions with customers، all have a common managerial character، and owe their success to process approach. This study aimed to determine the impact of Business Process Management on discharge process in Qaem teaching hospital in Mashhad.

This action research conducted in 2013، focused on inpatient discharge process. Data collection، in four phases of study، was based on a focus group for prioritizing processes، modeling، identifying problems and providing solutions. The instruments for data collection consisted of work flowchart، identification of improvement opportunities and problem identification table and some forms such as engineering analyzing.

After the implementation of Business Process Model، the saving time for patient discharge was 68 minutes.

After modeling the process، identifying problems and non-value added activities، the researchers implemented team members’ suggestions and showed changes in form of unit indexes.

Ever environmental changing and the rapid advancement of technology has forced the health care organizations to accommodate in line with appropriate changes. In sectors like healthcare، there are many legal restriction and clinical guidelines that practitioner have to comply with. Therefore، these features lead to less freedom and authority to free core business process from non-value adding activities and reengineering of process for practitioners. Nowadays، flexible principle of business process management (BPM) is a strategy that successfully applies in many developed countries. BPM includes identifying the current status of processes، modeling and determine effects of process’s reforms implementation. In many contexts، this approach has been introduced as the third wave of reforms that is the effective method، and its aims are to eliminate previous methods defects and considering budget constraints and the legal requirements. Through focusing on essential steps of process، integration and eliminating the non-value added steps، BPM provides the possibility of increasing the flexibility، quality and speed of processes. In healthcare organizations، employing BPM، via integration of electronic health record (HER) and hospital information system (HIS)، and guidelines، meet the above mentioned aims. In this paper، after brief description of process-oriented trend history، we introduced the BPM approach، and its aims and intervention scopes in healthcare organizations were described.