مجله مدیریت بهداشت و درمان
سال دوم شماره 1 (پیاپی 4، بهار و تابستان 1389)

The research examines the perception of senior managers in training hospitals located in Tehran city on the Quality Management Systems and its relationship with the effectiveness of performance. Hospital headquarters are regarded as the building blocks of health in every part of the country. Modification is doomed to failure without appropriate shift in performance of the mentioned centers. Rendering optimum services is of vital importance despite the entire restrictions and delay in yielding quality improvement. Concurrently, the study is to take into consideration the link between frequency of modern systems in quality management and performance efficacy of training hospital in the capital city.

To achieve the purpose, 50 administered questionnaires from the total 60 were accurately analyzed by top-notch managers and executives of 32 training hospitals from Tehran city. The reliability of questionnaire is significant following the experts’ analysis along with its validity drawn from Cronbach’s alpha coefficiency. To analyse the data, descriptive statistic, including frequency and standard deviation is applied to compare two groups of t-test and the Pearson productmoment correlation coefficient.

The relationship between simultaneous modern optimum performance system with the efficacy drawn from t-test is significant in 3.93 (P<0.01), which is meaningful in terms of efficacy in hospital performance with extra two approaches in the rest of the headquarters. The Pearson product-moment correlation coefficient is significant in terms of 0.630 (P<0.01), indicating positive relationship between the respective performance and the efficacy of systems.

To follow up quality paradigms, it is attempted to pay due attention to the shortcomings. Hence, other proposed approaches are applied to obtain better results.

Ignoring interpersonal conflict is a barrier in delivering services, leading to struggle,dissatisfaction, low efficacy and stained relationship between managers and the personnel. The main objective of the present study is to investigate the effect of effective communication on interpersonal conflict between managers and employees at Hasheminejad Kidney Center.

In this correlation study the research population comprises all managers and different groups of employees at Hasheminejad Kidney Center in Tehran (N=408) taken quota sampling (n=198). The data drawn from respondents is collected via questionnaires which were prepared by the researcher. The information was analyzed by analytic statistics in 2010. Correlation coefficiency is used temporarily on 10, 1389. The research population comprises all managers and different groups of employees at Hasheminejad Kidney Center in Tehran (N=408) drawn from quota sampling (n=198). The data drawn from the questionnaires is prepared by the researcher in the form of the questionnaire. The information is analyzed by analytic statistics in 2010.

Average score of the individual conflicts between managers and the employees is (1.55), which is lower than standard mean namely 3. The effective communication variables are at a satisfactory level. Despite the fact that a significant relationship between each variable with individual conflict of managers and the personnel is detected, regression analysis does not meaningfully indicate the effect of affinity variable on conflict.

Use of effective communication through setting a proper supportive environment and establishing a positive feeling can reduce negative conflicts in health services organization.

In the globalization era, each organization which can not produce faster, cheaper and more qualified will be omitted from the market and just organization using their full-fledged human resources will survive. If the current payment condition is not compatible with the efficiency of the functions, the emerged challenges will lead to losing motivation, injustice payment, lack of competition in job condition, waste of human resources and vast expenses. Hence, one of the purposes of designing payment system is to design the justified system for all workers and improve a condition fostering job satisfaction.

Present study is a cross – sectional descriptive study. The statistic population (office, medical, Para clinic and services) is drawn from Hasheminezhad hospital worker. From the total 450, 250 staff are selected at random. The tool for gathering data is questionnaire based on Likert scale in which above 3 and below 3 represent satisfaction and dissatisfaction in the payment system respectively. Consequently, data analysis is done by means of descriptive statistic scale and Excel software (version 16).

The obtained result on total staff payment satisfaction in terms of efficiency shows 44.6%, 21.3% and the rest are satisfied, dissatisfied and mildly satisfied respectively. Based on the secondary objective of the research, 34.2% and 29.2% of the respondents have called the procedure of payment fair and concurrent with job goals respectively. As the tertiary, fourth and fifth goals, 79.5 % and 77.3% and 66.4% of the respondents are of the opinion that the procedure will raise satisfaction, increase organizational responsibility and raise working quality. 73.7% of the respondents have also considered the respective procedure as a cause in raising working quality.

According to the research finding conducted in the respective hospital, the staff have expressed their satisfaction (Above average) on payment procedure, which has almost caused their satisfaction.

In many countries expenditure resulted from medicinal services for the elderly has raised, emerged as a social problem.

In the research paper the researcher has conducted a survey of physician-induced demand in terms of expenditure function. Consequently, the investigator applies ECM method to pay due consideration towards the long and short run implications of price on the demand for medicinal services.

We show that when number of physicians increase, using of hospital services and outpatient cares are used interchangeably, and a minimum alteration in the rate of doctor population density leads to a change in medicinal expenditure, which almost confirms the existence of physicianinduced demand.

When the per capita of doctors increases, the rate of frequent usage of them will be raised. There is rather a substitute for outpatient cares and hospital services in which the rate of demand can be highly affected by the mentioned factors.

Nowadays, not due attention is paid to the role of ambulance as a quick means of transportation in transferring the patients. Nevertheless, a fully equipped ambulance, especially in a critical condition, plays a crucial role in saving the life of patients with life-threatening diseases or with serious injuries. The Purpose of the study is to investigate of the ambulance status quo in the medical emergency hubs in three borderline cities (Gilane gharb, Gasre Shirin, and Sarpole zahab) of Kermanshah province in 1387.

The cross-sectional descriptive study is to examine the ambulances status in the emergency headquarters of three borderline cities (Gilane Garb, Gasre Shirin, Sarpole zahab) in the second 6th month in 1387 in Kermanshah province. The required data is collected from standard checklists derived from the Health ministry and Quality ISO 9002 questionnaire with respect to medical emergency. Following referring to the respective hubs, the investigator has collected data from existing files, observation and interview. To analyze the data, descriptive statistical significance (Mean, Median and Standard deviation) is used.

The finding indicates 30% of ambulances are out of order or damaged, whereas 50% of them are in order. Concurrently, 85% of them have technical problems and 20% of them are dirty, while 80% of them are clean. The three-mentioned cities have one MICU Ambulance with 50% technical problems. 10% of ambulance drivers do not have any information about their ambulances e.g., (stretcher, seats, car body parts, air conditioning system)

The paper shows the available ambulances of emergency ward in the three cities (Gilane gharb, Gasre Shirin and Sarpole zahab) are medium. Thus giving training service to the ambulance drivers and repairing the damaged ambulances are top priorities.

The goal of health information system is to improve the data quality used in decision making from service providing to policy making. Health service-rendering hubs play a crucial in health information system. The study is conducted to determine of current health data management in health centers.

The conducted research is based on a descriptive and cross sectional study in health centers in East Azerbaijan province. 150 health centers from the province are selected from the health care list with systematic sampling method at random.130 physicians and 220 health experts in motherchild health care as well as environmental health filled and submitted the questionnaires. The data are analyzed in SPSS 16 software.

On average, 62.8% of health center managers are trained initially in regard to statistical forms. 55.5 percent of health centers have not access to scientific resources in data management. Every physician has defined 54.8 percent of health indicators correctly. 85 percent of physicians are of the opinion that the data of vital horoscopes are reliable. 80.8 of physicians and 81.6 percent of experts are of the opinion that health service providers have registered the data correctly. On average 48 percent of the physicians are aware of statistical forms.

Due to the significance of service-rendering health centers in optimum performance of health information system, drawing up a proper draft of primary health care information system is of great importance. Consequently, performance indicators, the procedure of calculation and analytic method should be defined.

The organizations potential, in quick response to increasing environmental change and satisfying the customer in today's competitive conditions, are the important parameters. The study is to investigate the relationship between strategy agility of Tehran University hospital, Work agility, and their impact on the labor force.

The researcher has used the descriptive method in December, January and February 2010. It is worth noting that the validity of the questionnaire on the Likert scale with 7 options is obtained from 20 experts. Reliability of the test is confirmed following using Cronbach's alpha (a=0.841),which is a coefficient of reliability. Totally, 104 doctors, nurses and clinical staff of hospital emergencydepartment in Tehran University have participated in the study. In order to analyze the data, thestructural equation models are used.

The confirmed factor analysis shows that between latent variable strategy and agility andagility work there was no significant relationship (T-Value = -0.29), but the relationship betweenstrategy agility and workforce agility was significant (T-Value = 1.98), and the relationship betweenworkforce agility and work agility (T-Value = 1.96) was confirmed. The indicators of organizationnature and some components in complexity of job from agility strategy (T-Value <1.96) wereremoved.

Fundamental relationship between strategic management with an emphasis on workagility and work force agility was reported. The agility with which management education is withconsiderable impact on job characteristics and practice staff will be swift. Agility works as a latentvariable effect on the workforce agility.

All walks of people are innately born with diverse personality. Such a variation can also be posited as a source of challenge, conflict and frustration for a given organization. Consequently, it can aggravate the problem when due attention should be paid to the overall different dimensions of staff`s personality in terms of human resource management. The study is conducted by considering five dimensions of staff `s personality in Shiraz University of Medical Sciences based on Mc Crae and Costa” model.

This is a cross sectional study. The statistical population comprises 130 randomly selected staff members of Shiraz University of medical sciences. The data was collected using a 69- item questionnaire. Content validity and reliability of the research instrument are verified and considered appropriate for assessing personality dimensions. Parametric statistics and Pearson correlation are applied for data analysis, which are statistically at α=0.05 degree of freedom.

Results show significant differences between personality and organizational culture, focus of control and agreeableness with conditions. Furthermore, significant relationship is found between introversion and agreeableness with conditions and also between conscientiousness and focus of control, stress and agreeableness with conditions. On the other hand, personal agreeableness and neurosis show significant statistical relationship with stress and agreeableness with conditions.Finally, openness showed a positive statistical relationship with organizational culture andagreeableness with conditions in working consciousness.

Transparency of managers` expectation and their timely feedback to personnel, establishing clear relationship channels accompanied by appropriate appraising styles of conscientiousness within the organizations, flexibility to novel ideas as well as supportive behavior from organization can lead to reduction in neurosis, which promotes other personality dimensions.