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Background: Identifying the key factors effective on outsourcing can play a significant role in helping healthcare decision makers to present solutions to improve the outsourcing situation. This study was conducted in order to systematically review the factors influencing the decision making to outsource the services of Iranian medical centers. Methods: Data was collected through searching for keywords in Google Scholar, PubMed, Scopus, Web of Science, Science direct, Magiran, SID and Irandoc databases from January 2010 to December 2020. Also, the quality of the studies was measured and verified by three experts utilizing the Strobe checklist. Researchers classified results achieved by the study. Results: 10 articles were selected that responded to the study's questions. 44 components in seven dimensions including (economic and financial components, components of laws and regulations (legal), components of supervision and control, components of service type, components of executive capability of the organization, components of the external environment of the organization and components human resources) were recognized on the decision to outsource services in medical centers in Iran. Conclusion: olicy makers at the decision-making level and managers at the executive level should consider the efficient components and dimensions before deciding to execute outsourcing in units according to the wanted structure, process and consequences, and then make the needed decision regarding the implementation.

In the current competitive situation, hospitals are seeking to keep their position among patients. This study aimed to find factors influencing on the brand equity of hospitals.in the cross section...

BACKGROUND: One of the significant goals of healthcare delivery organizations is to promote people’s health and provide high quality care. In this regard, health reform plan was designed in Iran. Therefore, the present study aimed to evaluate the performance of teaching hospitals after running of health system reform plan in Iran. METHODS: This retrospective-descriptive study was carried out in 4 hospitals (Avicenna, Velayat, Rajaee, and Qhods) affiliated with Qazvin University of Medical Sciences, Qazvin, Iran, in 2014. Data collection tool was the checklist of standard indicators of Iranian Ministry of Health, because the checklist is standard to measure hospitals’ performance. In this study, 19 indicators (performance indicators, personnel indicators, and financial indicators) were investigated. To fill out the indicators checklist, the statistics unit of Ministry of Health was used according to the reports of two consecutive years of 2013 and 2014. The collected data were analyzed using Excel software. RESULTS: In general, out of the 7 performance indicators that were investigated in the hospitals, increase was observed in four, and decrease was seen in three items. Out of the six personnel indicators, all of the hospitals experienced a rise; and out of the six financial indicators, four items increased and two decreased. CONCLUSION: The results of this study indicated that after one year of implementing health reform plan, the mentioned health care system experienced a remarkable progress in the hospitals. Providing the necessary infrastructures can help better conduction of the plan and promotion of the mentioned indicators by removing or decreasing the effect of some barriers.

Background: A significant amount of revenues and deductions exist in the hospitals each year. This study aimed to determine the number of deductions applied and identify its causes. Furthermore, we aimed to provide management strategies to reduce these deductions in Shafa Takestan hospital. Methods: This applied and interventional study was conducted with a cross-sectional design. The data collection tool was a checklist from the previous studies. Data were analyzed using descriptive statistics such as mean, percentage, and standard deviation as well as analytical statistics of the Wilcoxon test. Results: Before the intervention, among 405 non-global inpatient cases, about 323 (80 %) contained subtractions. After the intervention, among 555 non-global hospital admissions, about 264 (47 %) included deductions. Most deductions were related to health services insurance (75.38 %). Concerning each hospital ward, most deductions were related to surgery ward (38 %). Before and after the intervention, service deductions were included in 5.59 % and 4.57 %, respectively. Conclusion: Therefore, medical personnel should pay more attention to documenting patients' records and minimizing documentation errors. Moreover, to reduce patient record deductions, the health care staff should be familiarized with proper documentation procedures by conducting training sessions.

Background: Cost analysis is an effective approach for planners and health system managers to address the issues regarding the increased shortage of resources. Activity-based costing (ABC) is a new system with various applications in daily service activities, the use of which is expanding for the estimation of real costs. Objectives: The present study aimed to calculate the total costs of CT-scan services in Shahid Rajaei Hospital of Qazvin, Iran using the ABC model and compared the results with the tariffs approved in 2016. Methods: This descriptive, applied research was conducted retrospectively. The total costs of CT-scan services were calculated using the ABC model and compared with the tariffs approved in 2016. Data were collected using checklists based on the hospital information system, observations, and interviews. Data analysis was performed in SPSS version 23 and Microsoft Excel software using the non-parametric Wilcoxon test. Results: The total costs of the CT-scan unit in the given year (2016 - 2017) was estimated at 398,380.07 dollars, with the largest share of the total costs in the human resources (57.9%), consumed materials (23.4%), and overhead (18.7%), respectively. No significant difference was observed between the total costs based on the ABC system and tariffs of these services. Conclusions: According to the results, the lack of a difference between the total costs and government tariffs suggested that earnings should be higher than the costs of these services, and these units could become profitable through proper cost control measures.

Attention to the functions and pattern organized staff are important to achieve organizational goals, especially for hospitals that are one of the important components into account a element in improving the health system and providing a fair field of utilization of health intervention. So this study was to review the opportunities of presence resident doctors in hospitals based on the instructions of the health system reform plan. This is a narrative review that returning to the site of the Persian (Magiran, Irandoc, Google Scholar, Iranmedex, SID) and English (PubMed, Scopus, EMBASE and Sciencedirect) and also library studies with keywords (physicians, resident physicians, health equity, project development, opportunity specialist and human resources) and the English word for them in this area and the 30 related articles was extracted. Given the evidence may not be fully implemented in all government hospitals because of problems such as the lack of doctors in public hospitals or other administrative problems, but it can be said that is one of the best model to achieve better clinical outcomes in hospitals. In order to solve problems, there is the need to design and create the appropriate environment for the successful implementation plan, or create an ideal environment for the implementation of evidence-based medicine moved.

BACKGROUND: Given new reforms in Iran's health-care system and due to the need for gathering evidence regarding the implementation of this plan, this study aimed to investigate opportunities and challenges created by resident specialist attendance plan guidelines in university hospitals. MATERIALS AND METHODS: This study used the qualitative method. Semi-structured interviews were used for data gathering. The study population included all experts of Isfahan University of Medical Science. Sampling was carried out using purposeful sampling method and continued until data saturation was reached. In total, 16 experts were interviewed. Criteria such as “reliability of information,” “trustworthiness,” and “verifiability of the information” were considered. Interviewees were assured that their names would keep hidden and that all information is confidential. Subject analysis method was used for data analysis. RESULTS: The findings of this study based on subject analysis led to extracting three themes in regards of challenges in the implementation of resident (specialist or fellowship) plan in hospitals including structural, management, and resource challenges and one theme in the area of opportunities which were improved quality and timely provision of services. CONCLUSION: The findings showed that despite the strengths of this guideline, there are some fundamental challenges in various areas and need better attention by national level policymakers. These results help health-care policymakers to evaluate the problem with a better attitude and improve the necessary plans for implementation of these guidelines.

The express development of internet and branches of multi medias in world wide channel, have created the new method for transfering the information to the students. Doubtless, timing education is the most effective method of education by face to face connection. But greatness of distance and shortage of time has limited the chance of participation of students in this kind of classes. This study had done with the goal of comparative investigation about the rate of effectiveness in teaching of procurement and production of materials and progressive tools lesson in environmental field in 2 groups of students of virtual and conventional study that did on 2 groups of students in each group we had 30 final semester students in environmental field in Payam noor university , Tehran virtual group trained the procurement and production of material and progressive tools about environmental education in the first semester of 2011-12 and face to face group trained it face to face. At the end of educational course, both groups evaluated in a same situation and same examinable materials. The required information analysised by the descriptive and perceptive statistic. Also the average of virtual scoures scoures were1=10/88and and for conventional students were1=8/85 and according to p=0/05 for this kind of students, so we can conclud that there is a specific different between these groups. As a result you can train procurement and production of materials and progressive tools lesson about environmental education by the distance education method and it doesnot have any educational grade reduction.

Background Using different methods of strategic thinking is essential for organizations such as hospitals; without them, many organizations will not survive. The aim of the present study is to evaluate the relationship between strategic thinking and management productivity in teaching hospitals of Shiraz. Objectives Because of the importance of strategic management in organizational productivity, the present study is conducted with the goal of assessing the relationship between strategic thinking and hospital managers’ productivity. Patients and Methods This descriptive-correlational study was conducted in 2015. The statistical population included all managers in different levels in the teaching hospitals of Shiraz (170 persons). Among these, 119 participants were selected through Cochran’s formula and a simple random sampling method. Data were collected by a questionnaire addressing strategic thinking based on Liedtka’s model and Hersey and Blanchard’s theory. Its validity was verified by a panel of experts and its reliability was measured in previous studies. Data analysis was performed in SPSS version 20 using descriptive and analytic statistics (analysis of variance (ANOVA), Pearson’s correlation test and t-test). Results The average and Standard Deviation of strategic thinking managers was (2.2 ± 0.04), and productivity of management (2.32 ± 0.37) was estimated on the average level. There was a direct meaningful relationship between strategically thinking managers and productivity (r = 0.387, P < 0.001). The results also showed that there is a meaningful correlation between strategic thinking and sustainability, organizational support and understanding of the job. Conclusions Due to the correlation between strategic thinking and productivity, we recommend educating and training managers in the use of strategic thinking, and that they understand its importance to productivity. Managers should understand that increasing efficiency in a competitive environment today is a necessity for survival.

Introduction: Family physician is the increasing efforts to promote physician and other human resources in the health care systems. Goal: Investigate Human resources situation of the family physician program in six pilot cities in Khuzestan province in the southwest of Iran. Methods: A cross-sectional descriptive study was conducted to examine the family physician program in 2011. In this study, 15 healthcare teams in six pilot cities in Iran were assessed. Data was compiled from family physician officer document in vice treatment of Ahwaz University of medical sciences. National instructions of family physician was used to identify current gaps. Results: The survey findings indicated that there is a doctor’s shortage about 36% in the health team that deployed in the first level of referral system. Also on the team, the 34% shortage of nurses and 60% shortages of nutrition personnel are seen. Specialists with offices in cities of second referral level, there have not welcomed the program. Conclusions: It seems that to facilitate patient access to physicians under contract with family physician program and the referral system in level two and level three, adopting arrangements to attract specialists and improving their maintenance is necessary.

Background The main purpose of any government from a healthcare reform is to improve the service quality and raised public satisfaction. Objectives As the important role of managerial human resources in any organizational changes, this paper tried to examine the point of view of this group about the recent reform in governmental hospitals of Qazvin. Patients and Methods This cross-sectional study was conducted in January 2015. The statistical population consisted of 50 executive managers of Qazvin teaching hospitals. The data gathering instrument was a research-made questionnaire with approved reliability and validity (α = 0.84). Data analyse was performed in SPSS version 20 using descriptive and analytic statistics (analysis of variance (ANOVA), Pearson correlation test and one sample t-test). Results A total of 43.2% of managers believed that this reform was a good restrictor for malpractices in healthcare and 31.8% believed that it will not be so useful to improve the society health status. The average score of resource preparation, insurance companies coordination, changing the routine workflows, and finally achieving the goals, had a meaningful difference (P ˂ 0.05) and the average score of these fields were upper than average. Conclusions The findings showed that based on the managers’ point of view, the reform plan was able to achieve its primary goals; however, it could not meet their exceptions in improving the society health status. Therefore, it is necessary to design some interventions for changing this perception.

Introduction: The productivity of healthcare staff is one of the main issues for health managers. This study explores the concept of executive regulation of Productivity Improvement Act of clinical staff in health. Methods: In this study phenomenological methodology has been employed. The data were collected through semi-structured interviews and focus group composed of 10 hospital experts and experts in human resources department working in headquarter of Mashhad University of Medical Sciences and 16 nursing managers working in public and private hospitals of Mashhad using purposive sampling. Findings were analyzed using Colaizzi’s seven step method. Results: The strengths of this Act included increasing spirit of hope in nurses, paying attention to quality of nursing care and decreasing problems related to the work plan development. Some of the weaknesses of Productivity Improvement Act included lack of required executive mechanisms, lack of considering nursing productivity indicator, increasing non-public hospitals problems, discrimination between employees, and removal of resting on night shifts. Suggestions were introduced to strengthen the Act such as increased organizational posts, use of a coefficient for wage in unusual work shifts and consideration of a performance indicator. Conclusion: The results may be used as a proper tool for long term management planning at organization level. Finally, if high quality care by health system staff is expected, in the first step, we should take care of them through proper policy making and focusing on occupational characteristics of the target group so that it does not result in discrimination among the staff.

Recognition of career motivators and understanding of managers and employees in prioritizing them, in order to plan incentives for this understanding, can play an important role in increasing productivity and creating harmony between the goals of the organization and staff. This study was done to survey the importance of career motivating factors from perspective of employees and managers in educational hospitals of Iran. In this study 269 from a total of 1843 employees of educational hospitals in Qazvin province of Iran were selected through Quota-Random sampling and studied along with all 49 Managers. Lawrence Lindale questionnaire with 10 factors where used in order to determine motivational priorities. The results indicated that among the 10 studied motivational factors, from employees’ viewpoint; “Good wages”, “Good Working Conditions” and “Job Security” have the greatest roles in motivating employees. In the context of perspective agreement amongst employees and managers, the results showed 20 percent agreement. In this study, results of “Independent T” test showed a significant difference in comparison, between prioritizing employees’ view and prediction of managers in the factors of “Job Security” (p = 0.031) and “Interesting Work” (p = 0.001). With respect to increase disagreement in the views of managers and employees as compared to previous studies, Managers need to pay more attention to cognition of motivational factors and make their viewpoints closer to actual motivational need of their employees. Attention to this fact can be a great help to the growth and productivity of the organization, making the organizational and individual goals closer and also keeping managers safe from execution of constant and undue motivational patterns.

Background: Today, the concept of organizational learning has attracted the attention of many managers and researchers in scientific and research circles as well as those in the organization-related studies. Taking the organizational learning into account might offer a means of organizational effectiveness that has gone unnoticed. Thus the present study aimed at investigating the relationship between the organizational learning in each of its four aspects as independent variables and organizational citizen behavior of the staff as constituting the dependent variable of the study. Methods: This was a descriptive-analytical study with a practical approach conducted in 2010. The sample included 167 staff members working in educational health centers affiliated with Qazvin University of Medical Sciences. The data were collected via both the organizational learning questionnaire and organizational citizen behavior questionnaire and analyzed by using SPSS software and Spearman test. Results: The results indicated that the mean of organizational learning indicator was 2.9±0.648 and that of organizational citizen behavior 3.78±0.413. In addition, the spearman correlation coefficient ranging from 0.058 to 0.129 between the elements of the organizational learning and the organizational citizen behavior was not statistically significant (p>0.05). The findings also indicated that the correlation between them was average among the staff of Shahid Raja’ee Educational health center (0.319), thus the relationship between the two sets of variables proved significant (p=0.031). However, the same was not true in other centers. Conclusion: It was concluded that management commitment, open space, transfer of knowledge, and systemic vision could all enhance the level of organizational learning in hospitals which calls for focus on the elements of organizational citizen behavior.