Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 One Verse, One Concept 9 9 FA Farzane Bagheri

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 A Comparison of Clinic Care and Home Care Regarding Costs of Treatment for Children with Cerebral Palsy 11 19 FA Esmaeil Sharifazar MSc Student in Rehabilitation Management, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Majid Ravanbakhsh Assistant Professor, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Amin Torabipour Assistant professor, Department of HealthCare Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mohammad Hossein Haghighizade MSc in Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Elham Amiri MSc in Rehabilitation Management, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Background: The problems associated with cerebral palsy and their socio-economic burden impose a large pressure on families with children suffering from cerebral palsy. This study aimed to compare clinic care and home care regarding costs of treatment for children with cerebral palsy. Methods: This cross-sectional study was conducted on 56 children with cerebral palsy; 28 patients were under home care and 28 patients were under the care of health centers. Data were collected using simple random sampling. The daily direct costs of patients were collected using checklists for 3 months. The information was analyzed using descriptive statistics (frequency, mean, and standard deviation) and independent t-test by the SPSS 16. Results: The mean cost of home care was less than clinic care (p < 0.05). The mean costs of patients had a significant difference with the types of cerebral palsy (p < 0.05). The per capita to take care of children with cerebral palsy in clinic was 27,980,000 Rials and in home care was 19,786,000 Rials. The total cost of care was 554,020,000 Rials at home and 783,426,000 Rials at the clinic (p > 0.05). Conclusion: The cost of clinic care was higher than home care. Therefore, home care is recommended as the appropriate and more cost-effective strategy for children with cerebral palsy. Considering the Problems of home care, it is essential to facilitate implementation of this strategy by improving insurance coverage and informing families with cerebral palsy children.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 The Relationship Between Participative Management and Resistance to Change from the Perspective of Administrators at Educational Hospitals in Yazd, 2013 21 27 FA Elham Tayefi BSc of Healthcare Management, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Gholamreza Ahmadi Tehrani MSc in Healthcare Management, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Fatemeh Afzali MSc Student in Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Khatereh Khanjankhani MSc Student in Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Samaneh Entezarian Ardekani BSc of Healthcare Management, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Fatemeh Sepaseh MSc Student in Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Background: To maintain their survival, organizations are forced to keep pace with the changes that occur. Participative management could be one way of reducing resistance to change by increased participation and commitment of the employees. The present study aimed to evaluate the relationship between participative management and resistance to change from the perspective of administrators at educational hospitals of Yazd in 2013. Methods: This was a cross-sectional and analytical study performed in 2013. The subjects consisted of 81 senior, middle, and operational managers working in educational hospitals of Yazd Shahid Sadoughi University of Medical Sciences. Data were gathered through 2 questionnaires of participative management and resistance to change. The reliabilities were assessed by Cronbach's alpha coefficient to be 0.78 and 0.70, respectively. The data were analyzed using SPSS 19, and Pearson correlation coefficient test. Results: The findings showed an inverse relationship between participative management and resistance to change which was meaningful (p ˂ 0.05, r = - 0.300). Also, 2 parameters of participative management including participation in implementation (p ˂ 0.05, r = - 0.325), and control and supervision (p ˂ 0.05, r = - 0.292) indicated an inverse significant correlation with resistance to change. Conclusion: According to the results of this study applying participative management could be an appropriate and beneficial strategy to reduce staff resistance to change.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 Computing Cost Price for Cataract Surgery by Activity Based Costing (ABC) Method at Hazrat-E-Zahra Hospital, Isfahan University of Medical Sciences, 2014 29 34 FA Masuod Ferdosi Associate Professor, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Ali Ghoveood M.D., Hazrat-e-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran Ali Nemati Ph.D. Student of Healthcare Management, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran Najmeh Sha'bani BSc of Healthcare Management, Department of Health Care Management, School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran Esmaeil Hosseinzadeh MSc Student of Healthcare Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Background: Hospital managers need to have accurate information about actual costs to make efficient and effective decisions. In activity based costing method, first, activities are recognized and then direct and indirect costs are computed based on allocation methods. The aim of this study was to compute the cost price for cataract surgery by Activity Based Costing (ABC) method at Hazrat-e-Zahra Hospital, Isfahan University of Medical Sciences. Methods: This was a cross- sectional study for computing the costs of cataract surgery by activity based costing technique in Hazrat-e-Zahra Hospital in Isfahan University of Medical Sciences, 2014. Data were collected through interview and direct observation and analyzed by Excel software. Results: According to the results of this study, total cost in cataract surgery was 8,363,722 Rials. Personnel cost included 62.33 % (5,213,575 Rials) of total cost of cataract surgery that is the highest share of surgery costs. The cost of consumables was 23.83 % (1,992,852 Rials) of surgery costs. Conclusion: Based on the results, there was different between cost price of the services and public Tariff which appears as hazards or financial crises to the hospital. Therefore, it is recommended to use the right methods to compute the costs relating to Activity Based Costing. Cost price of cataract surgery can be reduced by strategies such as decreasing the cost of consumables.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 The Correlation between Organizational Commitment of Nurses and the Quality of Hospital Services at Women's Hospital of Tehran 35 41 FA Amir Omrani Ph.D. Student of Health Care Management, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran Omid Khosravizadeh Ph.D. Student of Health Care Management, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran Behnam Najafi Ph.D. Student of Health Care Management, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran Samira Alirezaei Ph.D. Student of Health Care Management, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran Background: The present study aimed to determine the asociation between organizational commitment of the nurses and quality of hospital services at Women's Hospital of Tehran. Methods: This was an analytical, cross-sectional, and practical study in which 75 nurses and 187 patients were randomly selected from Women's Hospital wards. Data collection was done through 2 standard questionnaires. Statistical analysis was performed using correlation tests and one-way ANOVA by SPSS 20. Results: According to the results of this study, normative commitment was statistically associated with the quality of services (P = 0.03; r = 0.33) as well as its 2 dimensions of guarantee (p = 0.04; r = 0.35) and reliability (p = 0.05; r = 0.34). Also a significant positive relationship was found between the continuance commitment and reliability (p = 0.04; r = 0.30). Conclusion: Considering the correlation of normative and continuance commitments with some dimentions of the quality of hospital services it seems that planning and action twards improvement of these commitments may lead to high-quality services.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 Performance of Health Care System Reform Plan from the Perspective of University Hospitals Executives in Yazd Province in 2015 43 49 FA Ali Dehghan Assistant Professor, Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohammad Reza Mirjalili Associate Professor, Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohammad Hossein Zare Mehrjardi M.D., Department of Clinical Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Raghebian Maliheh MSc in Clinical Psychology, Department of Clinical Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Azam Samiyezargar MA in MBA, Department of Clinical Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Seyed Kazem Kazemeini M.D., Department of Clinical Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Background: To evaluate the performance of a program, it is necessary that human resources involved in the implementation evaluate the program as the main sources of information. Therefore, this study aimed to evaluate the performance of health care system reform plan in Yazd province from the perspective of university hospital executives. Method: This was a cross-sectional study in which all senior and middle managers of university hospitals in Yazd Province (n = 53) were enrolled through census. The data were collected using a researcher-made questionnaire. Data analysis was performed by SPSS 20 using descriptive statistics, frequency, and percentages. Results: 47.2 % of the executives believed that health care reform plan had reached 60 to 79 % of its goals. Only 7.5 % of the managers believed that health care reform plan could not succeed in dealing with out-of-tariff cost. Human resources was reported as the most important problem by 48.1 % and interaction with insurance as the least important problem in health care system reform plan by 9.2 %. Finally, most of the managers believed that the instructions of reducing out-of-pocket were implemented significantly better than the former five instructions of health care system reform plan and it was beneficial in practice. Conclusion: Achieving the objectives of health care system reform was evaluated as appropriate, however, the performance of some instructions was not as expected, hence the need for interventions in this area.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 Study of Marketing Components Affecting Health Care Services in Hospitals 51 59 FA Mohammad Javad Akbarian Bafghi Assistant Professor, Department of Healthcare Management, School of Public Health, Bam University of Medical Sciences, Bam, Iran Razieh Montazeralfaraj Assistant Professor, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 Incidence of Medical Errors in Voluntary Reporting System in Hospitals of Mazandaran University of Medical Sciences in 2014 61 69 FA Roya Malekzadeh Ph.D. Student of Healthcare Management, School of Medical Sciences ,Islamic Azad University, Sari, Iran Fereshteh Araghian Mojarrad Ph.D. Student of Nursing Education, Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran Afshin Amirkhanlu M.D., Shohada Hospital, Mazandaran University of Medical Sciences, Behshahr, Iran Sona Sarafraz MSc in Clinical Psychology, Department of Clinical Affair, Mazandaran University of Medical Sciences, Sari, Iran Ehsan Abedini Student of Ph.D. by Research of Healthcare Management, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran Background: A structured error reporting system, has a warning and connecting role in practitioners in patient care. The aim of this study was to investigate the causes of medical errors in voluntary reporting system in hospitals of Mazandaran University of Medical Sciences in 2014. Methods: This study is a cross-sectional study conducted in 2014. The population consisted of all the medical staff of hospitals affiliated to Mazandaran University of Medical Sciences. Data collection was conducted through review of medical errors reports. After classification, data were analyzed by Excell. Results: According to the results, during the first 6 months of 2014, 1927 cases of medical errors were reported of which 820 cases were in clinical wards, 550 in Intensive Care Unit, 76 in operating room, 401 in paraclinical wards, and 80 in other parts of the hospital. Furthermore, in terms of repeatability, the highest number of errors had a moderate repeatability and in terms of the severity, the highest number errors were minor. Conclusion: It is recommended to develop training programs for all employees to report medical errors. Aslo the findings of this study can help in planning for prevention of medical errors.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 1 1 2016 12 1 Relationship between Organizational Learning and Organizational Agility in Teaching Hospitals of Yazd 71 80 FA Mohammad Amin Bahrami Associate Professor, Hospital Management Research Center, Shahid Sadoughi University of Medical Sciences, Yazd , Iran Mohammad Mehdi Kiani MSc student in Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd , Iran Hossein Fallahzadeh Professor, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd , Iran Razieh Montazeralfaraj Assistant Professor, Hospital Management Research Center, Shahid Sadoughi University of Medical Sciences, Yazd , Iran Morteza Mohammadzadeh MSc student in Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd , Iran Background: In organizational learning theory, organization is defined as an open system that has the ability to anticipate, identify, define, design, and solve its problems. This study was aimed to examine the relationship between organizational learning and organizational agility in the teaching hospitals of the city of Yazd. Methods: This analytical and cross-sectional study was conducted in 2015 in 4 teaching hospitals of the city of Yazd. A total of 370 administrative and medical staff contributed in the study. We used stratified-random method for sampling. The required data were gathered using 2 valid questionnaires including organizational learning questionnaire (Neefe 2001) and organizational agility questionnaire according to the theory of Sharifi and Zhang (1999) being analyzed trough statistical softwares of R and lavaan package, semPlot and semTools for structural equation model and SPSS 18 for descriptive statistics. Results: Our results showed a positive significant relationship between organizational learning and organizational agility (0.521). Conclusion: Based on the findings it can be concluded that the implementation of appropriate strategies for improving the organizational capacity to direct its employees’ mental abilities, can improve the ability of organization’s rapid response to surrounding issues which is crucial for its survival and dynamics in today’s changing world.