Journal of Health Information Management
Year:2013 | Volume:9 | Issue:6|Papers Count:27

Introduction: Policy makers and decision makers of medical tourism must identify stakeholders who can be affected by and can affect this industry and determine their status for partnership. The aim of this study was to identify and analyze the main stakeholders of medical tourism in Isfahan, and provide strategies for developing this industry.Methods: A qualitative study was conducted in 2011. At first, key stakeholders of medical tourism in Isfahan were identified according to experts idea and literature review. Then we interviewed these key stakeholders. Data analysis was conducted using stakeholder analysis and development strategies were provided for medical tourism.Results: The key stakeholders of medical tourism in Isfahan were divided into 9 categories. They consisted of Governor of Isfahan Province, Cultural Heritage, Handcraft and Tourism Organization of Isfahan, Chamber of Commerce, State Medical Council, Isfahan University of Medical Sciences, health services providers, tourism services providers, private investors, and the Export Development Bank of Iran. Stakeholders’ characteristics showed that Cultural Heritage, Handcraft and Tourism Organization of Isfahan, clinic, and International Relations Office of the Isfahan University of Medical Sciences had full knowledge of the government policy about medical tourism. Private hospital, State Medical Council, investors, and University of Medical Sciences had great power. Private hospital, clinic, Cultural Heritage, Handcraft and Tourism Organization of Isfahan, and University of Medical Sciences had a supportive position. Effective strategies included strategies focused on increasing power, increasing support, and maintaining their position.Conclusion: There are different stakeholders in the medical tourism industry of Isfahan. Therefore, policy makers can plan, make policies and decisions, and use effective strategies in order to develop medical tourism by designing a medical tourism stakeholders’ network and a medical tourism provincial council, and by clarifying the roles and responsibilities of stakeholders.

Introduction: Recording the reasons of death especially its underlying causes are considered to be the most important data in modifying health-care programs of countries. Therefore, a comprehensive computer system, related databases is necessary in analyzing and understanding the main processes in health-care. The aim of this study was to evaluate the electronic death registration system in Iran based on its requirements.Methods: This was a descriptive-analytical study conducted in 2011 in 12 medical universities of Iran.The study population consisted of two groups of users and officials of the electronic death registration system in medical sciences universities of our country (n=50). The data collection Tools of this study is a researcher-constructed questionnaire based on the Likert scale, and a checklist. The questionnaire was based on 3 requirements (user requirements, general requirements, and security requirements). The checklist was designed to assess technical requirements. The validity of the questionnaire was approved by the content validity method (opinions of teachers and scholars of health information management and computer sciences). Its reliability was approved using Cronbach’s alpha. Data analysis was conducted by SPSS statistical software version 20 and descriptive statistics.Results: 84.6%, 75.7%, 40.9% of users and experts of medical sciences universities, type 1, respectively approved the existence of user, general, and security requirements.34.8%, 66.7%, and 22.7% in type 2, and 35.7%, 33.3%, and 20.7% in type 3 universities, respectively, approved the existence of user, general, and security requirements. Moreover, technical requirements are approved by 64.7% of software experts.According to these results, with a mean of 51.7% in user requirements, 58.5% general requirements, and 64.7% technical requirements the electronic death registration system is at an acceptable level. However, it is at a weak level in terms of security requirements (28.1%).Conclusion: Weak results of the security requirements show the inefficiency of this system’s software. Therefore, the Ministry of Health and Medical Education should plan to improve the performance of this software in terms of security requirements.

Introduction: One of the most important indices of effectiveness and delivery quality of sanitary and medical services is patient satisfaction with hospital services. It is necessary that hospitals pay attention to patient’s needs and ensure their satisfaction. Therefore the current study was conducted with the aim of identifying the level of patient satisfaction with hospital services delivered from the time of their admission to their release in educational hospitals of Isfahan, Iran.Methods: The present investigation is a descriptive and cross-sectional study conducted in the fall and winter of 2009. The statistical population consisted of 196 patients referring to educational hospitals of Isfahan. Simple random sampling method was used. The data collection tool was a researcher-made questionnaire consisting of 66 questions on 5 areas. Content validity of the study tool was approved by professionals, and its reliability was approved by calculating Cronbach’s alpha (a=0.87). Data was analyzed by SPSS software using chi-square test, Kruskal-Wallis test, and ANOVA.Results: The average score of patient satisfaction with outpatient admission was 15.5%, clinic physician 27.9%, hospitalization admission 15.9%, nursing services 33%, hospitalization physician 38.6%, public and welfare services 55.2%, hospitalization section 42.1%, and financial-administration section was 14.3%. No significant correlation was observed between demographic characteristics and satisfaction score.Conclusion: The results showed that overall level of patient satisfaction with hospital services was low. Therefore, it is necessary to pay attention to activities and performance of different units of hospitals, identify factors causing dissatisfaction, and direct efforts towards eliminating the shortages and empowering the strengths. It is also necessary to plan for delivering higher quality services, securing financial benefits of the health section, and recognizing and amending some hospital procedures, especially admission and release procedures.

Introduction: The health information system of hospitals depends on their medical records. Therefore, the detailed documentation, and maintenance of patient records can lead to timely diagnosis and effective treatment of diseases in any country, and should be included in the strategic program for disease control. This study aimed to determine the status of the documentation of tuberculosis patients in Razi Hospital of Ghaemshahr in 2010.Methods: This research is a description of the existing data in patient records. The study population consisted of all records of hospitalized tuberculosis patients in 2010 in the Razi Hospital of Ghaemshahr.The 66 patients were studied by using checklist, admission documents, papers, briefs, history, course of illness, prescriptions, and pathology, radiology, and laboratory reports. The checklist had formal validity based on data elements in the records. Data were analyzed by SPSS for Windows (version 16).Results: The results showed that from a total of 66 records of patients with tuberculosis, in the admission document and the final diagnosis in 25 cases (8.37%) the diagnosis was not stated and in 7 cases (6.10%) phrases such as BK+were recorded. No action was recorded in the measures section of any of the records (0%). However, documents such as surgery, radiology, and ultrasound reports show that diagnostic and therapeutic procedures, such as 5 cases of bronchoscopy, 4 cases of endoscopies and biopsies, 22 cases of CT scan of the lungs, intubation, dialysis and etcetera, have been undertaken.Conclusion: Much effort has been devoted to improving documentation of outpatients’ and inpatients’data, and to classification of diseases. However, many problems still exist in this respect. This was a teaching hospital; therefore, training physicians on data documentation is a necessity.

Introduction: The role of the computer in information management has gradually increased the motivation for investment in computer systems for medical records. Admission, coding, statistics, and filling units’ software have important roles in health information management. However, their adaption and implementation needs the support of users. The goal of the present research is to determine users’ point of view on software used in the medical record department of Isfahan’s educational hospitals.Methods: This is a descriptive study was carried out on all users (n=92) in educational hospitals affiliated with Isfahan University of Medical Sciences. The data was collected by a researcher-made questionnaire which was validated by experts. The reliability of the questionnaire was confirmed by test retest. The results were analyzed by SPSS version 16.Results: The satisfaction of users had a maximum of 76.5% related to coding unit and a minimum of 45.3% related to filing unit. The highest satisfaction in the admission unit was related to ease in use (100%), in the coding unit was related to deletion of indices (98%), in the statistics unit to confidentiality (100%), and in the filing unit to ease in use (89.5%).Conclusion: The average of users’ satisfaction of the software programs in the medical record department was 61.8%. This indicates deficiencies in the design of the studied software. These insufficiencies cause alteration in the function of computer systems in data management. Therefore, need assessment of users and health information management professionals (HIMP) before designing and implementation of software is necessary.

Introduction: Today, indexing is an important tool in information retrieval. The aim of the present Study was to identify the level of compliance of the Persian and English keywords in Farsi and English abstracts and titles of dissertations of the Isfahan University of Medical Sciences, with the Persian Medical Thesaurus and Medical Subject Headings (MeSH), which are the most important medical thesauruses.Methods: This was a descriptive survey done in 2011. The study sample included 2942 postgraduate theses from 8 libraries of the Isfahan University of Medical Sciences.340 theses were selected by stratified random sampling.. Data collection was performed by a researcher-constructed checklist and by visiting libraries and studying the dissertations. Data analysis was performed by non-parametric statistical analysis (X2) and correlation coefficient. Due to the nature of the survey it has no reliability and its validity was confirmed by reviewing 10 cases based on the checklist, and modifying them according to the views of two library professionals.Results: There is a significant correlation between Persian and English keywords, and the Persian Medical Thesaurus and MeSH. Most keywords had a composite or single-word structure, and most of the keywords were selected from the abstract. The majority of selected keywords were English.Conclusion: keywords selection at the end of thesis abstracts is a form of free indexing. Therefore, studying researchers’ keywords can pave the way for the modification of indexing tools for in science, especially the medical sciences.

Introduction: Many criteria are involved in the assessment of websites. The importance of these criteria differs depending on their various subject areas. The purpose of this study was to identify the importance of assessment criteria of health websites based on the opinions of hospital librarians.Methods: This descriptive study was conducted in 2011. After face and content validity of the researcher constructed questionnaire (based on the likert scale) were evaluated, its reliability was determined by Cronbach’s alpha coefficient (0.98). The questionnaire was distributed between all librarians of 30 hospital libraries affiliated with Tehran University of Medical Sciences and Shahid Beheshti University.53 questionnaires were collected. Data analysis was done using descriptive statistics (mean, median, mode, and standard deviation) in SPSS for Windows (version 19).Results: Of the information quality criteria, accuracy had of the highest degree of importance (4.56), and price and response time had the lowest degree of importance (2.52). Moreover, in the external indicators group author credentials had the highest mean (4.73), and accessibility and advertising policy had the lowest mean of importance (2.20).Conclusion: Based on librarian’s opinions, the evaluation criteria of websites’ content information quality are of greater importance than their external indicators.

Introduction: Recent progress in providing innovative solutions in the organization of electronic resources and research in this area shows the global trend in the use of new strategies such as metadata to facilitate descripting, locating, organizing, and searching resources in the web environment. In this context, library metadata standards are of great importance. Therefore, the purpose of the present study was to compare the central library websites of Iranian state universities in terms of HTML and Dublin Core metadata elements usage in 2011.Methods: This was an applied–descriptive study. The data collection tool was the researcher constructed checklist. The statistical population included 98 websites of Iranian state universities of the Ministry of Health and Medical Education (MOHME), and the Ministry of Science, Research and Technology. The sampling method used was census. Data were collected by observing and referring directly to every website. Data analysis was performed by descriptive statistics, and the graphs were prepared by Excel software.Results: The findings of study indicated that none of the websites have used Dublin Core metadata. Some of them have used corresponding elements of HTML and Dublin Core. In the MOHME the corresponding elements of description and keywords (both 56%) were most used. In the Ministry of Science, Research and Technology the element of keywords (45%) and description (39%) were most used. However, HTML meta tag elements were mostly used in the library websites studied. The most-used elements of HTML were keywords and description (both 56%) and the least-used elements were date and formatter (0%).Conclusion: It seems we can expect both ministries to use Dublin Core standard more in the future for designing these websites. As library’s websites are scientific web pages, special attention should be paid to designing them, in order to help researchers in accessing information resources faster and more accurately. Moreover, the role of librarians in the awareness of designers and developers of library websites in using metadata elements and applying their standards should not be overlooked.

Introduction: The issues of patient rights have recently been entered into medical and legal realms and have attracted the attention of scholars. This field, which is in early stages of development, requires studying the patterns and characteristics of its scientific production and its compatibility with the global norms of the worlds’ sciences. The present study aimed to investigate the scientific productivity and its impact patterns on patient rights during 1990-2010. Hence, it endeavors to discover their growth trend, local and global impact, the most productive contributing countries, authors and journals, document types, dominant languages, highly cited authors, and finally Iran’s share. It may help to reflect the progress of knowledge and its patterns and also highlight the weaknesses and strengths, and thereby be useful in managing and planning research and development in this field.Methods: The present study applied a survey method with a scientometrics approach. All the scientific productions indexed by the Thomson Reuters database during 1990-2010 constituted the study materials.A total number of 1236 records were extracted. The data were analyzed through Excel and Thomson Reuters HistCite software, using descriptive and analytical statistics including frequency, percentage, Spearman correlation, and linear, power and exponential regressions analysis.Results: The maximum scientific output production in this field has been published during 2006-2010. They showed an increasing trend on an exponential basis, illustrating the sustainability of scientific production in this field. However, the citation number did not show a significant growth. This could be resulted from the small size of this field and its related domains. The total global impact was lower than the total local impact implying that the papers were rather an inspiration source for other related fields than an intra-field source. Authorship pattern adhered to Lotka’s law in that the number of authors decreased as their publications increase on a power basis. However, the exponent equation is higher than two. The global distribution of the papers and their language variations signified the world’s concerns for patient rights.Conclusion: The patient rights exhibits many similarities to scientific fields and its publication foundation is being established and stabilized: the exponential growth of the papers, their language and document variation, global distribution, and specially its research nature indicated the development of this field as a research realm.

Introduction: Study habits and skills is one of the most important factors influencing academic achievement of students. The use effective study habits and skills are recommended for the better learning of students. This study investigates the study habits and skills of students of Zahedan University of Medical Sciences, Iran.Methods: This was a descriptive survey.342 (total 2382) Students of Zahedan University of Medical Sciences were chosen by stratified random sampling (with probability proportional to size) in the second semester of 2010-2011. Data were gathered with the Redwood college study habit inventory, which consisted of 2 parts including demographic question (10 questions), and general question (51 questions).Its validity was approved by experts, and its reliability was calculated by Cronbach’s Alpha (a=0.855). Data were analyzed by descriptive statistics (frequency, percentage, and mean), one-way ANOVA, and student’s independent t-test in SPSS 15 statistical software. P-values of less than 0.05 were considered statistically significant.Results: The main issues of students in respect to study habits and skills were in time management with mean of 2.86, remembering with 2.93, studying a chapter with 2.98, listening and note taking with 3.07, concentration with 3.09, test taking with 3.28, and motivation with 3.38. Girls scored slightly better in remembering, listening and note taking, and motivation. However, boys scored higher in test taking.Conclusion: The results showed that the study habits and skills of students are at a moderate level. Due to the importance of studying, planning to improve the study habits and skills of students is necessary.

Introduction: Nowadays, use of library software is a basic need for libraries and information centers.User interface is a part of computerized systems which is interacting to the user and it is an important factor in information searching process. This study aimed to compare librarian’s satisfaction rate from library software interface in Isfahan libraries in 2010.Methods: This was a descriptive-analytical study which was performed on Isfahan’s librarians (n=650), and the sample size (n=242) was determined according to the Morgan’s and Krejcie’s sample size table.Five library software were compared together including: Pars-Azarakhsh, Payam, Nosa, Kavosh, and Namayeh. Sampling was conducted through stratified quota method. Data were collected using questionnaire for user interaction satisfaction (QUIS) in 5-point Likert scale.Results: In terms of general features (mean=4), information display (mean=3.79), terminology and system feedback (mean=3.07), help (mean=3.64) and system capabilities and properties (mean=3.76), Nosa software was the first ranking software and Pars-Azarakhsh and Kavosh were the second and third, respectively.Conclusion: According to the results of this study, Nosa was the best software and Pars Azarakhsh and Kavosh were ranked the second and third, respectively. Since librarians spend most of their working hours with several library software, their job satisfaction from the software interface has a large impact on the success of software companies, thus supporting and training department of such companies must have regular meetings and forums to examine the factors influencing on librarians’ satisfaction from library software and also apply librarians’ comments in their designs.

Introduction: Today, human resources are the most important competitive advantage of organizations. Therefore, university administrators should be aware of how to effectively use this strategic factor and advantage. However, innovation is also a valuable tool in confronting uncertainty, and responding to and impacting the external environment. The aim of the present study was to determine the simple and multiple correlations between functions of strategic human resource management and administrative innovation in medical and nonmedical universities in the Isfahan province, Iran.Methods: This was a descriptive and correlational study. The study population consisted of all faculty members of public universities of Isfahan (1830 people) from which 480 people were chosen by stratified random sampling. The research tools included strategic human resource management practices questionnaire and the administrative innovation questionnaire. The face and content validity of the questionnaires were confirmed, and their reliability was calculated by Cronbach’s alpha. Data analysis was performed by descriptive and inferential statistics.Results: Findings showed that the mean scores of strategic human resource management practices and administrative innovation scores in public universities of this province were less than average. On the other hand, a significant multiple correlation existed between strategic human resource management practices (training, service reward, assessment of performance, providing human resources, and employee contributions) and administrative innovation. Beta coefficients were statistically significant between all the practices of strategic management of human resources and administrative innovation. The variance inflation factor for these variables was 1.33 to 2.75; which shows no line between them and that the regression model has been significant. The member’s comments regarding the relationship between strategic human resource management practices and administrative innovation in terms of demographic characteristics were similar.Conclusion: Educational organizations can pave the way for organizational innovation by adopting appropriate human resource functions.

Introduction: Iran’s social security organization provides hospital services through direct treatment system (hospitals owned by the organization) and indirect treatment system (purchasing of hospital services and other health care services from other providers). The current research aims to assess technical performance and determine the relationship between activity size and efficiency level of social security hospitals in Iran.Methods: This descriptive-analytical study was performed on 65 active social security hospitals that wereselected for Data Envelopment Analysis during the period of 2007–2009. In order to measure the technical efficiency of hospitals the input-output model and data envelopment analysis (DEA) were used.Furthermore, statistical tests were used to study the significance of the effect of activity scale on the efficiency level of the hospitals.Results: About 28.5% of small scale social security hospitals and 16.2% of large scale social security hospitals were found to be working with full efficiency. Statistical analysis showed a significant difference between the mean efficiency of small scale and large scale hospitals (Sig.=0.029).Conclusion: It is expected that, through improvement of managerial techniques in efficient input use, the managerial inefficiency level be reduced by 6%, and a 5% increment be achieved in the output services scale of hospitals through the efficient use of existing resources.

Introduction: Health care organizations, especially hospitals, must focus on patient safety as their main strategy. Cultural change is the most important challenge that they are faced with in creating a safe system. The present article aims to improve the patient safety culture with an assessment of the safety in Fatemeh Zahra Hospital, Najafabad, Iran.Methods: This descriptive and cross-sectional research was conducted in 2010. Patient’s safety culture was measured using the Persian adaptation of the Hospital Survey on Patient Safety Culture. This survey was validated by the opinion of 15 experts. The reliability of the questionnaire was determined by Cronbach’s alpha and was 0.846. The questionnaire was sent to all medical employees of Fatemeh Zahra Hospital. Data were analyzed with t-test and one-way ANOVA by SPSS Software. A P-value of less than 0.05 was considered as statistically significant, and 95% confidence interval was calculated.Results: Overall, 196 of the 350 individuals responded to the surveys. The overall response rate was 56%. Supervisor expectations and actions gained 76% of all scores, teamwork within hospital units 75%, organizational learning 73%, feedback and communication about error 70%, transitions 69%, communication openness 68%, management support 65%, teamwork across units 62%, non-punitive response to error 54%, and staffing gained 48%.64% of all employees had no reports of error. The mean patient safety score was 3.36 (out of 5). According to t-test results, there was no significance difference between patient safety scores in direct and indirect contacts with patient (P=0.373). Moreover, according to the results of ANOVA, there was a significant difference between the scores of the maternity department and midwifes, and other wards and employees (P<0.000). There was no significant difference between the patient safety culture scores of employees of different wards, work experience in the ward (their current place of work), work experience in the hospital, and type of contact with patients (P<0.05).Conclusion: Although the total score of patient safety culture was acceptable, non-punitive response to error, staffing, teamwork across units, and management support are in need of immediate intervention. The hospital can improve the patient safety culture by planning and taking action in these areas.

Introduction: In today’s competitive world and tendency of organizations toward privatization, the role of involvement and commitment of staff is more vital, and in health organizations, taking nurses into account is of much higher importance. Thus, this study aimed to investigate the relationship of perceived organizational support and corporate culture with organizational commitment among nurses employed in selected public and private hospitals in Isfahan, Iran.Methods: This was a comparative-correlational study. The study population composed of nurses employed in public and private hospitals. The sample size was estimated to be 200 and subjects were selected through simple random sampling method. The data collection tools were questionnaire of “perceived organizational support”, “corporate culture” and “organizational commitment”. The validity of the questionnaires were confirmed by psychology experts and professionals and their reliability were calculated using Cronbach’s alpha coefficient and were obtained 0.91 for perceived organizational support questionnaire, 0.84 for corporate culture questionnaire and 0.75 for organizational commitment. The study was conducted in four private and four public hospitals of Isfahan in 2010. Descriptive and referential analysis of the data was provided using SPSS software.Results: The findings indicated that there was a significant and positive relationship among perceived organizational support and corporate culture with most dimensions of commitment in both public and private sectors (P<0.05). In addition, the results showed that there was a significant difference among the perceived organizational support and all the dimensions of commitment between private and public sectors (P<0.01). However, there was no significant difference regarding corporate culture of these two sectors.Conclusion: According to the findings, by increased perceived organizational support and corporate culture and commitment in private sectors, it is expected that performance and quality of care will be improved.

Introduction: Establishing improvement in every organization requires assessment of organizational performance, planning and goal-setting to improve the performance. Despite remarkable progresses occurred in recent years on designing the frameworks and performance evaluation systems, many organizations still rely on traditional criteria. Therefore, according to the importance of performance evaluation, it has been tried to combine qualitative and quantitative approaches in evaluation of total quality management models under the European Foundation for Quality Management (EFQM) excellence model and mathematical models of data envelopment analysis (DEA); i.e. providing a model regarding performance evaluation for 27 clinics of Yazd city so as to evaluate the advantages of the both methods and minimize their disadvantages too.Methods: The study population of this descriptive study consisted of all the officials, staff and physicians in clinics of Yazd in 2011.283 subjects participated in the study and 215 of them completed the questionnaire. The data collection tool was a standard 50-item EFQM excellence model questionnaire.The validity of this questionnaire has been proved in many previous studies. Cronbach’s alpha was also used to determine its reliability (r=0.89). Data analysis was conducted through SPSS software and DEAP was also used to determine the organizational efficiency.Results: Out of the 27 selected clinics, the clinics of Akbari (1.09), Qaemiyeh (1.054), Shahrak-Sanati (1.04), Azadshahr (1.014), Kasnaviyeh (1.06), Khatamolanbiya (1.41), Fateme-Zahra (1.039), Mottahari (1.056), Paknezhad (1.03), Shah-Vali (1.016), Sepahepasdaran (1.038), dental clinic (1.043), Nickpoor (1.11) and Kowsar (1.027) were efficient and the rest were inefficient. Khatmolanbyah (1.41) and Rahmatabad clinics (0.89) obtained the first and the last rating in efficiency, respectively. In other words, more than half of the clinics in the city (52%) were efficient.Conclusion: Through combination of data envelopment analysis and organizational excellence models, which can constitute a strong performance assessment together, managers of the clinics can make a step toward realistic assessment of the clinics and therefore improve them. Furthermore, inefficient clinics can also change the human and financial resources in order to reach an acceptable level of performance.

Lean thinking requires certain techniques and tools to support lean processing and to penetrate an organization in which 5S system (sorting, set in order, shining, standardization, sustaining) is to develop value process workflow system. Kanban, a card containing a set of manufacturing specifications and requirements used to regulate the supply of components, is one of the most famous and important lean tools.5S system is in fact a technique to minimize wastes in the workplace and thereby can establish a better environment, a better communication, optimize productivity and eventually provides a general 5S system in the organization.5S system has been founded in the West and was developed in Japan and evolved all around the world. Development and acceptance of 5S system in various countries with different cultures indicates that the concepts of this system are compatible with a variety of cultures. There are some lessons and doctrines in Islam and Iranian national culture which are compatible with the 5S system and can facilitate the acceptance of this system. Lean processing emphasizes on performing the best well-organized task in the most appropriate place and in the first opportunity to reduce waste and optimize the processes in line with the customer’s needs. Industrial societies have long used lean management to improve their processes. In addition, arrival of lean management in healthcare system had significant impacts on management structure and providing healthcare services. Healthcare system can remarkably improve its performance through implementing the lean management system and provide the services in a just-in-time (JIT) and an optimized level for the clients. This new approach system has been established as a cultural strategy in order to provide high quality services at lowest price during the shortest time in hospitals.5S system is a tool, a management system and a philosophy for changing the approach of hospitals toward a managed and organized method. This system is a methodology which allows hospitals to increase quality of health care with reducing errors and waiting time.5S system is an approach to support health staff and physicians, eliminate the current obstacles in the workflow and help them to merely focus on providing patient’s healthcare. Therefore, the present study aimed to introduce the establishment of the 5S system which is one of the major lean tools in the healthcare system and extend its principles with an Islamic view. This was an unsystematic review study conducted in 2012 using the Google engine search in sites of journals, the Holy Quran, Nahj-al-Balagha, Bihar-al-Anwar, Al-Kafi, Kanz al-A’mal, Wasael al-Shia, and Al-khesal and using keywords of 5S system, lean, health system, healthcare, set-in-order, discipline, purification, cleanliness, hygiene, purity, durability in full texts and abstracts. Approximately, 100 articles, verses, hadiths and abstracts were obtained among which 45 cases were found to be related with the objects of this study. Regular enforcement of the 5S procedures can provide a clean and sanitary environment. Moreover, efforts to establish correct habits in staff is the most important factor in accomplishing standardized and sorted workplaces and this major factor is done by implementing the fifth technique (5th S i.e. sustaining). An organized environment is due to provide high quality services.

Introduction: An important aspect of human resource organization is mental health workers. The phenomena of emotional stress and burnout have a significant effect on employee performance. The purpose of the present study was to measure burnout and its dimensions in the librarians of Tehran Universities.Methods: This was a descriptive–correlation study. The data collection tool was the Maslach Burnout Inventory. The reliability of this test is 0.76. The study samples consisted of 111 university librarians working in academic libraries in Tehran, Iran, in 2012. They were selected using cluster sampling.Results: The findings showed that librarians had high emotional exhaustion, depersonalization, and lack of personal accomplishment during their work process. In addition, age and occupational experience were significantly related to occupational burnout and its components. This means that with increase in their age and their career experience their burnout also increased.Conclusion: The results suggest that with increase in age and work experience of librarians, burnout and its three components have increased. Accordingly library managers can create an environment for greater productivity and prosperity in human capital in order to provide users with appropriate and up-to-date information by making timely decisions and taking action.