JOURNAL OF HEALTH ADMINISTRATION
Year:2006 | Volume:9 | Issue:25|Papers Count:9

Introduction: Quality of patients care is directly linked with medical documentation quality, because in all medical professions related to patient care, quality of decisions depends on information quality. Thus, in this study two main populations that offer medical care in country, Ministry of Health (MoH) and Social security Organization, were selected to measure access rate, and level of medical care professions to quality data that including data accuracy, relevancy, definition, timeliness and data representation format. So we will present clear point of view of health information condition in own country to related masters and decisions. Unfortunately so far no research has be done to show facts of information quality in our health societies. Methods: This research is a comparative study conducted in April to October 2007. Multistage sampling performed for general hospitals of IUMS and Social Security, of which two hospitals were selected randomly. Research populations include discharge medical records of inpatients (about 31000 records) in general hospitals of IUMS (Hazrate Rasoul Akram and Firouzgar Hospitals) and Social Security (Shahid Fayazbakhsh and Ayatollah Kashani Hospitals). Then sample size allocated to each hospital was selected in centralized retrospective manner. So, 153 records for Hazrate Rasoul Akram hospital, 47 for Firouzgar hospital, 133 for Shahid Fayazbaksh hospital and 67 for ayatollah Kashani hospital were selected. Information was collected through direct observation by a checklist with 37 questions and five sections for any quality elements, reliability of which had been measured by specialists and the validity by test-retest method. Collected data analyzed by SPSS software for descriptive statistics and analytical statistics (t-test and chi-square). Results: Our study showed that regard rate mean of data quality elements in documents of IUMS is as below: Data accuracy 92.02 % ‚ relevancy 85/84% ‚ definition 85.87 % ‚ timeliness 78.2% and data representation format 82.87; and in Social Security hospitals: 87.65% ‚ 75.54% ‚ 82.06% ‚ 88.3% and 80.75% respectively. Conclusion: Regard rate of data quality elements of accuracy‚ relevancy‚ definition and data representation format in IUMS shows higher percentage and mean. But documentation of social security medical record about quality timeliness element has higher level as compared with IUMS; t-test analysis shows that in accuracy, relevancy and timeliness of quality elements there is a significant difference, but no significant difference in definition and data representation format quality elements. Considering the differences between our findings with ideal situation (100 percent), for improving quality of documented information in medical records, it is necessary to set national rules by health authorities for complete and quality documentation by documentarian of medical records. Also, legal supports of professional medical records staff for performing quality and quantity control of medical records documentation. 

Introduction: It has been five decades after the first official education for librarian science and informatics in Iran. During half century this field has been developed significantly. By comparing the numbers of educational librarianship centers and publications during past decades, and also review programs by approved headlines in this field, it is shown the matter too. This research has been done to review on Librarian science and informatics publications, and their agreement with contents of approved headlines courses. Methods: This research is descriptive survey; and its research community is the Persian books that have been published during 1978-2004. The number of the books is 1258 titles. Tools that have been used to collect the information are included two type of check list (inventory). Collected information by check lists, have been analyzed by SPSS (V.14) to answer the research questions. Results: Books that published during 1981-1985 (69 titles) 5.52% have minimum frequency and during 2001-2005 (410 titles) have maximum frequency; among all the librarianship and informatics services. "References" have the maximum frequency 57.36% (717 titles). "Educational librarianship" have minimum frequency (0%). There is no publication in such a title during the mentioned years. Among mentioned reviewed books based on title "library and librarianship" (18.2%) (27title) have maximum frequency based on books type, written books have maximum frequency 52.92% (724 titles) and translated books have minimum frequency 15.28% (191 titles). Books used as tools with references based have maximum frequency 46.88% and books used as indexing tools have minimum frequency 1.04% (13 titles). Considering agreement between the published books and the approved headlines courses: headlines of the bachelor of art curriculum in librarianship and informatics have maximum (46.40%). and librarianship in medical have minimum agreement 28.05%. Conclusions: Considering on research findings, it could be concluded that book productions have been increased enormously during recent years, however educational book publication have not a desirable situation and it is limited to the Z ranked books, and from this amount of existing book; some have not complete agreement by the approved headlines. Headlines of the bachelor of art period in librarianship and informatics have maximum, and librarianship in medical have minimum agreement. Therefore cases such as reviewing in educational books in librarianship fields and emphasizing on writing more books in subjects that have not been paid attention before, and periodical reviewing on headlines, have been suggested. 

Introduction: The recent advances in information and communication technology have increased the possibility to store and circulate information. EHR (Electronic health record) system, as an IT (Information Technology) in the healthcare field, can improve access to patient data. International research studies show that the benefits of e-health are significantly greater where EHR information can be shared and used by all involved in an individual's care. Messaging standards are critical for one system to communicate clinical data to another. Methods: The study was qualitative and comparative in nature and is considered as an applied study. For the first section of study an assessment of interoperable EHR messaging standards relies on Grey literature source. Based on these findings we set out the best EHR activity about interoperable EHR messaging standards, initial messages with regards to the studied documents designed and translate for the second section and interviews with specialists for verifying the designed messages. Results: Results were presented in two sections. First, a comprehensive summary report of every message standard was presented. The report describes weaknesses and strengths of HL7 and openEHR standards. Among all the studied articles, we did not find weak points for openEHR. OpenEHR has benefits like future- proof and evidence-based and interoperability, HL7 is supposed to provide maximum interoperability among systems .However it has an interoperability problem between HL7 v2.x and HL7 v3 messages and interfacing between version 2.x and 3.0 is currently impossible. Second, the designed messages were presented based on the findings acquired through the interviews and workshops. Conclusion: The evaluation of the EHR standards reveals no clear "winner". OpenEHR specifications over the past five years have had a significant influence on the development of EHR standards. Results show that openEHR facilitates the use of routine data for multi-centre clinical research. OpenEHR approach also ensures open, future-oriented Electronic Health Records, and it is highly desirable that multi-centre clinical trials adopt openEHR. In Iran the main focus is on HL7, in spite of the fact that there are some useful standards. Therefore, it is suggested that the whole current standards be studied and the weak and strong points of each standard be identified for use in the exchange of healthcare information.

Introduction: Now day, utilization of Information technology being to extend for increase of good efficiency and effectiveness in most cases, rapidly. Among that, skill in using information technology by Medical Record students, for business objectives is very necessary. This study carried out for determining of the Rate of information technology skills by Medical Record students. Methods: This comparative study conducted on Medial Record master degree students in four medical sciences universites namely, Iran, Tehran, Shahid Beheshti, and Isfahan in 2005-2006. Data collecting carried out by checklist, with direct observation, and interview. Data analysis was carried out using Kruscal Wallis test. Results: The ratio of skill in using information technology was totally 86%.Medical Records master degree students at Shahid Beheshti University with 82%, Iran University with 85%, gained less score in skill of information technology use. Kruscal Wallis test showed that there was a definite relation between the ratios of Excel software usage skill, and university of education site (p value=0.006). Conclusions: Medical Records master degree students in four universities have very good skills in using information technology, but Shahid Beheshti and Iran students have less skill. 

Introduction: Family health graduations are one of the most important health care personnel workers. Because mothers and children health have been monitored by them, their abilities of upgrading health, saving and returning population health - if it combined with appropriate, training, and efficacy performance, are very effective. Universities of medical sciences because of their direct contact to human are very important places, and so each and every person; and also societies' health depends on their activities in different job fields. Present research reviewed on to exploit theoretical and practical teaching in view of points of family health technicians, graduated from Health Faculty (2000-2001). Methods: Present research was a descriptive study. The research community was 76 people of three previous daytime, and two evening time of pervious graduated, who are presently employed. Data collecting tools were a package questioners based on ministry's approved guideline, which its validity and reliability have been after completing by ten graduated; confirmed by specialist (research group) and it had more than 90% validity. Four applied index were: theoretical courses, subject observation in classes, and practical program during education, ability to perform in practical job environment. For each index four grades (excellent, good, average, and poor) have been considered. Data was calculated by SPSS and three dimensional statistical software’s. Results: Data showed that hearing had the highest score, correct answer to the questions gained in ten studied subjects had maximum 96.3% (73 people), and minimum 67.88 %( 51 people).Observation of practical observation in for immunization with 69.52 %( 53 people) had highest and for demographic .course with 5.5(4people) had lowest scores. Practical courses during the students study period for immunization gained maximum 81% (62 people), and for demographic course minimum scores12.37% (10 people). Ability for practical work in post graduating future for immunization had highest score 76.1% (58 people) and for demographic course had lowest scores 17.32% (13 people). Average correct answer in this study gained lowest scores. Conclusions: Comparing to practical courses theoretical teaching had better scores in health family courses. Practical works under facilitator's supervision and independent of them have more important values, and students evaluated their abilities in practical courses such as immunization, school health, and administration and supervision on health centers shown much better; these which are their main duties in their future job. Due to upgrading the family health graduates in their future practical works we suggest that new guidelines should be considered by teacher precisely and workshops have to be done to gain skill, and it is not sufficient only considering participating in classroom; but it must considered a number of acceptable practical work to pass exams.

Introduction: The performance management unavoidably is required for each social organization, and presently hospitals as social organizations require the establishment of the performance management to preservation of resources to provide health and treatment services. Methods: The present study is aimed to evaluate the performance management system of the Amiralmomenin (P.B.U.H) Hospital's employees of Semnan county during a 3-year period of establishment this system The Balanced Score Card method was used for evaluation of this system, which determines the results achieved through allocating scores in four axles including: customers, internal processes, financial, and innovation & growth. The 'customers' axle determines the objectives such as the patients' satisfaction, reduction of complaints, and increase of motivation in the employees. The 'internal processes' axle determines objectives such as improving the productivity and quality of the offered services. The 'financial' axle determines objectives such as performance-based payment and reduction of expenses; and the 'Innovation & Growth' axle covers objectives such as increasing the information level of the personnel, improving the educational level, and increasing the stability rate of the employees. Findings: In the 'customers' axle, with customers' satisfaction being equal to 89.6%, complaints equal to 0.29%, and employees' satisfaction equal to 35.3%, the score of the 'customers' axle was estimated at 41.5. Related with the 'internal processes' axle, considering the percentage of different parameters such as Productivity of Services (73.55%), and Qualitative Deficiency of the Offered Services (0.57%), obtaining 0.6 negative scores. So that, the total score of the 'internal processes' axle was equal to 36.4. In the 'financial' axle, the performance-based payments allotted 16.6% to it, and so, the score of the 'financial' axle was equal to 16.6. In the 'innovation and growth' axle, considering the percentage of elements such as the Increased Information Level of the Personnel (100%), Increased Educational Level of the Personnel (39%), and the Stability Rate of Employees (89.4%), the total score of this axle was equal to 89.1. Conclusion: The highest score assigned to the Innovation & Growth axle; and the other aspects including the customers satisfaction, internal processes, and financial axles occupy the lower positions and scores respectively. Therefore, this system left the lowest success record in related with the 'financial' matter that considering the focus of this system on the performance-based payments. Weakness of the system is more observable in this axle. For the establishment of the system, achieving the participation of the employees and the managers- and not being disappointed due to failures in the initial executive stages through convening- educational-justification sessions, is necessary. As a result, to realization the goals of the Performance Management System, it is necessary to pay more attention to making the bed for improving the quality of the offered services, establishing performance -based payments, and meeting the satisfaction of the customers. 

Introduction: End stage renal disease affects many aspects of the hemodialysis patients life, and finally affects their health relate quality of life. The aim of this study was comparison between the hemodialysis patients and healthy population in the Fatima Zahra and Imam Khomeini hospital of Sari.(2007-2008). Methods: We interviewed and completed the SF-36 questionnaires for 100 hemodialysis patients and 100 healthy people; and collected data were analyzed by SPSS 15 software, with McNemar, Pearson, chi- square, and independent t-test. Results: Mean age for patients was 55.41 and for healthy people 55.16 years. Patients were mostly with low education, urban residents, and intermediate socio-economic class. Mental health score was the top; and the role emotional scores the least aspects of patients' quality of life. In addition there was significant difference between patients and healthy people scores on every subscale in quality of life. Conclusions: The results showed that there is necessity for socioeconomic support and counseling activities for patients with hemodialysis. 

Introduction: Due to the scarcity at health facilities, personnel, equipments, and progressive increase in health services costs, improving the length of stay (LOS) in hospitals, and factors affecting the LOS becomes much important. Bed occupancy, longer and unnecessary LOS is a waste of resource, and increase if OPP. This study carried out aimed to determine whether there is a relationship between LOS and type of admission, demographic characteristics of patients and physicians. Methods: This is a descriptive-analytic study. The sample- size includes 350 documents of coronary artery patients undergone bypass surgery in Madani hospital (Tabriz), patients' information gathered by check lists, and physicians related information by direct interview. Results: There were 70.4% men and 29.6% women; 261 patients with elective admissions, whose mean LOS were 5.38 days less than of emergency room admissions. We found a meaningful relation between patients, LOS and type of admission (p<.001). Also there was a meaningful relation between patients LOS and patients situation at the time of discharge (p<.01). Our findings indicate that there was a reverse relation between number of surgery operations per surgeon and patients' LOS; and between patients LOS and surgeon professional work (job) out of hospital (p<.01). Patients document show that average Los is 15.58 days, this is not compatible with the LOS calculated using time formula: 10.72 days. Conclusions: What surgeon believes as to be patients LOS; is 5 days less than what actually happens. Considering our findings for elderly the LOS should be reduced and thereby home care and community care must be taken in to account. On time diagnosis and hospitalization and as well as contracting with nonacademic surgeons is recommend.