Journal of Education and Health Promotion

Abstract BACKGROUND: Organizational health (OH) is an organizational aspect in which staff is encouraged
to be clearly involved and participate in decision‑making, problem solving, and collaborating to improve
organizational climate and culture. Multilevel staff involvement facilitates strengthened relationships,
open communication, trust, and organizational commitment. The purpose of this study was to find
components of OH for small‑sized health‑care organizations.
METHODS: A systematic review across three key databases by using an extensive list of keywords
components and interventions was conducted. This survey included studies that explored various
OH elements, components and interventions.
RESULTS: It comprises 34 full‑text studies from 221 received studies. Afterward, the OH elements
were classified into three main categories (OH elements, organizational health literacy, and
organizational health interventions). Then, according to the reviewed data, 23 dimensions were
defined similarly for all groups of studies and relevant explanations related to them were reported.
CONCLUSION: The OH encompasses multiple dimensions. Empirical research is required for
designing a questionnaire according to the final extracted components and measuring its validation
in small‑sized health organizations.

Abstract To develop the next generation of healthcare innovators, students at all levels of education should
be trained and encouraged to employ innovative and entrepreneurial approaches to deal with
complicated challenges of today’s health system. Applying innovation and entrepreneurship training
to solve complex problems and focus on solution design has recently become common in medical
universities all over the world. This paper clarifies the role of hackathons as an innovative educational
approach in healthcare education systems. We propose a process model concerned with organizing
hackathon events in the healthcare education system. This model can be used in the academic and
practical design of hackathons for innovation purposes.

Abstract INTRODUCTION: In the Iranian Accreditation System, leadership and management standards have
been almost ignored and not paid enough and necessary attention to the structural components
and the infrastructures standards in management and leadership sections. Governing body, medical
staff, chief executive officer (CEO), and nursing management standards are inadequate and lack
accountability. These standards could lead to reform and finally provide the context for accomplishment
of an appropriate accreditation program.
MATERIALS AND METHODS: This is a descriptive, comparative, and qualitative study. It was done
in two phases. The first phase included literature review of the standards of the selected countries
followed by comparison of the standards of the board of trustees, medical staff, CEOs, and nursing
management standards to develop the primary framework for Iranian hospitals. In phase two, the
primary framework was validated true three rounds of Delphi technique.
RESULTS: Surveying the accreditation system standards in selected countries included the USA,
Egypt, Malaysia, and Iran. It was found that the management and leadership standards were classify
as governing body, medical staff, CEOs, and nursing management standards. The result of this study
provides a framework for improvement of the Iranian national accreditation program.
CONCLUSION: In regarded to the importance of the leadership and management standards in
reform and change and promotion of the health services quality, efficiency, and effectiveness, the
results of this study showed that the present standards of the Iranian accreditation assessment
system and guidelines lack the necessary infrastructures for implementing a successful national
accreditation program.

Abstract CONTEXT: Health system reform plan refers to conducting some fundamental, systematic, and
sustainable changes.
AIMS: The aim of the present study was to evaluate different required inputs of Iran Health
Transformation Plan from experts’ viewpoints.
SETTINGS AND DESIGN: The data of this qualitative study were collected using semi‑structured
interviews.
SUBJECTS AND METHODS: The purposive sampling method led to 18 participant selection and
then they were interviewed. Interviewees were assured about confidentiality of information.
STATISTICAL ANALYSIS USED: The thematic analysis method and MAXQDA software were
employed for analyzing the data.
RESULTS: There were 4 main themes and 35 subthemes extracted including management
requirements for health development plan, human resources, information resources, and financial
resources. Each theme had subthemes such as “resource allocation,” “development of required
standards for human resources,” “human resources’ motivation,” “failures in IT infrastructures,”
“hospital information management software,” “guidelines and instructions,” “costs controlling,” and
“financing the plan”.
CONCLUSIONS: Results of the present study put significant emphasis on the path of improving
the effectiveness and efficacy of applying the discussed inputs, which can be a light for revising
past policies and taking better future steps, it also can be a resource guide for policy‑makers and
managers of the health‑care system.

Abstract 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.

Abstract Background: Sensitivity of teaching and learning processes in universities emphasizes
the necessity of assessment of the quality of education which improves the efficiency and
effectiveness of the country. This study was conducted with an aim to review and develop the
evaluation criteria of health information technology course at Master of Science level in Tehran,
Shahid Beheshti, Isfahan, Shiraz, and Kashan medical universities in 2012 by using CIPP model.
Materials and Methods: This was an applied and descriptive research with statistical population
of faculty members (23), students (97), directorates (5), and library staff (5), with a total of
130 people, and sampling was done as a census. In order to collect data, four questionnaires
were used based on Likert scale with scores ranging from 1 to 5. Questionnaires’ validity was
confirmed by consulting with health information technology and educational evaluation experts,
and questionnaires’ reliability of directorates, faculty, students, and library staff was tested using
the Cronbach’s alpha coefficient formula, which gave r = 0.74, r = 0.93, r = 0.98, and r = 0.80,
respectively. SPSS software for data analysis and both descriptive and inferential statistics
containing mean, frequency percentage, standard deviation, Pearson correlation, and Spearman
correlation were used. Results: With studies from various sources, commentary of experts, and
based on the CIPP evaluation model, 139 indicators were determined and then evaluated, which
were associated with this course based on the three factors of context, input, and process in the
areas of human resources professional, academic services, students, directors, faculty, curriculum,
budget, facilities, teaching–learning activities, and scientific research activities of students and
faculty, and the activities of the library staff. Conclusion: This study showed that in total, the
health information technology course at the Master of Science level is relatively good, but trying
to improve and correct it in some areas and continuing the evaluation process seems necessary.

Abstract Introduction: Works evaluation and critique is one of the most important phases in scientific
production cycle. Reviewers need some aptitude about rules and principles of writing good review.
Considering the important role of books for storage and transferring the scientific findings, book
reviewing is vital to scientific progress. Despite this fact, investigation of Isfahan University of Medical
Science’s journal, demonstrated the number of published book reviews to be very small. This study
aims to investigate the influence of reviewing training courses on participants’ book reviewing
awareness, attitude, and aptitude. Materials and Methods: The study method is experimental with
two group design (with pre‑test and post‑test) and applied. Statistical population is of all faculty
members of the faculty of management and medical information of Isfahan University of Medical
Science, including both hired and contracted employees, which, according to faculty’s department
of Education, consists of 86 people. The sampling method used in this study is random. Number
of samples in case and control groups was calculated using the following equation of n= (z1 + z2)
2 (2s2)/d2 and is 15 people. One checklist and two questionnaires were the means of data collection.
Data were analyzed using SPSS 18.0 software and two level of descriptive (mean and SD) and
inferential statistics (t‑test and t‑paired). Results: Findings showed that the mean score of awareness
of book reviews in case group increased meaningfully after the training course (55.7) compared to the
score prior to the intervention (33.1), P < 0.001. On the other hand, the mean score of awareness of
book reviews in control group remained mostly the same before (31.6) and after intervention (35.1),
P = 0.35. The mean score of attitude toward book reviews showed no significant difference before
and after intervention in both case group (71.4 before intervention and 74.4 after intervention,
P = 0.11) and control group (70.9 before intervention and 74.4 after intervention, P = 0.91).
The mean score of book reviewing aptitude in case group showed a significant increase from
10.2 ± 6.7 before intervention to 53.6 ± 26.3, showing a 43.4 increase (P < 0.001), while the control
group’s mean score showed no significant
difference (8.5 before intervention and 8.6 after
intervention, P = 0.996). Conclusion: This study
showed a significant influence of training course
on participants’ book reviewing aptitude and
awareness. But attitude toward book reviews
was in good level from the beginning to the end
and remained mostly unchanged.

Abstract Background: Many changes have been made in different sciences by developing and advancing
information and communication technology in last two decades. E‑health is a very broad term that
includes many different activities related to the use of electronic devices, software as well as hardware
in health organizations. Aims: The aim of this study is comparing electronic health indicators in the
selected countries and discussion on the best indicators. Settings and Design: This study has
chosen 12 countries randomly based on the regional division of the WHO. The relevant numbers
of health indicators and general indicators and information technology indicators are extracted
of these countries. We use data from the Bitarf’s comparative study, which is conducted by the
Iranian Supreme Council of Information Technology in 2007. Materials and Methods: By using
Pearson correlation test, the relations between health general indicators and IT indicators are
studied. Statistical Analysis Used: Data was analyzed based on the research objectives using
SPSS software and in accordance with research questions Pearson correlation test were used.
Results: The findings show that there is a positive relation between indicators related to IT and
“Total per capita health, healthy life expectancy, percent literacy”. Furthermore, there is a mutual
relation between IT indicators and “mortality indicator”. Conclusion: This study showed differences
between selective indicators among different countries. The modern world, with its technological
advances, is not powerless in the face of these geographic and health disparity challenges.
Researchers must not rely on the available indicators. They must consider indicators like e‑business
companies, electronic data internet, medical supplies, health electronic record, health information
system, etc., In future, continuous studies in this field, to provide the exact and regular reports of
amount of using of these indicators through different countries must be necessary.

Abstract Background: Growth and development in any country’s national health system, without an
efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the
system’s goals. The balanced scorecard (BSC) is a technique widely used to measure the
performance of an organization. The basic core of the BSC is guided by the organization’s
vision and strategies, which are the bases for the formation of four perspectives of BSC. The
goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in
Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods:
This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic
Medical Center in Isfahan University of Medical Sciences in 2011. The research populations
were hospital managers at different levels. Sampling method was purposive sampling in which
the key informed personnel participated in determining the performance indicators of hospital
as the BSC team members in focused discussion groups. After determining the conceptual
elements in focused discussion groups, the performance objectives (targets) and indicators
of hospital were determined and sorted in perspectives by the group discussion participants
. Following that, the performance indicators were calculated by the experts according to the
predetermined objectives; then, the score of each indicator and the mean score of each
perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by
the participants in the focus discussion group included five strategies, which were customer
satisfaction, continuous quality improvement, development of human resources, supporting
innovation, expansion of services and improving the productivity. Research participants also
agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community
perspective (customer), two objectives and three indicators were agreed upon, with a mean
score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed  upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives
and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial
perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%.
Conclusion: One way to create demand for hospital services is performance evaluation by
paying close attention to all BSC perspectives, especially the non-financial perspectives such
as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the
hospital managers improve their performance indicators. The learning and growth perspective
obtained the highest score, and the financial perspective obtained the least score. Since the
learning and growth perspective acts as a base for all other perspectives and they depend
on it, hospitals must continuously improve the service processes and the quality of services
by educating staff and updating their policies and procedures. This can increase customer
satisfaction and productivity and finally improve the BSC in financial perspective.