Yafteh

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Background: Hospital as the gravitational center of the health and treatment system and an open system involving complex processes and various (qualitative and quantitative) resources, needs an effective leadership style and an approperiate strategy to solve the organizational disagreements and conflicts in order to achieve its basic objectives. The object of this research is to study the relationship between leadership style and conflict management among the managers of the hospitals, which sponsord by Lorestan university of Medical sciences during the year 2004. Materials and Methods: This research is a descriptive – analytical study. The necessary information was gathered by three different questionnaires (personal information, leadership style using Fiedler’s LPC method and conflict management), and also by interviewing the subjects. The collected data were analyzed using statistical software. The research sample consisted of 177 managers from 13 hospitals, which were sponsored by Lorestan university of medical sciences. Results: The findings demonstrated that 54.2 percent of the subjects had a duty-oriented leadership style, 35.6 percent had a relationship – oriented leadership style, and 10.2 percent of the subjects had an independent – social leadership style. Considering conflict management strategies, 49.7 percent showed a non – confrontational strategy, 44.6 percent demonstrated a control-oriented strategy and 5.7 percent had a problem- solving strategy. The subject’s leadership style had a significant statistical relationship with their job experience (p=0.043). Also, there was a significant statistical relationship between conflict management strategies and the sex of the subjects (p= 0.036). Age of the subjects and their control-oriented strategy also demonstrated a significant statistical relationship(p=0.01). Conclusion: Determining the leadership and management styles and identifying the methods of dealing with disagreements and conflicts in hospitals is crucial. Since some of the factors involved in leadership style and conflict management have been studied in this research, it is suggested that the effect of other factors such as organizational culture , social culture , race , personality , etc. on the leadership style of people be studied more comprehensively.

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Equal access to health care services is among the basic human rights. Unequal distribution of hospital resources especially intensive care beds encounter access to this critical care with problem. intensive care beds is one of most valuable and important sources of health care system that its unequal and inequity distribution among our country provinces more over transportation of emergency patients can cause irreparable complications. The aim of this study was to assess degree of equity in distribution of CCU1, ICU2, Post CCU3, Post ICU4, NICU5 beds among provinces of country. Materials and Methods: The present applied study has been written by descriptive and analytical method. Needed data has been collected form the latest documents in ministry of health, treatment and medical education and statistical center of Iran. The amount of distributional equity calculated using EXCELL2007 by more applied equity indices in this field, Gini coefficient and Lorenz curve. Also the geographical concentration map, for intensive care beds in country, was drawn which is surely necessary for policy making in the health field. Results:The total number of CCU, ICU, PICU, PCCU and NICU beds were 4194, 3720, 291, 4097 and 1129 respectively. The maximum values for any intensive care beds by province were recorded in Tehran. The most proportion of CCU, ICU, PICU, PCCU and NICU beds per 100,000 people revealed in Yazd, Tehran, Yazd, Qom and Khorasan Razavi provinces respectively. Finally Gini coefficients for CCU, ICU, PICU, PCCU and NICU distributions were calculated 0.13, 0.17, 0.15, 0.11 and 0.23 respectively. Conclusion: Though geographic maps of intensive care beds concentration show different concentration of this bed among provinces but this difference in Gini index is negligible. Finally it can be concluded that approximately absolute equality in distribution of intensive care beds-except NICU- observed among our country provinces .

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Background: Based on recommendation of management development and organizational change center of the ministry of health. EFQM model is the most appropriate model to deploy in country`s hospitals. In this study we assess quality of emergency wards in khorramabad hospitals based on EFQM model and compare it with results of annual evaluation of the ministry of health. Materials and Methods: this descriptive, cross-sectional study was carried out in 2009. Emergency wards of khorramabad hospitals were our study population which were selected using census method. Data collection tool was questionnaire of EFQM model which was filled out by researchers in studied wards. RADAR logic used for scoring and EFQM consensus process used for agreement. The data were analyzed through descriptive statistics, SPSS and EFQM softwares. Results: Scores of studied wards (Social security, Shahid Madani,Shohaday-e Ashayer and Asali hospitals) were 216,108.1,129.9,72.1 respectively. The mean score in EFQM criteria were: leadership 12.3%, policy and strategy 7.1%, staff 11.8%, partnerships and resources 13.8%, processes 20.8%, customers results 8.3%, staff results 12.5% society results 9.5%, key performance results 18.8%. Conclusion: Findings show that quality of studied wards is less than the model standards and other similar studies considerably. From view point of the researcher the existing gap with external studies is logical and in comparison with internal studies is irrational. The studied wards acquired the most score in process criterion and the least score in policy and strategy criterion. Also ,findings shows a negative relation between results of assessment based on EFQM model and current evaluation system of the ministry of health, so it is suggested that the current system should be revised fundamenally.