Background:In spite of the pivotal role of clinical governance in enhancing quality of services provided by hospitals across the country, a scientific framework with specific criteria for evaluating hospitals has not been developed so far.Objectives:This study was conducted with the aim to identify the challenges involved in evaluating systems of clinical governance in Iran.Materials and Methods:For the purposes of this qualitative study, 15 semi-structured interviews with experts in the field were conducted in 2011 and the data were analyzed using framework analysis method.Results:Five major challenges in evaluating clinical governance include managing human resources, improving clinical quality, managing development, organizing clinical governance, and providing patient-oriented healthcare system.Conclusions:Healthcare system in Iran requires a clinical governance program which has a patient-oriented approach in philosophy, operation, and effectiveness in order to meet the challenges ahead.

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The main challenges in the family physician program include cultural, economic and environmental factors and work conditions. The implementation of this program can be improved through building a community culture and exercising minor and major modifications.

Background: Anabolic androgenic steroids (AAS) are currently used by many athletes for skeletal muscle development. The aim of this study was to evaluate the prevalence of AAS use among bodybuilder athletes in Iran at 2015. Methods: In this descriptive-analytical cross-sectional study 384 bodybuilders filled the study questionnaire evaluating age, education, and age at AAS use as underlying variables; pattern of AAS use as independent variable; and knowledge about AAS side effects and the relation between mental health and AAS use as dependent variables. Data was analyzed by SPSS using frequency tables, mean and standard deviation, chi-2, t-test, analysis of variances and regression. Results: Among 920 participants, 104 (11.3%) were current users, and 210 (22.8%) had the history of usage. Physical attraction was reason of use in 57.6% and increasing power and ability to enter professional sport were reasons for use in 44 participants each (21.2%). The marital status, age and education level did not have significant effects on AAS use. Friends (76.7%) and coaches (67.4%) had significant correlation with AAS use in participants (P < 0.000). The simultaneous use of alcohol (46.5%) and smoking (27.9%) among AAS users was significant (P < 0.001). Only 4.7% of participants had proper information about AAS side effects. Conclusions: The participants had little knowledge about AAS side effects, therefore educating adolescents and youth in high schools and universities, and also in sports clubs is necessary. Periodical assessment of coaches and athletes with regard to AAS use, and proper law enforcement in this regard is important.

Background: The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods: The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. Results:The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. Conclusion: The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety.

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Background: Balanced Score card is a performance evaluation tool that in combination with the AHP approach, creates a framework for transforming vision and mission to a set of targets and indicators, on the basis of importance in terms of the customer, financial and internal processes, and growth and learning perspectives. Objectives: The aim of this study was to evaluate the performance of Montaserieh hospital in 2015 using the balanced score card approach. Methods: This study combined quantitative and qualitative methods, and was conducted in Montaserieh Hospital in Mashhad, Iran, during year 2015. First, through group discussion sessions among the members of score card, a list of performance assessment indices were prepared using the BSC approach, and then the list was finalized using the Delphi method. After that, the hospital strategic map was illustrated based on its objectives, and with the completion of analytic hierarchy process (AHP) standard questionnaires, the priority of visions and indices with adjustment rate lower than 0.1 was obtained from 14 experts. At the end, the realization of each of the visions and indices and the hospital performance during 2015 was evaluated. Results: Thirty-four indices were selected regarding the four visions of the model, as seven indices were placed in each of the visions of customer, financial, growth and learning, and 13 indices for the processes vision. Among the visions of BSC, customer vision with 58.26% was more powerful than the other ones. Among the indices, the index of percentage of respondents (0.39) had the highest factor of importance among the hospital indices. The final score for hospital performance in 2015 was obtained as 89.27%. Based on the analysis obtained from the AHP questionnaire pair wise comparison, the importance coefficient was calculated as 65.7%, 19.7%, 9% and 5.6% for customer, financial, processes, and growth and learning, respectively. Conclusions: Given the gap between expected objectives and current status of the hospital and resource constraints and conditions, the hospital should consider the priority and weight of each of the visions and indices for its future planning to identify the appropriate goals and define improvement projects more efficiently, and take effective steps for better performance.

Background An electronic prescription system is a mechanism that has long been implemented in many countries around the world. In the present study, we reviewed the requirements, standards, and features of an electronic prescription system for its correct and accurate execution. Methods This scoping review was conducted according to the PRISMA-SCR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive literature search was performed with the related keywords in Web of Science, PubMed, Scopus, and ProQuest with no time limit. The selection of papers was based on inclusion criteria. After removing duplicates, reviewing titles, abstracts, and full-text, 13 articles were included in the analysis. Results Electronic prescription system requirements extracted from the studies: Patient data, Patient selection or identification and data access, Drug Selection, Security, Privacy and administration, Transparency and accountability, Interoperability and communication, Monitoring, report, reminder, and renewals, Feedback at the prescriber level, Infrastructure: Computer equipment, Awareness of physicians and System support, Patient education and information, Usability, Standards, History of Medications / Current Medications, Data transfer and storage, Alerts and other messages to prescribers, and filtering of user-selectable alerts for possible prescription problems and Decision support. Conclusions The results of this study showed that the electronic prescription systems have several functional and technical capabilities that can provide significant benefits to all system’s stakeholders, including service providers, drug distributors, patients, and insurance organizations if used correctly.