BACKGROUND: Evidence-based management (EBMgt) improves managerial decisions as a bridge from theory to practice. For reason that it has a critical impact on organization performance. The purpose of this study was to identify factors affecting EBMgtamong managers.METHODS: The following electronic databases were used: PubMed, Web of Science, Cochrane, ProQuest, Embase and Scopus. In addition, we searched Google Scholar, Emerald, Academy of Management (AOM), and the website for the Center nfor Evidence-Based Management (CEBMa) for articles related to EBMgt. We used data sources published up to September 2017, without language restriction. We appraised the methodologicalquality of studies using the checklists of SRQR and MMAT. The synthesis involved interpretative analysis based on the principles of meta-synthesis.RESULTS: Of 26,011 identified studies, 26 met the full inclusion criteria. Of the 26 studies assessed, the frequency of qualitative studies and mixed-methods were 20 and 6, respectively, and the quality of 3 studies was weak. A total of 23 studies from 7 countries were included: Canada (n=8), USA (n=6), Australia (n=4), UK (n=3), Iran (n=1, Brazil (n=1); none were from Africa. Meta-synthesis findings of 23 studies identified four main factors: facilitators (5 main themes), barriers (5 main themes), sources of evidence (4 main themes), and the process of decision making in EBMgt (1 main theme).CONCLUSIONS: EBMgt is crucial to improve the quality of management decisions, and hence, to improve service delivery, effectiveness and efficiency. Furthermore, to increase the benefit and utilization of EBMgt, training organizations and research institutes must more actively involve managers in setting research plans.

SummaryBackgroundLow‐income and middle‐income countries have a lot of problems in providing the financial, human, and capital resources for advanced medical imaging technologies (AMITs). Proper distribution of such expensive equipment might increase access to these services and enhance the quality and efficiency of health care. The present study aimed to identify the factors affecting the diffusion of AMITs including CT and MRI in Iran.MethodsThis is a qualitative research conducted in 2017. A number of purposively chosen policy makers and managers from Ministry of Health, medical universities, hospitals, health insurance, and vendor companies were approached for face‐to‐face and semistructured interviews. Data analysis was done using thematic analysis method.ResultsThree categories of influential factors were identified, including contextual, stakeholder related, and situational factors. With regards to the stakeholders, the ministry and physicians played the most important role in the diffusion process of the AMITs. Health insurance organizations and vendor companies played a minor role in distribution of the equipment. Application of political pressure by the authorities on the Ministry of Health to issue licenses for the acquisition of AMITs was taken as the most important factor and the greatest challenge in the diffusion of devices.ConclusionThe results sought to assist health system authorities to manage diffusion of AMITs effectively and assign an equitable access to the expensive resources. The diffusion management together with utilization management could largely improve efficiency and cost containment. Medical technology diffusion management de facto needs policy instruments in both supply and demand sides.

Background: Pandemic H1N1 influenza A 2009 (H1N1/09) virus has been identified as a leading cause of febrile respiratory diseases worldwide, and pregnant women constitute a high risk group. Objectives: To determine the clinical characteristics and outcomes of pregnant women with H1N1 influenza A hospitalized in university hospitals of Qom city in Iran. Patients and Methods: This descriptive retrospective study was conducted using existed data related to October and November 2009. All pregnant women with influenza manifestations were admitted to the hospitals to undergo nasopharyngeal culture. H1N1 virus was confirmed in 11 cases. Data including demographic characteristics, clinical manifestations, laboratory test results, and pregnancy complications was extracted from medical records, and analyzed by descriptive statistics. Results: The mean age of the women was 28.1 ± 4.7 years with a mean gestational age of 28.7 ± 10.9 weeks. The most common clinical manifestations included coughing (100%), fever (87.5%), and dyspnea (75%). The most common abnormal test was anemia (88%). Pregnancy complications included preterm delivery (36.3%), low birth weight (18%), oligohydramnios (9%), gestational diabetes (9%), and fetal distress (9%). Also one (12.5%) wound dehiscence happened. Conclusions: vaccination seems to be necessary to prevent this potentially fatal infectious disease. Furthermore, timely prescription of antiviral medications is recommended to decrease the risk of severe complications.

Background: As fast and accurate techniques, advanced medical imaging technologies (AMIT) allow healthcare professionals to better diagnose and treat various health conditions, which translates into higher use of non-invasive operational procedures. Objectives: The current study intended to investigate the effect of inpatient use of MRI and CT scan on the inpatient mortality and length of stay (LOS) in Tehran general university hospitals. Methods: Data were collected from all general university hospitals in Tehran in 2017. A multiple linear regression model was constructed for each combination of technology and outcomes (i.e., mortality and LOS), and all models were controlled for patients’ demographic and clinical characteristics and structural profile of hospitals. In calculating hospital standardized mortality ratio (HSMR) for each of 72 diagnosis groups related to death, a binary logistic regression model was fitted with predictors including LOS, admission type, comorbidity level, sex, and age. Results: The use of CT varied from 0.39 to 149.35, and MRI from 0.24 to 80.23 exams per 100 discharges. The HSMR ranged from 76.8% to 146%, and the average length of stay (ALOS) was 3 - 8.46 days. MRI and CT had no significant effect on the HSMR and ALOS. Conclusions: Further use of AMIT was not linked with improved efficiency and quality but was associated with better resource management in healthcare organizations. Effective management of the AMIT use requires clear rules and regulations with assertive commitment, in addition to establishing clinical guidelines with the support of insurance companies.

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