Journal of

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Background: Priority Setting is necessary. There are different ways of priority Setting. How they are used depend on the situation of the country.

Material and Methods: This research is literature review. Google Scholar, Medline, Iranmedex, SID, Irandoc data base are used to gathering data.

Results: According to this study, there are various standard ways to priority setting such as Essential national health research ( ENHR), combined method, The commission on health research for Development (COHRED), Five-Step Process of the Ad Hoc Committee on Health Research. These methods have their own characteristics. These methods vary from one country to another . However the final impact is the same.

Conclusion: The result shows that it is useful to know about priority setting and strength and weakness of them. Combined method is the best way because it has the strength of other methods and corrects weakness of them. 

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Background: The admission department as a first point of patients contact with hospital needed special attention. This study has tried to estimate number of needed personnel with work measurement of general functions of admission department.

Material & Methods: This study was a descriptive-analytical and practical research. This study tried to measure real and expected time and determined difficulty degree and skills needed for each task of admission department, then determined total work units and needed personnel in admission department of Children's Medical Center affiliated with Tehran University of medical sciences in 2009.

Results: Total work units in admission department were approximately 10780 units for one month. Counting at least 987 units for every person per month, the number of human resources needed for this unit was 11, while current number of human resources in this department is nine.

Conclusion: Finding of this study show that  Children's Medical Center  involves with inadequate human resources and  multiple pressure  due to insufficiency  in mentioned department, and tries to promote the  technology using in this department and increase the personnel and reset the  payment  system based on work load

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Background: Multiple environmental factors have roles in producing anxiety. Individualized differences and environmental conditions can affect the anxiety level. So, hospital environment and especially cardiac surgery ward have a great importance because they can save the patient's life.

Material & Methods: The present study is a descriptive- analytical one which has been conducted upon studying the level of anxiety pre and post coronary artery bypass graft surgery in the hospitals of Tehran University of Medical Sciences and preparing an educational program for such patients, was the other goal of the study.

Study population consists of 150 patients under examination that at the time of the study have been voluntaries to coronary artery bypass graft surgery. The sample was studied 24 hours before and weeks after surgery. The sample was selected randomly and data collected through a questionnaire with two separate parts. For the purpose of data analysis, SPSS software was employed.

Results: The result of the study shows that the level of anxiety before coronary artery bypass graft have been more than the level of anxiety after  the operation. The difference between of the levels of anxiety have had significant relations with some of independent variables of the study such as sex, age, number of children and marital status, but there were not significant relations between occupation, educational level, non cardiac disease background, background of MI, non cardiac surgery background, the period of suffering from coronary disease background of hospitalization.

Conclusion: It seems that the men's ability to return to pre-operation socio-economic condition reduces their post operation anxiety. When people become older, they will be more fearful regarding the future's events but people older than 46 years old will obtain more life expectancy after surgery due to more extended familial relationship.

Married people experience less anxiety due to post operation, familial responsibilities and relief of cardiac symptoms. It can be concluded that anxiety reduction in these patients can result from cultural, socio-economic and demographic variables. Believes as cultural factors in the life have a great role in appearance and the level of anxiety.

 

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Background: Reporting of  medication errors  leads to saving Patients &apossafety and also is counted as a valuable information source for further prevention of mistake in future.  The aim of this study was to determine the reasons for refusing to report medication errors from the viewpoints of nurses.

Material and Methods:In this descriptive study, 140 of 200 nurses who were employees of Baharlo hospital of Tehran participated in the study (response rate = 70%). Data were collected through a questionnaire. Test- retest analysis conducted for measuring reliability of the questionnaire and content and face validity of the instrument confirmed by key statisticians and methodologists. . SPSS software and descriptive statistics were used for analyzing the collected data. 

Results:Our findings indicate that the reasons of not reporting medication errors were Management factors (3.68 ± 1.12), Fear of reporting outcomes (3.09 ± 1.68) and Process related to reporting (2.73± 1.26). Management factors domain was the major cause of refuse of reporting medication errors. 

Conclusion:Since medication errors seem to be unavoidable, suppression, decreasing medication error depends on using a systematic approach with emphasis on management and nursing care. 

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Background: Most hospitals face with incremental demands, low facilities and readmission of patients as well as dissatisfaction of the clients in regarding to the quality and access of services. Investigating the reasons for readmission and solutions for decreasing the rate of these kinds of admissions can decrease hospital expenditures and improve the efficiency of hospital recourses. By offering high quality standard services and establishing appropriate procedures we can satisfy patients' needs and relieve their pains and discomfort. In this study we are going to evaluate the reasons for patients' readmission in Tehran University of Medical Sciences hospitals

Materials and Method:  This is a descriptive and cross- sectional study consisting of 9 hospitals. The samples were consisted of patients who readmitted in hospitals affiliated to Tehran University of Medical Sciences. The required information has been registered in a questionnaire by means of computer, admission forms and index cards. The medical records of 250 patients were collected and analyzed by t test, Fisher Exact Test and Chi Square test.

Result: 17.8% of understudy patients were admitted two times and 80.7% were admitted more than two times in the hospital. Most of these 80.7% of patients were over 60 years old. It was seen a significant relation between patients' age and readmission also occurring infection. In categorizing diseases according to the reason of patients' readmission (23.1% in the second period and 20.2% in the third period) encountered diseases related to body blood system while readmitting in the hospital. The average cost of patients bedridden admitted for the second and third times because of the same reason was 3241532 and 1576593 tomans. There was a significant relationship between readmission and length of stay in both periods. Pursuit of treatment in 101 cases with average cost of 1802757 tomans in second time and 84 cases with average cost of 1205283 tomans in the third period was among the highest costs of readmission causes. Also the highest length of stay was related to surgery unit (9.98 days). The highest average of patients' costs related to surgery unit was 3543854 and 3911168 tomans for second and third periods.

Conclusion: Most of readmissions are among 60 years old patients and the most important reasons for the second and third readmissions are as a result of treatment follow up, adverse effect and illness complication which can be for the reason of incomplete treatment, non compliance of clinical protocols and lacking standard instruments. Results show that readmissions can increase patients' length of stay and additional burden of costs for patients, hospitals and insurance institutes. Therefore we can prevent these unnecessary costs and increase patients' satisfaction by complying clinical protocols, standardizing hospital procedures and instruments, personnel training and using new methods of diagnosis and treatment. The reform in Health care policies and focusing on the health care quality on the side of the administrators also paying more attention to home visits and home care are recommended to this case.

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Background: The world is changing continually and organizations as the subsystems of the world should be adapted with these changes by helping to develope of creativity and innovation.This study to evaluate the relationships between conflict management styles and creativity of staff in training hospitals in  Kerman province.

Materials & Methods:This is a cross-sectional study from aspect of descriptive -analytical. For gathering data, the standard questionnaires of conflict management for managers and creativity for staff applied. The participants in the study were all disciplinary managers from selected hospitals in one group and all disciplinary staff of selected hospitals in another group.Data analysis used in SPSS software.

Results:The results showed that there is a significant and opposite assosiation between enforcing styles and negotiating styles between managers (P<0/05, r= -0/187) and creativity of staff (P<0/05 , r= -0/155) . Meanwhile, there is a significant relation between marital status and educated staff and their creativity. This research reveales that avoiding styles applied among men is less than women.

Conclusion: To develop creativity of staff and managers should decrease using of enforcing and negotiating styles to solve the conflicts in hospitals.

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Background: The elderly population in Iran is increasing .  The aim of this study is the survey of satisfaction rate and the effective factors on the elderly - aged peoples  satisfaction regarding to the given services in the hospitals affiliated to the Tehran university of medical sciences.

Materials & Methods: This research is a descriptive - analytical study with applied results. It shows the problems cross - section ally.The research society involves the whole elderly - aged people whit 65 years old   and more than that used the bedridden services of the hospitals affiliated to the Tehran university of medical sciences. The sample involves 360 elderly. For collecting the data, a questionnaire with three parts was used. The validity of questionnaire by the content measurement and the reliability of questionnaire by test re test (r = 0.84) were achieved. And also we used SPSS software for data analysis.

Results: : Results showed that 25/6%patients from management type, 41/9%from facilities ,17/2% from behavior personality and 30/3% from public services are dissatisfaction.  A total of 12 variable were analyzed, and the results showed that: The education level, age, sex, type of refer, dealing with the bed shortage and occupations have the meaningful relation with their satisfaction rate. The one - variable - analyzers in the logistic regration  model showed that among the whole meaningful variables, the education level has the strongest relation with satisfaction. With increasing the education level, the satisfaction rate have been decreased.

Conclusion: Due to results satisfaction rate among participant of this study is good and accepted. Using of results is effective step in increase productivity services and further evaluation needed to be done for functional styles patient elderly satisfaction.

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Background: Medical tourism is an opportunity for hospitals to fuel growth by tapping the potential of the international patient marketing. Some countries have specifically considered the need of the 21st century that man to fully benefit from the topic of "medical tourism" to use the available opportunities in their countries. The aim of this study was to develop of medical tourism through capability of the Tehran's hospitals.

Materials & Methods: This research is a practical in the aim used of correlations as in method. In this regards 4 hospitals in Tehran city which were active in the medical tourism area with a high number of foreign patients collected. The participants were 63 doctors and nurses worked in these hospitals. The Questionnaire was researcher made including 6 Likert scale points (5 = very much, 4=much, 3=mid, 2=little, 1 = very little and 0 = none) as the data collection tool. Validity was confirmed by using the expert opinion professional and the reliability was approved by obtaining a Cronbach alpha of 0.859. SPSS software was used for statistical analysis and Spearman's correlation coefficient was used to measure the associations between variables.

Results: The results showed that medical equipments had the best status with the mean score of 3.9 and information applying and communication techniques recorded the lowest scores with the mean of 1.7. The correlation between average revenue of foreign patients and medical equipment status followed by costs of services was 1 score with a positive significant correlation (P = 0.000).

Conclusion: Using the advance of medical equipments with high international technology and standards make a clear statement in the field of medical services fees, and making the competitive costs is the great benefit to develop medical tourism.

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Background: With more than 12 million new cases of cancers and nearly 7.6 million deaths all around the world in 2007, cancer currently is the third leading cause of death in the world. This study was conducted to determine medical and non-medical direct costs of cancer patients’ hospitalized in the cancer institute affiliated with Imam Khomeini hospital. Materials and Methods: This was a cross-sectional study. All patients over 18 years old with kind of head, neck, and stomach cancers that undertaken of oncology treatments in the cancer institute which affiliated ” Imam Khomeini Hospital”. Initially eligible patients invited to participate in this study. The data was collected through structured interviews with patients and or their carers. The data, then, was analyzed by SPSS software. Results: The average medical and non-medical direct out-of-pocket costs during primary treatment were 2,609,000 and 245,000 Tomans per patient, respectively. Furthermore, the direct average of medical costs for patients who lived in Tehran and other cities were 3,313,000 and 1,870,000 Tomans while the direct average of non-medical costs for patients who lived in Tehran and other cities were 136,000 and 360,000 Tomans, respectively. Conclusion: The new policies for costs coverage related to cancer patients’, particularly the medical insurance organizations, financial supports from finance intuits like as banks or charity organizations, appropriate distribution of cancer’s centers or providing accommodation to cancer patients who are referred from the remote sites in other cities, and also achieving the equities in health sectors could be reduced the financial costs of cancer patients and might be helped them to manage of cancers efficiently and effectively

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Background: Job Burnout is one of the important factors to reduce productivity, making mental and physical adverse effects on jobs related to human services and losing efficient manpower by considering the important role of nurses in the health care systems. This study has been done to survey the association between mental health and job burnout syndrome among nurses' staff in training hospitals in Qom province.

Materials & Methods: This is an analytic-descriptive study which has been performed among 200 nurses personnel in the training hospitals of Qom province with applying proboblity multistage statistical method.Three quetionnaires including demographic data,general health and Maslach,s Burnout questionnaire (Inventory) were used to data gathering by which validity and reliability were certified in the previous studies. Data analyzed by SPSS18. Descriptive statistics such as frequency, percentage, inferential statistics (Chi-square test and correlation coefficient of spearman and pearson) and also man-whitney test applied.
Results: Average score of job burnout was 60.8. Respecting general health, 53% of nurses was in danger. Average score of emotional fatique,the personalization and personal accomplishment was 27.2,12.17 and 21.7,respectively. 50 percent of nurses had physical dysfunction,44.5% suffered from anxiety and sleep disorders, 32.5 and 44.5% had social dysfunction and depression, respectively. There was a significant correlation between burnout syndrome and general health. Based on the spearman correlation test, there was a significant correlation between emotional fatique and physical disorders, anxiety and sleep disorders and social dysfunction.
Conclusion: Regarding srtessful nature of nursing job and high prevalence of disorders in general and mental health of nurses incomparision to others and also high prevalence of burnout among nurses in Qom province,it is nesecary to decrease these sort of problems through applying arrangements such as enhancing motivation, increasing work stability, increasing job satisfaction, clearance in how individuals respond to take actions and tasks division among personnels to reduce workload.

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Background: People give you an idea about variety of behaviors when confronting diseases. Different factors such as age, sex, economic and social situations have effect on its. Recognition of these behaviors helps politicians to deliver better services. This study aimed to identify health seeking behaviors of Zoroastrian residing in Yazd province due to advanced number of them in comparison to the other provinces.
Materials & Methods: This study is a cross sectional. The sample size was 196 cases which selected by using simple sampling method. The data was collected via the questionnaire, then data were analyzed by spss.11 software with two test of chi square and exact test of Fisher.
Results: The findings showed that 64.3% of the population was female whereas remaining 35.7% were male. 15.58% of participants were single, 76.5% married and the rest of them (7.7%) were widow. Data indicated that 4.1% of individuals were illiterate, 17.3% were high school , 51.3% had diploma, 23.5% had Bachelors degree and 3.6% had Masters Degree or Ph.D. 43.4% of studied population were unemployed and the rest of them (46.7%) were employed. 94.4% of participants had health insurance whereas 5.6% did not had uninsured card. The results showed that the following direct variables had relation with the following mentioned indirect variables sex with the action during the period of being sick, Place of born with reasons of neglecting sickness, marital status with action during the period of being sick, educational status with action during the period of being sick and referring to practitioner in different stages if sickness and using consultation of different groups, occupational status with the first place to get medical treatment, economical status with reasons of neglecting sickness and completion of treatment period and having health insurance with action during the period of being sick and using consultation of different groups.
Conclusion: Considering the fact that educational, occupational and economic status have relation with health seeking behaviors in individuals, developed in education and occupation status could be lead a chance to choose a better health behavior in people.

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Background: Increasing the receivables collection period make problems in the payment of personal salaries, medicine fees & facilities under surveillance centers. It finally has negative effects on delivered services. At present economic circumstances, paying attention to liquidity and its present value is very important to doing economic activities and to decreasing receivables collection period. The aim of the study was calculating the receivables collection and turnover period in selected hospital of the Qom University of Medical Sciences.
Materials & Methods: This is a descriptive research that conducted in the selected hospital of Qom university of medical sciences during the fourth national development program (2005-2009). Data was Collected from information based on the financial documents of the kamkar hospital and registered into information sheets and analyzed by excel software.
Results: Results show that during the fourth national development program , Receivables turnover has gradually decreased and unlike thereceivables collection period increased. Both of these relations showed an undesirable circumstances and graving with the contracting insurance companies in the payment of their obligation with the hospital.
Conclusion: Findings indicated that the receivables collection period of insurance companies takes Long and taken a long way from its normal .It needs a serious monitoring & intervention in the large scale decision making, except by using the power of law during the fourth development national program which it hasn 't a good impact in repayment approach of the policy makers in this issue that expected all of the general managers in the giving of services.

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Background: Health literacy is the degree to which individuals have the capacity to obtain, process, and understanding basic health information and services needed to make appropriate health decisions. The aim of this study was to assess relationship between health literacy and knowledge of women with type 2 diabetes.
Materials & Methods: In this cross sectional survey, 160 women with type 2 diabetes were selected by convenience sampling method. Data collected by using a STOHFLA standard questionnaire and knowledge was measured by self-administrated questionnaire. Obtained data analyzed by SPSS16 software in two categories of descriptive and inferential statistics (Chi-square and Pearson coefficient).
Results: The mean age of studied population was 52.73±8.56 years old. The means of health literacy and knowledge was 40.57±15.87 and 21.52±2.94, respectively. There was a relation between occupation, education and family history with knowledge and health literacy score, and also between incomes with knowledge. There was reverse significant relation between age and disease duration with knowledge and health literacy.
Conclusion: Results indicated that patients did not have the appropriate knowledge in type 2 diabetes, as well as health literacy which was also moderate. These results confirmed the need to develop of education for improving and increasing the appropriate knowledge and health literacy among studied women.

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Background: Organizational commitment among nurses as care providers provided the quality of patient care by their conservation. Therefore, nurses are committed to the investment and the competitive advantage of clinics and hospitals which have a significant impact on increasing the quality of services. In this study, the effect of psychological contracts and organizational trust studied
as an organizational commitment of Ghaem hospital nurses in Mashhad province.
Materials and methods: Strategy survey - analysis of data obtained for the study of 193 Ghaem hospital nurses in the city of Mashhad through distributed questionnaires by the structural equations and partial the least squares method to seek the help of software were analyzed.
Results: The results indicated that the first, model of the material used has a strong theoretical model that is to predict nurses' organizational commitment. Secondly, all direct and indirect relationships between variables in the model were significant. But the relationship between organizational trust and nurses' continuous commitment was not confirmed.
Conclusion: This study indicates not only depends on nurses' organizational commitment to creating positive psychological space, but also they are in the reliability of this space gives rise to the obligation. On the other hand, the quality of the organizational commitment for nurses could be effective and efficient in use of available resources. Therefore, hospital administrators need to be more attention to an effective component of organizational commitment as supply facilities, participate in decision making, good communication, and job enrichment.

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Background: Current paper aims at investigating factors affecting physicians'knowledge-sharing intention in teaching hospitals affiliated to Tehran University-Medical Sciences in which one of the most authentic model of behavior prediction namely planned behavior has been used as the theoretical framework of study.
Materials and Methods: The method of current study is descriptive/survey correlational type and statistical society includes physicians employed in hospitals affiliated to Tehran University-Medical Sciences.Date was collected by questionnaires and analyzed using Lisrel&SPSS software.Confirmatory factor analysis was employed to evaluate consistency,Cronbach's alpha was used to assess reliability and structural equation modeling was used to fit the model and test hypotheses.
Results: Prediction power of model for knowledge-sharing intention of physicians is(R2=0.66)The results suggested that impact of attitude on the knowledge-sharing intention is positive and significant with factor loading of(=0.87)However,influence of subjective norms and perceived behavioral control on the knowledge-sharing intention was not confirmed.Influence of subjective norms on attitude were evaluated positive and significant with factor loading of(=0.55)As a result, subjective norms affect knowledge-sharing intention through indirect mediation of attitude.All tests were significant at the level of(P0.01).
Conclusion: According to findings of this research on improvement of knowledge-sharing behavior of physicians, health authorities need to take corrective measures to enhance the attitude and subjective norms of physician.

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Background: aging is a very sensitive period of life and paying attention to the problems and requirements of this period seems to be a social necessity. Improving medication for old patients is challenging and sometimes medication`s benefits are less than its disadvantages for the patient.Because of the numerous evidences of problems caused by medication in the elderly in the recent decade, many specialists and physicians have introduced tools and techniques for identifying these problems which are caused by medication and prescription of risky medicines.
Materials and Methods: Several methods, tools and criteria for assessment of quality of medication and medicine prescription in elderly have emerged since 1990.. We found out two categories of criteria reviewing the literature which are generally named as distinct criteria (criterion based) and implicit criteria (judgement based).
Result:The distinct category including Beers, Zhan, McLeod, Laroch and STOP/START criteria are all developed by a panel of experts and consensus in several stages. The second category of criteria concentrates on evaluation of clinical information.
Conclusion: All the tools and methods described in this study are used in Europe and in the USA which have limited market similarities with our country thereforedevelopment of tools for assessing prescription quality for the elderly in Iran is absolutely necessary.

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Background: In the absence of medical facilities in Social Security Organization (SSO) hospitals in provinces, the patients will be dispatched to Tehran. This will dissatisfaction and intellectual and emotional tensions and imposes a lot of costs upon SSO for dispatching the patients . The objective of this study is to compare franchise elimination of medical services in hospitals in contract with social security organization in Provinces with costs of patients dispatching to Tehran .
Materials and Methods: The study was done as retrospective and analytical research. The neurosurgical patients dispatched to Tehran were selected for the study (using the census method). The data were collected in information forms. Research finding were analyzed by SPSS software.
Results: Among studied provinces, Khuzestan province ,with 233 cases, had the highest frequency of patients dispatched and Zanjan and Golestan provinces with 2 cases had the lowest frequency. There was a significant difference between average of dispatching costs paid by SSO and the average franchise paid by patients (p<0.001) such that patients dispatching cost was higher than the franchise paid by patients. There was also no significant difference between average dispatching costs and franchise margin among studied provinces.
Conclusion: Considering the fact that cost of studied dispatching patients was higher than the franchise paid by them in exchange of medical services from hospitals in contract with SSO, elimination of medical services` franchise and treatment of patients in their provinces could decrease in the SSO costs compared with dispatching them to Tehran.

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Background: This study aimed to survey the relationship between job stress, self- efficiency and coping ability among staff of therapeutic- educational hospitals of Tabriz University of Medical sciences.
Materials & Methods: This cross-sectional study was conducted in 2009 among therapeuticeducational hospitals of based on a two stage random sampling. Initially seven hospitals were selected using a simple random method and then 288 persons from the therapeutic and administrative staff were chosen as the sample to be studied using a classified random method. Data were collected using 4 questionnaires titled personal information, self-efficiency, Tores Theorell's job stress scale and Schwarzer's self efficacy and Coping Inventory for Stressful Situation CISS-21 ( Dutch's coping). Data were analyzed Using SPSS software version 11.5 and also Chi-Squared test, T -test, One-Way Anova , Regression analysis and Pearson correlation coefficient.
Results: All the demographic variables including age, gender, marital status, working hours and work experience had a significant relationship with job stress. Pearson correlation test indicated a negative correlation between job stress and self- efficiency, working hours, age and work experience (P<0.001). Additionally there was a positive correlation between self- efficiency and working hours and age and coping ability with work experience ( p< 0.05).
Conclusion: Considering the importance of staff`s mental health issue it is suggested that background factors such as high work load ,dignity level and social value and social supportive programs are taken into close consideration staff`s needs related to these issues are fully satisfied so that better health services are provided.

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Background: The family physician program is considered to be one of the most remarkable reforms in the health care system which will probably Increase accessibility to physicians especially in deprived areas. This study aims to assess the strengths and weaknesses of family physician program in Fouman and Shaft cities in 1390.
Materials and Methods: This is a descriptive cross-sectional and applied study in which all of the health care team`s members including family physicians, midwives, health workers, experts, technicians and also 856 individuals of service recipients in these two cities were involved .Data collection method was questionnaire of which. Validity and reliability was verified.
Results: The most important strengths of family physician program and referral system from perspectives of service providers included: easy access of people to medical services and decreased medical cost for the patients and the main weaknesses were low salary for physicians, reverse referral and inaccessibility to family physicians round the clock. The main strengths from perspectives of service recipients were easy access to physicians and the main weaknesses were inappropriate reception of hospitals and lack of services through the 24 hours of the day.
Conclusion: In order to eliminate the weaknesses and improve the quality of services, training the health staff in different levels of referral system, more comprehensive supervision, periodic assessments and effective supervision on the performance of family physician process owners is suggested

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Background: In case of disasters hospitals as one of the first centers to admit casualties need to be well prepared. This study aimed to determine the scale of preparedness of the hospitals located in the northern areas of Iran to deal with disasters.
Materials and methods: This applied and cross-sectional study was carried out in 2011. In this study all therapeutic-educational affiliated hospitals of Universities of Semnan, Shahroud, Mazandaran, Babol, and Guilan were investigated using the census method (53 hospitals). The data were collected using instruments were a managers' awareness Questionnaire (40 items) and a 141-item checklist which were filled using the self-assessment method. The data were analyzed using SPSS statistical software and Mann-Whitney , Kruskal Wallis and Pearson correlation coefficient statistical test.
Results: The average score of managers' awareness of the disaster confronting Preparedness status was 41.89±9.12 and hospital`s preparedness to confront disasters was 56.88±5.12 which show a mediocre level in all hospitals studied. There was a significant relationship (P=0.007) between the awareness of managers and receiving training on management of disasters. The least score was related to field of planning for decreasing structural risks (40.56±29.4 ).Significant relationships were observed between preparedness of hospitals in different universities and management plans for unanticipated events (P=0.047), hospital training program (P=0.019), planning for supporting vital services (P=0.005) and environmental health measures to deal with unanticipated events (P=0.001).
Conclusion: Regarding the previous of disasters in the studied provinces and the mediocre preparedness of the hospitals, educational planning to confront disasters, strengthening the hospital buildings and organizing practical maneuvers will be effective in enhancing the preparation of the hospitals.