HIV/AIDS Policy Making Process in Iran: Analysis of HIV/AIDS Agenda Setting Based on Kingdon's Frame

Background and Objectives:

Agenda setting is the process by which certain issues come onto the policy agenda from the much larger number of issues potentially worthy of attention by policy makers. The aim of this study was to deeply understand about how AIDS entered to health policy agenda in Iran.

Material and Methods

An exploratory qualitative retrospective study based on multiple streams framework to analyze AIDS agenda setting process, 32 semi-structured interviews were conducted with key informants and stakeholders in Iran and 30 policy documents were reviewed. Data were analyzed using framework analysis method and MAXQDA software .

Results

Problem, policy and politics, the three streams of HIV/AIDS in context of Iran were identified and the advent and continuity of multiple streams and their interactions and combination by policy entrepreneurs in couple of streams in policy windows were explained.

Conclusion

In this study, the assumption of independence of three streams from each other was doubted. Also, framework has ambiguities in explaining entrepreneurs' act when opening policy windows. Other researchers can modify the framework by learning-by-doing. 

 

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Citation

Khodayari-Zarnaq R, Ravaghi H,Mosaddeghrad A, Sedaghat A, Fallahi H, Seyed-Ali-Naghi A, Mohraz M. HIV/AIDS Policy Making Process in Iran: Analysis of HIV/AIDS Agenda Setting Based on Kingdon's Framework. Depiction of Health 2016; 7(3): 1-14.

 

The impact of quality management on reducing bill deductions at operating theatre department of Vali

 

Background: The health system of Iran is suffering from resources shortage. The health insurance companies (payers) do not confirm all hospitals’ claims (bills) and as a result do not reimburse them completely. Decreasing the amount of these deductions helps healthcare managers to use their resources efficiently. This study aimed to examine the impact of a quality management model on reducing the amount of healthcare insurance deductions at operating theatre department of Valiasr hospital in 2014-2015.

Materials and Methods: A participatory action research was used for the intervention. A quality improvement team was established and using the ten-step quality management model improved operational processes at operating theatre department.  Related data were collected before and after the intervention to determine the effect of quality management system on deductions.

Results: The average deduction per patient at the beginning of the study was 339572 Rials. Illegible and uncompleted patient’s medical records, using wrong codes of surgery and anesthetics in documents and miscalculation were the main reasons of deductions. The reasons for deductions were identified and appropriate solutions were applied to decrease the amount of deductions at operating theatre department. The average deduction per patient at the end of study was 262818 Rials. The amount of deductions has decreased from 6.9 % to 3.8 %. The quality management system helped reduce the amount of deductions by 44.9%.

Conclusion: Implementing an appropriate quality management model appropriately helps reduce deductions in hospitals effectively.

Keywords: Quality management, Deductions, Hospital, Action research

 

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Citation: Mosadeghrad A.M, Arab, M. & Afshari M. (2017).  The impact of quality management on reducing bill deductions at operating theatre department of Valiasr Hospital: A participatory action research, the Hospital; 16 (1):93-101. [in Persian]

Iran hospital accreditation system

 

 

 Accreditation of a health care organization is an external evaluation of the level of compliance against a set of standards (1). The accreditation process covers all areas of the healthcare organiza-tion‟s operation and practice. It aims to ensure that the healthcare organizations address the qual-ity and safety of patient care. The objectives of a hospital accreditation system are to assess quality and safety of care; to provide external recognition of the quality of care; and finally to improve pub-lic confidence in healthcare services provided by hospitals. An accreditation program is an effective strategy for improving the quality of care (2-4) and patient safety (5) and results in better organiza-tional performance (6-7).

Mosadeghrad, A.M., (2016). Iran hospital accreditation system, Iranian Journal of Public Health, 45 (6): 837-842

 

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HIV/AIDS policy agenda setting in Iran

 

Abstract

Background:HIV/AIDS control are one of the most important goals of the health systems. The aim of this study was to determine how HIV/AIDS control was initiated among policy makers’ agenda setting in Iran. Methods: A qualitative research (semi-structured interview) was conducted using Kingdon’s framework (problem, policy and politics streams, and policy windows and policy entrepreneurs) to analysis HIV/AIDS agenda setting in Iran. Thirty-two policy makers, managers, specialists, and researchers were interviewed. Also, 30 policy documents were analyzed. Framework analysis method was used for data analysis. Results: : the increase of HIV among Injecting drug users (IDUs) and Female Sex Workers (FSWs), lack of control of their high-risk behaviors, and exceeding the HIV into concentrated phase were examples of problem stream. Policy stream was evidence-based solutions that highlighted the need for changing strategies for dealing with such a problem and finding technically feasible and acceptable solutions. Iran’s participation in United Nations General Assembly special sessions on HIV/AIDS (UNGASS), the establishment of National AIDS Committee; highlighting AIDS control in Iran’s five years development program and the support of the judiciary system of harm reduction policies were examples of politics stream. Policy entrepreneurs linking these streams put the HIV/AIDS on the national agenda (policy windows) and provide their solutions. Conclusion: : There were mutual interactions among these three streams and sometimes, they weakened or reinforced each other. Future studies are recommended to understand the interactions between these streams’ parts and perhaps develop further Kingdon’s framework, especially in the health sector.

Keywords: HIV/AIDS Policy, Agenda setting, Multiple streams framework, Health system

Khodayari-Zarnaq, R. Ravaghi, H. Mosadeghrad, A.M. Sedaghat, A. Mohraz, M. (2016). HIV/AIDS policy agenda setting in Iran. Medical Journal of the Islamic Republic of Iran, 30 (392): 1-13.

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Developing and validating a total quality management model for healthcare organisations

 

Abstract

Purpose: The purpose of this paper is to develop a total quality management (TQM) model for healthcare organisations and validate it using a sample of Iranian healthcare organisations. Design/methodology/approach:  A validated questionnaire was used to collect data from all healthcare organisations that implemented TQM in Isfahan province, Iran. Findings: Using the proposed model, TQM implementation was measured in healthcare organisations. The level of TQM success in Isfahan healthcare organisations was medium. The highest score was achieved in the dimension of “customer management”, followed by “leadership” and “employee management”. Employee management, information management, customer management, process management and leadership had the most positive effect on TQM success. Using a series of quality management techniques had “synergistic” effect on TQM success. Practical implications: Top management support, effective management of human resources, full involvement of the entire workforce including physicians, education and training, team working, continuous improvement, a corporate quality culture, customer focus and using a combination of management techniques under a quality management system are necessary for TQM successful implementation. Originality/value: A healthcare context-specific model of TQM was developed and tested and suggestions were provided for its successful implementation.

Keywords: Total quality management, Success, Healthcare organizations

Mosadeghrad, A.M., (2015). Developing and validating a total quality management model for healthcare organisations, The TQM Journal, 27 (5): 544 - 564

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Factors influencing health care service quality

 

 Abstract

Background:The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations.  Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.  Keywords: Healthcare Organisations, Quality, Pluralistic Evaluation, Iran

Mosadeghrad, A.M., (2014). Factors influencing health care service quality. International Journal of Health Policy and Management, 3 (2): 77-89

 

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Why do organizational change programmes fail

 

Abstract

 

Many organisations have found it difficult to implement organisational change successfully. This paper using a systematic and meta-analysis review of the literature published between 1980 and 2011 explored the major reasons for organisational change failure. Unsuccessful change programmes were attributed to insufficient education and training, employees’ apathy, inadequate management support, poor leadership, inappropriate organisational culture, inadequate resources, poor communication, inappropriate planning, insufficient customer focus, and lack of a monitoring and measurement system. Change-programme implementation and its impact depend on the ability of managers to adopt and adapt the change programme principles in their organisations. A well-designed, wisely adapted and well-implemented change programme helps managers achieve desired results. Identification of those factors that contribute to change success or failure enables change leaders to develop effective strategies for enhancing the chances of achieving desired outcomes.

Keywords: Keywordsorganisational change, failure, obstacles, successful implementation

 

 

Mosadeghrad, A.M., & Ansarian, M., (2014).Why do organizational change programmes fail? International Journal of Strategic Change Management, 5 (3): 189-218

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Occupational stress and its consequences: Implications for health policy and management

 

Abstract

Purpose: This study aims to identify the status of occupational stress among a sample of hospital employees in Iran. It further intended to reveal the harmful effects of occupational stress on employees’ health and well-being. Design/methodology/approach: The study used a cross-sectional research design. A validated questionnaire was used to collect data from hospital employees. Findings: Job-related, working environment, interpersonal and organisational factors were related to occupational stress. One-fourth of employees rated their occupational stress high. The major sources of occupational stress were inadequate pay, inequality at work, too much work, staff shortage, poor recognition and promotion, time pressure, job insecurity and lack of management support. High levels of occupational stress have been linked to an increased risk of physical injuries, cardiovascular disease, high blood pressure, depression and increases in negative personal behaviours such as anger, anxiety and irritability. Occupational stress was positively associated with employees’ turnover intentions. Research limitations/implications: The findings of this study are not generalisable to the wider population of hospital employees in Iran due to the small sample size. Thus, future research should involve additional samples. Practical implications: The study has practical relevance for designing and implementing strategies to decrease occupational stress among hospital employees. Originality/value: This article contributes to health care theory and practise by identifying factors contributing to employees’ occupational stress and examining the association between occupational stress and two important employee outcomes – health status and turnover intention.

Keywords: Human resource management, Stress, Hospitals, Employees, Occupational stress

Mosadeghrad, A.M., (2014). Occupational stress and its consequences: Implications for health policy and management.  Leadership in Health Services Journal, 27 (3): 224 - 239

 

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Essentials of Total Quality Management in healthcare: A systematic review

 

Abstract

Purpose: The purpose of this paper is to identify critical successful factors for Total Quality Management (TQM) implementation. Design/methodology/approach: A literature review was conducted to explore the critical successful factors for TQM implementation between 1980 and 2010. Findings: A successful TQM implementation need sufficient education and training, supportive leadership, consistent support of top management, customer focus, employee involvement, process management and continuous improvement of processes. Research limitations/implications: The review was limited to articles written in English language during the past 30 years. Practical implications From a practical point of view, the findings of this paper provide managers with a practical understanding of the factors that are likely to facilitate TQM implementation in organisations. Originality/value: Understanding the factors that are likely to promote TQM implementation would enable managers to develop more effective strategies that will enhance the chances of achieving business excellence.

Keywords: Total quality management, Implementation, Quality healthcare, Critical successful factors, Healthcare organisations

Mosadeghrad, A.M., (2014). Essentials of Total Quality Management in healthcare: A systematic review. International Journal of Health Care Quality Assurance, 27 (6):544-558

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Why TQM does not work in healthcare organisations

 

Abstract

Purpose: Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran. Design/methodology/approach: – This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation. Findings: TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers’ about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers’ and employees’ commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively. Practical implications: Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence. Originality/value: Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

Keywords: Total quality management, Quality management

Mosadeghrad, A.M., (2014). Why TQM does not work in healthcare organisations. International Journal of Health Care Quality Assurance, 27 (4): 320-335

 

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Strategic collaborative quality management and employee job satisfaction

 

Abstract

 

Background: This study aimed to examine Strategic Collaborative Quality Management (SCQM) impact on employee job satisfaction.  Methods: The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees’ job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital.  Results: The hospital reported a significant improvement in some dimensions of job satisfaction like management and supervision, organisational policies, task requirement, and working conditions.  Conclusion: This paper provides detailed information on how a quality management model implementation affects employees. A well developed, well introduced and institutionalised quality management model can improve employees’ job satisfaction. However, the success of quality management needs top management commitment and stability.

 

Keywords: Strategic Collaborative Quality Management, Employee Job Satisfaction, Hospital

 

 

Mosadeghrad, A.M., (2014).Strategic collaborative quality management and employee job satisfaction. International Journal of Health Policy and Management, 2 (4): 167-174.

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Leadership, job satisfaction and organizational commitment in healthcare sector

Abstract

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related
attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style.
Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

 

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 

 Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

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Factors affecting medical service quality

 

 

Abstract

Background:A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Methods: Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Results: Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quali-ty of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Conclusion: Differences in internal and external factors such as availability of resources, patient cooperation and col-laboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for under-standing factors that influence medical services quality.

Keywords: Quality, Patient, Physician, Hospital

Mosadeghrad, A.M., (2014). Factors affecting medical service quality.  Iranian Journal of Public Health, 43 (2): 210-220.

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Patient choice of a hospital: Implications for health policy and management

 

Abstract

Purpose:  The purpose of this study was to identify the most important influencing factors in choosing a hospital by a patient. Design/methodology/approach: This study involved a mixed research design. Focus groups and in-depth individual interviews were conducted with patients to explore reasons for choosing a hospital. In addition, this study involved survey-based research on the patient choice. Findings: Type of the hospital, type of the service, word of mouth, cost of services, the health insurance programme, location, physical environment, facilities, providers’ expertise and interpersonal behaviour, and reputation of the hospital influenced patients’ choice of a hospital. Doctor recommendations and health insurance programme were the main reasons for choosing a hospital for inpatients and outpatients respectively. Practical implications: Identifying and understanding key factors that influence a patient choice of a healthcare setting helps managers and policy makers invest their resources in those critical areas and improve those aspects of their services to attract more patients. Originality/value: This article contributes to healthcare theory and practice by developing a conceptual framework for understanding the factors that influence a patient choice of a healthcare setting.

 

Mosadeghrad, A.M., (2014). Patient choice of a hospital: Implications for health policy and management, International Journal of Health Care Quality Assurance, 27 (2): 152-164.

 

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Why TQM programs fail? A pathology approach

 

Purpose

 Implementing total quality management (TQM) is not without difficulties and achieving its promised benefits is not easy. The purpose of this paper is to identify the barriers to TQM successful implementation. Design/methodology/approach: A literature review has been done to explore the major reasons for the failure of TQM programmes. Findings: An examination of 54 TQM empirical studies identified 54 obstacles to successful TQM implementation. There are both theoretical and practical difficulties in applying TQM in organisations. An ineffective TQM package, inappropriate TQM implementation methods and an inappropriate environment for implementing TQM are the main reasons for TQM failure. The most frequently mentioned reasons for TQM implementation failures include insufficient education and training, lack of employees’ involvement, lack of top management support, inadequate resources, deficient leadership, lack of a quality-oriented culture, poor communication, lack of a plan for change and employee resistance to the change programme. Research limitations/implications: – The review was limited to articles written in English language during the past 30 years (1980-2010). Practical implications: TQM does deliver better performance when an appropriate model of TQM is appropriately implemented in a supportive environment. The findings of this paper provide managers with a practical understanding of the factors that are likely to obstruct TQM implementation. Managers should overcome these barriers to achieve the TQM benefits. Originality/value: Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

Keywords:Total quality management, Barriers, Failure, Success, Obstacles, Successful implementation

Mosadeghrad, A.M., (2014). Why TQM programs fail? A pathology approach. The TQM Journal, 26 (2): 160-187.

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Quality of working life and turnover intentions: implications for nursing management

 

ABSTRACT

The main purpose of this study was to explore the status of Quality of Working Life (QWL) among hospital nurses in Isfahan, Iran. A survey study was conducted based on a sample of 296 hospital nurses using a valid and reliable QWL questionnaire. Hospital nurses reported low levels of QWL. The most important predictor of QWL was disturbance handling, followed by job proud, job security and job stress. Since QWL have strong correlation with turnover intention, it is very important to reinforce it by applying the right human resources policies.

Mosadeghrad, A.M., (2013). Quality of working life and turnover intentions: implications for nursing management. International journal of research in nursing, 4 (2): 47-54.

 

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Verification of a quality management theory: Using a Delphi study.

 

 Abstract

Background: A model of quality management called Strategic Collaborative Quality Management (SCQM) model was developed based on the quality management literature review, the findings of a survey on quality management assessment in healthcare organisations, semi-structured interviews with healthcare stakeholders, and a Delphi study on healthcare quality management experts. The purpose of this study was to verify the SCQM model. Methods: The proposed model was further developed using feedback from thirty quality management experts using a Delphi method. Further, a guidebook for its implementation was prepared including a road map and performance measurement.  Results: The research led to the development of a context-specific model of quality management for healthcare organisations and a series of guidelines for its implementation. Conclusion: A proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence.

Mosadeghrad, A.M., (2013). Verification of a quality management theory: Using a Delphi study. International Journal of Health Policy and Management, 1 (4), pp. 261-271.

 

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Occupational stress and turnover intention: Implications for nursing management

 

 Abstract

Background: The main purpose of this study was to explore the status of occupational stress among hospital nurses in Isfahan, Iran. It also aimed to examine the relationship between nurses’ occupational stress and their intention to leave the hospital. Methods:The study employed a cross-sectional research design. A validated questionnaire was used to collect data from 296 nurses. Respondents were asked to rate the intensity of 30 common occupational stressors using a five-point scale. Results: A third of hospital nurses rated their occupational stress high. The major sources of stress were inadequate pay, inequality at work, too much work, staff shortage, lack of promotion, job insecurity and lack of management support. More than 35% of nurses stated that they are considering leaving the hospital, if they could find another job opportunity. Occupational stress was positively associated with nurses’ turnover intentions. Conclusion: Hospital managers should develop and apply appropriate policies and strategies to reduce occupational stress and consequently nurses’ turnover intention.

Mosadeghrad, A.M., (2013). Occupational stress and turnover intention: Implications for nursing management. International Journal of Health Policy and Management, 1 (2), pp. 179-186.

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 

Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

 

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Quality of working life: Antecedents to employee’s turnover intentions

 

Abstract

 Background: The purpose of this study was to measure the level of quality of work life (QWL) among hospital employees in Iran. Additionally, it aimed to identify the factors that are critical to employees’ QWL. It also aimed to test a theoretical model of the relationship between employees’ QWL and their intention to leave the organisation. Methods:: A survey study was conducted based on a sample of 608 hospital employees using a validated questionnaire. Face, content and construct validity were conducted on the survey instrument. Results: Hospital employees reported low QWL. Employees were least satisfied with pay, benefits, job promotion, and management support. The most important predictor of QWL was management support, followed by job proud, job security and job stress. An inverse relationship was found between employees QWL and their turnover intention. Conclusion: This study empirically examined the relationships between employees’ QWL and their turnover intention. Managers can take appropriate actions to improve employees’ QWL and subsequently reduce employees’ turnover.

 

Mosadeghrad, A.M., (2013). Quality of working life: Antecedents to employee’s turnover intentions. International Journal of Health Policy and Management, 1 (1), pp. 49-58.

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 

Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

 

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 

Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

 

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 

Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

 

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Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testi

 

 

ABSTRACT

Introduction:job satisfaction and commitment depends upon the leadership style of managers. This study clarifies further the relationships between leadership behaviors of managers and two ’ related attitudes-job satisfaction and organizational at public hospitals in Iran. A better understanding of these issues and their relationships can pinpoint better strategies for recruiting, promotion, and training of future hospital managers and employees, particularly in Iran but perhaps in other societies as well. Methods: This cross-sectional study was conducted using self-administered questionnaires distributed among 814 hospital employees and managers through a stratified random sampling. Results and discussion: The dominant leadership style of hospital managers was participative style. Hospital employees were moderately satisfied with their jobs and committed to their organization. Salaries, benefits, promotion, contingent rewards, interpersonal relationships and working conditions were the best predictors of job satisfaction among hospitals employees. Leadership, job satisfaction and commitment were closely interrelated. The leadership behavior of managers explained 28% and 20% of the variations in job satisfaction and organizational commitment respectively. Conclusion: This study clarifies the causal relations of job satisfaction and commitment, and highlights the crucial role of leadership in ’ job satisfaction and commitment. Nevertheless, participative management is not always a good leadership style. Managers should select the best leadership style according to the organizational culture ’ organizational maturity.

Key words: Leadership, Job satisfaction, Organizational commitment, Hospital

 

Mosadeghrad, A.M. & Ferdosi, M., (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Mat Soc Med. 25(2): 121-126.

 

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The impact of top management turnover on quality management implementation

 

The purpose of this study was to investigate the impact of top management turnover on Strategic Collaborative Quality Management (SCQM) implementation in healthcare organizations. The role of top management turnover in the process and impact of the SCQM model was investigated using a case study of a public hospital. Methods: Both qualitative and quantitative methods were used for data collection. Results and discussion: Top management turnover is a major threat to the long-term success of the SCQM intervention and makes it very difficult to sustain its benefi ts. Successful quality management implementation needs supportive and committed leadership and management. Top management stability encourages long-term planning and commitment to pursuing long-term objectives. Conclusion: Th is paper has highlighted the critical role of top management stability during the course of quality management implementation

 

Mosadeghrad, A.M. Ferdosi, M. Afshar, H. & Hosseini-Nejhad, M., (2013). The impact of top management turnover on quality management implementation. Medical Archives, 67(2): 134-140.

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Healthcare service quality: Towards a broad definition

 

Abstract

Purpose – The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients,professionals, managers, policy makers and payers. Design/methodology/approach – This study represents an exploratory effort to understandhealthcare quality in an Iranian context. In-depth individual and focus group interviews wereconducted with key healthcare stakeholders. Findings – Quality healthcare is defined as “consistently delighting the patient by providingefficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient’s needs and satisfies providers”. Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. Practical implications – This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. Originality/value – This is the *rst time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

Keywords Healthcare organizations, Quality, De*nition, Pluralistic evaluation, Iran, Health care,

Customer services quality

Mosadeghrad, A.M., (2013). Healthcare service quality: Towards a broad definition. International
Journal of Health Care Quality Assurance, 26 (3); 203-219.

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Obstacles to TQM success in health care systems

Abstract

Purpose – Many healthcare organisations have found it difficult to implement total quality management (TQM) successfully. The aim of this paper is to explore the barriers to TQM successful implementation in the healthcare sector. Design/methodology/approach – This paper reports a literature review exploring the major reasons for the failure of TQM programmes in healthcare organisations. Findings – TQM implementation and its impact depend heavily on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in healthcare organisations can be attributed to the strongly departmentalised, bureaucratic and hierarchical structure, professional autonomy, tensions between managers and professionals and the difficulties involved in evaluating healthcare processes and outcomes. Other obstacles to TQM success include lack of consistent managers’ and employees’ commitment to and involvement in TQM implementation, poor leadership and management, lack of a quality-oriented culture, insufficient training, and inadequate resources. The review was limited to empirical articles written in the English language during the past 30 years (1980-2010). Practical implications – The findings of this article provide policy makers and managers with a practical understanding of the factors that are likely to obstruct TQM implementation in the healthcare sector. Originality/value – Understanding the factors that obstruct TQM implementation would enable managers to develop more effective strategies for implementing TQM successfully in healthcare organisations.

Keywords Total quality management, Failure, Obstacles, Successful implementation, Health care

 

Mosadeghrad, A.M., (2013). Obstacles to TQM success in health care systems. International Journal of Health Care Quality Assurance, 26 (2): 147 - 173.

 

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Developing a Total Quality Management model for health care systems

ABSTRACT

Background: Total quality management (TQM) is a managerial practice to improve the effectiveness, efficiency, flexibility, and competitiveness of a business as a whole. However, in practice, these TQM benefits are not easy to achieve. Despite its theoretical promise and the enthusiastic response to TQM, recent evidence suggests that attempts to implement it are often unsuccessful. Many of these TQM programmes have been cancelled, or are in the process of being cancelled, as a result of the negative impact on profits. Therefore, there is a pressing need for a clinical approach to establishing TQM. Method: The aim of this article is therefore: “To identify the strengths and weakness of TQM, the logical steps towards TQM, and to develop a model so that health care organizations aiming at using TQM to achieve excellence can follow through easily”. Based on the research questions proposed in this study, the research strategies of a literature review, a questionnaire survey, semi-structured interviews, and a participatory action research were adopted in this study. For determining the success and barriers of TQM in health care organizations, a questionnaire survey has done in 90 health care organizations in Isfahan Province, which implement TQM. The results of this survey were used for introducing a new model of TQM. This model will be developed via a semi-structured interview with at minimum 10 health care and quality managers. Then, through a participatory action research, this model will be implemented in 3 sites. At this time, the questionnaire survey has done and the model is introduced. Therefore, developing the model and its implementation will be done later. Results: In this survey, the mean score of TQM success was 3.48±0.68 (medium) from 5 credits. Implementation of TQM was very low, low, medium, high and very high successful respectively in 3.6, 10.9, 21.8, 56.4 and 7.3 percent of health care organizations. TQM had the most effect on process management and focus on employees and the less effect on focus on material resources, customers, and suppliers. The mean score of TQM implementation problems was 3.01±0.83 (medium) on a 5 scale. TQM Barriers in health care organizations were strategic problems, performance appraisal problems, human resource problems, structural problems, process problems respectively. Based on these results a Model with 10 enablers and 3 results’ indicators is introduced. Enablers are factors that enable organization to reach excellent and results are the out comes of organization, which can be achieved through implementation of enablers. This model will be developed through semi structure interviews and implemented in 3 health care organizations for determining the efficacy and efficiency ( this two phases has not done). Discussion: Total quality management is a good strategy for improving the productivity of organizations. However, if some important principles are not considered in TQM models before its implementation, the overall strategy of a TQM initiative may fail.  

KEYWORDS

Total Quality Management, Health care services organizations

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Developing a model for evaluation and accreditation of hospitals

Background: Evaluation and accreditation of Health Care organizations has an important role in increasing the effectiveness and efficiency of these organizations and developing the quality of services provided. The current system of evaluation and accreditation of hospitals in Iran is based on structure only with out considering the context, process and output and this cause many problems for both health care providers and customers. Therefore, there is a pressing need for developing a model for health care systems’ evaluation and accreditation, which help these organizations to improve the quality of services. Method: The aim of this article is therefore: “To identify the strengths and weakness of the current system of evaluation and accreditation of hospitals in Iran, determining the ideal system of evaluation and accreditation to develop a model so that health care organizations aiming at achieving effectiveness and efficiency”. A descriptive study using a cross-sectional survey for data collection performed. All of hospital managers and hospital evaluators in Isfahan province were studied via a self administrated questionnaire (53 managers and 30 evaluators). This questionnaire specifies the respondents’ opinions about the current and ideal system of evaluation and accreditation of hospitals. Data was analyzed via SPSS11 software. Findings: The mean score of current system of evaluation and accreditation of hospitals was 3.12 mean score of structure, process and outcome were 3.1 0.73, 3.120.83 and 4.41 0.91and 3.09 0.34 (in a 5 scale).The 1 in the current system of hospital evaluation respectively. From the view points of hospital managers and evaluators the differences between values of current and ideal scores of evaluation and accreditation system were statistically significant (P< 0.05). Therefore, there is a need for developing a model for hospital evaluation and accreditation. Based on these results an empirical model for Evaluation and Accreditation of Hospitals is developed. In this model, the context, structure (input), process and results (out put) were considered comprehensively. In this model items such as customer participation in treatment process, hospital information system, equity of services, employees’ participation in evaluation process, increasing employees and managers knowledge and capabilities level, risk and safety management  and so on are considered. Discussion: The evaluation and accreditation system of Hospitals should be a comprehensive system in order to evaluate the whole dimensions of these organizations.

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Towards a theory of quality management: an integration of strategic management, quality management a

 Abstract

    Despite the potential benefits of TQM, its application in healthcare organisations encountered difficulties. The main purpose of this study is to develop a model of quality management for healthcare organisations. Thirty quality management experts were approached by using a Delphi method to specify the components of an appropriate quality management model. The core research led to the development of a context-specific model of quality management for healthcare organisations. It includes creating the organisation’s long-term quality goals and objectives related to employees, customers, suppliers, society and organisation, developing strategies and action plans to achieve these objectives, providing the necessary education and training, adopting cultural change, and then allocating resources to implement the action plans.

 Keywords: strategic management; quality management; project management; healthcare organisations; modelling.

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A study of relationship between job stress, quality of working life and turnover intention among

Abstract

     Job stress is a serious threat to the quality of working life (QWL) of health-care employees and can cause hostility, aggression, absenteeism and turnover, as well as reduced productivity. In addition, job stress among employees affects the quality of health-care services. The purpose of this study was to gain a better understanding of the relationships between job stress and QWL of employees, and their impact on turnover intention at Isfahan hospitals, Iran. The study employed a cross-sectional research design. A validated questionnaire was used to collect data from hospital employees. Overall, 26% of employees graded their job stress high. The major sources of stress were inadequate pay, inequality at work, too much work, staff shortage, lack of recognition and promotion prospects, time pressure, lack of job security and lack of management support. An inverse relationship was found between job stress and QWL among hospital employees. The most important predictor of QWL was disturbance handling, followed by job proud, job security and job stress. Finally, while QWL was negatively associated with turnover intentions, job stress was positively related to employees’ intention to quit. Since job stress has a strong correlation with employee QWL and turnover intention, it is very important to apply the right human resources policies to increase employees’ QWL and decrease subsequent turnover. This study invites further research to explore, implement and evaluate intervention strategies for prevention of occupational stress and improvement in QWL

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A study of relationship between managers’ leadership style and employees’ job satisfaction

 Abstract

    The purpose of this descriptive and cross-sectional study is to explore the relationships between managers’ leadership styles and employees’ job satisfaction in Isfahan University Hospitals, Isfahan, Iran, 2004. The data were collected through the distribution of two questionnaires among the 814 employees, first line, middle and senior managers of these hospitals through a stratified random sampling. The dominant leadership style of managers was participative. The mean score of employee-oriented dimension of leadership style in first line, middle and senior managers were 52, 54, and 54 (from 75 credit) respectively. The mean score of task-oriented dimension of leadership style in first line, middle and senior managers were 68, 69, and 70 (from 100 credit) respectively. The mean score of employee’s job satisfaction was 3:26 ^ 0:56 on a 6 scale (moderate satisfaction), 1.9, 26.1, 64.7, and 7.3 percent of hospital employees had respectively very low, low, moderate, and high satisfaction with their job. Employees demonstrated less satisfaction with salaries, benefits, work conditions, promotion and communication as satisfier factors and more satisfaction with factors such as the nature of the job, co-workers and supervision type factors. There was significant correlation (p , 0:001) between the use of leadership behaviors and employees and job satisfaction. Research limitations/implications – Employee job satisfaction depends upon the leadership style of managers. Nevertheless, participative management is not always a good management style. Managers should select the best leadership style according to the organizational culture and employees’ organizational maturity. Although this study conducted in Iran, it is anticipated that the findings may have relevance on a broader scale. By replicating this study in different countries and contexts the results of could be very helpful for developing a new model of leadership with new implementation techniques that can be implemented easily and successfully in a cross cultural context.

Keywords: Leadership, Employees, Job satisfaction, Hospitals, Iran

 

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Healthcare service quality: towards a broad definition

Abstract

     Healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. The study’s main purpose, therefore, was to comprehensively define healthcare quality to encompass healthcare stakeholder needs and expectations. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Respondents were Iranian healthcare stakeholders and study results may not be generalised to other countries. Quality healthcare is defined as ‘consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient’s needs and satisfies providers’. Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed considering various healthcare stakeholder perceptions and expectations.

Keywords - Healthcare organisations, Quality, Definition, Pluralistic evaluation, Iran.

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A survey of total quality management in Iran: Barriers to successful implementation in health care o

Abstract

The objective of this research is to investigate the success of TQM and barriers to its successful implementation in health care services organizations in Isfahan province, Iran, 2004. This descriptive and cross-sectional research was done via two questionnaires (TQM success and its barriers). The statistical population of this research consists of all managers of health care services organizations who implemented TQM in their organizations (90 managers). TQM success in Isfahan health care organizations was high. In correlation analyses between the success of TQM and its principles, success, process management and focus on employees had a positive and the greatest effect and focus on material resources and on suppliers had a lower effect. In correlation analysis between the barriers to TQM and the problem dimensions, human resource, strategic and structural problems were the most important obstacles and barriers to TQM successful implementation respectively. Although conducted in Iran, it is anticipated that the findings may well have relevance on a broader scale. By replicating this study in different countries and contexts the results could be very fruitful for developing a model of TQM that can be implemented easily, effectively, efficiently and successfully in a cross-cultural context.

Keywords: Total quality management, Health services sector, Management effectiveness, Iran

 

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The impact of organizational culture on the successful implementation of total quality management

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     The purpose of the paper is to determine the impact of cultural values on the success of TQM implementation in Isfahan University Hospitals (IUHs), Iran, 2004. In this paper survey questionnaires were used to elicit responses from hospital managers and employees. Data collected included the characteristics of organizational culture in IUHs and the degree of TQM success and its implementation problems in these hospitals. The paper finds that TQM success in IUHs was medium. Implementation of TQM was very low, low, medium and highly successful respectively in 16.7, 16.7, 58.3 and 8.3 percent of hospitals. TQM had the most effect on process management, focus on customers and leadership and management and less effect on focus on suppliers, performance results, strategic planning and focus on material resources. Human resource problems, performance appraisal and strategic problems were the most important obstacles to TQM success respectively. A total of 75 and 25 percent of hospitals had mechanistic and organic structure respectively. In total 41.6 percent of hospitals had weak organizational culture versus 58.4 percent medium culture. The success of TQM in hospitals with organic organizational structure and medium organizational culture was higher than mechanistic and bureaucratic hospitals with weak organizational culture (p , 0:05). The paper shows that TQM requires a quality-oriented organizational culture supported by senior management commitment and involvement, organizational learning and entrepreneurship, team working and collaboration, risk taking, open communication, continuous improvement, customers focus (both internal and external), partnership with suppliers, and monitoring and evaluation of quality. By replicating this study in different countries and contexts the results could be very helpful for developing a model of TQM that can be implemented successfully in a cross-cultural context.

 

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A study of the relationship between job satisfaction, organizational commitment and turnover intenti

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     The purpose of this descriptive, co-relational and cross-sectional study was to gain a better understanding of the relationships between job satisfaction and organizational commitment of employees, and their impact on turnover intention at Isfahan Hospitals, Isfahan, Iran, in 2005. Data were collected by the distribution of two questionnaires among 629 employees of these hospitals through a stratified random sampling method. The results of the paper indicate that hospital employees are moderately satisfied with their jobs and committed to their organization. Employees’ job satisfaction and organizational commitment were closely inter-related and correlated with turnover intention (P, 0.001). The positive correlation between the two was expected, but there was also unexpected correlation with turnover intention. This may be due to external factors, such as job market conditions, which may influence perceived opportunities for career advancement elsewhere. The impact of such external factors is outside the scope of this study, but will have to be investigated in further research. As job satisfaction and organizational commitment have strong correlation with turnover, it is very important to reinforce them by applying the right human resource policies.

 

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Factors affecting employees' job satisfaction in public hospitals: Implications for recruitment and

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     Job dissatisfaction is a major cause of absenteeism and turnover among healthcare employees, and as such, it affects employees' organisational commitment and the quality of healthcare services. However, little is known about which factors influence job satisfaction and dissatisfaction in hospital staff. The purpose of this study was to investigate specific factors associated with job satisfaction and dissatisfaction in employees at the Isfahan University Hospitals (lUHs) in Isfahan, Iran. This study also focuses on revealing homogeneous demographic characteristics that these employees exhibited, which affect their satisfaction level. Questionnaires were distributed among the 950 employees through a classified randomised sampling. Overall, employees were moderately satisfied with their jobs, and more satisfied with the following aspects of their current work situation: supervision, job identity and co-workers. The lowest satisfaction scores were found for benefits, contingent rewards, communication, salaries, work conditions and promotion. Motivating factors included loyalty to employees, job security, good pay, good working conditions, tactful discipline, involvement, recognition and promotion.

 

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