Kalajahi Riaz Alaei, Ghorbani Mohammad, Arab Mohammad, Jaafaripooyan Ebrahim, Yaseri Mehdi
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Mathematics and Mathematical Statistics, Umeå University, Umeå, Sweden.
Iran J Public Health. 2024 Sep;53(9):2130-2139. doi: 10.18502/ijph.v53i9.16466.
We aimed to investigate Tehran's University of Medical Sciences (TUMS) affiliated hospitals organizational readiness toward implementing the 'Autonomous Hospitals' program as a change initiative from a managerial perspective in 2020.
A census covering all eligible managers working in TUMS affiliated hospitals, Tehran, Iran (350 individuals) was carried out. Overall, 281 questionnaires were returned (a 30% non-responsiveness rate). A standard construct was adopted for data collection which was validated through a process of translation- back translation, face validity, and content validity (CVI=0.86, CVR=0.76). The reliability was acquired using Cronbach's alpha coefficient (0.87 and over 0.7). Both descriptive and inferential statistics were employed to draw conclusions .SPSS 26 was used for data analysis.
Total organizational readiness for change (TORC) in hospitals was 60.75%±10.11 showing a state of medium to upper-medium readiness status. Also, the 'Clear mandate and centralized leadership' theme scored the lowest mean (53.02%±15.78) for ORC. 'Hospital accreditation level' (r=-0.14, ≤0.05), 'bed occupancy rate' (r=-0.19, ≤0.05), and 'leadership status' (r=0.26, ≤0.001), also showed significant association with TORC. In addition, 'standardized bed occuancy rate' (≤0.05, B=-2.41), a 'male' leader ( ≤0.05, B=3.42), and 'academic affiliation' (≤0. 1, B=-9.52), were good redictors of TORC based on 'Backward Multiple Linear Regression' analysis.
Full support from hospital and headquarters executives, delegation of sufficient decision-making authority to hospital managers, and implementation of comprehensive performance evaluation criteria were prerequisites for robust hospital autonomy in TUMS-affiliated hospitals.
我们旨在从管理角度调查2020年德黑兰医科大学（TUMS）附属医院对实施“自主医院”计划这一变革举措的组织准备情况。
对伊朗德黑兰TUMS附属医院所有符合条件的管理人员（350人）进行普查。总体而言，共收回281份问卷（无回应率为30%）。采用标准结构进行数据收集，并通过翻译回译、表面效度和内容效度（CVI = 0.86，CVR = 0.76）过程进行验证。使用克朗巴哈系数（0.87及以上0.7）获得信度。采用描述性和推断性统计得出结论。使用SPSS 26进行数据分析。
医院的总体组织变革准备度（TORC）为60.75%±10.11，显示出中等到中上准备状态。此外，“明确的授权和集中领导”主题在组织变革准备度方面得分最低，均值为（53.02%±15.78）。“医院认证水平”（r = -0.14，≤0.05）、“床位占用率”（r = -0.19，≤0.05）和“领导地位”（r = 0.26，≤0.001）也与TORC显示出显著关联。此外，基于“向后多元线性回归”分析，“标准化床位占用率”（≤0.05，B = -2.41）、男性领导（≤0.05，B = 3.42）和“学术隶属关系”（≤0.1，B = -9.52）是TORC的良好预测指标。
医院和总部管理人员的全力支持、向医院管理人员下放足够的决策权以及实施全面的绩效评估标准是TUMS附属医院实现强大医院自主权的先决条件。
