A Systemic Inquiry into a Hospital’s Reformation Actions

Abstract

Following a kitchen outsourcing in a hospital in Tehran, Iran, some purposeful replacements were made which turned out to generate significant outcomes. After two years, the researchers, in collaboration with the hospital authorities, designed a Soft Systems Methodology (SSM) in the form of a mixed-method action research (AR) in order to: (1) find out the actual initial problems, (2) discover the details of the actual planning and implementation processes, and (3) assess and evaluate the actual impacts of the transformations. Several open unstructured interviews were conducted followed by subsequent semi-structured interviews with 12 informed hospital staffs. To provide triangulation, some quantitative methods were also employed. The evaluating indicators were derived from analysis of the interviews, the Hospital Information System, and the Nationwide System for Hospital Accreditation Management. The indicators were matched with the hospital’s strategic goals using Balanced ScoreCard and Pivot Tables. The qualitative findings revealed the hospital’s initial problems which basically comprised shortage of space in dealing with Endourology and day care patients and problems with food provision and distribution. Due to the renovations, appropriate spaces were provided for the sections although some new complications were created. The quantitative findings showed significant growth in income, bed productivity, patient discharge rate, and education effectiveness with reduction in patient complaints and food leftover; chiefly suggestive of fulfilment of the hospital’s strategic goals. To help novice managers learn about change administration, worldwide leaders are recommended to circulate their fruitful renewals particularly with the comprehensive SSM they have employed.