[Identifying the constraints faced by medical sciences universities in entering the second phase of health financial management reform: a qualitative study]

Introduction: Due to the need for transition from accrual accounting as the first phase of health financial management reform to unit cost as the second phase of this reform, this study was conducted in 2012 to investigate the most important constraints faced by Medical Sciences Universities against this reform

Method: This was a qualitative study through happlying Delphi method. Fifteen experts including resource development assistants and financial managers of Medical Universities accompanied with experts in health new financial management reform from Ministry of Health and Medical Education were attended 3 rounds of Delphi for achieving agreement

Results: Findings indicated that the most potential constraint belongs to the "need for human resource empowerment in executive body of the universities". "Novelty of unit cost in health sector" and "lack of previous similar experience" were also identified as the first actual limitations in establishing the second phase of health financial management reform

Conclusion: Considering the complete establishment of accrual accounting as one of the most important pre requisites for unit cost success, in order to flatten the way for reform, it is necessary to prepare a unique and specific framework and guideline for unit cost of services through contribution of all departments and branches of MOHME and financial officers of Universities of Medical Sciences

[ effective factors on staffs` satisfaction in accordance with Smith- Kendall-Hullin model in teaching hospitals: a case study]

Introduction: Challenges of service provision systems necessitate the presence of staff with higher motivation to work more efficiently, so paying close attention to job satisfaction of these staffs to enhance organizational efficiency sounds essential. The aim of this study was to investigate and among those staffs working in a Shohadaye Tajrish educational Hospital in Tehran

Method: This was a cross-sectional correlative study on a 200-staff sample in a teaching hospital in Tehran which was selected by a simple accidental sampling in 2013. The research instrument was a questionnaire with 25 questions that was considered suitable for face and construct validity and reliability. Data analysis was done by parametric statistics and Pearson correlation on statistical level of 0.05 applying SPSS version 18

Results: Results indicated that the highest average of the participants was related to satisfaction of coworker's dimension 4.05+/-0.87, and the least average belonged to satisfaction of salary 1.54+/-0.74. Furthermore, there was positive and statisticant relation between the whole satisfaction and all other five dimensions of the model. Finally the analysis among two variables [sex and age] and whole job satisfaction had significant relationship

Conclusion: It seems that correcting reward mechanisms in hospitals and applying managerial tools like performance-based-management can improve the staffs` performance and motivation. In addition, reinforcing the social relationships among coworkers may lead to incremental changes in one of the most important dimensions of the model and finally affect the whole satisfaction