Journal of Education and Health Promotion

Abstract BACKGROUND: Today, hospitals need managers who, in addition to having the necessary skills for
management and leadership, are accountable to stakeholders, especially the community. Accordingly,
the purpose of this study was to evaluate the social accountability of managers of public and private
hospitals in Tehran.
MATERIALS AND METHODS: The present study is descriptive‑analytical and cross‑sectional and
was performed on 155 managers of selected public and private hospitals in Tehran. The research
tools included a demographic characteristic questionnaire and a researcher‑made social accountability
questionnaire for managers. Data analysis was performed using descriptive and inferential statistics
in SPSS 22 software.
RESULTS: The situation of social accountability in the managers of public hospitals was at a
weak level and in the managers of private hospitals in Tehran was at a good level. In comparing
the status of social accountability and its dimensions in the managers of public hospitals with the
managers of private hospitals, the status of social accountability in the dimensions of human resource
management, quality improvement, executive management, and overall social accountability were
significantly different from each other (P ≤ 0.05). However, in terms of governance, the status
of social accountability of public hospital managers was not significantly different from private
hospitals (P ≥ 0.05). Overall, the results of social accountability in private hospitals were better
than in public hospitals.
CONCLUSION: The social response status of managers in private hospitals was better than public
ones. Lack of attention of managers to social accountability affects the quality of other educational,
health, and medical services. This fact raises the need for managers to pay more attention to the
issue of social accountability.

Abstract INTRODUCTION: Outsourcing, as one of the important managerial strategies to improve performance,
has become one of the main areas of research in hospital management studies. The aim of this
study was to identify the challenges of outsourcing hospital services in Iran.
METHODS: This research was conducted in a qualitative manner with the aim of determining the
challenges of outsourcing hospital services in Iran. The research community consisted of managers
and experts in the field of outsourcing. 21 managers and staff experts of the Ministry of Health,
universities, and hospitals affiliated to Iran University of Medical Sciences, Tehran, and Shahid
Beheshti, were selected as the target for the interview. Finally, the data were analyzed using content
analysis method.
RESULTS: Outsourcing challenges were extracted and reported in the form of 6 theme topics and
40 subthemes. The main issues included legal and political challenges, finance, human resources,
organizational, managerial, and private sector.
CONCLUSION: Outsourcing hospital services in all six areas faced serious challenges. To this
end, partnership between the private and government sectors through outsourcing requires the
continuous development of effective political, organizational, and managerial capacity in order to
guide and manage this process properly and efficiently to ensure that the goals and policies in the
field of health. It is clearly understood and not forgotten or neglected.

Abstract INTRODUCTION: Reporting medical errors is a major challenge in patient safety and improving
service quality. The purpose of the present study is to investigate the status of error reporting and
the challenges of developing an error‑reporting system in Iran.
METHODS: This study was designed with qualitative approach and grounded theory method in
teaching hospitals affiliated to Iran University of Medical Sciences. The views of safety authorities
at various levels of management, including those responsible for safety at the Ministry of Health,
Vice Chancellor and Hospitals affiliated to Iran University of Medical Sciences, were investigated in
2019 regarding adverse events.
RESULTS: Four major themes were identified included iceberg reporting and disclosure, weak
reporting, underreporting, and non‑error disclosure. The most common problems in reporting
medical error were non‑involvement of physicians in the error‑reporting process, structural (human
and information) bugs in root cause analysis sessions, and defective error prevention approaches
designed based on the failure mode and effects analysis.
DISCUSSION: Despite a large number of medical errors occurred in health‑care settings, error
reporting is still very low, with only a limited number of errors being reported routinely in hospitals
and the rest are minor and occasional reports.
CONCLUSION: Creating a mandatory error‑reporting system and requiring physicians to report and
participate in error analysis sessions can create a safety culture and increase the error‑reporting rate.

Abstract INTRODUCTION: Nongovernmental organizations (NGOs) play a significant role to provide
humanitarian services in natural hazards. However, few studies have been conducted on the
coordination models of NGOs. Using these models, NGOs are expected to act along with other
agencies to provide unified and effective humanitarian’s services. The present study aimed to identify
the published coordination models of NGOs.
MATERIALS AND METHODS: This systematic review was conducted from October to November
2017. Electronic source, including PubMed, Web of Science, ProQuest Research Library, and
Scopus were examined. All English articles published in journals or presented at conferences were
included in the study. Nonjournal and irrelevant articles were excluded from the study. Furthermore,
papers which were not available as a full text and published in languages other than English were
also excluded. Thematic analysis technique was used to analyze the articles.
RESULTS: From 871 documents which captured in initial search, only 7 studies identified as eligible
articles for extract 8 coordination models of NGOs in disasters and emergencies including: (1) Sphere
project, (2) Cluster approach, (3) Code of conduct, (4) Decentralized approach, (5) National Disaster
Response Framework, (6) Conceptual integrated NGO collaboration framework for community
postdisaster reconstruction, (7) Model of temporal coordination of disaster response activities,
and (8) Collabit application.
CONCLUSIONS: This systematic review identified eight proposed coordination models that have
been implemented internationally, nationally, and locally in natural hazards. However, these models
are not enough, and there are some gaps between what is it and what should be. More effective and
efficient models and strategies are needed to increase the effectiveness of coordination activities
at all levels of community. These results should serve policy‑makers and administrators of NGOs
delivering humanitarian services during and postnatural hazards to choose from a number of options
on how to coordinate their efforts.