Restructuring Non-teaching Hospitals into Teaching Hospitals in Iran: Component Change in General Hospitals

Abstract

Background: The present study investigated how a general hospital is restructured in Iran when transforming from a non-teaching into a teaching hospital. Methods: This applied study was conducted based on a mixed-method design from 2020 to 2021 using a systematic search and review, document analysis, comparative and cross-sectional design, multiple voting technique, and qualitative phenomenological method. Results: The conceptual framework of the components of a hospital as a system includes inputs (governance and policy-making, goals and mission, clinical and support departments, physical space, clients, and human resources), processes (internal and external relations, key processes, type and level of services, and teaching mission systematization), and outputs (performance evaluation, internal and external customer satisfaction, human capital empowerment, organizational behavior, income-cost management, cost-effectiveness and efficiency, service quality, and legal and social responsibility). Conclusion: The findings from the present study depicted how the components of teaching and non-teaching hospitals are restructured when changing their functions. Restructuring an established organization, such as a hospital, is very challenging and requires multiple changes. This study had some implications including highlighting the need to formulate protocols for restructuring non-teaching hospitals into teaching hospitals or constructing new teaching hospitals, classifying teaching hospitals and clarifying their differences, focusing on the teaching mission in hospitals, and reviewing and updating the integration of medical education in providing health services.