In recent years, the frequency of attempts to implement accrual accounting in the public sector, some countries do have reporting systems in our country in recent years, efforts to use the accrual accounting system occurred throughout the University of Medical Sciences countries according to their bylaws and financial transactions that use this system have been approved. The main purpose of accounting and financial reporting systems in universities to provide information that could act as effective managers in corporate decision-making executives. The present study investigates the impact of the implementation of accrual accounting to meet the medical directors of the North West University (Ardabil, East Azerbaijan, West Azerbaijan, Zanjan, Hamedan, Kurdistan, Ilam, Kermanshah) is discussed. The sample consisted of 180 managers in 1392 is mentioned universities and research information using a questionnaire containing 27 items with a Cronbach's Alpha 943 /. Were collected for this purpose, initially characterized by descriptive statistics on the demographic questionnaire and the responses obtained are presented in the next step inferential statistical tests such as t-Student (hypothesisthe test statistic for), and the Variance analysis Friedman (for ranking hypotheses) was used. The results of testing research hypotheses suggest that the managers of Medical Sciences, University of the North West directors influence the implementation of accrual accounting in the decision variable.The results showed that the implementation of accrual accounting in management decision making speed of decision-making is most effective and timely receipt of minimum impact indicators shall be accepted.