راهکارهای اصلاحی ارتقاء عملکرد نظارت و بهبود زیر ساختهای اجرای دستورالعمل طرح جدید کارانه1394(یک مطالعه کیفی)

Background: In year 1995, new system administration plan of hospitals (fee for service) was notified. This scheme was implemented in hospitals for 20 years. In the early September 2104, new guidelines of performance-based fee for service plan with the aim of deficiencies in the previous plan was reviewed and implemented in hospitals in Isfahan. This study aimed at investigating reform strategies to improve monitoring performance and infrastructure implementation development of the new scheme of fee guidelines in 2014. Materials and Methods: This study was a qualitative one based of phenomenology. Depth interviews were used to collect data. Eleven individuals assessed including top and middle managers and professors of Isfahan University of Medical Sciences using content analysis method. Results: In this study, eight main themes and ten sub-themes extracted including appropriate policy making, health management reform in health system, cultural building in monitoring, proper planning, physicians' motivation, infrastructure improvement, improving training, informatics and constructive interactions between senior managers and hospitals' directors. Conclusion: With the aim of rationalizing the health system, new instructions and fee for service plan should be considered well to tackle weak points. It seems that coping with these weak spots in new fee for service plan, has feasibility to provide more satisfaction among physicians and staff. To achieve main goal of the project which defined as patients and staff satisfaction, using new reform strategies to facilitate plan implementation, continuing observation and stronger mentoring recommended.