Challenges and Opportunities Faced by Teaching Hospitals in the Perception of Stakeholders and Hospital System Managers

Today, hospitals are the most important medical institutions providing health care services, and a large share of health care resources is allocated to especially teaching hospitals. Given the fact that these hospitals have three main missions; namely, therapy, education, and research that paying attention to their challenges and opportunities can be vital for providing high quality services for patients. The aim of present study is to survey the viewpoints of stakeholders towards teaching hospitals. The qualitative study was done in 2017. For data gathering, we used interviews with 41 key informants, senior and middle managers in teaching hospitals and stakeholders in health care fields. Framework analysis approach was applied to analyse the data by MAXQDA software. Four themes and 13 subthemes were explored; three of them were about education, treatment and research challenges and one for teaching hospital opportunities. Education challenges includes: decline of educational mission attendance, lack of educational facilities, and non-compliance with educational standards. Treatment challenges like quality of health services provision, lack of resources and facilities and research challenges such as research structure, research quality in the hospitals, and low research facilities. Teaching hospital opportunities including potential of student presence, research opportunity, medical specialist training, meriting from up-to-date medical faculty and the benefits of them for patients. The results showed that teaching hospitals are more complex than other organisation as they have a big mission. They have a huge number of opportunities. On the other hand, they faced some challenges in the field of therapeutic, education and research because they perform all of these duties together, which by identifying them, they can be developed in these three goals and ultimately the efficiency and quality of teaching hospitals can be promoted in comparison with other hospitals.