Journal of

Background and Aim: The Emergency Medical services(EMS) is a community-based health management system that has coordinated with the entire health care system and the employees are the most important asset of it. The purpose of this study was to identify the stressful factors that cause dissatisfaction of employee in the pre-hospital EMS in Kerman.

Materials and Methods: This study was a qualitative study and sampling was targeted. Acception criteria for the study was more than three years of experience as a technician operating in urban and road sites in the EMS. In this study, semi-structured interviews were conducted with 15 personnels and data was analyzed using "frame structured analysis" was used.

Results: This study identified four main axis and fifteen sub axis. The main issues related to the tensions and dissatisfaction include the employees personal problems, organizational problems, poor coordination, and problems with the community.

Conclusion: Considering Psychotherapy for staff and the creation of job rotation between the bases are the constructive suggestions for improving employee performance and improve the system of EMS is Kerman.

Background and Aim: Transforming government hospitals into autonomous units improved hospitals. This study was performed to evaluate the responsiveness of board of trustees hospital according to the world bank’s organizational reform model (Preker Model) in isfahan city.

Materials and Methods: The study was a qualitative research method. In this research, depth and semi-structured interviews were carried out and purposive sampling was used.

The study population were top managers of Amin and Alzahra hospitals . Sampling was started with the first participant until saturated level of information, participants completed the 8 cases.

Results: According to interviews, the current role and contribution of non-university institutions (e.g. municipalities representatives) in hospital board of trustees is neither bold nor transparent. These hospitals can address minimum changes in their mechanisms of accountability after developing board of trustees.

Conclusion : It is rational for hospitals as they undergo organizational reform and developing board of trustees, to have more rights for decision making. Further more, their accountability mechanism should change accordingly.