Journal of School of Public Health and

Background and Aim: Organizational centralization, an important concept/system in management, relates to hierarchy of authority and degree of participation in decision-making. In this study we aimed to determine the extent of organizational centralization in hospitals affiliated with Tehran University of Medical Sciences (TUMS), Tehran, Iran and identify factors affecting the organizational centralization at the level of executive managers.

Methods and Materials: All the managers and head nurses of 13 TUMS hospitals (26 subjects) were included in this cross-sectional study in 2005. Data, collected using questionnaires, were analyzed using the following tests: t-test, ANOVA, Pearson and Spearman, the software being the SPSS. The extent of organizational centralization was categorized into centralized, semi-centralized, and uncentralized.

Results: Five of the 5 variables studied were statistically significantly associated with organizational centralization. They were gender (p=0.001), organizational position (p=0.005), attending management courses (p=0.001), and financial burden of decisions (p=0/03) in the hospital managers group, and possibility of controlling the decision (p=0.014) in the head-nurses group.

Conclusion: The average organizational centralization in the hospitals was 75.38% it was 76.3% and 73.38% for hospital managers and head-nurses, respectively. On the whole, the management system of TUMS hospitals is a semi-centralized system.

Background and Aim: The objective of this study was to determine and compare the attitude of hospital staff and practice of hospital managers regarding management of conflicts in hospitals affiliated to Tehran University of Medical sciences.

Materials and Methods: The participants in this cross-sectional study were 330 individuals, including 300 nurses and 30 managers, working in hospitals affiliated to Tehran university of Medical Sciences, Tehran, Iran during 2008-2009. Data were collected using a valid self-administered questionnaire containing 30 questions designed by the investigator. The SPSS software was used for data analysis.

Results: The data show that 178 of the staff (59%) and 14 of the managers (47%) were of the opinion that avoidance is not utilized in conflict management. The proportions of the staff and managers believing that problem solution is not utilized in conflict management were 60% and 60%, respectively the corresponding proportions as regards not utilizing avoidance were 178% and 14%. Furthermore, 40% of the staff and 13% of the managers thought that usually compromise is utilized in conflict management. Finally, the proportions of staff and managers who thought that in conflict management accommodation is utilized were 41% and 43%, respectively.          

Conclusion: The findings show that the hospital staff believes that hospital managers with an avoidance, problem solution or forcing attitude base their conflict management style accordingly, while managers more inclined to compromise do not utilize a compromising approach in practice.