farhad adhami mogadam

The implementation of the health care reform plan and the increase in workload on the same number of nurses can undoubtedly lead to dissatisfaction and Followed by job burnout and Leaving nurses Job. Therefore, this study was conducted with the aim of comparing the desire to quit serving, burnout and job satisfaction of nurses working in hospitals affiliated to Tehran University of Medical Sciences before and after the implementation of health system development plan.
This Descriptive-comparative study was performed on 362 nurses working in hospitals affiliated to Tehran University of Medical Sciences in 1395. The data gathering tool was a questionnaire that included demographic characteristics, Spector's Job Satisfaction Questionnaire, Maslach Job Burnout, and need desire to quit serving.
The job satisfaction of nurses before and after the implementation of the plan (3.12.3917) and (2.98.3279), burnout (4.62.765) and (4.61.8374) And the desire to quit serving of nurses (3.26.141) & (2.778.252). The results of paired t-test showed a significant difference in job satisfaction and desire to quit serving of nurses before and after the implementation of the plan (p=0.0001). The Paired t-test did not show a significant difference in burnout before and after the implementation of the plan (p = 0.848).
The results indicate that after implementing the health system reform plan, job satisfaction of nurses decreased, the desire to quit serving nurses has increased and nursing job burnout has been fixed.

Ever-increasing development of quality-oriented and customer orientation in health services, through continuous feedback of patients expectations and continual recovery of service presentation, is possible. Patient satisfaction can impact on compliance with suggested treatment and therefore impact on health outcomes.
this correlation-descriptive study of 405 bedridden patients was done at 3 hospitals that are depending to Tehran medical sciences Islamic Azad University that were selected according to the available sampling. Information collecting tools was a questionnaire including of two parts demographic and questions measuring service quality (SERVQUAL).
The highest quality of hospital service in the perceptions of the reliability dimension was with 17.5 averages and the lowest percentage was related to tangibility dimension with the average of 12.84. The highest average of hospital services quality in the expectation part was related to Empathy dimension with the average of 21.12 and the lowest percentage was related to tangibility dimension with the average of 17.23. The gap between patients’ perceptions and expectations at hospitals depending to Tehran medical sciences Islamic Azad University equal to -19.9 units. The lowest gap with -2.52 unit related to service Assurance dimension and the most gap with -4.6 units related to Empathy expectations.
For promotion of treatment health service quality, it’s necessary to establish a balance between services presenting and patient expectations. Suitable quality control is was to decrease of quality gap.