title: Evaluation of outsourcing in nursing services: a case study of kashani hospital, isfahan in 2011.
abstract: BACKGROUND
  Hospitals need to focus on their core activities, thus outsourcing of services may be effective in some instances. However, monitoring and supervision is a vital mechanism to preserving and enhancing the quality of outsourced services, and to identify the benefits and losses occurred. The purpose of this study is evaluation of nursing services outsourced in a general hospital from different point of views.
  
  
  METHODS
  This is a descriptive and applied study done by case study (before and after) method. Outsourcing nursing services of clinical wards (ENT and Neurosurgery) of Kashani Hospital in 2011 has been studied. We extracted data from a handmade questionnaire about internal customer's satisfaction and semi-structured interviews with officials, and also survey of financial and administrative documents and records related to the topic.
  
  
  RESULTS
  The findings indicate an increased number of graduated nurses per bed to fulfill the main objective of outsourcing in this case. But achieving this objective is accompanied with remarkable increased costs per bed after outsourcing. Besides, we noticed minor changes in internal customer satisfaction rate.
  
  
  CONCLUSIONS
  While outsourcing should bring about staff and patients' satisfaction and increase the efficiency and effectiveness, outsourcing nursing workforce singly, leaded to a loss of efficiency. Therefore, the applied outsourcing has not met the productivity for the hospital.
authors.affiliation: School of Management and Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Ferdosi
authors.forename: Ehsan
authors.initials: E
authors.lastname: Farahabadi
authors.forename: Maryam
authors.initials: M
authors.lastname: Mofid
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Rejalian
authors.forename: Maryam
authors.initials: M
authors.lastname: Haghighat
authors.forename: Parnaz
authors.initials: P
authors.lastname: Naghdi
keywords: Evaluation; Hospital.; Nursing Services; Outsourcing