Table 3.

Feasible options to improve the efficiency in the public hospitals.

Sub-themes	Quotations
Hospital objectives	“The hospitals need to adopt MOH aims in developing strategic plans in line with the capabilities, logical ambition and the needs of the patients and the community of that hospital” (MOH official).
Hospital management	“We need to establish specific criteria and set standards by the health committees to select hospital leaders at the level of the MOH and each district for deploying competent hospital managers” (MOH official).
Decentralization of powers	“To improve the performance, we need decentralization of hospital management and involve health workers in decision-making” (HM).
Efficiency assessments	“There must be an analytical study of the causes of the waste in hospital resources and find practical solutions to treat it and generalize the successful experiences” (MOH official).
Performance measurements	“We need to develop a performance measurement system under the supervision of MOH to assess the health resources used to produce the services as well as considering the patients' feedback on their consumed services” (DHA).
Research and education	“It is essential to educate and raise awareness of health practitioners about the importance of operational efficiency of hospitals and value of health services” (DHA).
Health practitioners	“The MOH should consider activating the part-time contracts (e.g., LOCUM) to overcome the need for specialized medical services (e.g., neurosurgery). It is also needed to establish a system of promotions for health workers to retain them in the hospital” (HM).
Health education	“I encourage to promote health education in the communities to raise patients' awareness about health services they receive and gain the patient trust in the hospitals” (HM).
Health information	“We need to establish health reporting systems focusing on patient's information, medical history and clinical cases, linking electronically with other departments, hospitals and the MOH. This database also should include health resources and services provided” (HM).