Designing a Model of Organizational Capacity Appropriate for Social Cohesion (Case Study: Public Hospitals in Tehran Province)

Abstract

Background: Public hospitals play an important role in the healthcare system, and strengthening their organizational capacity is essential. Social cohesion, through improving human interactions and relationships, may contribute to enhancing the organizational capacity of these institutions. This study aimed to design an organizational capacity framework aligned with social cohesion in public hospitals in Tehran Province.

Methods: This applied-developmental study employed an exploratory mixed-methods design. In the qualitative phase, experts were selected through purposive sampling, and 18 in-depth, semi-structured interviews were conducted. The data were analyzed using thematic analysis. In the quantitative phase, 222 participants were selected through stratified random sampling and using Cochran’s formula from a population of 526 managers and specialized staff working in public hospitals in Tehran. Data were collected using a researcher-developed questionnaire, whose validity and reliability were assessed and confirmed. SPSS ₃₂ was used for descriptive data analysis, while Smart PLS _4.1.1.8 was used for confirmatory factor analysis and Partial Least Squares Structural Equation Modeling (PLS-SEM).

Results: Thematic analysis identified seven dimensions of organizational capacity: cognitive, emotional, spiritual, interactional, infrastructural, leadership, and sustainability capacities, comprising 35 components and 175 indicators. Cronbach’s alpha ranged from 0.78 to 0.89, composite reliability ranged from 0.80 to 0.92, and average variance extracted ranged from 0.58 to 0.75. Furthermore, all factor loadings exceeded 0.50, and t-values were greater than 1.96, confirming the reliability, validity, and measurement structure of the framework.

Conclusion: The findings indicated that organizational capacity aligned with social cohesion in public hospitals consists of seven cognitive, emotional, spiritual, interactional, infrastructural, leadership, and sustainability dimensions. The confirmed validity and reliability of these dimensions suggest that their simultaneous strengthening may enhance organizational capacity, improve organizational performance, and promote the quality of healthcare services.