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Aim: The EHUO project of reorganization of medical units into the new activity poles is a complex exercise and a challenge in relation to structural, organizational, and especially cultural barriers. The relationships between the EHUO and the Ministry of Health leave no room for autonomy. Funding continues to be provided through grants. Furthermore, no regulatory and technical support is available to the EHUO actors for development of the local project and even less for restructuring., Methods: The authors describe and analyze the planned new organization from limited material available produced by the administration (notes and instructions) and the services projects analysis document prepared by our team., Results: The proposed poles are based on draft projects integrating the various units, with no reformulation in the context of a shared vision or a coherent point of view including the interactions between all parts of the project. Theoretically expected effects, such as autonomy, and management contracts for instance, are not on the agenda. The internal contract does not appear to be at the heart of the debate. Economies of scale and sharing of resources are only vaguely discussed., Conclusion: Important prerequisites are necessary for this ambitious and highly structuring project. The EHUO actors must strive to reach an agreement on a common vision and values to be protected together as part of a collectively designed project to ensure good governance.

Aim: Quality of care is a strategic priority of any management approach in order to meet users' expectations of health care systems. This study tried to define the role of patient satisfaction surveys and the place of user in the quality of care project., Methods: The results of patient satisfaction surveys conducted between 2010 and 2012 and the draft quality of care project were analysed., Results: Patient satisfaction surveys from 2010 to 2012 focused on logistic shortcomings. No comment was formulated about health care. Comments and suggestions did not provide any contribution in terms of patient involvement in the health care process., Conclusion: The multiple perspectives of quality of care include clinical care and other social objectives of respect for the individual and attention to the patient. User satisfaction as assessed by patient satisfaction surveys or patients' experiences only reflect the health professionals' representation. However, the objective is to measure what the user perceives and feels and his/her representation of the attention provided. These approaches, conducted outside of the quality of care strategic plan, only provide a basis for actions with limited or no effectiveness.

Aim: Oran university hospital has been operating since 2010. It is a public institution that must assess the resources required to achieve institutional goals integrated into the strategic objectives defined in the hospital development project. Implementation of this project could be supported, among other things, by a strong and efficient hospital information system., Methods: Three investigations were conducted: 1- evaluation of the hospital information system, 2- assessment of the quality of the hospital discharge summary reports, 3- assessment of the quality of medical records., Results: The six components of the hospital information system (resources, indicators, sources, management, quality and dissemination and use of data) were clearly present but not satisfactory with a score ranging from 25 to 50% of the total score. The scores by component were as follows: 36% for resources, 37% for indicators, 42% for patient records, 19% for data management and 27% for the dissemination of information. The overall completeness of medical records was 85.2%. Completeness by group of variables gave the following results: 66% for medical information, 54% for the patient's stay and 38% for information relating to the patient's discharge. Hospital discharge summary reports were available in 59.8% of cases, but were blank in 4% of cases. The critical variable, the principal diagnosis was found in 51% of cases. The correct principal diagnosis rate was 33.3%., Conclusion: The deficiencies observed for content and data management raise real questions concerning data management at Oran university hospital as part of a real managerial approach.