Background: OUTSOURCING, as an important strategy in healthcare, can also have its failures, including the case of "Z" Hospital in Isfahan Province, Iran, which engaged in an eight-year partnership between the contractor and the hospital. While the initial phase was successful, the second phase faced numerous obstacles, including legal and judicial disputes that extended until 2024. This research aims to analyze the outcomes and lessons learned from this OUTSOURCING experience. Methods: This applied research employed a qualitative methodology with a content analysis approach. Data were collected through interviews and a review of hospital documents. Participants in the study were selected using purposive sampling. Interviews were coded using a reductionist approach. The study's novelty lies in its simultaneous examination of multiple perspectives, including those of the client, contractor, hospital staff, and experts. Results: The OUTSOURCING period at "Z" Hospital was marked by considerable fluctuations, influenced by economic conditions, management changes, and consequent policy shifts at the University of Medical Sciences. The identified challenges were categorized into three main areas: client-related issues, including inadequate pre-OUTSOURCING research, lack of a precise contract, insufficient contractor support, and client inexperience; contractor-related issues, such as poor financial planning regarding bank loans and subsequent bankruptcy; and policy-related issues, including inconsistent government policies during specific periods, such as a lack of support for outsourced hospitals during economic crises and the expropriation of certain contractors at the onset of the Health Transformation Plan. Conclusion: OUTSOURCING can address management, quality, and efficiency issues in healthcare. However, without meticulous planning, implementation, and evaluation, it can create substantial challenges for both the client and the contractor. Comprehensive attention to all phases is crucial for successful OUTSOURCING.

Nowadays, OUTSOURCING in manufacturing has become global affair, and is increasing in research and development areas and occupations with a high technical level. This research was conducted with the aim of designing a decision-making OUTSOURCING model for the managerial activities of defense research and development projects based on scientific studies, criteria and decision making options for OUTSOURCING research and development activities have been identified and the main components of decision making have been determined. After this stage, using the method of analytical hierarchy and using experts' opinions, the required coefficients are calculated and computed by modeling and combining it with the scoring method, the decision-making model of OUTSOURCING of the managerial activities for defense research and development has been designed, and important applied element for external management of executive activities of these projects were proposed. At the end of the outsourceable activities, one of the research and development projects has been prioritized separately and in the whole project phase and OUTSOURCING contractors of activities were selected.