The aim of this study was to evaluate peculiarities of staff organizational systems in general hospitals in Lithuania. A cross sectional survey was carried out in 2009. Questionnaires were sent to all general hospitals in Lithuania with requests to chief executive officers or other senior managers in charge of personnel and human resource departments to complete these surveys. Data was received from 58 hospitals (response rate 90.6%). Results revealed that only 14% of hospitals are using a full range of work or system practices relating to staff organization. The most common practices were: organization of staff development (96.5%), human resource or workforce planning (82.5%), and staff recruitment programs (82.5%). Individual career planning and employment probation was not widely practiced (36.8% and 40.4%). In most of hospitals (83.5%) the annual turnover of employees was low (=5 %). Our study evaluated the difficulties hospitals had in finding new candidates for vacant staff positions. Results showed that physician recruitment was the most challenging task for hospitals. Participants of this study evaluated positively their competency in management of human resources. Nevertheless hospital managers expressed the desire for competency improvement in this area, particularly in relation to management for probation, personnel development and workplace analysis.