In city hospitals established with Public-Private Partnership (PPP), the fact that both the public and private sectors have a say in various management levels makes the managerial decision-making processes of these facilities more complex. As a matter of fact, the aim of this study is to identify the barriers and facilitators of evidence-based decision-making in the managerial decision-making processes of city hospitals, to identify the most effective and important ones, and to propose a model for managers within the framework of the PDCA cycle. The research consists of two stages, qualitative and quantitative. Qualitative research participants were determined by criterion sampling method, provided that they were the manager of at least one unit. In total, in-depth interviews were conducted with 17 managers. Directed content analysis was applied to the data obtained in the qualitative research using the MAXQDA 2020 Pro Analytics program. Accordingly, 7 different barriers and facilitators themes were determined. In the quantitative stage, expert opinions were collected through the DEMATEL questionnaire form from 8 different managers and academics to determine the impact and importance levels of barriers and facilitators. As a result, the most effective and important barriers themes in the evidence-based managerial decision-making process in city hospitals were organizational structure (%14.78) and cooperation and partnership (%14.66) respectively; the most ineffective and insignificant barriers theme was individual factors (%13.73). On the other hand, the most effective and important facilitators themes were organizational structure (%14.92) and organizational culture (%14.78), respectively; the most ineffective and insignificant facilitator theme was individual factors (%13.93). Considering the rankings of the most effective and important barriers, priority strategy suggestions were presented, and a model was developed within the framework of the PDCA cycle with facilitators.