Journal of

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Background: Human Resources in the health sector not only is the most crucial source in health providing but account for nearly three-quarters of the health sector's costs. The purpose of this study was to estimate the required Human Resources of the CT scan department of the Reza Radiotherapy-Oncology Center based on the workload indicator of staffing needs in 2019.
Materials and Methods: This cross-sectional descriptive study used human resources determination based on staffing needs' workload indicators. The method of conducting expert meetings was used to determine the components of workload and standard time. Also, Interviews and rules, and personnel systems were used to determine the amount and factors related to available working time, and to determine the annual workload, the hospital management system and observation of activity logs were used. Excel and SPSS19 software were used to analyze the data for determining the required human resources and timing data, respectively.
Results: 7 factors related to staff annually available work time were identified. The available work time for CT scans staff was 1113 hours per year. In this study, imaging and simulation were determined as the main activities of the CT scans ward. The results of the workload indicator calculations showed that the CT scan section lacked 3 Personnel.
Conclusion: This study showed that Reza Radiotherapy Oncology Center is experiencing a shortage of professional CT scan staff, and the work pressure is (0.4). Therefore, CT scans are a top priority to provide the human resource.

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Background: Employees’ empowerment is the best and efficient organizational strategy for improvement of human resources productivity. Therefore, the present study was aimed to investigate the relationship between empowerment training courses with human resources productivity among Tehran University of Medical Sciences employees.
Materials and Methods: This was a descriptive-analytical and cross-sectional study. The study population included 1452 employees of the university deputies. Research sample was calculated 304 according to Krejcie and Morgan table. The research tool consisted of Hersey's empowerment training courses effectiveness translated by Jafari “et al.” and Hersey-Goldsmith's human resources productivity questionnaires. The content and structural validity including convergent and divergent validity of questionnaires were determined, and their reliability was confirmed by Alpha Cronbach with 0.86 and 0.89 coefficient, respectively. Data were analyzed by SPSS version 23, and descriptive results were presented by absolute and relative frequency and analytical results by inferential statistical techniques and Structural Equation Modeling.
Results: The mean of empowerment training courses effectiveness of employees and human resources productivity was relatively desirable. Also, the relationship between empowerment courses effectiveness and human resources productively of employees was confirmed.
Conclusion: Using different procedures of employees’ empowerment in early period of employment including organizational socialization, on-the-job training courses by workshops, distance learning and in-person training for empowerment of self-esteem, compatibility, and innovation of employees’ for promotion of organizational and individual productivity is recommended.

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Introduction:The purpose of this study is Investigating the effect of strategic planning on human performance from the perspective of the staff of Shohada Tajrish Hospital in Tehran.
Materials and Methods: This research is applied-practical in terms of purpose and correlational in terms of nature and descriptive method. The statistical population of the present study includes all permanent staff of Shohada Tajrish Hospital. Using simple random sampling method and according to Cochran's formula, 184 people were selected as a statistical sample. In this study, the Strategic Human Resources Management Questionnaire and the Performance Questionnaire were used to collect data. Experts' opinions were used to confirm the validity of the questionnaire and SPSS software was used to assess the reliability. Cronbach's alpha was 0.868 and 0.751. SPSS software and simple linear regression were used to analyze the data.
Results: The results showed that planning, supply, development, performance management, reward and employee relations have a significant effect on the performance of employees of Shohada Tajrish Hospital in Tehran.
Conclusion: Since the results of the research indicate a very strong relationship between strategic human resource management and the performance of the organization in Shohada Tajrish Hospital, it is necessary to pay sufficient attention to human resource management in health centers. It is also necessary to pay special attention to categories such as human education and development, effective interaction and communication with employees, and hiring and hiring.

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Background: Social media is one of the low cost tools used by many organizations. The purpose of this qualitative research is to present a public accountability model based on the use of social media in public universities of medical sciences in Tehran.
Materials and Methods: The present study was performed using Clark's position data analysis method. In-depth interviews were conducted with 21 experts in 1400 to extract the main components of this model. The subjects of this study were managers and experts of medical universities in Tehran (Tehran, Shahid Beheshti, Iran) that participants were selected using purposive sampling method of theoretical sampling.
Results: The analysis of the accountability situation in medical universities showed that the "government" is the main and determining factor. Within this factor is the "Ministry of Health". The third factor is the "universities of medical sciences" and the social worlds active in it. The fourth factor is "public relations units", but in the corner of these overlapping factors is the "target community" factor.
Conclusion: The basis of accountability is reporting and information. Universities should give their staff the necessary leeway to report directly. According to the research findings, it is suggested that by forming a specialized department of public relations in relation to public accountability, in addition to identifying capacities, to remove existing barriers.

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Background and Aim: Burnout is one of the most important factors that reduces the productivity of personnel. Therefore, this study aimed to determine the relationship between human resources management functions and job burnout from the perspective of managers and staff of deputy of Health in Iran University of Medical Sciences.
Materials and Methods: Subjects of this cross-sectional study consisted of 657 managers and staff members of deputy of Health in Iran University of Medical Sciences that 242 individuals were selected according to Morgan's table as the study population. Research data were collected using two questionnaires of burnout and human resources management functions.
Results: 174 (70.7%) participants in the study were women, with mean age and work experience of 41.3 and 15.8 respectively and a standard deviation of 7.35 years. 78.9% of married people and 69.1% of the participants were dissatisfied with the status of their salaries. The dimensions of consequential evaluation, transparent job description and comprehensive training with averages of 4.17, 4.12 and 4.03 out of 7 had the highest score among the various dimensions of human resources functions. Different dimensions of burnout showed that the highest mean was related to feelings of personal inadequacy and depersonalization (4.72). The results of the Pearson correlation test showed that there was a statistically significant relationship between human resources management functions and burnout with a correlation coefficient of -0.439 (P <0.05).
Conclusion: Job burnout can be significantly reduced with the improvement of human resources management functions.

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Background: The performance of nurses as the largest human resources element of health care organizations has an important impact on the quality and results of patients' treatment. The main purpose of this research is to investigate the impact of internal marketing orientation on nurses’ performance by considering the mediating role of nurses’ engagement.
Materials & Methods: In this regard, while reviewing the implications of internal marketing orientation, engagement with the job and performance of employees, using path analysis and structural equation modeling, we examined the effect of internal marketing orientation on the performance of nurses by examining the role of mediation in job engagement. The study population included nurses of Sasan and Parsian hospitals in Tehran. Stratified random sampling and a questionnaire were used to collect the data. In order to analyze the data, Kolmogorov-Smirnov tests were used for the normal test and Path Analysis and Structural Equation Modeling for confirmation of hypotheses.
Results: Results showed that internal marketing orientation, through the engagement of nurses, influences their performance. Moreover, it was proved that internal marketing orientation has a direct relationship with engagement, but it does not directly influence nurses’ performance.
Conclusion: The most significant achievement of this research is that the managers and executives of healthcare centers can provide a more suitable environment for nurses caring patients, through improving working conditions. Implementing internal marketing orientation is one of the practices that can enhance nurses’ performance through affecting work attitudes, especially work engagement.

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Introduction: Hospitals have conflicts because of their complex nature, so they need managers with high emotional intelligence for effective conflict management. There are contradictory results in the correlations between demographic characteristics, emotional intelligence and conflict management; therefore, this study was conducted to investigate the correlation between them in different managerial levels of the hospitals.
Material & Methods: This analytical observational study was conducted on 100 senior and middle level managers (samples) of 8 selected hospitals affiliated to Tehran University of Medical Sciences in 2019.  We used a three-part questionnaire: Demographic characteristics, Emotional intelligence and Conflict management strategies, to collect data. SPSS 20 and statistical correlation tests including Pearson, t-test and analysis of variance were used for data analysis.
Findings: There was a significant direct relationship between the mean score of emotional intelligence and its domains with problem-solving strategy (P <0.001). Also, statistically significant correlations were observed between age, marital status, major, organizational position, and work experience in a managerial position with emotional intelligence (P <0.05). In addition, there was a direct and statistically significant relationship between avoiding and problem-solving strategies with age and work experience, respectively (P <0.05).
Discussion& Conclusion: It is necessary to take appropriate action to raise emotional intelligence and improve conflict management in hospitals, and according to the significant and direct relationships that observed, we can pay attention to select relevant managers for the hospitals.

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Objective: Organizational bullying leads to uncontrollable stressful situations in which people cannot perform their tasks properly and relax and this may lead to fatigue and exhaustion. The aim of this study is to determine the effect of organizational bullying on emotional exhaustion mediated by nurses' psychological distress.
Methodology: This study is applied research and descriptive. The population of the study is the nurses of Shariati Hospital in Tehran. 148 questionnaires returned Based on simple random sampling and the research data analyzed using SPSS and AMOS software. Research variables measured using the questionnaire of organizational bullying of Inerson et al. (2009), psychological distress of Kessler et al. (2003) and emotional Exhaustion of Maslaj and Jackson (1981).
Results: Organizational bullying has effect on nurses' emotional Exhaustion directly and also effect on nurses' emotional Exhaustion through mediation of psychological distress indirectly.
Conclusion: The results of the present study have brought innovations in the field of organizational bullying and psychological distress of nurses and also help hospital managers to understand the effect of organizational bullying on nurses' emotional Exhaustion by providing comfortable working conditions to prevent emotional Exhaustion. Also because of the effect of organizational bullying on psychological distress, managers have to create a friendly atmosphere to prevent such psychological states so that they can provide appropriate services. 

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Background: Covid-19 pandemic peak put additional strains on healthcare system. In this crisis, the resilience of nursing staff is critical. This study aimed to investigate the relationship between burnout and resilience in frontline nursing staff working in high-risk areas during the outbreak of Covid-19 pandemic.
Materials and Methods: The present study is a Descriptive-analytical survey, and the target group is Iranian nurses. According to the Ministry of Health statistics, 125369 people are participated in this study. information is collected from 384 people by cluster distribution using questionnaire. The statistical analysis in this study is performed by SPSS and SMART-PLS software
Results: According to the study, all the collected information is normal. Based on factor analysis, there is an inverse significant relationship between resilience and burnout, and also, the sense of success has a significant effect on resilience as part of burnout.
Conclusion: In order to increase the resilience of nursing staff in such conditions, it is necessary to pay more attention to the factors affecting their burnout and plan to minimize it. Developing educational programs and adding diversity in service delivery might be useful to enhance personal feelings and also reduce burnout.

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Introduction: change and innovation for gaining competitive advantage in health system will lead to the continuation of activities in health care. Therefore, managers ' entrepreneurial orientation to promote organizational goals in the turbulent health industry is one of the requirements of human capital managers. Materials and Methods: In this study , semi-structured interviews were conducted to identify promoting and obstacles in the organizational entrepreneurship factor to design entrepreneurial human resource management model and were analyzed by content analysis method . The population of the study consisted of operational and middle managers in the field of health, among which 20 were selected by non-probability and snowball sampling methods .
Results: The results showed that organizations in health care areas are influenced by three factors of managers , employees and environment of the organization and have an impact on the organizational entrepreneurship variable in human capital management. In the case of obstacles and promoting factors, employees and managers had the highest number of codes (meaning unit) respectively.
Conclusion : Human capital managers in the field of health by creating the necessary ground in strengthening the driving factors and overcoming the confounding factors of corporate entrepreneurship in their management strategies and processes promote the performance of the staff and personnel  and consequently play a significant role in the health of the entire society .

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Background and Aim: Hospital is organization which its performance improvement is very important. In order to do this, we must evaluate the allocated resources and performance of hospitals. Calculating hospitals efficiency is one of the possible ways to evaluate the performance of them. In this study, the efficiency of allocated financial and human resources of public hospitals by provinces is examined.
Materials and Methods: This study was conducted in 2017-2018. Data were collected from 31 provinces of Iran. Input (including: number of physicians, number of nurses and number of active beds per ten thousand population) and output (number of hospitalizations and number of outpatients per ten thousand people). Data were collected from studies. The efficiency analyzing of the provincial treatment department was performed with DEAP software.
Results: The input population (nurse, doctor, bed) is related to hospitals and health centers in Semnan, Yazd and Mazandaran provinces And the least amount of input was related to Sistan and Baluchestan, Khuzestan, North Khorasan provinces. The highest output (inpatient and outpatient) belongs to East Azarbaijan province and the lowest output belonged to Hamedan province. Efficiency score, variable return to scale and constant return to scale for all hospitals in the country are 0.565, 0.813 and 0.47, respectively.
Conclusion: proper and correct distribution of resources between provinces may increase efficiency of resource distribution.

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Background: Human resources determine the quality of performance of health care organizations and are one of their most important competitive advantages. Also, committing is very important to perform their duties. Therefore, it is necessary to recognize the factors that affect organizational commitment. This study aimed to investigate how organizational transparency could affect organizational trust and commitment from the perspective of hospital staff.
Materials & Methods: The present study is an applied descriptive-analytical study conducted on 640 staff members in teaching hospitals affiliated to Tehran University of Medical Sciences. The instruments used were: Organizational Transparency and Trust developed by Rawlins (2008) and  Organizational Commitment developed by Meyer and Allen (1997). Data were analyzed using SPSS software version 26 and AMOS.
Results: Organizational transparency dimensions (overall transparency, participation, substantial information, and accountability) had a positive indirect effect on organizational commitment dimensions (affective, continuance, and normative commitment). Additionally, secrecy has a negative indirect effect on organizational commitment dimensions. The relationship between organizational transparency and commitment was also statistically significant, which indicates that organizational trust mediated the relationship between organizational transparency and commitment.
Conclusion: Managers might be able to improve transparency and staff participation in decision-making by taking cognizance of the priorities and information that can be disseminated by hospitals. In fact, increasing organizational transparency expands cooperation and leads to enhancing staff’s organizational trust, and ultimately increases their organizational commitment.

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Introduction& Purpose: One of the challenges that organizations face today is the issue of retaining employees in the organization. Meanwhile, addressing the causes of early retirement among health workers is doubly important. The aim of this study was to investigate the causes of early retirement in retirees of Yazd University of Medical Sciences.
Methods: The present descriptive research was conducted to find the causes of early retirement among retirees of staff of Yazd Medical Sciences between 2016 and 2018. Collecting dada was done by examining the personnel file, retirement system and through interviewing people. Data description was done using descriptive statistics and SPSS.21 software.
Results: The average number of years of service lost was 3.7 years. In total, there were more than 528 years of service lost. Regarding job characteristics, the majority of retirees were employed in service and nursing positions (4701%), in hospital (45%) and health centers (42.9%). The study of the causes of early retirement showed that the most common causes of retirement were related to boring work environment (55.7%), physical problems and underlying diseases (40.7%) and lack of support from officials (24.3%).
Conclusion: According to the findings, multilateral support in the organization, promotion of rewards and economic benefits, creating morale in the organization, observing the principles of mental health, reducing anxiety and creating hope and increasing participation of employees in the decision-making process can be effective in reducing early retirement.

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Background: Since the health and treatment staff are constantly exposed to critical and stressful situations during the outbreak of the Covid-19 pandemic, the present study aims to investigate the relationship between spiritual health and resilience in the personnel of hospitals accepting patients with the corona virus affiliated to Tehran University of medical Sciences.
Materials and Methods: The current study is a descriptive and analytical study that was conducted cross-sectionally in 2019. The study population included medical staff, including doctors, nurses, paramedics, and service personnel who participated in the fight against Covid-19. In order to measure resilience, Connor and Davidson's questionnaire was used, and Polotzin and Ellison's spiritual health questionnaire was used to measure spiritual health. 145 questionnaires were included in the study. Statistical tests of mean, standard deviation, Pearson correlation coefficient, analysis of variance and independent t were used to analyze the data.
Results: The average resilience score among the subjects was 64.3. The results showed that resilience in the field of spiritual effects with an average of 3.07 was the highest and in the field of tolerance of negative effects and strength against stress with an average of 2.33 had the lowest average. Spiritual health in 55.9% of the studied units was at a moderate level and none of them had a low level of spiritual health. Resilience and all its domains had a statistically significant positive correlation with spiritual health and its domains.
Conclusion: Managers' attention to the spiritual health of health center staff can reduce stress and pressures caused by work in critical situations and be an effective step towards greater productivity of human resources.

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Background: Global statistics shows that health tourism grew significantly before the outbreak of Covid-19, but with the beginning of the pandemic and the closure of countries' borders to immigrants, this trend has declined significantly. The present study aimed to identify the bottlenecks of health medical tourism in the context of the outbreak of Covid-19 and to present scientific solutions for its development using two stages of content analysis and surveying.
Materials & Methods: This research is exploratory in terms of purpose and descriptive in terms of type, which was conducted by field method. Study population was selected in two stages; the first stage consisted of 20 physicians with more than 15 years of experience in Ardabil province who were chosen by snowball sampling method and the second stage consisted of 200 employees of the province's University of Medical Sciences who were randomly selected. In order to analyze the data in the first stage, the content analysis  was used in 6 stages and in the second stage, the first and second order confirmatory factor analysis test was used.
Results: The research findings showed that 9 main themes and 29 sub-themes were identified as barriers and bottlenecks in health medical tourism and 23 scientific solutions were presented to reduce barriers and bottlenecks in health medical tourism in the event of COVID-19 outbreak.
Conclusion: The adaptive fit indices are good and the RMSEA value is 0.047 which indicates that the model has a good fit.

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Background and purpose: One of the main challenges of human resource management in hospitals is the proper distribution of nurses, which is necessary to improve the efficiency and quality of health services. In this review, this rate is compared in selected countries and Iran in order to provide the necessary evidence for managers and policymakers in human resource management
Materials and Methods: This study was conducted as a field review in 2019 with the aim of comparing the standards of nurse distribution to beds/wards in selected studies. The search was conducted with related keywords in "Scopus", "Web of Science", "PubMed" databases without a time limit.
Results: The distribution of nursing per bed was reported in Australia, England, Northern Ireland, Wales, Israel, America, California, Pennsylvania and New Jersey. In Iran, the rate of nurses to intensive beds was slightly higher than the average and the ratio of nurses to ordinary and emergency beds was lower than the average of selected countries average.
Conclusion: Nurses' distribution was generally lower than the average of other countries, and this ratio was lower in some sectors and higher than the average in some sectors. Recruitment and redistribution of the appropriate nurse in different sectors by benchmarking successful countries are suggested.

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Background and purpose: Considering the dimensions of organizational bullying and the context of its creation in the emergency department of the hospital, the decrease in the quality of patient care and the increase in dissatisfaction with the services received and the limited research studies in this area, the research was conducted in the emergency department of a hospital of Yazd University of Medical Sciences.
Materials and methods: To carry out this descriptive-analytical research, the interpretive structural modeling method was used. The experts included 30 doctors, nurses, and nurses who were either working in the emergency department of a Yazd University of Medical Sciences hospital or had experience of service in this department. From the extraction of these factors, they were returned to them for scoring, and the effects of these factors were measured from their point of view, and the final analysis was done by MATLAB software.
Results: The results show that the greatest effect in reducing bullying is related to "adequate training for personnel to communicate" and "proper and courteous treatment in the face of clients" (with influence power of 5) and the least effect is related to "creating a suitable comfortable environment". and "Perform appropriate triage" (with penetration power of 1).
Conclusion: Considering the destructive effects of bullying, creating appropriate mechanisms to reduce this phenomenon shown in this research and using the factors identified by the people involved in bullying can prevent this phenomenon, which occurs frequently in the emergency room of the hospital. 

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Context: The intention to quit is a step before the actual leaving the job. The complex conditions of treating covid 19 patients, nurses physical pressures and mental tensions during the covid-19 pandemic, encourage them to quit their jobs. The present study was conducted to determine the factors related to the willingness of nurses to quit during the covid-19 pandemic in the hospitals of Isfahan city.
Method: 416 nurses working in the hospitals of Isfahan participated in this cross-sectional descriptive-analytical research in the form of quota sampling and systematic random stratification. The data collection tool was a researcher-made questionnaire with high validity and reliability (0.95) that measured the intention to quit of nurses during the covid-19 pandemic in 4 dimensions of individual, occupational, organizational and transorganizational factors. SPSS version 25 software was used for data analysis.
Findings The average score of nurses' willingness to leave during the corona pandemic in Isfahan hospitals was 2.98 out of 5. The average of Transorganizational factors (3.30) was higher than the average of organizational factors (3.05) in driving the intention to leave of nurses. A relation was seen between demographic information such as; received compensation, secondary job and total income and intention to quit.
Conclusion: During the covid-19 pandemic, several factors lead to the quit in the group of nurses. Since the willingness to leave the job in public hospitals is higher than in private hospitals, managers of these organizations should pay more attention to evaluating factors, determining their impact and making effective decisions.

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Background and purpose: Assessing job satisfaction within any organization is essential due to its impact on productivity and overall effectiveness. This study aimed to evaluate the validity and reliability of the Persian version of Spector's Job Satisfaction Questionnaire among employees of emergency medical centers.
Methods: This descriptive-analytical study was conducted among 270 employees of emergency medical centers in Ahvaz between February 2021 and June 2021. Data collection was performed using a census method and Spector's Job Satisfaction Questionnaire. Face validity, content validity, and translation accuracy of the questionnaire were reviewed by experts. Convergent and divergent validity and reliability were assessed using factor loadings, average variance extracted (AVE), reciprocal factor loadings, Cronbach's alpha, and composite reliability in SMART-PLS 3 software.
Results: The face validity, content validity, and translation accuracy of the questionnaire were confirmed by experts to suit the Iranian context. All item factor loadings and the AVE index for all constructs exceeded 0.4. The AVE index for the entire questionnaire was 0.523. Examination of reciprocal factor loadings confirmed divergent validity. Cronbach's alpha and composite reliability indices for all constructs were above 0.7. The Cronbach's alpha coefficient and composite reliability for the entire questionnaire were 0.83 and 0.88, respectively.
Conclusion: The validity and reliability of this questionnaire, as adjusted for the Iranian population, were confirmed to be high. Therefore, this questionnaire can be effectively used to evaluate job satisfaction among employees in various organizations, particularly in healthcare organizations and centers.

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Background and purpose: Effective management of human resources is crucial for improving healthcare services, as personnel are an organization's most valuable asset. This study aims to identify challenges in human resource management and propose solutions to enhance service quality in hospital settings.
Methods: This qualitative study employed semi-structured interviews with 53 managers and key decision-makers from Social Security hospitals in Tehran, using purposive and snowball sampling techniques. Thematic analysis was utilized to analyze the data. The validity and reliability of the qualitative findings were ensured through participant and expert review methods.
Results: The study identified numerous human resource challenges, categorized into five main groups and 20 subgroups. Key issues included flawed recruitment and hiring processes, unfavorable working conditions, weak human resource organization, inadequate staff training, and ambiguity in employment laws and regulations. Proposed solutions, classified into five main groups and 29 subgroups, encompassed: enhancing recruitment and hiring processes, fostering a dynamic organizational culture, improving human resource productivity and efficiency, transforming hospitals into learning organizations, providing comprehensive and effective training, and increasing transparency in rules and regulations, particularly in job descriptions.
Conclusion: Regular identification of human resource management challenges and implementation of evidence-based, scientific, and operational solutions can significantly improve human resource management and, consequently, hospital performance in Social Security hospitals.