The aim of this study was to investigate the effect of "human and financial resources" on the operational planning process in teaching hospitals of Mashhad University of Medical Sciences. 176 planning experts participated in this applicable research, which was performed using review, comparative, and quantitative methods. To collect the data, a researcher-made questionnaire was used, which was designed based on review and comparative studies of various operational planning models. Its validity was confirmed by consulting experts, and its reliability was confirmed by pilot studies and Cronbach's alpha calculation of 0.96. After data collection, exploratory and confirmatory factor analysis was performed using Spss22 and Amos22 software. There has been the highest score of an average of 4.35 in the results of the variable "Supply of specialized manpower for the development and implementation of programs" in the survey of experts opinion, and the most importance has been in the analysis of variable "Accurate calculation of program costs" by varimax rotation method with a factor load of 0.772. Also the effect of "human and financial resources" factor in operational planning in teaching hospitals based on the calculation of the regression coefficient of factor analysis was estimated to be 0.829. Therefore, providing "financial and human resources" affects the quality of medical and educational services of Mashhad University of Medical Sciences hospitals, and the optimal use of these resources can improve the performance of operational planning in hospitals.
Planning is of special importance in the pyramid of managerial tasks. It is the most basic principle of management that affects all the tasks of managers; performing other tasks will be possible when planning is achieved (Seyed Javadin, 2019). Operational planning with a realistic view relies solely on the available facilities and is short-lived, and the preparation of the operational and executive plan is the stage in which the output of the plans is determined and resources such as personnel, financial resources and training budget, equipment, information and technology are allocated. Budgeting and financing is one important aspect of the planning process in organizations or its affiliated units (Tabibi, 2018). Teaching hospitals affiliated with medical universities in the country are not only considered as one of the important institutions providing health services (Barouni, 2015), but also as an educational environment for medical students. Clinical departments in fact have a high potential in creating the best learning and teaching opportunities for medical education, and the quality of the educational environment plays an important role in the effectiveness of students' learning (Rezaei et al, 2020). Lack of belief in planning, mismatch of goals and activities, lack of proper planning model, lack of specialized and trained manpower, and lack of budget have been among the most important planning challenges (Mosadeghred et al, 2020). Meet the human needs of the program and practice to acquire planning skills by them, limited resources, the need to create coordination between different parts of the organization, create team spirit and commitment in key people to achieve goals, increasing demand for services, preventing the exercise of tastes, and avoiding multiple workloads (Tabibi, 2018) highlights the need for research on the impact of financial and human resources on operational planning; so in the present study we seek to answer the question of the extent of impact of human and financial resources on the planning process of the operation planning in the teaching hospitals of Mashhad University of Medical Sciences.
Planning means determining the future path and method to achieve a goal. It can be said that recognizing and predicting and determining the steps and sequence of operations by time, cost and necessary manpower, control if necessary and revise them is called operational planning (Asefzadeh, 2018). Mossadegh Rad et al (2020) in a study on planning in Tehran University of Medical Sciences, examined its challenges and solutions and concluded that poor management and leadership, poor planning, inappropriate organizational culture, lack of attention to organizational learning and poor management of staff and resources and work processes are major barriers to planning for university administrators (Mosadeghred et al, 2020). The results of the study of Nafari and Behruzi (2022) to investigate the relationship between human resource strategies and organizational performance in a public hospital in Isfahan, showed that there is a positive and significant relationship between human resource strategies in planning and organizational performance, and organizational performance in learning and growth perspective had the highest correlation with human resource strategies, and financial perspective had the lowest correlation; all human resource strategies were effective on organizational performance (Nafari & Rezaei, 2022).
Balqis Free et al, (2021) in a study examined the impact of human resource planning and management on hospital services in Indonesia and concluded that innovative methods of human resource management and knowledge management such as medical, nursing and Electronics management services can improve the performance of hospitals (Balqis Ferry et al, 2021). Shortell et al, (2019) in their research studied the relationship between human resource and financial functions and information technology on the performance of hospitals in the University of California and concluded that there is a positive and significant relationship between human resource, financial and information technology functions and hospital performance, and managers must have the necessity skills to use these resources to achieve goals (Shortell et al, 2019).
The present study is an applicable type in terms of purpose in which review, comparative and quantitative methods have been used in order to collect data and analyze them. This study sought to investigate the impact of human and financial resources on the operational planning process in the teaching hospitals of Mashhad University of Medical Sciences. In the first stage, different theoretical and practical models of operational planning were collected through library studies and literature review, and then the different dimensions of these models were arranged in a comparative table. In the second stage, a research questionnaire was designed and validated. The questionnaire was adjusted according to the different variables of the studied models in such a way that it could cover the necessary components to examine the effect of different factors in hospital planning. This questionnaire was distributed among 30 academic experts and specialists in operational planning in hospitals to be validated and their opinions were applied. To assess the reliability of the questionnaire, the modified questionnaire was tested by pilot in three hospitals and Cronbach's alpha was calculated (0.96), and finally the study tool was extracted as a questionnaire containing 44 questions. In the third stage of the study called field study, the final questionnaire from the previous stage were distributed among 176 people (4 times the questionnaire questions); professors of health services management, members of the planning committees of the University of Medical Sciences, heads and managers, supervisors and experts of the Office of Hospital Excellence, which had sufficient knowledge and experience in designing and preparing hospital programs, and the necessary data were collected and analyzed with SPSS22 software. In the fourth stage of the research, the factors affecting the operational planning of the hospital were extracted based on the findings of the field stage using exploratory factor analysis. In the fifth stage of the research, the exploratory factor from the fourth stage was validated by confirmatory factor analysis using Amos22 software.
Discussion and Results:
Examination of the average score of the respondents' opinions on the variables identified in this field showed that the variable "Supply of specialized manpower for the development and implementation of programs" with an average of 4.35 has the highest score among the variables in this field, this result is consistent with Findings of studies (Nazarzadeh et al, 2021), (Mosadeghred et al, 2020), (Gile et al, 2018), because one of the most important factors influencing the success of human resource planning is paying attention to human resource. The second important variable in experts viewpoint, this field has been accompanied by stakeholders, senior managers and executives to plan and implement it, which is consistent with the findings of studies (Pourrashidi, 2021), (Mostafapour et al, 2021), (Rezaei et al, 2020). in explaining these common results, it can be said that the association of these groups and individuals with programs has supportive, leadership, scientific, financial and intelligence roles. Another important finding in the field of human resources with a high average score from the perspective of research samples is "formulation of evaluation strategies of programs and practices"; this finding is consistent with the results of studies (Shortell et al, 2019), (Doshmanziari et al, 2018), (Mosadeghred et al, 2020), because the existence of employee evaluation systems and programs can exclude them from being slogans and non-operational. Findings of Exploratory Factor Analysis showed that the highest factor load for the examined variables were related to "accurate calculation of program costs", "review of how programs are financed" and "payment to employees based on their performance according to the plan", respectively. These findings are consistent with the results of research (Mosadeghred et al, 2020), (Mostafapour et al, 2021), (Nafari & Rezaei, 2022), (Rezaei et al, 2020), (Balqis Ferry et al, 2021), because there must be a clear link between the plan and its budget in operational planning.
In the review stage, through comparison of 16 models of operational programming, their comparative matrix adjusted and the effective factors on operational programming in each model as well as the common and non-common parts was specified. Considering the comparative matrix of operational programming models, the effective factors on operational programming was named in the shape of 6 factors including financial and human resource provision. The high amount of kaizer- meyer- alkin index as much as 0.907 indicates the sufficiency of sample volume, and also significance of kroit bartlet test as much as 313.5461 and freedom degree of 955 and significance of <0.001 indicated the fitness of applying the factor analysis on the data of this research. In the survey of experts' opinion, the "Supply of specialized manpower for the development and implementation of programs " variable with the average of 4.35 had the highest score, and in analysis according to varimax rotation, the "Accurate calculation of program costs" variable with the factor load of 0.772 has had the most importance. Also, the effect of "financial and human resource" factor in operational programming in teaching hospitals was estimated 0.829 based on the regression coefficient calculation of factorial analysis.
According to the research findings, the following items are suggested for the optimal use of financial and human resources in planning and as a result of improving the quality of medical and educational services in hospitals:
Creating an organizational culture in the field of belief in planning and its implementation through continuous training of managers and employees
Forming a team consisting of managers and experts in various fields for planning
Justify and execute employees to participate in their planning and implementation
Continuous monitoring of performance based on schedules and receiving the necessary feedback and making necessary corrections in schedules
Budgeting based on annual operational plans and preparing financial reports in a categorized manner and in accordance with the activities of the university, trying to attract and distribute and allocate resources at the appropriate time in the implementation of programs, providing specialized training and consulting to empower human resources to manage financial resources.