Relationship between human resources strategies and organizational performance based on the balanced scorecard in a public hospital in Iran: a cross‑sectional study

Background: Today, due to the complex environment and rapidly changing of health industry, hospitals should optimize
their organizational performance to achieve a competitive advantage. One of the important factors for achieving
a competitive advantage is effective human resource management through the application of appropriate human
resources strategies. This study investigated the relationship between human resources strategies and organizational
performance based on balanced scorecard.
Methods: A cross-sectional study was conducted among clinical and administrative staff in a public hospital in
Isfahan province, Iran. All eligible staff entered the study (n=200). Data were collected using two self-reported questionnaires
during July 2018. The main questionnaire contained 32 items that investigated human resources strategies
(including seven types of strategies) and organizational performance based on the balanced scorecard approach.
Data were analyzed via Pearson correlation coefficient and multivariate regression using SPSS/21 software (P<0.05).
Results: In this study, 154 questionnaires were completed and returned (return rate=77%). Human resources strategies
and organizational performance were evaluated at the intermediate level. There was a significant positive correlation
between human resources strategies and organizational performance (r=0.73, p=0.001). The organizational
performance in learning & growth perspective had the highest correlation (r=0.669, p=0.001) with human resources
strategies while the financial perspective had the lowest (r=0.455, p=0.001). Multivariate regression analysis showed
that all human resources strategies were effective on organizational performance (R=0.998, R2=0.997, ADJ.R2=0.997).
Staff training and development strategy (Beta=0. 265, p=0.000), staff compensation & reward strategy (Beta =0.212,
p= 0.000) and recruitment strategy (Beta = 0.208, B, P=0.000) had the greatest impact on organizational performance,
respectively.
Conclusions: To improve hospital performance (especially in non financial perspectives), the development of human
resources strategies (especially staff training and development strategy, staff compensation & reward strategy, and
compensation strategy) can be considered by hospital managers. The findings of this study can be used for developing
hospital performance in a similar context.