Manpower Allocation Research Articles

Relevant factors affecting nurse staffing: a qualitative study from the perspective of nursing managers.

To understand the current situation of nursing manpower allocation, explore the factors affecting nurse staffing, improve nurse staffing level, and provide reference for better formulation of nursing human resources staffing standards. A descriptive research method was used to conduct semi-structured interviews with 14 nursing managers. The data were analyzed and refined by content analysis. The sample size was subject to content saturation. Nine themes and twenty sub-themes of influencing factors for nursing staffing were identified across four levels: hospital level, department level, patient level, and nurse level. Hospital and department managers need to comprehensively consider the factors of affecting nurse staffing. Adopting multidimensional optimization measures, improving relevant systems, optimizing nurse structure, and establishing flexible and mobile nurse database to cope with public emergencies, so as to effectively improve nurse staffing and nursing service quality.

Introduction and Effectiveness of Early Clinical Exposure Among Dental Students in Pre-clinical Prosthodontics.

Lack of patient contact in the pre-clinical prosthodontics curriculum makes it difficult for the students to comprehend and correlate the series of complex steps involved in complete denture fabrication. Early clinical exposure in the second year of the undergraduate program will facilitate a smooth transition of dental students from pre-clinics to clinics, thereby helping to mitigate the lacunae existing in the present curriculum. A non-randomized prospective educational interventional study was conducted among 50 second-year dental students. Early clinical exposure in the form of clinical demonstration for complete denture steps of border molding and jaw relation was given subsequent to the completion of didactic and laboratory sessions. Pre- and post-multiple-choice question tests were conducted to explore students' knowledge. Student perception towards early clinical exposure was assessed using a self-administered anonymous questionnaire, while faculty perception was gauged with the help of in-depth interviews. A statistically significant difference was observed when pre- and post-multiple-choice question test mean scores were compared, showing an overall improvement in students' knowledge following early clinical exposure. Students and faculty held a positive perception towards the program and found it to be useful in enhancing the overall learning experience of the students.Faculty expressed their concern regarding limited manpower, paucity of time, and difficulty in integrating early clinical exposure into the present timetable. Early clinical exposure can be integrated into the traditional pre-clinical prosthodontics curriculum with appropriate time and manpower allocation. Faculty sensitization and training workshops need to be conducted before implementing this program.

The Use of Production Factors and The Allocation of Labor in Plant Nurseries in Sudaji Village, Buleleng Regency

The management of the nursery business in Sudaji Village is expected to be a reference in conducting business in the agricultural sector. The nursery business has a positive impact on business actors and the surrounding community in addition to obtaining optimal profits as well as being able to create employment opportunities for the surrounding community. This study aims to determine the management of plant nurseries through business characteristics, use of production factors, allocation of labor and analysis of business income to see the profits of the nursery business being undertaken. This research was conducted in Sudaji Village, Sawan District, Buleleng Regency from November 2022 to January 2023 with a total of eight respondents in nursery businesses in Sudaji Village. The analytical method used is quantitative and qualitative descriptive analysis. Based on an analysis of the characteristics of the plant nursery business in Sudaji Village, it shows that the business is included in the micro business category based on business turnover value, land ownership, number of workers in accordance with Government Regulation no. 7 of 2021 concerning Ease, Protection, and Empowerment of Cooperatives and Micro, Small and Medium Enterprises (PP UMKM). The allocation of manpower for the plant nursery business in Sudaji Village, Buleleng Regency utilizes the majority of local workers from Sudaji Village and Suwug Village. Suggestions for nursery entrepreneurs are to increase promotion and marketing through the digital market and farmers are expected to be able to take advantage of experience that is already qualified so that they can overcome the development of pests and diseases by starting to direct organic farming and environmentally friendly agriculture.

Intelligent manufacturing: bridging the gap between the Internet of Things and machinery to achieve optimized operations

The access gateway layer in the IoT interior design bridging the gap between several destinations. The capabilities include message routing, message identification, and a service. IoT intelligence can help machinery industries optimize their operations with perspectives on factory processes, energy use, and help efficiency. Automation can bring in improved operations, lower destruction, and greater manufacture. IoT barriers are exactly developed for bridging the gap between field devices and focused revenues and industrial applications, maximizing intelligent system performance and receiving and processing real-time operational control data that the network edge. The creation of powerful, flexible, and adjustable Human Machine Interfaces (HMI) can enable associates with information and tailored solutions to increase productivity while remaining safe. An innovative strategy for data-enabled engineering advances based on the Internet of Manufacturing Things (IoMT) is essential for effectively utilizing physical mechanisms. The proposed method HMI-IoMT has been gap analysis to other business processes turns into a reporting process that can be utilized for improvement. Implementing a gap analysis in production or manufacturing can bring the existing level of manpower allocation closer to an ideal level due to balancing and integrating the resources. Societal growth and connection are both aided in the built environment. Manufacturing operations are made much more productive with the help of automation and advanced machinery. Increasing the output of products and services is possible as a result of this efficiency, which allows for the fulfillment of an expanding population's necessities.

Willingness of healthcare providers to perform population-based cancer screening: a cross-sectional study in primary healthcare institutions in Tianjin, China

ObjectiveTo evaluate the willingness of healthcare providers to perform population-based screening in primary healthcare institutions in China.MethodsHealthcare providers of 262 primary healthcare institutions in Tianjin were invited to fill out...

Risk analysis of electrical power grids in India using best-worst method and grey causal modelling

PurposeThe study aims to identify the possible risk factors for electricity grids operational disruptions and to determine the most critical and influential risk indicators.Design/methodology/approachA multi-criteria decision-making best-worst method (BWM) is employed to quantitatively identify the most critical risk factors. The grey causal modeling (GCM) technique is employed to identify the causal and consequence factors and to effectively quantify them. The data used in this study consisted of two types – quantitative periodical data of critical factors taken from their respective government departments (e.g. Indian Meteorological Department, The Central Water Commission etc.) and the expert responses collected from professionals working in the Indian electric power sector.FindingsThe results of analysis for a case application in the Indian context shows that temperature dominates as the critical risk factor for electrical power grids, followed by humidity and crop production.Research limitations/implicationsThe study helps to understand the contribution of factors in electricity grids operational disruptions. Considering the cause consequences from the GCM causal analysis, rainfall, temperature and dam water levels are identified as the causal factors, while the crop production, stock prices, commodity prices are classified as the consequence factors. In practice, these causal factors can be controlled to reduce the overall effects.Practical implicationsFrom the results of the analysis, managers can use these outputs and compare the risk factors in electrical power grids for prioritization and subsequent considerations. It can assist the managers in efficient allocation of funds and manpower for building safeguards and creating risk management protocols based on the severity of the critical factor.Originality/valueThe research comprehensively analyses the risk factors of electrical power grids in India. Moreover, the study apprehends the cause-consequence pair of factors, which are having the maximum effect. Previous studies have been focused on identification of risk factors and preliminary analysis of their criticality using autoregression. This research paper takes it forward by using decision-making methods and causal analysis of the risk factors with blend of quantitative and expert response based data analysis to focus on the determination of the criticality of the risk factors for the Indian electric power grid.

Distilling lessons from home hospital implementation: a narrative scoping review.

Multiple Cochrane Reviews have demonstrated 'hospital at home' (HaH) as a promising healthcare model to be explored, with benefits such as higher care quality, reduced readmissions, shorter lengths of stay, lower cost and greater patient satisfaction. While there have been many reviews focusing on the quantitative clinical outcomes of HaH, there is generally a lack of collation of qualitative insights from stakeholders and lessons learnt from past HaH implementation. We performed a systematic literature search on four databases and included 17 papers involving the provision of acute and/or subacute care by healthcare professionals in patients' homes. Review characteristics and relevant outcomes were extracted from the reported findings and tables in the reviews, and these included stakeholder attitudes and factors contributing to the success of HaH implementation. Factors relating to patients and caregivers included home setup, preference for care and death settings, and support for caregiver. Factors involving the healthcare professionals and intervention included a multidisciplinary care team, accessibility to emergency care and support, training of providers and patients, adequate manpower allocation, robust eligibility and referral criteria, sufficient awareness of the HaH referral pathway, communication and medication management. HaH presents a promising alternative care model, and many of the success factors identified, including the strong push for multidisciplinary single care teams, existing frameworks for data sharing and strong community network, are already present today. As such, Singapore appears to be well positioned to adopt a new care model like HaH.

Data Analytics for Decision-Making in Evaluating the Top-Performing Product and Developing Sales Forecasting Model in an Oil Service Company

This study addresses the strategic challenges faced by a company specialising in the manufacture of oil and gas equipment. Following organisational restructuring, which involved the dissolution of one business unit and the creation of another, the company is navigating complexities in product focus and manpower allocation within the Asia-Pacific region. The research problem centres on identifying the top-performing product, determining potential countries for establishing a support base facility based on sales performance, and developing a method for forecasting future sales. The research involved retrieving and pre-processing historical sales data, then performing a thorough descriptive and predictive analysis. The data was partitioned into training and testing sets to facilitate predictive analytics. Several predictive models were developed and tested, including neural networks, linear regression, gradient-boosted trees, random forests, and ARIMA methods. Tableau Public was utilised for descriptive analytics, whereas RapidMiner Studio was employed for predictive analytics. The study’s results, derived through both descriptive and predictive analytic methods, reveal critical insights. The Blowout Preventer (BOP) emerged as the top-performing product in the Asia-Pacific region. In terms of establishing support base facilities, Malaysia was identified as the ideal location for the BOP, while Indonesia was found suitable for the Manifold product group. Furthermore, the Random Forest model was determined to be the most effective for forecasting future sales. These findings provide strategic guidance for the company in product focus, regional expansion, and resource allocation, contributing significantly to the company’s decision-making process in a competitive industry.

Guidance and Counseling in Colleges and Universities in Taiwan: Challenges and Perspectives

<p>本文旨在探討臺灣大專校院諮商輔導工作歷經超過60年之發展，輔導工作現況、挑戰與展望。本文採文獻分析法與文件分析，以學生輔導法為依歸，依三級輔導機制、輔導組織定位與資源人力配置，以及績效評估與自我改善機制等三面向探討，並提出如下展望：(1)大專校院諮輔單位之專業形象與組織定位、角色功能宜再定義與明確化；(2)建立校園生態系統合作模式，型塑正向輔導氛圍，共同推動三級輔導工作；(3)建立資料庫或大數據平台，以利掌握現況資訊及趨勢脈動。(4)在績效展現部分，宜結合校務研究建立證據導向與持續改善機制之校本輔導工作特色與品保系統；(5)發展嚴謹、具公信力之諮商輔導認證機制。(6)同時為因應與日俱增之輔導工作需求與挑戰負荷,宜提升區域平台之功能，確保輔導工作品質與效能；(7)網路及後疫情時代宜善用科技，使諮商輔導工作與時俱進。</p> <p> </p><p>This study aimed to explore the development, implications, challenges, and prospects of counseling work at Taiwan’s colleges and universities for more than 60 years. This study employed the literature analysis and document analysis methods to explore the current situation and challenges from three aspects of counseling, namely organizational position and manpower allocation, three levels of guidance and counseling and transition mechanism, and performance evaluation and self-improvement mechanism. It anticipated the following prospects: redefine and clarify the professional image and organizational position and role and function of guidance and counseling units in colleges and universities. Additionally, according to the comprehensive professional definition and by integrating the division of work, a campus ecological system based on a cooperation model should be established, fostering a positive counseling image and collectively promoting the three levels of guidance and counseling. It is recommended that government or academic organizations establish a database or big data platform to acquire current information and trends to expand and improve guidance and counseling work. Regarding performance, it is advisable to incorporate institutional research to establish an evidence-oriented and continuous improvement mechanism for school-based counseling characteristics and quality assurance systems and develop an authentic and rigorous guidance and counseling credential-awarded mechanism. Guidance and counseling professional associations should promote effectiveness evaluation, performance presentation, and counseling work quality assurance system of each school, broadening the implications and scope of colleges and universities’ counseling. Simultaneously, to cope with the ever-increasing needs and challenges of counseling, it is advisable to enhance the functions of the regional platform to ensure the quality and effectiveness of counseling work. Guidance and counseling in the post-epidemic era should be integrated with emerging technologies to develop technological consultation work that can align with current trends.</p> <p> </p>

Measures to Strengthen Patient Safety Management Competencies for Patient Safety Coordinators: A Qualitative Research

Purpose: This study aimed to identify strategies to enhance the competencies of patient safety coordinators in Korea.Methods: Fourteen participants from nine hospitals were interviewed between May and November 2022. Qualitative content analysis was used to analyze the data.Results: As for the strategies to enhance patient safety management competency, 3 themes and 11 sub-themes were derived. The first theme was ‘Having individual competence as a patient safety coordinator’, and the sub-themes were ‘Communication skills with members’, ‘Flexible thinking from multiple perspectives’, and ‘Preparing for administrative work competencies that they had not experienced as a nurse.’ The second theme was ‘Responding strategically to promote improvement activities’, and the sub-themes for it were ‘Multi-angle approach to the problem’, ‘A careful approach so as not to be taken as criticism in the field’, ‘Increasing the possibility of improvement activities through awareness’, ‘Activating the network between patient safety coordinators’, and ‘Expanding learning opportunities through patient safety case analysis.’ The third theme was ‘Obtaining support to facilitate patient safety activities’, and the subthemes for this were ‘Improving staff awareness of patient safety’, ‘Providing a training course for nurse professional of patient safety’, and ‘Expanding the manpower allocation standard of patient safety coordinators.’Conclusion: This study explored personal competencies such as document writing and computer utilization capabilities, focused on ways to improve the field of patient safety management, and emphasized the need for organizational and political support.

Changes in pediatric fracture patterns presenting to US emergency departments before, during, and after the COVID-19 pandemic

The purpose of this study was to analyze the demographics of pediatric fracture patients before, during, and after the COVID pandemic using US national emergency department (ED) data. The National Electronic Injury Surveillance System (NEISS) data for the years 2018 through 2021 was extracted for those <16 years of age, and organized into 24 consecutive bimonthly groups. There was a decrease in the number of ED visits for fractures in 2020 and returned to pre-COVID levels by March/April of 2021, except for small hospitals which demonstrated an earlier rebound beginning in late 2020. During the pandemic the incident locale was more frequently the home and less at schools/sporting venues, which returned to pre-COVID levels by March/April 2021. The proportion of those not discharged from the ED increases from March/April 2020 to March/April 2021. The median age was 8.8, 9.0, 8.2, and 8.7 years respectively for the years 2018, 2019, 2020, and 2021. Early in the pandemic there were more radius/ulna and fewer finger fractures and more tibia/fibula and fewer toe fractures; these changes did not return to pre-COVID percentages until the end of 2021. Fractures associated with bicycles and trampolines remained stable throughout the pandemic, those due to skateboards increased, and those due to playground and sporting activities decreased, with varying times of return to pre-COVID levels. In conclusion pediatric fracture patterns during the COVID-19 pandemic demonstrated many changes; most returned to baseline patterns by early/mid 2021 except for small hospital EDs which saw a much quicker rebound by late 2020. This national data gives health care providers/administrators information about what can happen during a modern day pandemic. If another pandemic occurs in the future mandating lockdowns, this data may be useful to guide resource and manpower allocations.

Design of a Conceptual Model for Improving Company Performance Based on Lean Management Applying the Viable System Model (VSM)

Abstract Designing, changing and adapting organizations to secure viability is challenging for companies. Researchers often fail to holistically design or transform organizations. Thus, the aim of this study is to propose a holistic approach how organizations can be designed, changed or managed considering also its implications to production management following lean management principles. Hereby the Viable System Model was applied. This structure can be applied to any kind of structured organization and for its management with goals to be achieved in modern society; however focus of the research is the cluster of manufacturing and assembly companies. Goal of the developed organizational model is to be able to react to all potential company environments by taking decisions regarding organization and production management functions correctly and in the right moment based on the needed information. To ensure this, standardized communication channels were defined. In conclusion this proposed approach enables companies to have internal mechanisms to secure viability and also in production to reduce necessary stocks, lead times, manpower allocation and leads to an increase of the service level to the final customer.

A branch-and-price-and-cut for the manpower allocation and vehicle routing problem with staff qualifications and time windows

This paper addresses a manpower allocation and vehicle routing problem with staff qualifications and time windows (MAVRP-SQTW), which is an extension of the manpower allocation and vehicle routing problem. This problem focuses on developing an optimal schedule for integrated staff assignment and vehicle routing in transportation systems to minimize outsourcing costs and travel costs. We first formulate this problem as an arc-flow model. Then, we design a branch-and-price-and-cut (BPC) algorithm based on a set-packing model for MAVRP-SQTW. To accelerate the column generation process, we apply the bounded bidirectional search and the decremental state–space relaxation. Meanwhile, we utilize subset-row inequalities to tighten the master model. Numerical results based on the modified Solomon’s instances show that our set-packing model solved by the BPC significantly outperforms the arc-flow model solved by CPLEX. Sensitivity analyses show that the numbers of vehicles and staff members as well as the number of staff types have great effects on the performance of the BPC. Results also suggest that the BPC can be able to optimally solve some instances with 70 requests, but solving large-scale instances is still the limitation of the BPC. Thus, we further develop a primal heuristic to improve the efficiency of solving large-scale instances and obtain relatively good solutions.

Application of Improved Artificial Immune System Algorithm Based on Applied Mathematics for Optimization of Manpower Allocation in Construction Engineering

The outbreak of the COVID-19 pandemic has led construction companies to prioritize the intelligent and optimal scheduling of human resources in construction projects to reduce costs. This study addresses the problem of heterogeneity in human resource scheduling in construction projects, presents a mathematical model with generic human resources as an example, proposes an improved artificial immune system (NAIS) algorithm to solve the problem, and verifies its effectiveness. Experimental results show that the NAIS algorithm achieves the optimal duration of 9 days in just 2 s using the Matrix Laboratory (MATLAB), which is significantly faster than mathematical optimization technique software (CPLEX), thus confirming the feasibility of the NAIS algorithm. Additionally, the average PD values for the NAIS algorithm, calculated for different worker counts, skills, and the number of tasks, were lower compared to the comparison algorithm. Overall, the NAIS algorithm effectively addresses the heterogeneous problem of human resource scheduling in construction projects with multiple modes, thereby optimizing construction engineering labor allocation.

Manpower Allocation of Work Activities for Producing Precast Components: Empirical Study in Taiwan

The production of precast components in the construction industry is a labor-intensive process. The objectives of this study are to prove the feasibility of using rough set theory to classify and weigh impact attributes, and to develop a model to assess the total quantities of labor needed for precast structural elements using a rough set enhanced K-Nearest Neighbor (KNN). Three main building components (beams, girders, and columns) were collected from the production of precast elements in Taiwan. After trimming and analyzing the basic data, the rough set approach is used to classify and weight the attributes into three levels of impact based on their frequency. A rough set enhanced KNN is accordingly developed, yielding an accuracy rate of 92.36%, which is 8.09% higher than the result obtained when using the KNN algorithm. A practical and effective prediction model would assist managers to estimate the manpower requirement of precast projects.

A Practical Study of a Nursing Manpower Deployment Program Under Temporary Tasks

<i>Objective</i> We aim to investigate the practical methods and effects of hospital nursing manpower allocation under large temporary tasks and emergency situations of public emergencies. <i>Methods</i> A TFF nursing manpower deployment plan based on the principle of a three-level nursing management system, fixed and dedicated shift scheduling, and the assistance of flexible nurses was constructed. Under the condition of ensuring the normal work of in-hospital treatment, 936 nursing staff was flexibly deployed from the whole hospital to support large temporary tasks outside the hospital and emergency tasks of public emergencies. <i>Results</i> During the period of facing large temporary tasks, our hospital managed human resources from April to August 2022 on the basis of ensuring the quality and safety of in-hospital nursing work, and efficiently completed all emergency medical treatment tasks issued by the superior. The nursing staff was 95% satisfied with the manpower deployment program, and the SRQ questionnaire after reasonable manpower deployment showed that the nursing staff had good mental health status. <i>Conclusion</i> The TFF nursing manpower deployment program, with good operational effect, can smoothly cope with large temporary tasks like COVID-19, optimize nursing manpower organization and management, and complete large temporary rescue tasks in an efficient and orderly manner.

Assessment of Man and Method Toward the Assembly Line Improvement in Automotive Manufacturing

This research deal with root cause analysis of using Lean Manufacturing principle for assembly line at X manufacturing automotive company in Malaysia. This research aims to improve the process and manpower allocation in the T-Model assembly line and to increase the productivity efficiency of Man and Method toward production output. Movement waste and waiting waste were subjects that were studied in this research. Data was collected through the interview process, observation, photos and calculating the current total production process time related to the assembly process. Process flow in the actual layout, process setup and simulation of the existing design using Witness Software were used to determine the section or method with the highest idle percentage or setup time. The witness Software was also used to simulate the improved layout, and the improvement then is suggested. In conclusion, the entire production process is presented, which initially offered very low productivity. With the line balancing and discrete event simulation model combination, productivity is increased from 3 units per shift initially to 6 units per shift manufactured product at the end. 40% increase in the production output. The proposed layout and practice are done, and the improvement was highlighted at an assembly line.

Implementation and evaluation of a model-based risk management process and service enhancement for home-based community care services amidst COVID-19 pandemic in Hong Kong: A mixed-method approach.

The COVID-19 pandemic has greatly challenged all public social services, particularly home-based community care services (HBCCS). Aberdeen Kai-fong Association (AKA) is a non-government organization (NGO) in Hong Kong that systematically manages the challenges to HBCCS. This paper presents a practical example of the implementation and evaluation of the risk management process for HBCCS. Mixed-method design was used to evaluate the implementation of the risk management process in encountering the challenges from existing and potential problems to maintain and enhance HBCCS in four major areas amidst the pandemic. A cross-sectional questionnaire survey and three qualitative focus group interviews were conducted by AKA from 30 December 2021 to 12 March 2022 to collect staff feedback on the institutional risk management process in four areas. 109 HBCCS staff members (69% aged 40 years or above; 80% female) completed the questionnaire survey. For resource arrangement and staff training, over 90% of the participants agreed (including strongly agreed) that they had sufficient and reliable personal protective equipment and clear infection control guideline and effective training. Over 80% agreed they had safe working space and effective manpower allocation. However, only 75% agreed they had received emotional support from the organization. Over 90% agreed that the basic services were maintained for service continuation and enhancement, the service users and their families trusted the organization, and the provided services were adjusted according to users' needs. 88% agreed that the organization had obtained support from the neighborhood. For communication among stakeholders, over 80% agreed they had open discussions with the senior management team, and the senior management team was willing to listen. Twenty-six staff members joined the three focus group interviews. The qualitative findings corroborated the quantitative results. Staff appreciated the organisation's work to enhance staff safety and continue advancing services during this difficult period. Regular in-service training, updated information and guidelines to staff, and proactive phone calls to service users, especially the elderly, were suggested to enhance the quality of services. The paper could help NGOs and others encountering management challenges in community social services in diverse settings amidst the pandemic and beyond.

국내외 신규간호사 채용 과정 및 특성을 바탕으로 한 간호사 채용 관리를 위한 제언

With a focus on the aspect of recruitment within “nurse manpower management,” this study examined the status and characteristics of employment of new graduate nurses in tertiary hospitals of Korea. It also explored the recruitment process and characteristics of new graduate nurses in foreign countries by referring to case studies. The new graduate nurse recruitment was carried out as an open hiring as a consequence of an analysis of recruitment announcements at 45 tertiary hospitals in Korea. The recruitment process began with document screening, followed by competency test, interviews, and physical examination. Around 80% of the institutions surveyed started document screening between June and August, and the timing of joining the hospital was determined by grades and hospital conditions. In other countries, new graduate nurses were hired by each ward throughout the year, and various forms of employment were used. In some countries, preceptorship programs or pre-hospital field trip programs were running. In Korea, recruitment of new graduate nurses is carried out by hospitals instead of wards. Therefore, it is essential to plan and implement a manpower allocation strategy to represent the desired department of the nurse as much as possible when assigning new graduate nurses. In addition, it is necessary to establish flexible employment options and working environment to encourage long-term service. Instead of manpower management policies focused on increasing the supply of nurses, it is necessary to come up with measures to address the actual causes of turnover, such as wage gaps, organizational culture, and improvement of working environment.

Iranian health financing system challenges to promote health outcomes: Qualitative study.

Adequate health financing system should have key criteria and characteristics such as risk distribution over time, risk accumulation, sustainable resource provision, and resource allocation based on meeting essential needs. Weakness of the tariff system, lack of attention to strategic purchasing, inefficient allocation of manpower, and a weak payment system are among the problems within the Iranian financing system. Given the weaknesses of the current health financing system, it seems necessary to identify challenges and provide effective solutions to address them. This qualitative study was conducted to explore the views of a group of 32 major policymakers and planners in the various departments and levels of the Ministry of Health, Universities of Medical Sciences, Medical System Organization, and Health Insurance Organization in Iran (n = 32), selected through purposive sampling. The data was collected through in-depth and semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis methods. The trial version of MAXQDA 16 software was used to manage the coding process. Based on the results of data analysis, a total of 5 categories and 28 subcategories were obtained. In this study, five main categories were obtained through the content analysis method, including (1) stewardship; (2) providing services; (3) production of resources; (4) collecting resources; and (5) purchasing and allocation of resources. It is suggested that those in charge of the health system, following the reform of the organization of the health system, move toward the improvement and widespread implementation of the referral system and that clinical guidelines be carefully compiled. Also, appropriate motivational and legal tools should be used to implement them. However, insurance companies need to make cost, population, and service coverage more effective.