Design and Validation of a Healthcare Workforce Resilience Model with an Employee Retention and Maintenance Approach in Tehran Hospitals
Keywords:
Healthcare workforce, organizational resilience, employee retention, hospital management, structural equation modeling, human resource managementAbstract
The objective of this study was to design and empirically validate a comprehensive model of healthcare workforce resilience with a focus on employee retention and maintenance in hospitals of Tehran. This study employed a sequential exploratory mixed-methods design. In the qualitative phase, semi-structured interviews were conducted with ten healthcare management experts and senior administrators selected through purposive sampling until theoretical saturation was achieved. Data were analyzed using grounded theory procedures, including open, axial, and selective coding. The resulting conceptual model was operationalized into a researcher-made questionnaire. In the quantitative phase, data were collected from 230 healthcare employees working in public and private hospitals in Tehran using stratified random sampling. Measurement validity and reliability were examined through content validity indices, Cronbach’s alpha, composite reliability, AVE, and the Fornell–Larcker criterion. The structural model was tested using structural equation modeling with SmartPLS. Structural modeling indicated strong predictive power for key endogenous constructs, including employee participation (R² = 0.870), employee outcomes (R² = 0.934), employee retention and maintenance (R² = 0.700), organizational outcomes (R² = 0.507), and societal outcomes (R² = 0.531). The global goodness-of-fit index demonstrated a strong overall model fit (GOF = 0.641). All measurement constructs showed acceptable reliability (α > 0.70; CR > 0.75) and convergent and discriminant validity (AVE ≥ 0.50). The validated model confirms that healthcare workforce resilience is a systemic and multi-dimensional construct that significantly strengthens employee retention, organizational performance, and societal health outcomes, offering a robust framework for sustainable workforce management in hospital systems.
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Copyright (c) 2025 Masoumeh Noorianinezhad (Author); Rashid Zolfaghari Zafarani; Seyed Ahmad Hosseini Golafshani (Author)
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