台灣自1995年全民健保開辦以來，健保署為了有效控制健保支出，不斷對醫院採取各項費用管控措施，且醫院被認為是工作負荷過重的職場環境，加上醫療法規及評鑑等因素使醫療專業人員不宜過度縮減，因此若醫院能給予員工合適的職位，使其在工作中發揮最好的綜效，降低人力資源成本，必能有效提昇競爭優勢，強化醫院永續經營之利基。
本研究目的旨在瞭解醫療從業人員所應具備之關鍵職能，以及影響工作績效之因素，由於前人的文獻鮮少取得大規模且類別齊全的醫療資料，且國內尚無研究範圍涵蓋醫學中心、區域醫院及地區醫院之文獻，加上較少文獻採用一系列統計方法探討不同群集的職能差異，以及職能對心理健康、工作績效的影響，故本研究透過人力資料庫取得各項資料，樣本規模具備代表性，探討不同群集間的職能差異，以及影響工作績效的重要職能。
研究結果顯示，行政人員的工作控管正向直接影響工作績效，正向樂觀及顧客關係正向影響心理健康且間接影響工作績效；護理人員的成就動機、溝通協調及執行能力正向直接影響工作績效，人脈拓展負向直接影響工作績效，成就動機正向影響心理健康且間接影響工作績效，人脈拓展負向影響心理健康且間接影響工作績效；醫技人員的顧客關係正向直接影響工作績效，正向樂觀正向影響心理健康且間接影響工作績效。
就人才晉用而言，團隊精神、執行能力、溝通協調及同理關懷為醫療從業人員所應具備之基本素質。就人才培訓而言，可納入正向樂觀、顧客關係、工作控管、成就動機、團隊精神、執行能力及溝通協調等課程，提升醫院整體人力資源綜效。

Extend Abstract
A Correlative Study of Competencies, Mental Health and Job Performance in Hospital Staff
Tsai-Lin Huang
Jung-Hua Wu
Department of Resources Engineering, National Cheng Kung University
SUMMARY
Since the launch of Taiwan’s National Health Insurance in 1995, the Health Insurance Administration has continuously adopted a range of cost control measures in hospitals to effectively manage health insurance expenditures. The hospital is considered an environment that exerts a heavy workload on practitioners, and it is essential that the number of healthcare professionals are not excessively reduced in order to fulfill medical regulations and assessments. Therefore, if hospitals can provide employees with suitable positions to enable them to display the best overall effort in their work and reduce human resource costs, they will be able to effectively enhance their competitive advantage as well as strengthen their niche for sustainable operations.
There is currently limited literature that has obtained large-scale and comprehensive medical information and none of the studies cover research on medical centers, regional hospitals, and local hospitals in Taiwan. Moreover, only a small number of studies apply a series of statistical methods to explore the differences between the competencies of different clusters, as well as the impact of such competencies on mental health and job performance. This study obtained different types of data through a human resources database to select a representative sample to investigate the competencies differences of clusters and important competencies that affect job performance.
The results of the study indicate that some of the basic qualities that medical practitioners should possess with respect to talent acquisition are team spirit, executive ability, coordination of communication, and empathetic concern. With respect to personnel training, nursing personnel training may include courses on topics such as achievement motivation, team spirit, optimism, executive ability, and coordination of communication. In addition, concentration at work should be promoted, and information on public relations activities, appropriate care, etc., should be reduced to enhance the overall efficiency of the hospital’s human resources.

Keywords: Medical human resource management, Competencies, Mental health, Job performance.
INTRODUCTION
Deployment of human resources in the medical and healthcare industry, which mainly involves professional personnel in hospitals, must comply with definite standards to comply with factors such as medical regulations and evaluations. The remuneration levels of such personnel are generally high and governed by specific market mechanisms. As such, it is not appropriate to use labor costs as the basis for downward moderation of salaries. In a situation where revenue cannot be increased effectively but staff strength cannot be reduced either, an effective method of enhancing synergy among human resources is to conduct competencies evaluations. Doing so assists hospitals in the identification of suitable personnel, and helps those personnel achieve peak performance at their jobs. The aim of this study was to understand the key competencies of medical personnel, as well as the factors that affect their job performance. The findings serve as reference to hospitals while planning future recruitment and training content.
MATERIALS AND METHODS
The data for this study was collected from medical personnel from various hospital districts under a particular non-profit proprietary hospital group in southern Taiwan. The scope of the sample covered medical centers, regional hospitals, and district hospitals. The total number of respondents were approximately 5,000. After eliminating invalid questionnaires, the maximum number of valid samples were 3,959. The competencies examined in this study were based on the theory of competencies proposed by Spencer & Spencer (1993).
After referring to the research findings by multiple scholars and the related literature, 15 competencies were measured, namely (i) achievement motivation, (ii) work control, (iii) team spirit, (iv) responsibilities, (v) executive ability, (vi) coordination of communication, (vii) expansion of personal network, (viii) empathetic concern, (ix) self-improvement, (x) adaptability, (xi) resistance to stress, (xii) optimism, (xiii) analytical thinking, (xiv) creativity, and (xv) customer relations. Mental health was measured using the Mental Health Scale (BSRS-5), while job performance was based on the assessment scores determined by the supervisors during the hospital’s annual performance appraisal.
RESULTS AND DISCUSSION
The research findings indicate the following:
1. Most respondents were from medical centers (57.1%), followed by regional hospitals (34.4%), and district hospitals (8.5%). Nursing staff formed the highest proportion (54.3%) by job category, followed by medical technicians (21.7%), administrative staff (20.3%), and physicians (3.7%).
2. The basic competencies needed by the medical and healthcare industry were team spirit, executive ability, coordination of communication, and empathetic concern. The subject hospital group derived its core competencies from team spirit, empathetic concern, optimism, and customer relations.
3. When comparing competencies, medical centers were better able to deploy and schedule resources than regional hospitals, as well as have higher-quality medical personnel. As such, the former is generally superior to the latter in terms of the abilities to work control and executive ability. Since district hospitals are smaller in scale in terms of their establishment and staff strength, the situation of medical personnel having to offer mutual support to one another was more common. This facilitated the development of stronger team spirit among them compared to personnel of medical centers and regional hospitals. By job category, administrative staff had the best team spirit, executive ability, expansion of personal network, and overall job performance. This was mainly because they were promoted for their superior job performance in the first place.
4. The main factors affecting job performance varied depending on the hospital type. In medical centers, job performance was positively affected by achievement motivation and coordination of communication. For regional hospitals, it was achievement motivation and work control that affected job performance positively. In terms of job category, administrative staff’s work control affected job performance positively, while optimism and customer relations directly affected mental health positively and indirectly affected job performance. For nursing staff, achievement motivation, coordination of communication, and executive ability directly affected job performance positively, whereas expansion of personal networks directly affected job performance negatively. Achievement motivation affected mental health positively and indirectly affected work performance. Expansion of personal networks also affected mental health negatively and indirectly affected job performance. Customer relations directly affected the job performance of medical technicians positively, while optimism affected mental health positively and indirectly affected job performance.
CONCLUSION
When hiring talent, applicants are deemed to have the basic competencies of a medical personnel if they possess good team spirit, executive ability, coordination of communication, and empathetic concern. These competencies make them suitable for related work in the medical and healthcare industry. For talent training, courses for administrative staff can incorporate content related to optimism, customer relations, and work control. The suggested training content for nursing staff are achievement motivation, team spirit, optimism, executive ability, and coordination of communication. As for medical technicians, training courses can incorporate content on optimism and customer relations to improve their job performance.

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