Human Resource Management in Hospitals
Introduction
People constitute the valuable
human resource needed for the development of any country. The promotion and
protection of health of the people is essential to sustained economic and
social development. Since independence,
India India
Hospitals are the most crucial
organizations in the health sector and stand unique to any other organization
because they deal with life and death situation of the consumers i.e., the
patients. Hospital activities and
functions are specific and are directed to achieve the healthcare needs of the
society. Each hospital is distinct in its characteristics as it differs in structure, functions, performance
and the community it serves. In the true
sense there has been a basic change in the nature and character of healthcare
services offered by the modern hospitals. The process of technological
sophistication has been efficacious in making the process of diagnosis and
treatment more authentic. The hospital personnel render services for the cure and
comfort of the patients. In the operation theatre skilled surgeons perform
life-saving surgeries. In the nursery, newborns receive the tender care of
trained nurses. In the laboratory, expert technicians conduct urine, stool and
blood tests vital for disease confirmation. In the kitchen, cooks and
dieticians prepare balanced meals that
contribute to the patients speedy recovery.
The development of healthcare
facilities is influenced not only by the opening of hospitals and health care
centres but more so by their proper administration and management. Unfortunately,
in the Indian environment hospital administration and management has lagged
behind in most of the hospitals. Some of the sophisticated and the so called
modern and hi-tech hospitals in India
Over the years, the importance of
human factor in the accomplishment of organizational goals and objectives has been growing considerably due to increasing
competition and professionalisation of management. There is growing awareness
on the part of the academicians and the professional managers to review management
as a process concerned basically with the management of people because a
tremendous overhaul is underway on the
human resource management front. These days the thrust is on to create work
environment that motivates, retains and gets the best out of people. In the
rapidly changing management scenario, human resource management has an
important role to play. No organization
can survive for long without proper utilization of its human resources.
Human resource management is a
process of bringing an organization and its employees together so that the
goals of the employees as well as those of the organization are met. It is that
part of the management process which is concerned with the management of human
resource in an organization. Human resource management involves all managerial
decisions, philosophy, policies and practices that directly influence human
resource in the organization. Human resource management integrates and
emphasizes on human resource planning, recruitment and selection, training and
development, career planning, organizational development, systems development,
wage and salary administration, welfare measures, performance appraisal etc.
Human resource management activities
have probably been performed since time immemorial but it is very surprising
that only in recent years it has received tremendous attention. Human resource
management is a specialized field that
attempts to develop programmes, policies and activities to promote the
satisfaction of both individual and organizational needs, goals and objectives.
Human resource management is a comparatively new and fast-growing profession in
India India
In the beginning of the present century, the words
‘human resource policies’ and ‘human resource departments’ were unheard of in
hospital administration. The matron, medical superintendent or business
manager who were the immediate
supervisors were responsible for the hiring and firing of employees. Training,
promotions and other benefits were handled by numerous supervisors without any
rationale. The nature of the handling of employees in hospitals depended
primarily upon the whims and fancies of
these authorities. As more and more people
are added to an organization, whether it be an industry, a hotel or a hospital
the management of human resource becomes
more important and more complex. It is essential that the importance of
hospital human resource management be recognized, so that by the establishment
of a separate human resource department, the workload of the general administrator may be reduced optimum
utilization of personnel is possible and
better service is rendered to the patients.
Human Resource Management in Hospitals
The
time has now come for the hospitals to adopt
human resource management as a part of hospital administration. Hospital
personnel are not only dealing with machines and tools, but more so with human
beings. Their dealings with the management, medical staff, patients and their
attendants involve a wide range of
interpersonal relationships. Unless these relationships are of a positive
nature, it is likely to affect the functioning of the hospital.
Thus, the significance of employee contact with the human beings in
hospital is greater than any other occupational areas. This is particularly so
because a considerable number of individuals with whom the hospital employees
have to deal are under constant stress and strain. A patient’s reaction to his
physical and mental conditions may not be the same as that of a healthy person.
Visitors may be anxious and worried of the condition of the patient. Thus, the hospital employees need to be given
adequate training not only in the
professional skills necessary to perform their daily tasks, but also in the art
of getting along with people who are sick and worried. It is evident,
therefore, that human resource management in hospitals involves more
complexities than that in an average industrial situation.
The hospital, an institution
dedicated to the attention of human suffering, the treatment of human ailment
and the promotion of general health of the community has to take care of the welfare of those who
run it, i.e., its personnel. Every individual engaged in the singular service
of promoting the cause and mission of a
hospital is a vital link in its overall chain, whether he is skilled surgeon or
an unskilled sweeper. In a period of
rising costs and shortage of trained hospital
employees, every possible step should be taken to reduce employee ‘turnover’.
Good personnel practices and policies can produce much better results through
employees who are well selected, thoroughly trained and who work under
satisfactory working conditions. Human resource management in hospitals has now
become a necessity for the future and it has to achieve effective utilization
of human resources, desirable working relationships among the employees, high
morale in the organization and continuous development and appreciation of human
assets.
Role of HR Managers in Hospitals
Human resource managers should
always keep in mind that they are working in health care organizations which
render the highest and noblest form of service to the society at large through
a team of dedicated and committed personnel. Being entirely people oriented
institutions, employees form the axle of
healthcare institutions and their development become the prime concern of the
human resource managers. They should leave no stone unturned to motivate their
employees by adopting a fair and
suitable salary structure, training programmes, employee welfare schemes, incentive schemes, promotion
appraisal system, redressal procedures etc.
The ultimate aim of human resource manager is to build team morale by
taking good care of their employees at all levels so that the organization
keeps going successfully and continues to provide quality services to the
patients. Considering the personnel as
resources rather than costs, human resource manager should develop a sense of
commitment among its employees to achieve the overall goals and objectives of
the organization.
Human Resource Functions in Hospitals
Human Resource Planning
Human resource planning starts
with the analysis of the future needs of the hospital and its objectives. It
determines organization structure,
decides what jobs have to be filled and what their requirements are. HR planning
is basically concerned with having the right type of personnel for the right
job at the right time. The core determinants of staffing the hospital
organization are quality, quantum of work, round-the-clock service,
professional and technical skill required in the job and optimum utilization of
its personnel. The variables determining the quality of personnel are
appropriate recruitment, selection, induction, on-the-job training, continuing
education, promotional avenues, decent salary with attractive pre-requisites etc. The staffing norms should aim at matching the
individual aspirations to the objectives of the hospital. In the hospital
environment efficient employees should be considered as an important resource
to the organization. Each hospital has
to consider various factors which influence its human resource planning before arriving
at an appropriate staffing pattern.
Recruitment, Selection and
Induction
One of the important
responsibilities of the human resource department in a hospital is to recruit
and select the right persons for the right jobs. Hospitals are particularly
dependent upon their employees and their commitments because patients and
visitors are more impressed and concerned with the sympathetic and empathetic
attitude and attention of the health-care personnel than with any other aspects
of the hospital. In the hospital environment recruitment is generally made
through giving advertisements in professional journals and newspapers for
different categories of posts such as doctors, paramedical staff and
others. Recruitment, selection and
induction are crucial, complex and continuing functions of the human
resource department. Hospitals present an unusually wide range of positions in terms of skill and personality
requirements. Each hospital should pay close attention to evolve effective
policies and procedures of recruitment, selection and induction because hospital’s success depends to a great
extent on the quality of its human resources. If the hospital wants to develop
a team of competent staff, the right place to begin is in selection. Selection
in the hospital is made through different stages such as careful scrutiny of
the resume, personal interview, enquiry into personal history, background, work
performance etc with special emphasis on professional competence, human
relation skills, integrity, loyalty and commitment and identification of the
personnel with hospital’s mission and philosophy.
In the health care services
people playing a commanding role. The success of a hospital is tied closely to
the selection, training, motivation and management of people. There are many
examples of services succeeding or failing as a consequence of efficient or
inefficient people. The dress of the employees, their personal appearance,
their attitudes and behaviour and their performance and commitment all
influence the patients perception of the services. Hence, the hospitals need to
recruit the right people for the right job, train, develop and motivate the
people to deliver quality services and retain the best people. The hospitals
need professionally sound, personally
committed and value based personnel who all the time think of the welfare of
the patients and strive to improve the quality of services. The personnel serving
the hospitals need to have humanity and human values. These attributes are to
be given due weightage during the selection and training of the personnel.
Training and Development
With the growth of industries
training has mushroomed into a large-scale activity in India
All the employees in the
hospital, from top management to housekeeping, however qualified they are, need
to be given orientation, training and development programmes to enhance
understanding of the jobs, job skills and ability to perform at a high level,
make them responsive and level up to the requirements of their jobs.
Training and development
programmes of the hospital employees include;
Ø Orientation programme which is
generally an orientation to the hospital, its mission and philosophy, policies
and procedures, service rules, safety
rules and more importantly, to the employees department, work and work
procedures.
Ø Developmental programmes for top and
middle level managers.
Ø Training and skill development
programmes for technical and
professional personnel.
Ø In-service continuing education
programme and refresher courses for all employees.
Ø Professional meetings, seminars,
workshops and conferences for the doctors and other technical staff
Ø Guest relations programme for all
employees to train them in the practice of aggressive guest relations to woo
patients to make them loyal to the hospital, and
Ø Management review programmes
etc.
Wage and Salary Administration
Fair and equitable
compensation for each hospital employee should be the objective of the wage and
salary administration programme. The way in which this function is discharged
varies depending upon policies, size and other characteristics of the hospital.
The ability of the hospital to pay the wages prevalent in comparable hospitals
is an important consideration. If a hospital pays low, it will find it
difficult to attract and hold the employees. If a hospital can pay more, it can
attract, retain and motivate its employees. Any job may be arbitrarily assigned
in hospitals to any particular pay scale, but a more satisfactory result may be
achieved if a job evaluation programme is completed before hand. The financial position of the hospital is a major
factor to be considered in the establishment of a wage and salary plan. The
mode of disbursement of salaries to employees differs from hospital to
hospital. Some hospitals pay in cash on a working day during working hours
while some others by crediting in the bank accounts of all the employees. In
most of the hospitals the length of the pay period is usually a month.
Working Conditions, Safety, and Employees’ Welfare
Hospital employees have to work
constantly under conditions of great stress. It is therefore, the
responsibility of the hospital authorities to provide them good working
conditions which meet the accepted standards of cleanliness, ventilation,
illumination, natural air etc. so as to ensure their safety and welfare. In
this respect, factories are governed by statutory provisions under the
Factories Act, 1948. However, it is a pity that there are no such
provisions applicable to hospitals. The necessity of good working conditions in
hospitals cannot be over-emphasized. Hospital employees are exposed to various
diseases and conditions as they have to work with patients. Providing good
working conditions in hospitals will go a long way in improving the efficiency
of the hospital employees, which in turn will improve the level and quality of
patient care. It is important to introduce a system of accident prevention in
the hospitals because at any given time
there are large number of people inside the hospital premises mainly the employees, patients
and their attendants. Any sincere attempt to give real service to patients can bear
fruit, only if the employees are given the right work environment and are provided with those
basic amenities which have direct bearing on their efficiency. Some of the
facilities and services in the hospitals which come within the purview of
welfare plans and schemes are canteen,
recreation rooms, rest rooms, transportation facilities, health facilities etc.
Team Work in Hospitals
Team
work is coordinated action by a group of members who contribute responsibly and
enthusiastically towards achieving a common goal. Team work is essential at all
levels of management in a hospital. The hospitals should create an environment
in which team work will be encouraged and at the same time individuals will be
able to achieve their potential. In
order to meet the collective health needs of the patients in the hospitals, it
is often necessary for all categories of employees to work together as a
team. Team work among the employees in
the hospital improves work quality, productivity, attitude about work and lowers their stress. It also leads to better
supervision and realistic performance appraisal.
Performance Appraisal
Performance
appraisal is the process of evaluating the ability of an individual employee
against predetermined standards. The objective of a good appraisal is to ensure the overall development and growth of
the employees in the context of their strengths and weaknesses. Inevitably,
counselling of the concerned employee by way of appreciating his plus points
and minimizing the minus points should be the primary focus of a good appraisal
system. The performance appraisal of employees of the hospital should not aim
at criticism but an improvement of performance through recognition of their
strength and making them realize their
weaknesses. Some hospitals have developed a system of executive appraisal,
while some others are adopting the KRA( key result areas) appraisal
system.
Human Relations in hospitals
Human relations is the art of
getting along with people either as an individual or as a group. Hospitals
provide medical care to the sick and needy. They are not in the business of
manufacturing goods but for rendering service and are far more dependent upon
their employees morale and commitment than other organizations. Their primary
aim is to provide patient care of the highest quality. Patients and visitors to
the hospital are more impressed and concerned with the attentiveness, empathy
and responsiveness of the health-care personnel than with the architecture of
the hospital buildings, sophisticated machines and other recreational facilities. An often
overlooked truth is that efficient patient care develops not from modern
medical equipment and drugs alone but from the work force, a group of dedicated
and motivated medical, para-medical, skilled and unskilled personnel. Since
human relations is the interaction of people in a given situation, interaction
among employees in the hospital is known as employee-human relations and
interaction between employees and patients is employee-patient human relations.
The role of human relations in health organizations is concerned with the
integration of people into a work situation. It is also concerned with
motivating personnel to work together co-operative and productively. Thus,
the more affection and concern hospital authorities have for their employees,
the more cooperative will be the employees’ attitude towards work.
Hospital staff face challenges
from different quarters. They face hostility from ailing patients and their
anxiety stricken attendants. Patients who are suffering need all the sympathy,
empathy and unstinted support they can get. The response and performance of the
customer-contact employees heavily influence customers’ perceptions of service
quality. It is their professional excellence, personal-touch-in-service,
humanitarian approach and ethical values that play a significant role in the
satisfaction of patients. It is only during the last two or three decades that
a different view of health care services has come into vogue and slowly
recognition of the finer elements of patient care such as medico-social
services, patient care relations, patient guidance, counselling etc. have been introduced into hospital activities. The
hospitals of today are judged by the quality of service they give (i.e.,) personalized services rendered by courteous,
caring and friendly staff.
Thus, the quality in the
hospitals depend on the level of excellence of the medical, nursing,
paramedical, managerial, frontline and supportive staff. Hospitals will do even
better if they combine high-tech with high-touch. The service quality in the
hospitals would depend both on the technical quality as well as the functional
quality. The technical quality can be improved with the help of new generation
of sophisticated technologies, whereas
the functional quality of human resources can
be improved by strong emphasis on behavioural areas such as attitudes,
service-mindedness, accessibility, inter-personal relations, appearance and
commitment. Thus, the human factor is very essential in a hospital unlike in
other organizations, since a hospital involve care of the physical, mental clinical and also the psychological aspects of
patients.
Philosophy / Principles of the Hospitals towards HR
Ø To believe that human resources
including governance, management, medical staff, employees and volunteers are
their greatest asset and their success is dependent upon the careful and
systematic selection, development and utilization of these resources.
Ø To create an organizational climate
in which team work will be encouraged and at the same time individuals will be
able to achieve their potential.
Ø To ensure that the employees clearly
understand their duties and responsibilities and to discharge them properly
empower all the employees with the requisite authority.
Ø To provide the staff and employees an
equitable and competitive level of compensation commensurate with their
qualifications, skills and experience and linked to performance.
Ø To maximize the availability and
quality of human resources at all levels through careful selection,
development, evaluation and retention of such personnel.
Ø To develop a work environment which
is conducive to individual effectiveness, positive morale, effective two-way
communication and opportunities for career
advancement.
Ø To emphasize educational and
developmental programmes for personnel at all levels.
Conclusions
Employees communicate the real spirit
of the hospital. They are indeed its
living and breathing extensions. The manner in which they perform the duties
assigned to them, what they say and do, how they say and do it and the degree
of cordiality and cooperation that exists among them make for the efficient and
smooth functioning of the hospital inside and create the public impression of
the hospital outside. Therefore,
progressive personnel policies which lay emphasis on employer-employee
relationship, employee-oriented working conditions and working environment,
adequate pay scales, caring supervision and an enlightened and progressive
management in the hospitals will result in high morale, high productivity, internal
harmony and above all motivated, loyal and contented employees who take pride
in their organization. Thus, it is
evident from the fact that human resource management in hospitals has now
become a necessity for the future and the need of the hour is to develop and
adopt scientific principles of human resource management in the hospitals to
make optimum utilization of its greatest resources i.e., its personnel to
improve and render the highest quality
of medical care to its patients.
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