human resources functions as a management tool is fast changing

8/7/2019 Human Resources functions as a management tool is fast changing

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Human Resources functions as a management tool is fast changing. The psyche people at

work has also undergone a sea change. Hospitals unlike other industry are a different entity

when compared to other industries. The role of this department and its head has a role

cutout and exclusive. Unlike any other industry, the advent of technology, moderniza tion,

computerization, newer diagnostic and intervention techniques, has not reduced the need

of human labour in hospitals, which is now an industry. On the contrary, there is a quantum

growth in the need to appoint specialized manpower at various levels o f patient care, which

has emanated from the thought process of those professionals and promoters, who are

enlightened with the need to induce QC in patient care. Hospitals shall always remain

human intensive.

The role of the HR manager in a hospital is mu ltifaceted and complicated too. Manpower

planning and recruitment involves a lot of thought process. Training and development has

to be a qualitative and quantitative activity, especially for those who are employed as junior

doctors, nurses, front office, ward staff, housekeeping/ward attendants, F & B etc. Since

these are the people who come in contact with the patient or his attendant, "FIRST". It is

they who create the first impression and therefore, make or mar the reputation of the

hospital. "The first four minutes and the last two minutes". In a scenario, where human

labour is intensive, the need for an efficient human resources department [hrd] is a

prerequisite.

It is debatable as to what qualitative experience should the front office, ward staff, p ossess.

While some hospitals tend to appoint staff with experience in a hospital, this is debatable,

especially when we are dealing with established Psyche and mindsets. Large multinationals

prefer to select freshers or candidates from a different Industry, since they are sans

mindsets and are easily mouldable, by rigourous training.

The advent of corporate hospitals has changed the mindset of healthcare conscious people.

Medical tourism, debates it further. A school of thought feels it prudent, to appoint people

from the hotel industry, who are expected to possess faces and etiquettes in hospitality.

The nurses are the frontiers in a hospital, who need constant upgradation, training and



development. They have to be constantly reminded of bedside manners. It is also

perfunctory that their numbers are adequate. It differs from hospital to hospital. A broader

perspective study revealed that on an average, about 20% of patient in a hospital are

completely dependent, 40% are partially dependant and 40% are full y ambulant. It is

observed that an average nurse works for 265 to 290 days a year. Therefore, as a

thumbrule, 30% of the total nurses required should be added to the figure, due to leave

necessities, which are religious, and for ceremonies like marriage. A t least 15% should be

male nurses. While doing this exercise, it should be kept in mind that on an average, 60 -65%

beds are occupied at any given point of time. A section of the nurses should periodically be

withdrawn from their posts and subjected to clas s room training, purely to upgrade them. It

is a pre-requisite, that all nurses have the basic knowledge of working on a computer, since

modern HIS software calls for online entries at all levels and departments.

Hospitals work 24 X 7 and are never closed . It is therefore perfunctory that requisite

personnel are available round the clock. Festivals in our country are dime a dozen, beside

offs, EL, CL, SL et al. It may not be prudent to suggest that the employee recruitment mix

ratio should be based on reli gions and could be a better way of handling absenteeism,

ensuring that, whatever be the festival or holiday, 66.5 % of the staff are available, at a

given shift, enough for such exigencies.

To be successful, employees with leadership, can be categorized i nto:

- Technical

Those who belong to this category are highly specialized people, who deal with procedures,

are analytical, conceptual, touch me nots, could be the doctors and nurses.

- Human

Those who belong to this category are those who implement to achieve the goals of the

organization, through the help of their subordinates and are deft in handling men and

material. They are expected to have a high level of motivation and inevitably with an

infectious attitude. They are available always, on a whistle, since for them, functionally,

customer satisfaction is paramount.



- Conceptual

Those who belong to this category are those who understand the nitty -gritties of the PCDS

[Patient Care Delivery System] have the abilty to co-ordinate and can induce changes, with

the first hand knowledge, as to how such changes can effect the chain and command. They

are expected to visualize the larger picture of things to come. In fact their ability to take a

decision and their personality as a whole essays the fabric o f the organization. These

handful few are the top level decision makers of the organization.

Human Resources, therefore needs to recruit an admix of the above, to be successful in

their respective objectives. Be that as it may, the base line elucidates th at whoever and

wherever, the ability and skill to deal with Human beings with their respective

idiosyncrasies, is the key.

The power vested by default in the department of Human Resources is considerable. But it

has to be understood that powers should be utilized to solve issues rather than use it for

fascist attitudes. He should understand that the psyche in changed management issues is to

delegate powers, trust and encouraging efficiency in subordinates, that makes the

organization more efficient and successful. A tight fist has faded knuckles.

HUMAN RESOURCEPLANNING INHEALTHCARE

B. Ray*

Human beings are the most important resources in health care. Machines and gadgets

which are integral parts of health care require the human touch, expertise, and

commitment for their full utility and application in delivery of health care.

Therefore planning of human resources is the key to any health care provision. The

objective of human resource (HR) policy is to a) attract, recruit, retain and develop

competent personnel and b) create a continuously learning health care organisation.

I. TARGET HUMAN RESOURCES



INHEALTHCARE

The patient unquestionably is the focus of all health care personnel. While doctors,

nurses, hospital attendants, technologists, clinical assistants and pharmacists are directly

involved in providing OPD and ward care, administration, public relation, security,

catering, laundry, electronics, civil, electrical and air conditioning maintenance are involved

in supporting the former for providing safe health care. Planning needs to be done for all

these personnel and not only for the direct care givers.

II. IMPROVEMENTOF HUMAN

RESOURCES

This is done through three ways such as

a) Work system, b) employee education, training and development, and c) employee

well being and satisfaction.

a) Work system :

The aim of work system improvement is to get co-operation and collaboration among all

employees. Health care employees look for good systems in place so that their endeavours

would yield favourable results without any wasteful activities. They would like to participate

and feel important in laying down these systems. A system that is thrust on them often

breeds cynicism as they do not own it. In order to own the system they have to actively

participate in designing it. While doing so a cross functional team across various sections

brings about greater effectivity and cohesion than an intra departmental team. Some of the

examples of such teams are given under the following headings :

(i) Design/organise formal/informal, temporary or long term units (teams). Infection Control

team, waste management team and quality improvement (QIP) team are some of the

examples that have been doing good quality work in Tata Main Hospital.



(ii) Encourage and motivate innovation through quality circle (QC), value engineering (VE)

and suggestions. There are over 104 quality circles actively functioning in TMH. These are

small circles of five members picked up from supervisors and workers who take small local

problems and solve them with organisations support. Employees are encouraged to do cost

savings without affecting the quality through intra or inter departmental teams. Suggestions

are encouraged from the employees and wherever appropriate those are implemented.

(iii) Encourage higher learning, give them higher responsibilities and help them identify their

training needs.

(iv) Encourage multi skilling and rotate their jobs wherever possible so that there is no

boredom with the repeatitive type of job. This has been implemented amongst the hospital

attendants who rotate in various areas with different job specifications in the hospital.

(v) Performance management system: Every level of employees must work with a purpose

and their work must be evaluated against their target from time to time so that they achieve

their target at the year end. In TMH, this is done by giving targets to all doctors and officers

in the form of key result areas ( KRAs) which are reviewed twice a year. The annual appraisal

identifies the super achievers who are recognised as fast trackers. They move aggressively

and groom rapidly.

(vi) Compensation, recognition and reward practices This could be non monetary or

monetary. Non monetary recognition could be formal by a letter or informal by a pat on t he

back in front of other employees. Monetary recognitions are through promotions, special

increment, joint department council (JDC) award or long service awards after 20 yrs, 25 yrs,

35 yrs and 40 yrs of service.

(vii) Communication meetings at all levels Communication upward and down-ward helps

inculcate among the employees a sense of oneness in the organisation. This is done at a pre-

decided interval regularly in TMH.

(viii) Recruiting and hiring new employees While recruiting employees, the hospital must

first identify the job requirement and while interviewing, an attitudinal and aptitudinal

survey of the candidate must be done. Transparency must be practiced while explaining to

the candidate his/her future growth in the organisation. The new employee should be made



familiar to the working of the hospital through induction to various areas before he/she is

finally posted to his/her place of work.

(b) Employee education, training and development

Employees education, training and development should be a continuous process. Their

training needs in terms of technical, managerial and behavioural aspects should be

identified. Short term goals of training need to be directed towards customer satisfaction

and reduction of cycle time and long term goals should be towards better technology. The

important thing is to link their training with the patients need in the hospital they are

working in. In TMH, the deployment of training has been done through regular continuing

medical education (CME) for doctors, nurses and technologists, bed side teaching for

doctors & nurses, training through joint departmental councils (JDC) for hospital attendantsin subjects such as waste management and oxygen therapy. Communication with patients

(or relatives) was identified through periodic surveys as one of the weakest links with our

employees at all levels. This was repeatedly addressed through motivation, attitude and

time management (MAT) programme which was designed by a group of highly motivated

employees drawn from all sections in TMH. Having a training programme in place is not

enough. There has to be an evaluation system in place for monitoring the effectiveness of

training. The parameters which need to be monitored should be directly related to patient

well-being. Some such parameters could be catheter induced infection rates, mortality and

morbidity parameters, feed back from patients and relatives, number of re-admissions for

the same ailment and above all retaining the customer.

(C ) Employee well being and satisfaction

Employee satisfaction is essential for a motivated work force. It will do what a state of the

art technology cannot do in health care. This issue could be addressed under three heads

such as i) work environment ii) work climate and iii) employee's satisfaction. (i) Work

environment: A healthy work environment needs to be created where employees feel safe

to work. Universal precautions need to be enforced; proper disposal of waste should be

implemented; periodic health checkup for all the employees need to be done and hepatitis

B vaccination should be compulsorily given to all the employees. The organisation needs to



identify and safeguard against unsafe practices. Serious efforts have been made in the past

two years in TMH to achieve the desired goals for all the employees in the aforesaid areas.

(ii) Work climate : Every employee needs to be provided with certain awareness

programmes and facilities for him or her to feel proud and being looked after by the

organisation. AIDS awareness programme, cooperative society, injury on duty (IOD) facility,

subsidised (no profit - no loss) canteen facility, academic activity and library are some of the

measures TMH has provided to improve the work climate.

(iii) Employees satisfaction: This is not an easy area to tackle. There are few hospitals where

most of the employees are satisfied. Human mind is not satisfied with what it has achieved

and therefore to expect that employees will be satisfied with certain facilities is far from

being true; however the or ganisation must collect feedbacks through formal/informalassessment methods and relate these findings to identify improvement priorities. This will

at least make the employees feel that management is sincere about its concern for them.

DNB course was started in TMH after identifying a long standing need of the graduate

doctors in TMH.

III. CONCLUSION

A satisfied human resource is valuable and has no alternative. Human beings needs are

dynamic and therefore to satisfy those the health care organisation has to be dynamically

thinking. Only then our most important customer, the patient, can get his just need fulfilled.

Employee's growth and development should be the result of both the employers

responsibility and the employees initiative. Appropriate timely rewards and recognition go

a long way in retaining a motivated employee. Inspite of providing all the help and resources

if certain human resources cant be moulded to fit into the organisations needs, the

organisation should not hesitate to leave them behind. Tatas H.R philosophy attract good

people, retain the better people and advance the best people is a right step in this

direction. It may appear a bit harsh but at present it appears to be the only scope for a fast

changing health care organisation.

human resources functions as a management tool is fast changing

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