CHAPTER – IV:

HUMAN RESOURCES ISSUES

IN HOSPITALS

 General HR Issues
 HR Issues in Hospitals
 HR Issues related to
Nursing
 Other Important Issues
related to Research
 CHAPTER – IV

HUMAN RESOURCES ISSUES IN HOSPITALS

THE MOST COMMON HUMAN RESOURCES ISSUES:

Human resources (HR) issues commonly experienced by employers

include establishing productivity, recruiting employees, arranging and carrying out
training, and preventing discrimination. Workers in personnel management also
face challenges such as resolving conflicts and keeping workers safe. Establishing
and distributing benefits, encouraging and maintaining diversity, and handling
outsourcing are major concerns as well. How each business deals with its specific
human resources issues depends on the HR manager or director as well as company
policy. No matter what approach a business takes, addressing these issues usually is
an ongoing process.

Productivity: A primary goal of a human resource department is to manage

and organize employees so that they can be as productive as possible, as this
generally leads to more revenue. HR personnel, therefore, think very critically about
the number of people per shift, team assignments, motivational offers like bonuses,
and keeping morale high. These factors can have strong correlations, so the
difficulty is how to make changes in one area without overly affecting another. It can
be challenging to make modifications and “correct” arrangements that don‟t strain
the company‟s budget.

Recruitment: Personnel management workers have always been responsible

for at least some aspects of employee recruitment. They have to find methods, such
as attending job fairs and sending out promotional mailings, to generate interest in
particular positions and the company as a whole. Many companies face an even
bigger problem in this area, however, because globalization means that companies
are competing with each other around the entire world rather than just one small
area or country. Modern employees also are looking for jobs that provide more of a
balance between employment and family. Companies sometimes need to offer more
in terms of benefit packages or incentives, as well, because people increasingly look
for jobs that reduce their risks in unstable economic situations.

Training: Training is needed in virtually every business and industry because

every company has its own policies and procedures employees must follow. It is
HR‟s responsibility to figure out how to conduct the training so that operations are
not interrupted or strained. The department also determines how training sessions
and seminars factor into the company calendar and budget. Coordinating with third
parties involved in the training is also necessary, in some instances.

Discrimination: Companies often value diversity because it provides

different modes of thought and experiences that can generate new ideas and better
productivity. It also fosters a sense of equality that is well-suited to teamwork.
Businesses look to their HR departments to build diversity into the workplace, as
those in personnel management generally are responsible for company recruitment,
hiring, promotion, and termination. Many places have laws that make various forms
of discrimination in the workplace illegal, so human resources workers have to
recruit and train in a way that follows both legal and business standards. Since more
employees are aware of their rights, a modern HR department may also need to
handle a potential increase in complaints about discrimination.

Conflict Resolution: Even though members of personnel management

departments work hard to find employees who are a good fit for the company‟s
culture, the wide range of personalities, experiences, and skill sets found in the
workforce mean that some conflicts are bound to happen. Investigating complaints of
verbal or physical harassment is common, but other conflicts, such as those involving
broken promises from managers, stolen property, and other problems, also occur.
This is one of the biggest human resources issues for companies because it is almost
always cheaper to retain an employee than to find and train a new one. If HR doesn‟t
resolve conflicts when they are present, resignations or firings can result, which
ultimately costs the company money.

Safety: Workers often use equipment that, if not properly used, can result in
accidents or health problems. Even something like a desk that is not ergonomically
positioned can be a potential injury source. The HR department has to take this into
account when it organizes workers. It also investigates allegations of unsafe
equipment or managerial direction.

Benefits: Virtually all companies offer some benefits to employees, either to

appear competitive or to comply with local, regional, or national regulations. HR
directors work with the heads of companies to create benefit policies and packages.
Common employee benefits include health insurance, life insurance, a dental plan,
and employee product discounts. When employees are terminated, their benefits
usually are too, so HR must keep records of the exact hiring and termination dates
of each employee.

Outsourcing: Outsourcing refers to companies giving work to independent

contractors outside the company rather than to in-house employees. Independent
contractors are freelance workers who pay their own taxes and insurance.
Outsourcing is one of the most common human resources issues, as many
businesses are hiring freelancers rather than creating more overhead costs by
taking on additional in-house employees. Overhead costs include equipment and
workspace as well as benefits such as medical insurance.

HR ISSUES IN HEALTH CARE INDUSTRY:

Dr. J. Sivakumaran, Sr. VP, SPS Apollo Hospitals expounds on the

importance of human resources and the need to handle them efficiently to improve
healthcare delivery. In spite of technological advancements, one cannot rule out the
importance of manpower in hospitals. Latest and modern technologies cannot
substitute the contribution made by specialized manpower in the healthcare
industry. Human resource (HR) is a very vital resource, a veritable sine qua non in
the healthcare industry. To err is human, goes the old adage, probably suggesting
that one need not make a big deal of mistakes committed. However, in healthcare
mistakes can prove quite grave, with fatal consequences for the patient.
Hence, healthcare staff should have the ability to follow and implement safe and
ethical practices with highest level of technical competency. There are many
challenges before the human resource department of a hospital. Few of the
important challenges are discussed here.

Shortage of workforce: The first and foremost challenge is

the identification, recruitment and retention of the required workforce. In healthcare,
there is a dearth of talent and trained manpower. India faces a huge gap between
demand and supply of healthcare workforce. This is due to the heavy shortage of
beds and human resource, and to compound the situation further, a highly skewed
infrastructural growth. As per a survey conducted by Tecknopak, by the year 2020,
we need 2.5 million hospitals, one million doctors, two million nurses and 10 million
paramedics, with the growth opportunity to do a healthcare business of $280 billion.
It is a fact that we are struggling to meet the demand even for the current level of
operations. The shortage of workforce is due to various reasons. Many of the quality
manpower are being hired by hospitals abroad, causing shortage and brain-drain in
India. Skilled workforce from India is much sought after in the international market.

Indian healthcare employees seek overseas opportunities due to prevalence of poor

pay scales, lack of professional growth, skill development and poor working
conditions in India. These factors contribute to the flight of local talent seeking
greener pastures abroad. It is to be noted that it takes at least five years to train a
doctor and minimum three years to train a nurse before they attain the expected
level of service delivery after their professional degree. There are no shortcuts here.
Any attempt at trying to shorten the gestation period would be highly detrimental.
When there is a shortage, it becomes necessary to have effective HR strategies in
place to achieve better outcomes. Therefore, the HR personnel need to act as
coaches, mentors, counsellors, identifiers of successors by promoting organizational
ethics, values, culture and beliefs.

Training and retention of employees: Apart from the challenge of having

the right people for the right task, technological advancement warrants consistent
training for maintaining the highest standards of medical excellence. Whether it is
for accreditation, technology up gradation, service customization, quality service
delivery or developing medical tourism, constant training and retraining of the
employees is essential for aligning their skill sets in line with the objectives of the
organization. A professionally trained and skilled workforce is essential for running
any hospital successfully. Once trained properly, retaining the workforce is also a
huge challenge confronting hospitals. Retaining talent is less expensive than hiring a
new employee and training him/her to suit the organizational needs. Developing a
workforce is, in a way, upgrading the skill set of the existing workforce as well as
helping the staff in acquiring competencies and skills for their current and future
roles. Mentoring employees to take up bigger roles within the company often helps
unearth latent talents and skills, benefitting individuals and the hospitals. This will
improve the motivational and confidence level of staff to perform efficiently and
effectively.

Developing multi-tasking workforce: Employee cost is a major expenditure

in hospitals and it keeps increasing consistently. Sometimes it goes beyond the
budgeted level due to repeated revision of wage norms by state governments. With
the healthcare sector witnessing an unprecedented boom, there is an abundance of
employment opportunities for healthcare professionals, further pushing up the costs
of retaining them. Due to this, hospitals are working on methods to keep the cost
under control, without compromising on the quality of service. One such method is
to have a multi-tasking manpower pool which can be made to perform multiple
functions based on business exigencies. Identifying, orienting, training, inducting
and retaining a multi-tasking manpower is an onerous task which many hospitals
have taken upon themselves. Talents are being identified and trained to do multi-
tasking and this task force is often called upon to make up for manpower deficiencies
in specific areas. This strategy helps hospitals retain the manpower cost at a
reasonable level and ensure better utilization of the manpower employed.

Developing second line staff: Migration of healthcare workers is

comparatively high, as compared to other industries. In case of nurses, the hospitals
are not only facing threat from competitors within the city hospitals, but also from
government hospitals, teaching institutions and from healthcare institutions abroad.
Retaining this vital workforce despite the „pull-factor‟ from competitors is a
challenge. In spite of the best efforts being put in by hospitals to retain talent, the
employee turnover ratio in the Indian healthcare space is a whopping 30 per cent. In
such a scenario, hospitals need to constantly work on developing a second rung
workforce to fill in the shoes of the employees leaving them. Identification of such
talent and grooming them to take up bigger roles is a real challenge before hospitals.
This exercise needs to be done in all areas and at all levels. Replacing a talent from
the existing work force often proves to be cheaper than hiring from outside, as long
as the competency level is sufficient to meet the challenge.

Managing younger workforce: The population demography of the country

is heavily skewed with the youth making up for a substantial percentage of our
population. Many of the fresh recruits are barely into their twenties when they are
inducted into the workforce. Their attitude is different from the more seasoned
seniors. The younger generation needs to be handled with care, largely owing to
their outlook, upbringing and attitude. The youth of today are ready to take on any
challenge, assume ownership of work and run the extra mile in pursuit of their
ambitions. However, the flip side is that they are fiercely independent and are
generally unappreciative of a senior constantly watching over their shoulders. They
are generally go getters, flexible, non-conservative and liberal in culture. Training
and aligning them to the organizational culture, maintaining high decorum,
sustaining a safe workplace that keeps up with their self-actualization objectives is a
challenge in itself. Therefore, it is essential that hospitals try and maintain a
workplace which would cater to the dynamic needs of the workforce. The deserving
employees need to be recognized, encouraged and rewarded for getting the best out
of them.

Accountability of workforce: Patient care, in general, is a team work and not

an individual task. The team mix is hybrid, consisting of uneducated, unskilled
workers to highly qualified doctor(s). In such a scenario, it is important to fix the
accountability for each job performed by each individual, so as to ensure seamless
delivery of quality healthcare. Documentation of responsibilities given to each
individual in the healthcare delivery system is very important for achieving desired
results. This is again a challenge before us.

In spite of all these challenges, hospitals find their own ways and means to
overcome these problems. Undoubtedly, the sector is growing year after year and
these challenges are expected to settle down over a period of time if the stakeholders
come together and take suitable initiatives.