Hospital industry is manpower intensive industry. Manpower management is critical for its performance.
1. Dr. A. K. KHANDELWAL ASSESOR OF NATIONAL ACCREDITATION BOARD FOR HOSPITAL AND HEALTH SERVICE PROVIDER Medical Director Anandaloke Hospital & Neuro Sciences Centre 2. Introduction The importance of the human resources management (HRM) to the success or failure of health system performance has, until recently, been generally overlooked. Health sector reform in many countries in the 1990s focused on structural change, cost containment, the introduction of market mechanisms and consumer choice but with little direct attempt to address HR aspects. In recent years it has been increasingly recognized that getting HR policy and management "right" has to be at the core of any sustainable solution to health system performance 3. The hospital utilises widely divergent groups of professionals, semi-professionals and nonprofessionals. It represents high interdependence among services. A hospitals success is largely dependent on the quality of work of its employees. The HR role is the most crucial in a hospital as it is more people oriented and intensive rather than equipment oriented. 4. HRM Characteristics in the health sector HRM in health has to function in a sector with some unique characteristics. The workforce is large, diverse, and comprises separate occupations. Some have sector-specific skills; other can readily move from the health sector to employment in other sectors. The avowed first loyalty of those with sector-specific skills and qualifications (physicians, nurses, etc.) tends to be to their profession and their patients rather than to their employer. Health is also very labour-intensive the proportion of the total spent on staff is much higher in health than in most manufacturing industries and in many service industries. 5. WHY HRD becomes imperative in health organizations ? 1. Manpower is the most important factor of production of services. 2. Human resource costs are usually 60 to 70 per cent of the total cost of the hospital. 3. There is a shortage of quality and quantity of human resource in our hospitals. 6. 4.There is high turnover among professionals and para-professionals due to brain drain. Therefore, how to retain employees has been a challenging task in hospitals. 5. There is underutilisation and wastage of human resources in health care organisations due to lack of professional HRD functions. 6. There is low motivation due to the poor working conditions, top management being out of touch with the people, inadequate growth opportunities and lack of cordial relationships among the staff. 7. How an organised HRD programmes will help? To achieve and maintain good human relations within the hospital. To enable each employee to make his/her maximum contribution to the recovery of patients. To ensure respect and well-being of other employees To ensure maximum development of an individual who provides quality care to the patient. To ensure participation in decision making. To ensure satisfaction of various needs of the patient in order to help realize the hospitals goals. 8. Constituents of Health Care Organisations Doctors who provide the medical treatment. Nurses who take care of peripheral treatment. Patients who are the ultimate customers. Paramedical staff, which provide support services to the medical staff. Non-medical staff, which provide maintenance, ancillary, supportive,administrative and other services. 9. HRD Model for Hospitals There is a need for a conducive HR climate, which is reflected by values of openness, confrontation, trust, authenticity, proactivity, autonomy, collaboration and experimentation (also called the OCTAPACE culture). In the presence of these values, there exists harmony in HRD practices, which will result in concrete results. 10. OPENNESS It is the spontaneous expression of feelings and thoughts and the sharing of these without defensiveness. Both upward and downward communication should be encouraged. CONFRONTATION Facing rather than shying away from the problem. 11. TRUST Trust should be developed between team member. It means accepting what other says at face value rather than looking for ulterior motives. AUTHENTICITY It is the congruence between what one feels , says and does. It reduces distortion in communication. 12. PROACTIVITY: It means taking initiative, preplanning,and taking preventive action. Both employer and employees should be proactive to slve the problem in early stage. AUTONOMY: It means using and giving freedom to planand act in ones own sphere. This is effective delegation. 13. ACHEIVEMENT- 42% RECOGNITIONS-31% WORK ITSELF-22% RESPONSIBILITY-21% ADVANCEMENT-12% GROWTH-7% SALARY-6% CAUSES OF EMPLOYEES SATISFACTIONS 14. COMPANY POLICY AND ADMIN.-36% SUPERVISION- 18% RELTIONSHIP WITH SUPERVISOR-10% WORK CONDITIONS-10% SALARY-7% RELATIONSHIP WITH PEERS-6% PERSONAL LIFE-4% CAUSES OF EMPLOYEES DISATISFACTION 15. COLLABORATION It means working together to solve the problem and with team spirit. EXPERIMENTATION It means using and encouraging innovative approaches to solve problems. 16. Motivation can be defined as the willingness to exert and maintain an effort towards organizational goals. Motivation develops in each individual as a result of the interaction between individual, organizational and cultural determinants. 17. FEATURES OF SOUND MOTIVATION SYSTEM To motivate employees positive and reward based approach should be followed. stick policy should be used for reforming erring employees. This carrot and stick policy should be followed in balanced manner. A objective appraisal system should there with aim of improve employees efficieny. Participative and consultative style of management and supportive supervision should be adopted.. Career and personal development training programs Good grievances handling system should be there There should be good intra-organizational communication processes. 18. INNER MOTIVATORS A person's inner drives push and propel him/her towards an employer, a particular job, career, line of study, or other activity (such as travel or recreation). It is these drives that Maslow delineates in his hierarchy of needs, and which we must understand and internalize, use as guidelines in our efforts to help employees feel motivated. 19. Self-Actualization Ego Social Needs Safety Needs Physiological Needs MASLOW'S HIERARCHY OF NEEDS 20. MASLOW'S HIERARCHY OF NEEDS Applied to workers, it translates as follows: Physiological Needs Basic physical needs: the ability to acquire food, shelter, clothing and other basics to survive Safety Needs A safe and non-threatening work environment, job security, safe equipment and installations Social Needs Contact and friendship with fellow-workers, social activities and opportunities Ego Recognition, acknowledgment, rewards Self-Actualization Realizing one's dreams, using one's gifts, talents and potential. 21. EXTERNAL MOTIVATORS The outer (external) motivators are the mirror image the employer or outside world offers in response to the inner drives. These are: Good salary Old age security benefits Medical and other insurance coverage An atmosphere of teamwork and cooperation Social activities Reward and recognition programs Incentive programs 22. ACHEIVEMENT- 42% RECOGNITIONS-31% WORK ITSELF-22% RESPONSIBILITY-21% ADVANCEMENT-12% GROWTH-7% SALARY-6% CAUSES OF EMPLOYEES SATISFACTIONS 23. COMPANY POLICY AND ADMIN.-36% SUPERVISION- 18% RELTIONSHIP WITH SUPERVISOR-10% WORK CONDITIONS-10% SALARY-7% RELATIONSHIP WITH PEERS-6% PERSONAL LIFE-4% CAUSES OF EMPLOYEES DISATISFACTION 24. PRESENT CONDITIONS and HR Suggestions The uniqueness of a hospital is that the working environment is unpleasant and the client system that one deals with is sick (unhealthy). This makes the environment difficult and demanding for an individual. The following suggestion are useful. 25. Doctors The doctors role in the hospital is becoming complex day by day. With the advancement in diagnosis and treatment for various dise