Healthcare Reform and Healthcare Strategic Human Resources

Human Resources

Healthcare

Strategic human resource management:

Applications in a healthcare organization

It has been said that one of the great ironies of healthcare is that despite the fact it is an industry where the 'human' dimension is so important, the HR department is often one of the most-overlooked aspects of healthcare organizations. "There is arguably no other labor-intensive industry that is so reliant upon a highly skilled, highly educated, high-cost, and high-in-demand workforce that literally makes life-or-death decisions every day. And yet, in many hospitals and health systems HR remains an afterthought in the C-suite" (Commins 2013:1). However, the need for change is constant, and many organizations are finding they must 'adapt or die,' given the new realities they are facing. "by the federal healthcare law, the inevitable and growing shortages of skilled healthcare professionals, and the newfound and measurable importance of patient satisfaction scores for reimbursements will prompt a reassessment of HR in strategic planning" (Commins 2013:1). HR must be first and foremost in the minds of the strategic thinkers of today's organizations and HR professionals must act as advocates for the needs of their department.

In the past, HR has often taken what has been described as a 'reactive' role to any crises that might beset the industry, which is the very antithesis of the strategic approach demanded by current organizational circumstances. However, when HR is prioritized and "the different kinds of clinical and non-clinical staff responsible for public and individual health intervention are given equal priority to considerations such as finance and technology," then the "the knowledge, skills and motivation of those individuals responsible for delivering health services" may be optimized (Kabene et al. 2006). Without these factors, other aspects of healthcare are not useful to patients, as they must be in the hands of clinically competent staff: technology, marketing, and quality controls all must be implemented by doctors and nurses who are qualified and care about their patients.

One critical example of how HR can affect healthcare delivery is staffing, specifically the chronic shortage of nurses. "The number of health workers available in a country is a key indicator of that country's capacity to provide delivery and interventions" (Kabene et al. 2006). HR can help design incentives to attract new nurses, to retain good nurses, and even work with educational institutions to mentor and encourage new entrants into the profession. HR must be able to recruit candidates with the needed skills and training to function and also continue to support their efforts with education to ensure that practitioners' skills remain current. "It is essential that human resources personnel consider the composition of the health workforce in terms of both skill categories and training levels. New options for the education and in-service training of health care workers are required to ensure that the workforce is aware of and prepared to meet a particular country's present and future needs . A properly trained and competent workforce is essential to any successful health care system" (Kabene et al. 2006).

However, it is equally true that "a practitioner without adequate tools is as inefficient as having the tools without the practitioner" (Kabene et al. 2006). Nurses and doctors must have access to high-quality medical technology to dispense care; healthcare administrators must have the means to keep accurate patient records. This means that HR must also provide input about how to balance the needs to financially compensate the staff while still ensuring that the organization has an adequate budget so that the existing staff can function at its optimal level with the 'right tools.' Additionally, new regulations such as the requirement for institutions to have electronic medical records and the increased cost of staff to deal with insurance-related issues places financial demands upon the organization. This is, in part, where the 'strategic' nature of HR must come into play, balancing the different needs of the organization, not simply focusing on specifically HR-related issues such as pay.

When healthcare organizations are faced with the need to make cutbacks, the need to balance financial demands with the needs of the organization is even more acute. In healthcare, "rigorous quality measures require constant performance improvement, while at the same time hospitals are expected to do more with less," including reducing staff and also reducing pay and benefits in some instances (Smith 2013: 1). HR can act as an advocate for workers to ensure that 'penny pinching' does not result in a 'pennywise but pound foolish' strategy in which workers are not adequately compensated. If the best workers leave while overall staff cuts compromise patient care and ultimately cost the organization more, this is not an effective strategy. No quality control system, no matter how rigorous can make up for undertrained or incompetent staff and often the most onerous and difficult-to-implement quality control systems are the result of underpaying workers or cutting staff.

Given concerns about cost, the interpersonal experience of patients has been deprioritized in many organizations, which can also lead to inadequate consideration for the needs of staff. "The 2009 HealthLeaders Media Patient Experience Leadership Survey covering more than 200 healthcare CEOs, CFOs, COOs, CNOs, directors, senior vice presidents, and other high-ranking healthcare officials found that 33.5% of respondents said the patient experience is their top priority and 54.5% said it is among their top five priorities (Smith 2013: 2). These numbers are extremely low and can result in HR itself being given a low priority in the hierarchy of organizational priorities, given that it is the human 'resources' of the organization that serve a profit. Less funds will be allocated to training, retention, and to creating effective programs to ensure staff are well taken care of if the human element of healthcare is not seen as generating real value. Once again, HR must make a case that caring for patients are strategic necessities and part of the values and vision of the organization, not merely something that 'feels good.' By linking HR activities directly to strategic goals, HR priorities are less likely to be seen as a luxury and more as a necessity.