Human Resource Management in Health Care Organizations

What Is Human Resource Management?

Human resource management (HRM) covers considerably more ground than many people initially assume. Some describe it simply as the exchanges between employer and employee during the period between hiring and separation, but in reality HRM begins even before that — with the strategies formed by the institution and the laws that govern workplace organizations. Human Resource Management is the process of working with people so that both they and their organizations achieve their full potential, even as accelerating change creates the need to acquire new talents, take on new tasks, and build new relationships (Blessinger, Human Resource Management; L. Dobb and P. Dick, 1993).

HRM is defined as that part of management which deals with plans, decisions, issues, ethics, processes, routines, work, performance, and systems associated with the management of people as employees in any type of organization — including small, micro, and virtual enterprises. Its scope encompasses all matters connected to people in their employment relationships and all the dynamics that flow from those relationships, including recognition of individual employees' ambitions. The ultimate aim is to add value to the delivery of goods and services, to improve the quality of work life for staff, and thereby to help guarantee sustained organizational achievement in a transformative environment (The Definition and Scope of Human Resource Management).

The main activities of the HRM function include deciding whether to use independent contractors or employ workers, determining staffing needs, recruiting and preparing the best employees, managing performance, addressing productivity problems, and ensuring that personnel and management practices comply with applicable regulations. Organizing approaches to staff compensation, maintaining employee records, and developing personnel policies are also central activities (Human Resource Management, mapnp.org).

For an organization to succeed, individuals in a team must work toward common goals — something achievable only through effective communication. In practice, however, the goals of the organization often differ significantly from those of individual employees. True organizational effectiveness emerges when employees genuinely work toward organizational goals because they can see their own goals within them. This alignment is possible only when employees are recognized and rewarded through both intrinsic and extrinsic means, and it requires leadership and motivational tools. Most employers today regard HRM as a strategic process through which the gap between organizational and individual goals can be substantially reduced. The growing popularity of HRM reflects a shift away from traditional personnel management — which focused on employee benefits — toward actively managing individuals so that their goals align with those of the organization, while simultaneously providing meaningful intrinsic and extrinsic rewards (Human Resource Practices and Policies).

Core Objectives and Strategic Integration

Smaller businesses typically must perform these functions themselves, as they cannot afford part-time or permanent HR assistance. However, they must still ensure that staff have access to, and are aware of, personnel policies consistent with current standards — typically provided in an employee handbook. There has long been debate about where HR-related functions should be positioned in large organizations. Over the past twenty to thirty years, both the HRM function and the HRD profession have changed enormously. In earlier decades, large organizations looked to the "Personnel Department" mainly to manage the formalities of hiring and paying people. Today, organizations view the "HR Department" as playing a major role in recruiting, developing, and helping to manage people so that both the individual and the organization perform at their highest capacity in a fulfilling way (Human Resource Management, mapnp.org).

There are three fundamental objectives of HRM, all of which contribute to achieving management goals. The first is the integration of HRM in two senses: incorporating HRM into an organization's corporate plan, and ensuring that an HRM perspective informs the decisions and actions of line managers. Integration in the first sense involves selecting HRM options that are consistent with — and that actively support — the specific corporate plan. The type of employee behavior required to advance the corporate strategy determines those options. For example, HRM strategies regarding staffing, appraisal, compensation, and training will differ depending on whether the business strategy emphasizes innovation, quality improvement, or cost reduction. A strategy of innovation may call for a pay system less tightly tied to market rates but which rewards creativity — even if base pay is modest, provided the overall compensation package is competitive. A cost-reduction strategy, by contrast, may result in pay rates being closely aligned with market levels, while training and development receive less emphasis than they would under an innovation or quality strategy (Human Resource Management in Achieving Management Objectives).

Such integration, however, is difficult to achieve without also embedding an HRM perspective in the decisions and practices of line managers — which requires that HRM not operate as a purely centralized, federal function. Building strong cultures and securing commitment is the second objective of HRM. This involves promoting organizational goals by uniting employees around a shared set of values — such as excellence, service, and innovation — grounded in a convergence of staff and organizational interests. Larger Japanese enterprises have been notably successful at this approach. Achieving flexibility and adaptability in response to the rapid changes driven by globalization is the third objective. Relevant HRM strategies in this area include training and multi-skilling, work restructuring, and the elimination of narrow job classifications. Appropriate HRM strategies are designed, for example, to recruit, develop, and retain quality staff, to establish and implement agreed performance objectives and measures, and to build a cohesive organizational culture (Human Resource Management in Achieving Management Objectives).

There are also many critical issues in human resource management, ranging from workplace communication to problem behavior and workplace health. Effective managers must be aware of the laws governing the workplace and must maintain written policies and procedures in a handbook that employees can readily consult.

Workplace Practices: Communication, Orientation, and Problem Behavior

It is essential to plan a thorough orientation for new employees rather than simply placing them in a role without guidance. Each step of the orientation should be carefully prepared, and care should be taken not to overwhelm new staff with too much information at once. Some managers believe that an employee's first day on the job can permanently shape how that person thinks about working in the organization. During orientation, supervisors should review company policies and procedures, give new employees a tour of the premises, introduce them to colleagues, and answer any questions they may have. Establishing clear objectives and timelines is also advisable, as is a probationary period during which the manager can assess how well the employee performs and whether a permanent position is appropriate (Blessinger, Human Resource Management).

In the workplace, communication is a critical factor. When an employee feels at ease with their manager, it not only creates a positive working atmosphere but also facilitates the open exchange of ideas and information. A communicative manager is more likely to become aware of difficulties a worker may be experiencing. Effective communication involves careful listening and thoughtful consideration of the appropriate course of action. Communication can take many forms; some organizations prefer to hold regular meetings, which, when conducted properly, can be excellent forums for inter-office exchange. Team building is therefore an important and ongoing process that helps work groups develop into cohesive units — a process vital to successful human resource management (Guide to Managing Human Resources). Employee health is likewise an important consideration, and providing a comfortable and safe working environment is essential (Blessinger, Human Resource Management).

Problems are inevitable when people of different personalities work together. Problem behavior, however, is not simply a matter of interpersonal friction. It can range from absenteeism and substandard work to workplace misconduct — and these are only a few examples. It is advisable to have written guidelines addressing problem behavior and to ensure that these are clearly set out in the employee handbook provided upon hiring. When a manager becomes aware of a problem, they should arrange a confidential meeting with the employee in question. A private setting is essential — a manager should never reprimand an employee in front of their peers. It is also important to keep a written record of all interactions with an employee who is exhibiting problematic behavior. If termination becomes unavoidable, it should take place in a confidential and impartial setting where both the manager and the departing employee can leave immediately afterward. Managers can also build a distinctive form of loyalty within their workforce by demonstrating a genuine commitment to employees' futures — consistently helping them develop their skills, capabilities, and adaptability (Blessinger, Human Resource Management).

The level of involvement by the HRM function in the lives of employees and the broader community is growing as part of the overall evolution of HRM. Previously, attention was largely confined to workers within the organization. However, with greater awareness of the importance of well-being and the role of family and community in determining it, the HRM function now needs to engage more extensively than before. HRM is also undergoing transformation in terms of the nature of the roles performed. Whereas in earlier years many tasks were carried out directly by HRM professionals, the role increasingly taken on is that of adviser to line management, with line managers handling many of the functions once exclusively managed by HR professionals. Similarly, there is a growing trend toward outsourcing all functions not directly connected to the core business, which means that many HR tasks are now performed externally — representing a significant change in the nature of services provided (The Definition and Scope of Human Resource Management).

Conclusion

HR matters should be treated as vital to the reform process and taken into account from the very beginning. Attention must be paid to the process of improvements as well as to their content; the timing of planned change and the participation of different stakeholders can be critical to successful implementation. How human resources have been managed in the past, and the institutions and incentives that have developed from those systems, will have a bearing on the success of reform. More effective HR management means going beyond narrow issues of wages and training to consider the broader incentives and systems for encouraging and organizing good performance.