Health Care Human Resource Management

Industry Competency Model

Rather than assessing jobs using the task analysis approach, the industry competency job analysis approach provides an alternative method of assessment. Competencies are skills, knowledge, or abilities needed to perform a job or activity in an organization. A competency model organizes the competencies needed to perform in a particular industry. The U.S. Department of Labor’s Employment and Training Administration has developed a competency model for the long-term care, supports, and services industry. The administration’s goal is to provide education to employees who work with the elderly and disabled to encourage independence in their clients’ lives. The American Health Care Association, Paraprofessionals Healthcare Institute, College of Direct Support, National Center for Assisted Living, American Network of Community Options and Resources, Institute for the Future of Aging Services, University of Minnesota Institute on Community Integration, University of Alaska, Anchorage for Community Development, and the National Alliance for Direct Support Professionals participated in the development of the competency model.

The Building Blocks Model is a competency model that is viewed as a pyramid. It consists of personal effectiveness competencies; academic, workplace, industry-wide, and industry-sector competencies; occupational-specific knowledge areas; technical requirements; occupational-specific requirements; and management competencies. These areas are considered the building blocks for model development ( Figure 3.1 ). The following is a description of each of the nine tiers of competencies.

Tier 1: Personal effectiveness competencies: They are located at the base of the pyramid and influence the other competencies. These competencies include interpersonal skills, initiative, dependability, and willingness to learn. These represent generic types of traits and motivation that can be applied to many different industries.

Tier 2: Academic competencies: These are located one level above the personal effectiveness competencies and represent critical skills learned from an academic setting. Competencies such as mathematics, reading, writing, and communication apply to many industries.

Tier 3: Workplace competencies: These competencies are specific to many industries and include planning and organizing, problem solving, computer proficiency, adaptability, and customer focus.

Tier 4: Industry-wide technical competencies: These competencies are generally needed within an industry such as supply chain management, operations, health, and safety.

Tier 5: Industry-sector technical competencies. These competencies must be identified by the industry that is assessing the competencies such as the food manufacturing industry.

Tier 6: Occupation-specific knowledge areas: These areas are identified in O*NET and include food production, chemistry, sales and marketing, and accounting. O*NET has a large list of these areas. They are customized according to the specific area of the occupation.

Tier 7: Occupation-specific technical requirements: Building on level 6, there are technical areas that must be identified by the specific occupation.

Tier 8: Occupation-specific requirements: This is the top level of the pyramid and includes certification, licensure, and educational degrees required to obtain certain competencies.

Tier 9: Management competencies: These are specific to supervisors and include delegating, networking, motivating and inspiring, and strategic planning (Building Blocks Model, 2010).

Based on the Building Blocks Model, industries such as health care will develop a competency model to perform in the industry. For example, Figure 3.2 is a model for competencies in long-term care and Figure 3.3 is a competency model for electronic health records. Under Tier 1 and Tier 2, each of these industries would select different personal effectiveness and academic competencies that would be important to the long-term care industry. For example, under Tier 1 and 2, both industries select the same personal effectiveness and academic competencies; however, under Tier 2, information literacy was important to the electronic health records industry. Under Tier 3, there continued to be a similar focus on workplace competencies; however, long-term care chose instruction and business fundamentals as important to learn. Electronic health records focused on checking, examining, and recording information and workplace fundamentals. The remaining tiers focus on specific competencies needed for each industry. Long-term care focused on long-term care and services, daily living focus, crisis prevention, ethics, and competencies related to accreditation. Electronic health records competencies focused on health information and healthcare delivery, ethics, and health informatics.

These models are interactive, and the user can select which competencies are needed for a specific job. The model contains certain competencies and allows the user to add competencies if needed based on application to different industries or organizations.

Figure 3.1 Building blocks of the competency model.

Reproduced from: CareerOneStop (2011). Career Competency Models: Geospatial Technology Competency Model. http://www.careeronestop.org/CompetencyModel/pyramid.aspx. Accessed December 5, 2011.

Figure 3.2 Long-term care, supports, and services competency model.

Reproduced from: CareerOneStop (2011). Career Competency Models: Long-term Care, Supports, and Services Competency Model. http://www.careeronestop.org/CompetencyModel/pyramid.aspx?LTC=Y. Accessed December 5, 2011.

Importance of Competencies

These competency models can play an important role in an organization. Organizations develop both short-term goals and long-term goals. Establishment of organizational goals provides a foundation for all employees including management to work together to achieve organizational success. Part of this goal-setting process is to determine the existing competencies of an organization. As stated earlier, competencies are an activity that an organization performs well. Competencies are derived from the employees’ skills, education, or experience. To succeed, companies should develop core competencies or activities that a company performs better than its competition (Thompson, Strickland & Gamble, 2010). In a healthcare organization, competencies could focus both on clinical and administrative competencies. Therefore, the competency model provides an opportunity to assess existing competencies and any lack of competencies in different jobs. This analysis will be helpful when recruiting and selecting appropriate employees.

Figure 3.3 Electronic health records competency model.

Reproduced from: CareerOneStop (2011). Career Competency Models: Health: Electronic Health Records Competency Model. http://www.careeronestop.org/CompetencyModel/pyramid.aspx?EHR=Y. Accessed December 5, 2011.

 Job Design

As stated earlier, job analysis represents the building blocks of human resource management. Once job and workflow analyses have been performed, the next step is job design, which determines how the tasks, duties, and responsibilities will be performed and how the job fits into the organization. The focus of job design is to develop a strategy to maximize job efficiency, to promote health and safety in the work environment, and to encourage employee motivation (Noe, Hollenbeck, Gerhart & Wright, 2011). Job design can occur in healthcare organizations but can be difficult to implement because many jobs can only be performed by individuals with very specific job specifications such as nurses and physicians, who require specific licenses and maintain very specific skill sets (Fried & Fottler, 2008, p. 178).

Industrial engineering is the best way to analyze jobs to maximize efficiency. The American Institute of Industrial Engineers defines industrial engineering as the mathematical and natural science application to maximize labor efficiency utilizing appropriate equipment and task structure using time and motion studies. Once it determines the most efficient motions to perform a job, the organization recruits potential employees based on the skills needed to perform the job (Industrial Engineering, 2011). Although efficiency is important in healthcare operations, it is also important that a job design include a health and safety component. The Occupational Safety and Health Administration is responsible for implementing and enforcing labor regulations related to employee safety and health. Ergonomics is the study of the link between employees and their physical work environment to ensure that the conditions are optimal for employees to perform physically to the best of their abilities without causing undue stress on an employee’s physical condition (Industrial Engineering, 2011). This is particularly true in the healthcare industry. Physical therapists are required to lift patients. Healthcare administrators may work long hours sitting at their desks. Surgeons perform arduous operations. All of these instances require equipment that is conducive to the employees providing the best performance possible; therefore equipment that is ergonomically designed has become more popular, which has resulted in a reduction of workplace injuries.

Based on the workflow analysis and job design, an organization defines a job with a written document that contains several components. The components typically include job identification, job responsibilities or functions, and job specifications. The job identification typically consists of the job title, the geographic location of the job, and the type of job—whether it is full time, management, or salaried. As discussed earlier, essential job functions are the primary duties of the position. Oftentimes, a job description may have a list of the tasks, duties, and responsibilities (TDRs) that are required. The job specifications identify the qualifications needed to be successful in the job, which consist of education, licensing, experience, and skills or competencies. These are often called knowledge, skills, abilities, and other characteristics (Mondy, 2012). Job conditions and any physical requirements are also indicated. Job applicants typically see a job posting, which provides many of those elements. A job posting is located on an organization’s employment website, in a newspaper, or at a job fair. A job posting typically provides job identification, a job description, the minimum and preferred specifications for the job, and the list of job responsibilities.

Job Redesign

The healthcare industry is a competitive industry, particularly in the nursing profession. There continues to be a shortage of nurses nationally. As a result, nurses have become disgruntled because their workload has increased resulting in the lowering of patient satisfaction and safety. A major task of job design is to redesign the structures of jobs to encourage and to motivate employees. Job enlargement, job rotation, and job enrichment are examples of job redesign. Job enrichment is the most common job redesign in the healthcare industry. Job enlargement broadens the types of tasks that are performed to make a job more interesting. It is considered a type of horizontal loading. For example, nurses may be given the responsibility of managing patients in several departments. Job rotation also increases job interest by transferring an employee from one job to another. It is a type of cross-training and provides variation to the employee. It is less common in health care because of licensing and accreditation issues with several types of jobs. Job enrichment increases the responsibility of the employee by increasing decision-making power within the employee’s job. Job enrichment is a form of employee empowerment, providing more autonomy to the employee to encourage decision making and management skills. For example, a nurse may be asked to participate in strategic planning or in managing a quality improvement committee (Ozcan, 2009).

Other Types of Job Redesign

Self-Directed Work Teams

Many organizations, particularly healthcare organizations, organize employee teams to manage work goals. These teams are called self-directed work teams. Team members have control over the work schedule, and the employees are empowered to complete the work process as they design it. Healthcare organizations are inherently designed to produce work as a team. For example, the care of a patient with a chronic heart condition could comprise a team including the primary care provider, the specialist, the nurse, the pharmacist, and the physical therapist. They all collaborate to achieve their ultimate goal of providing quality care to their patient. Healthcare studies indicate that high teamwork performance is the result of commitment to collaboration, commitment to quality outcome, and commitment to the organization. This is achieved by ensuring strong communication in the organization so that employees are clear about the organizational goals (Leggat, 2007).

Depending on the job position in the organization, different training may be required to ensure a high-performance team. For example, many clinicians also have their own practices, so training must be provided to ensure that the employees have a commitment to the organization where they treat their patients. Entry-level positions in a team may require different training than that for a middle manager in a team concept because the focus of these positions is different. Entry-level positions are less focused on management than are middle manager positions. Senior management focuses more on organizational goal completion rather than on task completion. Although teams are evident in many aspects of health care, training needs to be customized to ensure a quality outcome (Wallick & Stager, 2001).

Job Sharing

Job sharing occurs when two employees share the same position. This is an attractive option for employees who are valuable but want more time for personal obligations. It is becoming more popular in health care. A 2010 survey indicated that healthcare organizations were going to offer more opportunities for job sharing (Careerbuilder.com, 2010).

Flexible Work Schedules

Flexible work schedules provide flexibility in a work schedule. This option is an attractive choice for employees. Flextime allows employees to start and end their workdays at alternative times within specified guidelines. Employees may need different work schedules for family obligations, for example. Healthcare surveys indicate that nearly 75% of healthcare employers would offer flexible work schedules as a benefit. Approximately 10% of employers are also considering summer work hours (Colonna, 2005). This can be motivating to employees but also can be a service to the organization because healthcare consumers often require 24-hour attention.

Telework

Healthcare organizations recognize that technology continues to play a vital role in healthcare delivery. Telework, or telecommuting in an organization, designates certain employees to work outside the physical organization. Telework is becoming more common in the healthcare industry, as clinicians are providing more care to their patients via telemedicine. For example, SSM Health care, which won the Malcolm Baldridge National Quality Award and owns, manages, and is affiliated with 20 acute care hospitals, developed a telework contact center to deliver care. The SSM Health care telework contact center served as the benchmark for the industry by establishing a telework center where employees would be on call for all healthcare needs. Results indicate that operating expenses were lowered and employee satisfaction was increased. More nurses were attracted to working at SSM Health Care because of this telework opportunity (Healthlinesystems.com, 2011).

 Conclusion

Evaluating the workflow of any organization is the first step to developing jobs for individuals to perform that will ensure the workflow produces the desired outputs of the organization. Once the workflow is analyzed, the next step is to create jobs for individuals who will be employed by the organization and be responsible for producing the output of the organization. Prior to creating a job, a job analysis must be performed to determine which types of activities will be performed within a certain position in the organization. Job analysis is the foundation of human resource management because the analysis of a job is required before an organization begins to recruit individuals for specific jobs. At the conclusion of a job analysis, a written job description and written job specifications are developed that outline the responsibilities, skills, and experience needed to perform the job successfully.

An important component of job development is how jobs are designed so that the health and safety of employees are ensured through ergonomics, the work is efficiently performed, and employees are motivated to perform at a high level. Motivational job designs include flextime; job sharing; job enlargement, enrichment, and rotation; and telework. The same process must be performed if the organization decides to alter the way a service is being offered. For example, if electronic medical records will be implemented in a healthcare facility, it is necessary to determine the current workflow patterns and then redesign the projected workflow to accommodate the new technology. If an organization If an organization is diligent in these processes of job analysis and design, it will help the organization perform at its highest level.