1st Project

166

Economics, Management, and Financial Markets Volume 8(4), 2013, pp. 166–171, ISSN 1842-3191

THE IMPORTANCE OF HUMAN RESOURCES MANAGEMENT

TO THE HEALTH CARE SYSTEM

ELVIRA NICA [email protected]

Academy of Economic Studies, Bucharest

ABSTRACT. This paper discusses the major trends in scholarship about the role of HRM in strategic management, the migration of health workers, human resource professionals’ attempt to deliver high-quality health care to citizens, and the im- portance of human resources in the health care industry. The purpose of this article is to gain a deeper understanding of the impact of human resources on health sector reform, the importance of HRM in all aspects of healthcare organizations, the positive impact of increased job autonomy on employee outcomes, and the dynamics of employee engagement in healthcare. The literature on the link between HR system perceptions and civility towards patients, specific roles for HRM in building shared values that can service both the care needs of patients and the business needs of health organizations, the complex linkages between employees’ perceptions of human resources systems and hospital performance, and the mechanisms through which HRM can enhance patient satisfaction in health care organizations is relevant to this discussion. JEL Codes: E24, J24, O15 Keywords: HRM; health care system; hospital; employee; patient

1. Introduction I am specifically interested in how previous research investigated the im- portant roles that HRM can play in orchestrating organizational change, the relationship between human resources and health care, the job satisfaction of healthcare employees, and the impact of HRM in the health sector. This paper aims to analyze and discuss the impact of human resources on the health care system, information that human resource managers can apply to the healthcare industry, the education and in-service training of health care workers, and the impact of HRM practices on health sector outcomes. The theory that I shall seek to elaborate here puts considerable emphasis on the

167

different types of employees in the healthcare industry, HRM’s significant role in the distribution of health care workers, the importance of safety climate in determining patient safety outcomes, and the use of HRM in the health sector. The mainstay of the paper is formed by an analysis of the impact of changes in HRM practice on employee and patient outcomes, the role that HRM activities play in the operations of a healthcare organization, the labor shortage in the healthcare industry, and the ability of public health organizations to afford full-time human resources employees.

2. The Impact of HRM in the Health Sector Human resources management (HRM) plays an essential role in the health care system. The relationship between HRM and health care is complex. Both the number and cost of health care consumables can drastically increase the costs of health care. In both government-funded and employer-paid systems (Hunter, 2013a), HRM practices should help in finding the appropriate balance of workforce supply (Kunnanatt, 2013) and the ability of those prac- titioners to practice effectively and efficiently. Human resources in health sector reform aim to improve the quality of services and patients’ satisfac- tion. Effective HRM is crucial to health care in a practical setting, playing a vital role in the success of health sector reform. HRM plays an important role in investing in employee development. The migration of health care workers arises when examining global health care systems. The specific health care reform process varies by country. Accessing good-quality health care services can be arduous for those living in developing countries (med- ical personnel and resources may not be available or accessible for such residents), and the issue of migrant health care workers is critical. The mig- ration of health workers to more affluent regions and/or countries results in citizens in rural areas of developing countries experiencing difficulties re- ceiving adequate medical care. (Kabene et al., 2006)

Human resources can be applied to any activity of the operations of an organization (HRM is an administrative function of an organization). It is the responsibility of HRM personnel to ensure that legally mandated em- ployee benefits are implemented correctly. Terminating an employee influ- ences the individual’s life and livelihood. Healthcare organizations aim to provide quality of care to their patients. Underperforming employees could risk the lives of their patients. Employees are motivated to perform well by the quality of work environment. The increasing diversity of the workforce, the globalization of health care, technology’s impact on the healthcare sys- tem, and the focus on teamwork and quality patient care influence HRM. The increased diversity of employees and patients can be linked to the increased globalization of health care. (Niles, 2013)

168

3. The Relationship between Human Resources and Health Care Human resources have been a neglected component of health-system devel- opment in low income countries. Investment in human resources for health has been insufficient in absolute terms and has been inefficient in its dis- tribution. The pool of health workers in low and middle income countries has been depleted. HIV/AIDS increases the numbers of health workers willing to work overseas. Training strategies tend to emphasize initial training over continued professional development. Poor working conditions and remuner- ation push health workers out of the public sector, the health sector, or the country. Training strategies that fail to emphasize continued professional development and poor working conditions and remuneration affect the num- bers of health workers and their quality and performance. Nurse training is a highly saleable asset in the international market. In Africa, nurse aids, medical assistants, and clinical officers are doing essential medical tasks despite the existence of professional restrictions and regulations. Use of non-medically qualified health staff may affect quality and safety, whereas use of provider incentives and enablers (Pera, 2013) can improve performance under specific circumstances. Human resources have been a neglected com- ponent of health-system development. The grounds of public and health sector reform are strongly contested, whereas reforms have undermined human resources in health sectors. The HRM (strategic) function should be substantially upgraded in the health sector. (Hongoro and McPake, 2004)

Governance encompasses the role of the government in health care and its relation to other actors whose activities impact on health, involving dif- ferent components, from policy and legislation formation to financing and monitoring. There are glaring inequalities between countries in terms of their public financing (Nicolăescu, 2013a) of mental health. Level of human re- sources and presence of advocacy groups are liable to influence the invest- ment made in mental health. Primary care and mental health services are linked by the establishment of formalized referral procedures. Training on mental health issues is weak in primary care settings. Outpatient facilities provide a primary point of care in community settings. The continued expan- sion of outpatient facilities is vital to reduce the treatment gaps for mental disorders. Mental hospitals represent the primary mode of inpatient service. A mental hospital provides inpatient care and long-stay residential services for people with mental disorders. A decrease of resources spent on mental hospitals represents a positive change, whereas a paucity of general hospital psychiatric beds does not replace mental hospitals in caring for acute mental disorders. Family and user associations are important allies in fighting for the health care and rights of people with mental disorders. (Morris et al., 2012)

169

4. The Various Functions of HRM in Health Care Systems In the health context, high-involvement management adds to the human capital of the workforce. HRM practices affect intermediate outcomes in the health sector. (Patterson et al., 2010) Some elements of health-related activity have not received the full benefit of modern human resources capa- bilities. (Fleming Fallon, Jr., and McConnell, 2007) The relationship between employees’ human resources system perceptions and patient satisfaction is mediated by employees’ civility towards patients (i.e., by the extent to which employees treat patients with courtesy, dignity and respect), a behavioral human resources outcome negatively affected by employees’ intention to leave. (Baluch, Salge, and Piening, 2013) Hospitals aim to achieve high levels of clinical performance. HRM processes positively influence organi- zational-level performance. In the context of management, information management, and health and safety processes, the effective functioning of HRM processes (Hunter, 2013b) influence the continuity of quality patient care. The effectiveness of HRM processes (Yuan, 2013) moderates the re- lationships between: (1) strategic and operations management processes, and (2) health and safety processes and the continuity of quality patient care. When examining the influence of the effective functioning of HRM processes on organizational-level performance (Bacalu, 2013) in hospitals, one should consider the simultaneous and interdependent influence of mul- tiple processes. (Townsend, Lawrence, and Wilkinson, 2013) Pro-social organizational behavior (PSOB) is important in health organizations where service provision involves high levels of task interdependence (Sánchez de Madariaga, 2013), task complexity and uncertainty: value-driven human re- sources may offer one means of maintaining and encouraging both altruistic and conscientious act of PSOB on which health care depends. (Hyde, Har- ris, and Boaden, 2013)

Managers can improve patient care experiences by improving employee satisfaction and retention. Health system performance depends on a capable workforce in healthy and productive workplaces. The quality of the work environment (Fost, 2013) for staff and physicians is a key determinant of a high-performing healthcare organization. More-engaged employees are better able than their less-engaged colleagues (Cremers, 2013) to achieve organi- zational goals. Using a variety of tools, healthcare organizations assess the quality of patient care and of the non-clinical services provided. Achieving higher levels of employee engagement is part of the solution to quality im- provement. Engaged employees benefit patients and reduce the workforce costs associated with turnover. Higher levels of employee engagement must become a strategic goal for all healthcare organizations. The key to unlock- ing higher levels of engagement is for managers at all levels to build trust

170

with employees. Trust building happens in every interaction (Nicolăescu, 2013b) and becomes engrained in an organization’s culture (Prager, 2013), whereas culture becomes the vital link between positive staff experiences and performance. Highly engaged employees are able to perform effectively in their job (they have a supportive supervisor and adequate resources and equipment). (Lowe, 2012)

5. Conclusions Over the past decade, there has been increasing evidence describing effec- tive HRM practices and their effects on employees within the health sector, the roles human resources play in improving performance outcomes, human resources initiatives for health sector reform, and the quality and produc- tivity of the health workforce in low income countries. My paper contributes to the literature by providing evidence on initiatives made by human re- sources professionals in an attempt to improve the overall standard of care in the hospital, the contribution of HRM to successful strategic planning, strong relationships between employee engagement and organizational per- formance, and the various functions of HRM in health care systems. The paper generates insights about HRM’s integral role in strategic planning to address workforce needs and projected shortages, training as a solution to human resource difficulties, the impact of HRM interventions or practices on job satisfaction among health professionals, and the trends in health sector reform.

REFERENCES

Bacalu, Filip (2013), “The Role Language Plays in Social Behavior,” Analysis and

Metaphysics 12: 154–159. Baluch, Alina M., Torsten Oliver Salge, and Erk P. Piening (2013), “Untangling the

Relationship between HRM and Hospital Performance: The Mediating Role of Attitudinal and Behavioral HR Outcomes,” The International Journal of Human Resource Management (Special Issue: HRM in the Healthcare Sector) 24(16): 3038–3061.

Cremers, Jan (2013), “Non-financial Reporting and Reference to Workers’ Repre- sentatives,” Contemporary Readings in Law and Social Justice 5(2): 50–89.

Fleming Fallon, Jr., L., and Charles R. McConnell (2007), Human Resource Management in Health Care Principles and Practice. Sudbury, MA: Jones and Bartlett Publishers.

Fost, Joshua (2013), “The Extended Self, Functional Constancy, and Personal Iden- tity,” Linguistic and Philosophical Investigations 12: 47–66.

Hongoro, Charles, and Barbara McPake (2004), “How to Bridge the Gap in Human Resources for Health,” Lancet 364: 1451–1456.

171

Hunter, Murray (2013a), “Capabilities throughout the Organization Lifecycle,” Psy- chosociological Issues in Human Resource Management 1(1): 37–107.

Hunter, Murray (2013b), “Imagination May Be More Important than Knowledge: The Eight Types of Imagination We Use,” Review of Contemporary Philosophy 12: 113–120.

Hyde, Paula, and Claire Harris, and Ruth Boaden (2013), “Pro-social Organizational Behavior of Health Care Workers,” The International Journal of Human Re- source Management (Special Issue: HRM in the Healthcare Sector) 24(16): 3115–3130.

Kabene, Stefane M., Carole Orchard, John M. Howard, Mark A. Soriano, and Raymond Leduc (2006), “The Importance of Human Resources Management in Health Care: A Global Context,” Human Resources for Health 4: 20.

Kunnanatt, James Thomas (2013), “Globalization and Developing Countries: A Global Participation Model,” Economics, Management, and Financial Markets 8(4): 42–58.

Lowe, Graham (2012), “How Employee Engagement Matters for Hospital Perfor- mance,” Healthcare Quarterly 15(2): 29–39.

Morris, Jodi, Antonio Lora, Ryan McBain, and Shekhar Saxena (2012), “Global Mental Health Resources and Services: A WHO Survey of 184 Countries,” Public Health Reviews 34(2): 1–19.

Nicolăescu, Eugen (2013a), “Developments in Corporate Governance and Regulatory Interest in Protecting Audit Quality,” Economics, Management, and Financial Markets 8(2): 198–203.

Nicolăescu, Eugen (2013b), “Understanding Risk Factors for Weaknesses in Internal Controls over Financial Reporting,” Journal of Self-Governance and Manage- ment Economics 1(3): 38–43.

Niles, Nancy J. (2013), Basic Concepts of Health Care Human Resource Manage- ment. Burlington, MA: Jones & Bartlett Learning.

Patterson, M., J. Rick, S. Wood, C. Carroll, S. Balain, and A. Booth (2010), “Sys- tematic Review of the Links between Human Resource Management Practices and Performance,” Health Technology Assessment 14: 51.

Pera, Aurel (2013), “The Social Aspects of Technology-enhanced Learning Situations,” Geopolitics, History, and International Relations 5(2): 118–123.

Prager, Jonas (2013), “The Financial Crisis of 2007/8: Misaligned Incentives, Bank Mismanagement, and Troubling Policy Implications,” Economics, Management, and Financial Markets 8(3): 11–56.

Sánchez de Madariaga, Inés (2013), “Advancing Gender Equality in Research and Innovation in Europe and Beyond: COST Network and GenderSTE,” Journal of Research in Gender Studies 3(1): 131–143.

Townsend, Keith, Sandra A. Lawrence, and Adrian Wilkinson (2013), “The Role of Hospitals’ HRM in Shaping Clinical Performance: A Holistic Approach,” The International Journal of Human Resource Management (Special Issue: HRM in the Healthcare Sector) 24(16): 3062–3085.

Yuan, Shengjun (2013), “Educational Policies and Economic Growth in BRICS: Comparative Perspectives,” Knowledge Cultures 1(3): 32–44.

© Elvira Nica

Copyright of Economics, Management & Financial Markets is the property of Addleton Academic Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.