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Human Resources Strategies to Improve Performance in Healthcare
Organizations
Section 1: Foundation of the Project
Background of the Problem
Human resource management strategies add unique value to healthcare
organizations by serving as a mechanism for managing and delivering quality through
expertise and creating functional organizational processes, policies, and procedures (van
Nisterlrooij & Homan, 2019). Inefficient use of management resources jeopardizes the
integrity and quality of services provided by healthcare professionals. Researchers study
how human resources practices improve quality and performance in healthcare
organizations. The leadership in healthcare organizations is responsible for developing
strategies to achieve the goal of increased patient care and implementing strategies for
quality assurance (Hamm et al., 2021). The initial step is to examine management
processes for integrating high-quality care and identify human resources practices that
positively impact management strategies and overall patient care.
Business Problem Focus and Project Purpose
The specific business problem was that some healthcare leaders lack strategies to
use human resource functions to enhance organizational processes and systems for
improving performance. Therefore, this qualitative, pragmatic inquiry explores human
resource functions healthcare leaders use to enhance organizational processes and systems
to improve performance. The population for this qualitative, pragmatic inquiry was
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comprised of seven healthcare leaders in the Northeastern and Southeastern regions of the
United States who utilize human resources strategies to improve efficiency and improve
the quality of patient care. The data sources used were semistructured interviews with
healthcare leaders and publicly available documents. The purposive sampling method was
utilized for the study. Purposive sampling is a technique commonly used by researchers to
validate data collected that relates to a particular phenomenon (Denieffe, 2020). Using
purposive sampling allowed me to select experienced leaders from healthcare facilities that
have integrated human resources strategies to improve patient care. Participants’ eligibility
criteria included leaders in healthcare, specifically clinical directors, human resource
managers, director of nursing, and members of the chief executive leadership team. The
theory that grounds this pragmatic inquiry design is Kurt
Lewin’s change management theory. Kurt Lewin’s concepts of original research in 1939
on organizational development inspired a movement of scholars to focus on
organizational change theory in 1947.
Research Question
What human resources strategies do healthcare leaders use to enhance
organizational processes and systems to improve performance?
Assumptions and Limitations
Assumptions
Assumptions are unverified facts (Sebele-Mpofu & Serpa, 2020). Several
assumptions exist when conducting research with managers. The initial assumption is that
healthcare managers possess a foundation in management techniques. The second
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assumption is that healthcare managers and the employees in those departments are
interested in managing healthcare departments. The last assumption is that all managers are
interested in improving patients’ overall quality of care.
Limitations
Research limitations are barriers that I cannot control. It is recommended for
researchers to integrate tools while conducting research to identify limitations and
vulnerabilities systematically. (Munthe-Kaas et al., 2019). Limitations included accessing
participants, participant objectivity, researcher and participant boundary issues, and
participant mistrust of the research process (Howard, 2021). One limitation is that the
healthcare organizations in this study was restricted to a specialization in healthcare and
did not account for all types of healthcare practices; an alternative healthcare specialization
may have a different experience. Another limitation was leaders with experience managing
may be limited in utilizing human resources management. Another limitation is that all
participants are from the United States; other countries may present a varied experience.
Transition
In Section 1, the background of the study, business problem and purpose, research
question, assumptions, and limitations were discussed. Section 2 will consist of a review
of professional literature. Project ethics, the project’s nature, population, sampling, data
collection, analysis techniques, reliability, and validity will be covered in Section 3.
Findings will be presented in Section 4.
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Section 2: The Literature Review
A Review of the Professional and Academic Literature
A review of professional and academic literature, including critical analysis and
synthesis, is vital to this study. This qualitative, pragmatic inquiry explores healthcare
leaders’ strategies to analyze performance while implementing human resources functions
to manage organizational processes and systems. The literature review included
professional and scholarly work on healthcare leaders’ human resources strategies to
enhance organizational processes and systems for improving performance. The alignment
of present data and varied research materials in the recommended pragmatic inquiry will
be demonstrated through data accumulation, research analysis, and synthesis. Several
academic resources were reviewed for this research, including ABI/Inform, Business
Source Complete, ProQuest, Google Scholar, Scholar Works, ScienceDirect, Academic
Search Complete, and Sage Journal. Key words being searched to guide this literature
review include human resources, consultants, field change theory, field theory, Kurt
Lewin, performance in healthcare organizations, business process theory, organizational
change, strategic planning, and healthcare leader’s role.
The comprehensive literature review was systematic and exhaustive. First, the
conceptual framework was explained, and a critical analysis of supporting theories will be
provided. Second, the literature was critically analyzed and synthesized data on themes
relating to the study’s purpose: to examine human resources strategies to improve
performance in healthcare facilities. Lastly, a comparison of different perspectives was
completed that evaluated the relationship of this pragmatic inquiry to previous research and
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findings. The study provided a vigorous, substantiated review of professional and academic
literature related to data on human resources strategies for quality improvement in
healthcare facilities.
The literature review contains 67 references published between 1939 and 2024.
Table 1 contains the sources accompanied by their respective publication years: (a) 97%
peer-reviewed journal articles, (b) 1% non-peer-reviewed journal articles, and (c) 2%
seminal works.
Table 1
Literature Review References
Reference
Total
Total Published After
2019
Percentage In Or
After 2019
Non-Peer Reviewed
1
1
100%
Peer Reviewed
64
64
100%
Seminal Works
2
0
0
Total
67
65
97%
In this literature review, I explore the inefficient use of human resources
management strategies as an issue that plagues quality improvement in the healthcare
field. In a pragmatic inquiry, Burrell (2020) identified additional consequences in
organizational processes: negative organizational culture, decreased employee
satisfaction and motivation, a negative management perspective, increased operational
costs, and high employee turnover rates. A decrease in the quality of patient care is a
significant consequence of ineffective human resources management strategies.
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Kurt Lewin’s Change Management Theory
In 1939, Kurt Lewin studied social and behavioral influences and their impact on
psychology, social facts, and social relationships (Lewin, 1939). The critical concepts of
Kurt Lewin’s change management theory are the process of change in organizational
processes intact, integrating a new process, also known as the change process, and
refreezing this process to influence organizational culture and develop a new cultural norm
(Khalfallah et al., 2023). The influence of an organizational cultural norm through
observation of physical and physiological processes (Lewin, 1939). The logical
connections between the framework presented and this pragmatic design include Lewin’s
organizational change management theory, which identifies the impact of organizational
change during process management implementation.
Identifying the most appropriate theory to support the research data is crucial when
conducting a study. Business process theory and change management theory are suitable
for this research topic. Housebane et al. (2020) indicated that business process analysis in
healthcare needs to be more utilized and that improvements within the healthcare system
will remain unrealized by analyzing and reviewing healthcare processes. The benefits of
evidence-based process improvement within healthcare organizations will remain
underdeveloped (Housebane et al., 2020). Containing costs while maintaining quality is
the dichotomy that healthcare organizations face. Business process analysis helps identify
processes that need a strategy change. Kurt Lewin’s change management theory is the
seminal research to support this pragmatic inquiry as it explains the process of change and
the stages leaders import to positively implement change. Khalfallah et al. (2023)
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identified the importance of performance process improvement for success in healthcare
organizations. Increasing organizational performance using business process design helps
improve the quality of care of services. Housebane et al. (2020) also noted the importance
of the performance management process. They added that in healthcare, it has been used
in modeling, deployment, execution, monitoring, analysis, and optimization of business
processes. Therefore, this process analyzes strategies healthcare leaders use to effectively
utilize organizational resources to improve performance.
Research indicates the utilization of human resources management techniques to
improve healthcare quality. Various studies identify specific benefits of implementing
human resources strategies in management processes; there are challenges to aligning
present management goals with the goals of human resources leaders. However, there is an
illustrated need for alignment with human resources strategies to integrate the strategic
plan. Presenting perspectives of executives, management, and human resources leaders
provides a comprehensive analysis of the implications of improved performance and
quality when integrating human resources strategic goals.
Supporting information included in the literature review consists of peer-reviewed
journal articles, books, and website content. The peer-reviewed and scholarly information
that supported this research was accessed using search engines, including ProQuest,
Google Scholar, JPNA, Scholar Works, ScienceDirect, Academic Search Complete, and
Sage Journal. Research articles utilized in this pragmatic inquiry provided contributing
information about business management practices in healthcare organizations and their
impact on improving patient quality and care. The literature demonstrates the significance
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of incorporating business management theory, change management theory, and human
resource strategies into the strategic plan for healthcare leaders to increase patient care
quality.
Two theories that were researched but did not best support the basis of the research
were Neisser’s cognitive theory and Ludwig’s change theory. Both theories are key
concepts and vital in analyzing and devising organizational resolutions. As applied to this
study, the cognitive theory focuses on information processing limitations in using mental
models and decision-making processes (Van Rossem, 2021). The cognitive theory would
analyze the relationship between independent variables (human resources value creation
and improvement of organizational processes) measured by the Repertory Grid Technique
and a rating procedure for statistical data. The measurements will predict the appropriate
use of management resources. This design was suitable for my research as my study aimed
to explore the value created by integrating human resources management strategies to
improve performance by examining administrative processes, organizational systems, and
inefficient use of management resources.
The literature review was used as a tool to analyze various assessment processes to
determine the implementation of human resource practices in management strategies and
the criteria for selecting subject matter experts to employ human resource practices (Van
Rossem, 2021). Delegation of standards for choosing a consultant contributes to the
validity of the expertise of human resources consultants. The illustration of the added value
that human resource strategies contribute to healthcare leaders provides evidence of the
need for human resource strategy implementation. The outcomes of the study provide the
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perimeters for integrating human resource strategies with healthcare leaders. The literature
also presents a hypothesis of the benefits of integrating human resource strategies to
improve performance (Pemer et al., 2020); this hypothesis aligns with the research by
demonstrating the benefits of using these strategies in healthcare organizations to improve
the overall quality of patient care. The study’s data presented an analysis of the importance
of investigating the value of alignment in the human resource management and
organizational relationship in healthcare (Chudzikowski et al., 2020). Improper
implementation can result in a decrease in employee motivation and, ultimately, a failure
in performance, which results in a decreased quality of patient care.
All measures researched surrendered justifiable data that supported the addition of
human resource strategies in an organization but did not produce financial benefits to
organizations or the economic costs of additional resources. Companies are ultimately
interested in the bottom line. Future research will benefit by including a cost-value analysis
to support the benefits of employing human resources experts and its impact on quality of
care and organizational growth against maintaining current management strategies and
employee and patient satisfaction.
Change Management Theory
Kurt Lewin’s influential research on organizational development inspired a
movement of scholars to focus on organizational change (Albrecht & Roughsedge, 2023).
Lewin studied behavioral influences in a workplace setting, the importance of change
processes, and the findings in the research conducted that shape today’s workforce.
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Albrecht and Roughsedge (2023) identified that employees feel a part of the
decisionmaking process when they participate, and inclusion reduces workplace resistance
among employees. Research also connects the motivational interview technique and
Lewin’s organizational change management theory. Albrecht and Roughsedge (2023)
identified three grounds for an integrative framework for motivation through organizational
change. Healthcare leaders use motivational interview techniques to assess employee and
patient issues and use human resource strategies to motivate and provoke organizational
change.
Lewin’s change management theory identifies three stages in the organizational
process of transition: unfreeze, change, and refreeze. The unfreezing phase is preparing for
the desired change, implementing the desired change, and refreezing to solidify the desired
change. The three supporting grounds include Lewin’s suggestion that employees should
not be coerced or pressured when asking for feedback, which is the premise of motivational
interview theory. Lewin identified how processes in the workforce influence behavioral
change, and motivational interviews identified individuals in various stages of change and
the behavioral changes that accompany the process (Lewin, 1939). Both frameworks are
based on cognitive dissonance and applied psychology (Albrecht &
Roughsedge, 2023). Lewin’s groundbreaking research on organizational change Lewin
(1944) specified standards for studying organizational production and performance.
Lewin asserted management’s role and responsibility in maintaining and increasing
productivity. This methodology correlates with this pragmatic inquiry as it provides
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evidence-based theory to integrate practices for increasing productivity by increasing
employee satisfaction.
The study identified three management styles (autocratic, democratic, and
laissezfaire) and their impact on employee motivation (Lewin, 1944). The seminal work
concluded that setting performance measures to increase productivity is vital and proposed
that relaxing standards would decrease productivity. The research identified the benefit of
increasing standards and raising goals to increase employees’ internal motivation and
productivity (Lewin, 1944). Lewin’s foundational research demonstrates how human
resource strategies and organizational leaders can implement policies, develop change
initiatives, and influence positive performance improvement in a healthcare facility. This
background supports the data presented in this pragmatic inquiry through the illustration of
the value of assessing organizational change; Kurt Lewin’s seminal change management
theory is the grounds for the organizational change process as he is known as the “father of
organizational change.” The data presented in the study aligned with the research presented
to exemplify the influence of organizational change, employee motivation, the quality of
patient care, and increasing organizational performance.
Organizational Change
Interrelationships guide the human resources strategic plan to support business
functions. Strategies and operations drive an organization’s business decisions. The
operating plan works in tandem with the strategic plan. Human resource strategies are
regarded as the backbone of sound business practices. The operating plan directs human
resources, focusing on developing initiatives through developing a mission, value
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proposition, development goals and objectives, value chain, research evidence, timeline
and milestones, and budget (Cooke et al., 2021). Successful strategies to incorporate an
operating plan must contain organizational objectives, activities to be delivered, quality
standards, desired outcomes, staffing and resources requirements, implementation
requirements, and a monitoring process.
Human resources leaders who develop operating plans analyze existing successful
strategies. Assessing an organization’s mission, vision, and values is essential in aligning
the strategic and operating plans. Dyer et al. (2020) defined business strategy as a
company’s dynamic plan to gain and sustain competitive advantage. The strategic plan
identifies what markets to compete in, identifies the unique value the firm will offer in
those markets, connects the resources and capabilities required to provide that unique value
better than competitors, and indicates ways to sustain market advantage while increasing
performance. The study used the literature as evidence to support the theory of human
resources and the integral role devised in strategic planning by integrating the needs of the
stakeholders and employees to improve the value of care provided to patients.
Strategic planning in business is instrumental to the success of implementation.
Developing a strategy for organizational sustainability is the responsibility of business
leaders. Human resources focus on the operating plan and identifying the organization’s
key activities to accomplish organizational goals. Human resources leaders can devise a
successful operating plan for their organization by analyzing an existing strategic plan and
examining current business needs. Dyer et al. (2020) described business strategy as a road
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map to achieve market position and desirability over the competition. These strategies can
be translated by a leader directly into an active business operations plan.
Human resources analyze issues and develop an operating plan incorporating a
business’ mission, vision, and plan for future business strategies. Successful
implementation is dependent on the examination of organizational strategic goals and
implementing a plan to accomplish the mission and vision business goals, focusing on
value creation through examination of the workforce and positive change initiatives,
assessing the organization’s strengths, weaknesses, opportunities, and threats, and
examining a GAP analysis to devise an action plan to move from current position to
achievement of operational goals. This pragmatic design includes the evidence found in
this literature to highlight the effect of the absence of operational objectives, resulting in
the need to amend an organizational strategic plan in a healthcare facility and integrate
human resources roles.
Organizational Change Alliance
The success or failure of a strategic plan depends on the effectiveness of
management’s communication of the strategy. Northouse (2019) indicated that leadership
is a process that involves influence, and in an organization, leadership works towards
common goals. The literature suggests that leaders in an organization should execute
business strategies well to prevent failure by integrating human resources practices. Dyer
et al. (2020) indicated that companies that fail to complete business strategies fail to
communicate clear objectives, do not have a transparent compensation system for
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achieving goals, and fail to do so. Leadership needs a clear direction. Chmielewska et al.
(2022) asserted that leaders must understand the benefits of utilizing McKinsey’s 7S
framework and the importance of strategy, structure, and systems.
Human resource subject matter experts know the difficulty and time it takes to
develop staffing, shared values, skills, and style. Comprehending this framework
provides essential factors that help sustain market position (Chmielewska et al., 2022).
These strategies align with the study in providing a framework for healthcare leaders by
identifying leadership roles, executing intricacies, understanding organizational culture
influences, resolving execution challenges, and converting identified challenges into
opportunities to influence change and implement the vested requisites of patients and
employees. Using the literature in the pragmatic design should illustrate the importance
of satisfying all interests to improve quality in healthcare facilities.
Dyer et al. (2020) identified eight steps to implementing successful strategic
change: act with urgency, build a team of experts and leaders to design and communicate
change, motivate the vision, empower individuals in the organization, celebrate
individual successes throughout the organization, consolidate gains and continue to
innovate and make change a part of the organization. Utilizing practices may enable
leaders to develop a strategy to distinguish market value, forming a relationship between
the organization and design (Dyer et al., 2020). The importance of creating a strategy map
and identifying the tools needed for strategic change is instrumental for plan
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development; a strategy map and identifying the tools needed for strategic change is
instrumental for plan development, which is what this study will illustrate.
Using human resources functions enables leaders to determine the value creation
and divides strategic objectives into four perspectives: financial, customer, internal
process, and learning and growth (Jo et al., 2024). Healthcare leaders should understand
the vital role they have in the development and implementation of these processes.
Through an assessment of the literature, the research will demonstrate the focus of
strategic planning, the implementation and formulation phase, and the importance of
continuing to incorporate change in day-to-day operations, which is vital for continued
success. Assessing ongoing strategic change is challenging for management. The study
will support the assertion for an assessment tool to analyze differences and evaluate the
need for additional changes.
Strategic Planning
Strategic planning is instrumental in identifying an organization’s goals. Boon et al.
(2024) indicated that the strategic vision is the organization’s plan that predicts all current
variables in the future and added that the strategic vision would be realistically efficient
and effective in organizations if technological standards were adopted. There are numerous
benefits to developing strategic planning. The advantages are a good understanding of
administrative function, development of human capabilities and skills, and improvement
in an organization’s competitive advantage. A successful strategic plan determines long-
term sustainability. The study will support the literature’s findings on the importance of
strategic planning for an organization to meet and exceed quality goals. Strategic planning
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and the integration of human resources strategies in developing the goals in a healthcare
facility are instrumental to accomplishing the goals.
Variables and indicators measure sustainability. Boon et al. (2024) indicated that
variables of successful strategic planning are analysis, technological knowledge
management, electronic training, and cost management. The outcomes connected to the
variables include innovation management, research and development, value-added,
efficiency, and performance effectiveness. Measuring indicators is an integral part of the
strategic planning process. The outcome of measuring indicators results in sustainable
competitive advantage, which produces increases in the following areas: innovation rate,
quality, development rate, budget for development, standard and effectiveness of
performance and efficiency, job satisfaction, and value-added (Ali Albaz, 2019). The
literature aligns with the goals of the pragmatic study as it is imperative to measure
variables in a healthcare facility like innovation rate, quality, development rate, job
satisfaction, and value standards to understand the impact each variable has on the quality
of care for patients.
Steps of Strategic Planning Cycle
Formulating a strategy involves selecting the company’s actions to gain and
sustain a competitive advantage (Cooke et al, 2021). Strategic goals provide unique value
to customers in the appropriate markets, developing a set of resources and capabilities
that allows organizations to deliver unique value to customers better than competitors and
sustain the competitive advantage by figuring out how to prevent imitation of the chosen
strategy. Dyer et al. (2020) proposed four phases in strategic planning: the organization’s
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mission, SWOT analysis, strategy formulation, and strategy implementation. Dyer et al.
(2020) indicated that external analysis involves examining the competition and the forces
that shape industry competition and profitability, as well as customer analysis, to
understand what customers want. The study will attempt to understand what patients want
in healthcare facilities, what employees want, and the role human resources strategies
play in achieving these goals.
Shamuratovna et al. (2024) identified the steps of the strategic planning process
include setting strategic direction, strategic gap analysis, documenting the plan, executing
the plan, and monitoring the plan. After the monitoring and planning phases, leaders
continuously inform and reassess the Strategic Planning Process. Responsible parties
document the planning phase, followed by executing the planning phase, progress, outlook,
and feedback to monitor the planning phase. The study aims to identify the imperative
nature of the planning process and understand the stages of planning and execution that
exhibit the correlation between human resources as a strategic planner, management
processes, and assurance of quality improvement.
Long-Term Benefits of Strategic Planning
There are several long-term benefits of strategic planning. Successful strategic
planning includes business sustainability and financial success. Companies that achieve a
successful strategic plan meet organizational goals. Shamuratovna et al. (2024) asserted
that strategic planning benefits include clear directives by describing the essence of what
an organization does, the value it wishes to create, how future stakeholders if the
organization is booming, and what the organization intends to do going forward.
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Effective risk management is another long-term benefit of the strategic planning process.
Shamuratovna et al. (2024) defined effective risk management as the process companies
use to identify and assess as many risks as possible to affect the organization’s success.
Motivation is another long-term benefit of strategic planning. The study will use
this literature to demonstrate the long-term benefits of strategic planning and aims to
explain the consequences of change strategies and the implications of a structured
organizational strategy. Shamuratovna et al. (2024) defined this phase by providing a
clear direction that ties the needs of stakeholders and the environment in which the plan
operates. A strategic plan can energize, motivate, and focus on every level of the
organization.
Aburmishan and Baum (2022) asserted that a completed strategic plan is not
effective if it has myriad goals and objectives connected to functional areas of leadership.
For strategic planning to be influential, leaders must successfully balance critical missions
and evolving cultures (Aburmishan & Baum, 2022). Despite being committed to change,
leaders must overcome the plagues of strategic planning. Leaders face deeprooted cultural
expectations, conflicts with entrenched institutional values, and institutional inertia that
will fight change long after the need. When faced with challenges among employees,
leaders can produce a commonly overlooked challenge in creating a culture of inclusion
(Aburmishan & Baum, 2022). This study highlighted consequences and challenges in
existing organizational processes, the value of communicating change, resistance to
change, influencing transition, change implementation, and continued reassessment
through the change management process through utilizing human resources
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strategies.
The role that human resources play in an organization continues to
evolve.
Nyfoudi et al. (2024) associated the evolution of the human resources function from
staffing and training to an instrumental role as a leader with a critical role as a strategic
planner, illustrating a tremendous progression. The evolution began as staffing and
training expanded to an indispensable role in the National Labor Relations Act of 1935,
evolving further to adopt the scientific management approach based on productivity, to
the role of a company advocate, and development of a focus on the organization’s human
capital (the people), marketing, communications, and public relations (Jo et al., 2024).
Human Resources functions are not limited to supporting business goals but include
organizational development across multiple areas of the organization.
Another phase is to include more educated managers who continued to focus on the
human dimensions but also included more significant facets of the business, such as the
influence of employees on the marketing, communications, and public relations of the
organization, inclusive of a strategic business partner developing tactics for organizational
goals, planning, and implementation through the employees of the organization. This
pragmatic inquiry used the literature’s contribution to show the emphasis human resource
strategies have on employee relations and improvement in employee satisfaction. This
study supported the connection between employee satisfaction and improving patient care
in healthcare facilities through existing literature.
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Human Resources Management
Prabowo et al. (2020) advised the importance of human resources in an
organization despite the company’s design. The authors asserted that the Human
Resources entity focuses on the idea and helps the establishment’s employees (Prabowo
et al., 2020). Human Resources recognizes the importance of human capital and will
demand and advocate for the most qualified candidate for the organization despite all
factors adding to the firm’s integrity, innovation, and quality. Cooke et al. (2021)
indicated that the collaborative relationship triggers significant organizational change,
and these changes impact the employees, resulting in perceived trauma and stress in the
workforce. Elgoibar et al. (2021) identified additional unequivocal strengths of human
resource strategies that are beneficial to remedy perceptions during a transitional phase
and emphasized trustworthiness, relationship resolution of conflicts, well-being, and
influence of parties. These attributes contribute to the positive inception of an alliance
and partnership.
Human resource strategies emphasize the value of alliance as it enables a smooth
transition where mutual trust is achieved. The benefit is a culture of overall organizational
support while possessing the ability to resolve conflicts and accomplish organizational
objectives (Elgoibar et al, 2021). This is a necessary step in the strategic process when there
is an adversarial display of conflicting issues and rewards, and losses are high throughout
the change process. The literature demonstrated the emphasis healthcare organizations
place on medical technologies and evidenced-based medical theories in management while
not emphasizing human resource practices in managing employees. Healthcare
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organizations routinely focus on the hierarchy of employees, the highest being the medical
director. However, the literature exhibited the importance of all employees in healthcare
organizations and the impact each has on increasing performance and overall quality of
patient care through the integration of human resource practices.
Human resource involvement in developing policies and procedures is essential to
help leaders implement processes to manage organizational resources most efficiently.
Prabowo et al. (2020) defined the role of human resources as crucial and urgent in an
organization. Is offered human resources roles to maintain organizational continuity, build
community trust, and sustain organizational credibility (Prabowo et al., 2020). Human
resources aim to develop long-term and short-term goals for the organization while playing
an instrumental role in strategic plan development.
One focus of human resources is to utilize human capital to maximize performance
and result in maximum employee contribution. Prabowo et al. (2020) asserted that human
resources’ performance assessment factors include recruitment or procurement of
employees, training and development, mutation of tasks, and compensation. The
department is also instrumental in healthcare organizations. They assess the current
environment and adapt, improve the organization’s quality by developing and
implementing policies, maintain the integrity of services by implementing organizational
competence, and identify and monitor the work of everyone (Prabowo et al., 2020).
Human resources can assess organizational processes and assist with devising a
strategic plan to improve those processes. Kim (2019) advises that human resources
achieve quantum innovations while enhancing business and being ambidextrous.
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Organizational ambidexterity has been acknowledged as a source of sustainable
competitive advantage, and the outcomes include performance growth, perpetual
performance, innovation, and market valuation (Kim, 2019). Ambidexterity is “the
organizational capability to simultaneously achieve exploitation and exploration (Kim,
2019). This strategy is helpful when deciding to implement consultants in healthcare,
identifying creative strategies that improve patient quality.
Another strategy that is instrumental in the role of human resources to help
management effectively manage resources through the strategic plan is ensuring quality in
human resource quality as the critical aspect of achieving optimal organizational
performance. Song et al. (2023) advised that the human resources strategic plan is to nurture
and develop the organizational competence necessary to thrive in a competitive
environment. Research shows that human resource management and knowledge
management influence organizational performance. Human resources strategies that impact
organizational performance include a focus on improvement strategies, factors including
human resources management, organizational learning, knowledge management,
leadership, organizational culture, actors, alternative approach with the development of
human resources policies, organizational infrastructure, and knowledge management
development of policies, and sub-alternative strategies including conducting recruitment
and selection processes, budgetary support, facilitative leadership, and building a shared
vision. (Song et al., 2023).
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Organizational Leadership
Transparency is an essential concept in an organization. Transparency produces a
cohesive relationship between leaders and members of an organization. Employees feel a
part of the decision-making process when there is transparency coupled with providing
feedback. The literature explores the correlation between transparency and an increase in
employee motivation. The literature supports the outcomes of better patient care in
healthcare facilities and an increase in employee motivation. DeVito and Goldacre (2023)
defined transparency as the lack of hidden agendas and conditions and the availability of
complete information required for collaboration, cooperation, and collective
decisionmaking.
Transformational leaders emphasize relationship-building connectivity and
transparency while leading. Northouse (2019) defines transformational leadership as
engaging with others and creating a connection that raises motivation. Moore and Ahmed
(2021) indicated that transformational leaders motivate people to make organizational
transitions. Moore and Ahmed (2021) showed that leadership and motivation are mutual
interactions, and followers have the most motivated leadership. Employees can be
stimulated when they feel part of the process and when leadership is transparent about
strategic plans.
DeVito and Goldocre (2023) identified that although transparency is ideal within
an organization, not all decisions should be made in the open and stated that stated decisions
should be personal, salary, and performance. The processes for these issues should be
transparent to employees, but the individual information should remain confidential.
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Information that may cause high anxiety or make employees question the organization’s
stability may also be considered information carefully shared. Albrecht and Roughsedge
(2023) asserted that staff should know and understand the context of decisions and the
happenings as they react negatively when they do not know or understand the context.
Leaders can exert influence using transparency with employees as they establish trust.
Employees feel free to communicate issues and be part of the resolution openly. DeVito
and Goldacre (2023) noted that the relationship is a building block that allows a more open,
honest flow of ideas where staff and constituents are valued.
Management strategies are an essential theme in the research. For healthcare
consultants to be beneficial in helping management processes for the long term, policies
and procedures must be developed outlining their utilization. Human Resources
departments are instrumental in developing organizational policies that enable employees
to produce efficiency in identified roles. The issue of ethics in healthcare with consultants
and transparency has been an issue of concern. The literature for implementing the strategy
of using consultants in healthcare while having a plan to protect patients and their medical
information must also be researched. Endalamaw et al. (2023) inquired about how some
healthcare organizations need to improve quality processes and studied the improvement
efforts and implementation despite barriers.
The methodology of organizational systems has become a more significant focus
as it studies the when, why, and where organizations can be successful. Research illustrates
evidence of improving quality in healthcare through building community alliances and trust
in the healthcare system (Endalamaw et al., 2023). The current trend of emphasizing quality
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improvement and quality identifiers impacting healthcare demonstrates a needed shift in
performance improvement and implementation.
Change in Organizational Culture
Culture and leadership are purposely connected in organizations. Saeed et al.
(2023) stated that leaders must understand the importance of strategy and culture in
building a successful organization and prioritize both in their decision-making practices.
Saeed et al. (2023) stressed the importance of culture. They indicated that culture is
recognized as such a significant factor in an organization’s success that Fortune’s annual
Best Companies to Work for are based on anonymous reports about workplace culture.
Northouse (2019) defined culture as learned beliefs, values, rules, norms, symbols,
and traditions common to a group of people. Creating a cohesive organizational culture is
a high priority for organizational leaders. The literature correlates exhibitions of the impact
employee satisfaction in healthcare have on the quality of patient care. This assertion also
supports theories of the impact of culture and group thinking. Focusing on connectivity and
accessibility to leadership while creating a culture of cohesion is a strategy for success.
Highlighting the leadership’s desire to be a part of the team and connect with
management and those on the front line with the customers is an important message. Staff
should know they have support from leadership and direct access to the support.
Leadership’s ability to create cohesion and trust in the culture is instrumental to this
strategy’s success. Mohammed and Al-Abrrow (2023) stated that bringing a team together
and giving them a shared purpose helps employees determine what the group stands for
and how to better deliver on their business goals by working toward the desired culture.
26
Strategic Planning of Human Resources
Research suggests that developing the leading management team in a buy-build
circumstance is vital to the organization’s growth. The human resources strategic partner
plays an instrumental role in communicating with staff and advocating for staff through
situations of transition and change. Through outsourcing or a business partnership, an
organization’s ability to recognize the value of new information, assimilate it, and apply
it is vital to achieving organizational goals (Andrieiev et al., 2023). The study will support
the imperative nature of employees having an avenue they trust to express grievances,
make suggestions, and feel empowered as change agents.
Absorption capacity is the key to organizational growth, and the building blocks
of strategic plans depend on core processes and strategic capabilities (Andrieiev et al.,
2023). This pragmatic design will suggest strategies to integrate into a healthcare facility’s
strategic plan by exploring leadership practices in a healthcare facility. Malvestiti et al.
(2021) identified integrating organizational capacity with knowledge from external
sources, education, and the accessibility of additional information. An indestructible
human resources strategic partner will introduce and maintain the motivation to achieve
organizational goals through outsourcing processes and absorption capacity from external
sources. Innovation is the key to growth in an ever-changing global society and indicates
sustainability in an organization’s capacity absorption.
Malvestiti et al. (2021) identified organizations’ multifaceted responsibilities and
noted the social, environmental, and economic factors. Sustainability includes
profitability, human capital, business assets, internal organization culture, and external
27
financial, ecological, and social issues. Human resources strategic partners must possess
a solid plan for absorption capacity and seek knowledge and innovation from other
sources to maintain a competitive market position (Malvestiti et al., 2021). Through the
guidance of a strategic alliance, the strategic plan positions the organization to identify
and obtain new knowledge and innovation to assimilate current practices and resolve
organizational issues that affect society at large.
The results from this research may contribute to positive social change by
increasing the quality-of-care patients receive, as this action enhances the lives of
individual recipients on a micro level and the communities of those individuals on a macro
level. Organizations possess a unique opportunity to remedy societal challenges in
healthcare by implementing human resource strategies of shared value and inclusive
growth while instigating social change and stimulating economic returns (Malhotra et al.,
2021). This study will show the impact of positive social change with support from
peerreviewed literature.
The steps utilized for a successful collaboration include the participation of all
parties in creating a plan for organizational capacity, taking advantage, and using the
existing talent internally. This study assesses resources and managerial capacity, a
reconceptualization of an organization’s objectives, and how they sustain the business
and stay with the flow of innovation in health care. The study supports the recognition
that employees are a vital organizational resource and create the capacity to assess and
grow employees’ cognitive abilities to develop innovations.
28
Policymakers can also create organizational capacity; strategic partners and
organizational policymakers such as HR and government policymakers withhold this
power. Human resources leadership is integral to developing policies that impact a
managerial process. Jo et al. (2024) indicated that strategic partnerships are essential in the
strategic construction of operations and the organization’s perceptions by the staff. Human
resources strategic partners can shape the outcome of an alliance as they are a direct line to
the staff. The process will only succeed if the employees support an organization’s
development, growth, and sustainability efforts. Goggins and Rau (2021) identified that
sustainability is an organizational objective and consistent and that systems and
productions of consumption in organizations play a significant role in accomplishing
sustainability.
Embracing Organizational Change
Strasek et al. (2020) identified that the objective of relationships in businesses is
to relate to resolving organizational issues by exploiting organizational opportunities.
Connectivity is such an important concept in organizations. Showing interest in the
people who support the organization is essential. Leaders need to be more careful when
they believe their position as leaders is an automatic relationship of loyalty and trust.
These relationships must be developed and cultivated. Leaders also need to consider
work-related and, at times, life issues that negatively impact operations and cause
employees to be unhappy. This failure results in a lack of support from human capital.
This inevitably impacts organizational productivity, and employees are likely not
motivated to produce the best results.
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Human resources strategic partners can help cultivate this organizational culture by
leading by example and connecting with all levels of employees within the workforce,
training and developing leaders and managers to promote this organizational culture, and
developing policies and procedures to ensure this is an organizational expectation. Strasek
et al. (2020) indicated that the objectives of strategic business relations relate to resolving
development problems and exploiting organizational opportunities. Eliminating the deficits
of available funds and exploiting available resources is a common goal between strategic
allies.
Strasek et al. (2020) stated that the success of the strategic alliance is determined
by developing cooperation with partners that focus on the success of the future business.
The study will illustrate through the literature that success is measured by total
performance, profit, sales, company growth, market share, growth, and potential capital
(Strasek et al., 2020). Healthcare facilities can demonstrate an increase in quality of care
while improving profitability by implementing human resources strategies in
management.
Benefits and Consequences of Organizational Change
Positive change initiatives are essential to the core of an operating plan; the study
will define the importance of a successful operational plan and roles delineated by
healthcare leaders using human resources functions. Organizations strive to develop
initiatives or base business on positive social change, focusing on promoting positive
change in the external environment. The agendas are not driven solely by profitability but
focus on results that positively impact people or the environment.
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Malvestiti et al. (2021) identified the importance of positive social change through
actions of changing thoughts, behaviors, and the domain to benefit outcomes locally and
globally. An operating plan should examine the risks and benefits of integrating a positive
social change into an organization’s operating strategy. Another key to the successful
implementation of an operational plan is strategic alignment. The consequences of failed
social change initiatives include neglecting to align with the organization’s strategic plan,
loss of profits, and decline in stakeholder support.
Aburmishan and Baum (2022) identified benefits as alignment with the
organization’s strategy and motive and stakeholder involvement and motivation. Other
services include positive profitability, enacting global change, and influencing the market
and industry. The operational plan must align with the organization’s missions, values, and
philosophy. This study will illustrate the advantages of healthcare facilities’ alignment of
the relationship with employees and stakeholders.
Increasing Performance Improvement
The literature will support the study by demonstrating the successful
implementation in a healthcare organization. The literature suggests a total synthesis of the
healthcare market, including profit analysis, analysis of competitors, and potential growth
assessment. This process is completed during the strategy formulation phase, but leaders
must know that the implementation phase is equally important to ensure effective business
strategy execution. Dyer et al. (2020) identified the three strategic change tools as building
alignment between the organization’s segments, strong leadership for effective
implementation and cohesion, and measuring strategic performance by developing a
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measurement system. These tools ensure the carry-over of strategy formulation and
development to strategy implementation. Successful implementation depends on
leadership to ensure proper alignment between the strategy, communicating the process to
the followers, and using strategic change tools. Using the tools recommended in the
literature will exhibit positive change and organizational growth in healthcare facilities.
Implications of Change on Employees
The literature suggests the need for a healthcare organization to assess the
company’s strategic plan continuously. Remaining in sync with changes in the
environment, technology, the work environment, and societal changes may require a shift
in strategic planning. Developing a new strategic plan is also necessary to ensure the
organization is not operating under antiquated and inefficient systems. This pragmatic
design will use the literature to assert the benefits of utilizing the five phases of strategic
planning for successful change implementation. There are five phases to strategic planning.
Shamuratovna et al. (2024) identified the five phases of strategic planning: developing the
strategic planning position, analyzing the strategic plan, gap analysis, formulating a written
strategic plan, and continuing to review and track the strategic plan. These steps are
essential in assessing the need to shift a strategic plan in an organization.
Another critical phase to be highlighted and included as a strategic planning phase
is communicating the plan to the stakeholders. Devising a strategic plan but failing to
communicate the plan effectively will fail the plan. With appropriate communication of
the plan, stakeholders will be aware of the organization’s goals and the plan to
32
accomplish the goals. Freudenreich et al. (2020) indicated that stakeholder relationships
are vital to the functionality of an organization, as the withdrawal of support from
stakeholders directly affects the sustainability of an organization. This proves why
communication and stakeholder buy-in are instrumental to shifting an organization’s
strategic plan. Reviewing and tracking the strategic plan for success is another crucial
step. It provides information to planners of strategy in an organization if changes in the
strategic plan are necessary.
Measuring Performance Improvement and Outcomes
The study will use literature to support the theory of integrating human resources
strategies in management practices in healthcare facilities to improve the quality of patient
care. Strategic change and developing cohesion with the change is an act that does not
occur overnight and is a time-consuming process. During this process, management must
assess progress toward organizational goals and strategy (Dyer et al., 2020). Measuring
tools are practical in gauging progress toward goals and evaluating progress in strategic
organizational change. Dyer et al. (2020) defined line of sight as the principle that followers
and leaders in a company should connect their respective duties and overall organizational
goals. Another measurement tool is the balanced scorecard. Dyer et al. (2020) define a
balanced scorecard as a tool that measures equally aspects of an organization to meter;
these measurement areas are devised from the organization’s strategic plan: financial and
profitability goals, consumer goals, systems and process goals, and innovation and growth
goals.
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Measurement is an essential tool to focus on. It helps leadership make instrumental
decisions about implementing continued change, implementing innovation when to enter
another market, how to do so, and the projected time (Dyer et al., 2020). The study will
use the literature recommendations to adequately measure quality outcomes for patients
through an examination of strategic influence. These strategic influences include
environmental technological advances and impact measurement tools. Other geographic
regions may have various supply and demand needs, which affects the measuring tool, and
there will be a need for a varied tool.
External and internal factors impact the implementation of strategic changes but do
not impact the measurement tool, as it is necessary for all organizations to assess the
performance of strategic goals and changes. Jo et al. (2024) indicated that the usefulness of
a measuring tool would include teamwork between departments and with followers and
leaders, a high level of communication within the organization and externally with
consumers and stakeholders, built on the strategy of the organization, clear understanding
and transmission of the relationship between strategic objectives and tasks, compensation
initiative linking compensation and attaining organizational goals, and continuous
assessment, reassessment, and revision of the measuring tool. Utilizing a measuring tool
when integrating human resources strategies in a healthcare facility is imperative to
deciphering successful integration, amending the strategic plan to ensure successful
implementation of the approach, and identifying opportunities for improvement in the
inception of these functions.
34
Exploring organizational strategic plans healthcare leadership utilizes to improve
organizational performance. Human resources leaders create unique value in healthcare
organizations, delivering quality and expertise to develop and maintain an organization’s
processes and systems (van Nisterlrooij & Homan, 2019). The research identified that
sixty-eight percent of organizational leaders identified specialized skills as a benefit to
employing consultants, and sixty-two percent of leaders noted quality as an additional
benefit (Van Rossem, 2021). The background and overview of the general and specific
problem were identified in the pragmatic inquiry design.
The literature provided evidence of the benefits of integrating human resources
functions in strategic planning and the impact of positive change integration in healthcare
facilities. Reviewing the theoretical framework as a guide to the research identified critical
concepts in Lewin’s change management theory to identify strategies to improve medical
practices and the quality of care, which helped illustrate the research’s underlying focus.
Identifying areas of needed improvement for management in healthcare, identifying
strategies that have been successful in the integration of implementing change management
processes in healthcare organizations, and identifying ineffective management practices
will help with recommending the incorporation of strategies for successful incorporation
of human resources management techniques to increase quality in patient care.
Assumptions and limitations in the literature were identified as unidentified beliefs and
circumstances in the study beyond the researcher’s control.
35
Transition
A critical analysis of supportive literature was introduced in section 2, and the
data was synthesized to identify common themes and phenomena in this pragmatic
inquiry. In Section 3, the use of ethical research codes to identify the researcher’s role,
participants’ eligibility, and the interview protocol was highlighted. In Section 4, the
findings are presented.
36
Section 3: Research Project Methodology
The research supports the benefits of human resource function implementation in
healthcare management by examining human resources’ role in strategic planning,
illustrating the long-term benefits and challenges of implementing strategic planning in
healthcare facilities. Comprehending the role of human resources and leadership in
healthcare facilities is instrumental in assessing human resources strategies in management
practices. Weighing the benefits and consequences of moving to a human resources-based
management style is imperative to increase performance and the quality of care in
healthcare facilities. Once a change has been embraced and implemented in the
organization, outcomes and performance measurements of the success of the integration
can identify successful integration and opportunities for improvement.
Presenting literature to support the business problem in this pragmatic study and
grounding study design with Kurt Lewin’s change management theory contributes to
qualifying the impact implementation of human resources in healthcare to improve the
quality of patient care. The qualitative study design will outline the research process of
the pragmatic inquiry, explicitly describing the role of the practitioner in the data
collection process and the practitioner’s relationship with the topic and participants. The
study’s data will also explain the research method, design, population, sampling,
participants, data collection activities, data organization analysis techniques, reliability,
and quality indicators.
37
Project Ethics
Researchers in qualitative studies act as a tool for collecting and implementing data
to introduce research (Howard, 2021). I qualified the data presented by assessing the
information gathered, incorporating data to support the research question, identifying
appropriate participants for data collection, and providing instruction on the direction for
the data collection strategy (Subedi, 2024). One data source in this study is open-ended
interviews with human resources managers and senior managers designated in an
organization. Another source is supportive data from public information about policies and
procedures on organizations.
Healthcare leaders are faced with maximizing standards of care. Many healthcare
leaders are faced with analyzing strategies for efficiency for management resources. Pemer
et al. (2020) indicated that top leadership has the discretion to fundamentally affect
organizations’ outcomes and actions. This pragmatic inquiry solicited participants from
healthcare leaders from organizations in the Southeastern and Northeastern regions of the
United States with experience implementing human resource strategies in management
practices. Potential participants were identified through research by gathering a list of
healthcare leaders to be emailed an inquiry for participation. There was no previous
relationship with this study’s topic or potential participants.
Establishing initial communication with potential participants is imperative, and
communicating the importance of maintaining confidentiality is imperative in
establishing rapport with participants (Sperling, 2022). The Belmont process provides a
road map that researchers can follow to meet the moral requirements of respecting
38
participants in a translational and understandable study. This pragmatic study followed
the framework of the Belmont process. Participants had the option of open flexibility in
scheduling and location for the interviews; this practical design further strengthened the
relationship with participants by soliciting healthcare leaders to provide a lived
experience as leaders in healthcare facilities who utilize human resources strategies for
quality improvement. Guaranteeing participants understanding of the research protocol,
the interview process, their role in the process, and the procedure to withdraw from the
process was the base of this pragmatic inquiry. The IRB’s informed consent form, which
is included in Appendix A, was reviewed and used with participants to guarantee their
understanding of the research process. Consent was obtained from leaders who agreed to
participate. Once consent was obtained, participants received an explanation of the
interview protocol in Appendix B, ethical protection, and ways to withdraw. Ethical
protection and anonymity of participants were clarified. The method of data storage was
reinforced for the protection of participants.
Specific characteristics for the selection of leaders in an organization to provide an
analysis process for the efficiency of management resources for business processes and
systems is imperative. Participants’ roles aligned with the analysis process to aid
healthcare leaders in maintaining management activities, strategic development, business
processes, and systems. In qualitative research, information from participants through
shared experiences provides invaluable data specific to the individual’s encounter.
Healthcare facilities and providing significant knowledge to organizational leaders
39
conducive to utilizing human resources strategies for management activities, providing
opportunities to focus on patient-specific needs.
Nature of the Project
The three research methods are qualitative, quantitative, and mixed (Park et al.,
2021). Qualitative research methods are used for data collection and interpretation of
results provided by participants’ lived experiences. A qualitative methodology enables a
researcher to collect data in an interview or a non-numeric data analysis procedure
(Subedi, 2024). Qualitative research also allows the comparison of themes across groups
(Munthe-Kaas et al., 2019). In contrast, quantitative researchers use data collection
through a questionnaire or data analysis through graphs or statistics (Subedi, 2024).
Mixed methods research includes qualitative and quantitative components (Park et al.,
2021). Qualitative research methodology is the most appropriate for this study as it
provides lived experience from healthcare providers to observe this research phenomenon.
This qualitative, pragmatic inquiry targeted leaders in healthcare facilities and the
integration of human resources strategies to benefit management practices and positively
influence the quality of care for patients. This qualitative, pragmatic inquiry scouted
leaders in healthcare facilities who integrate human resource strategies to benefit
management practices and positively influence the quality of care for patients.
The research design is a pragmatic inquiry to address the research question in this
qualitative study. Semistructured interviews are appropriate for this study because, in
qualitative studies, is explore observations of the behaviors from the participants’
perspective. By utilizing a qualitative research design, I was provided the opportunity to
40
gather data and accomplish data saturation, examine fieldwork, and use reflexive
interpretation (Chitac, 2022). Data will be utilized to address the research question, and
various strategies to improve performance in a healthcare facility will be identified and
explored using a qualitative case design approach. Qualitative research also enables the
comparison of themes across groups (Munthe-Kaas et al., 2019).
The benefit of pragmatic inquiry is that it is a research design that can be utilized
in a qualitative study to analyze human resources strategies by analyzing various research
theories. Pragmatic designs incorporate reflexivity with research literature to solve a
business problem (Levitt et al., 2021). The qualitative research method and pragmatic
inquiry design were selected because I intended to understand how inefficient utilization
of management resources necessitates leadership to employ human resources management
strategies to help re-institute value and expertise
Population, Sampling, and Participants
The targeted population was purposely selected to comprise healthcare leaders
from the Northeastern and Southeastern regions of the United States who work in
healthcare facilities and have facilitated strategies to analyze the efficient use of
management resources. I gained leadership access through email and inquiry about
participation in a study focusing on management practices and patient outcomes. Then, I
followed up with a phone call to affirm participation and clarify questions about
participation. The final step was for the participants to provide written consent for
participation. I completed several actions before beginning the data collection process,
inclusive of the identification of healthcare facilities to participate in research, recruitment
41
of organizations through communication, an explanation of the research question,
agreement from organization to participate, completion of affiliation agreement,
identification of individual participants, and submission to university for request to begin
collecting data. Participants recruited for this pragmatic inquiry were 20 leaders in
healthcare facilities from healthcare facilities in the Northeastern and Southeastern
regions of the United States. Purposeful sampling was used to recruit for participation in
semistructured interviews to provide a lived experience of utilizing human resources
strategies to improve patient quality of care. Each participant was interviewed with a set
of research questions. The answers provided were analyzed to identify themes. I ensured
data saturation by analyzing the data obtained in interviews. The interview process was
conducted virtually via Zoom. I established a working relationship with participants
through open, transparent, and ongoing communication efforts, reassurance of
confidentiality and protection from organizational retaliation, and assurance of flexibility
with the interview time and place.
The research development process rendered 11 potential healthcare leaders to
participate in the study. Nine participants responded, and one leader needed to meet the
participant criteria due to limited employees and unstructured and documented
management practices. Two of the requested participants declined due to new management
and a lack of willingness to provide to be interviewed. Seven participants agreed to
participate in the study. Purposeful sampling was used to assess if participants are qualified
to participate in the research meeting standards. Qualitative research enables a researcher
to conduct a thorough and in-depth analysis of data provided by participants in the study
42
(Munthe-Kaas et al., 2019). Using fewer participants allowed me to provide an in-depth
analysis of an organization’s standards, operating procedures, and processes instead of
solely using numerical probability (Howard, 2021). A smaller population supports evidence
to answer the research question and allows a researcher to obtain information for the study
through observation and participants’ lived experiences,
Recordings helped with facilitating reliability and validity in the study. In
qualitative studies, data saturation strengthens scientific accuracy (Levitt et al., 2021).
The method of data saturation provides an ethical guarantee that the participants in the
research and the data analyzed meet ethical transparency and give depth of information
based on sound research practice. McGill et al. (2021) define the concept of data
saturation as the process of guaranteeing that the data collection process renders no
additional information or themes. Interviews will be conducted with leaders from
healthcare facilities in the Northeastern and Southeastern regions of the United States. to
seek data saturation actively. Data saturation will be ensured by clarifying information
when questions are asked, expanding the information provided by participants, and
identifying all codes and themes. Methodological triangulation will be utilized to
guarantee the level of depth in data and to illustrate that data saturation is met.
The quality of data collected is essential in research. Data saturation in pragmatic
inquiries does not have a minimum or maximum requirement but is focused on the quality
and depth of information obtained (Tomaszewski et al., 2020). The varied experiences of
healthcare leaders and their individualized management perspective will enrich and
support the research provided in the study.
43
Data Collection Activities
This researcher was the primary data collection instrument. Semistructured
interviews, policies and procedures from organizations, and public information on the
organization’s website were utilized in the data collection process. It is vital to have an
interview protocol as it is essential to have a road map to guide the interview process.
Ensuring neutrality in research is imperative; I followed the research protocol, and the
ethical guidelines provided by the IRB, utilizing the triangulation method, member
checking, and providing an in-depth analysis of the data through a review of interview
notes. Participants received verbal and written explanations of the interview protocol (see
Appendix B).
Researchers facilitating pragmatic inquiry studies use data obtained from
participants’ lived experiences and data provided about the organization to develop a more
in-depth understanding of phenomena; ethnographic studies describe, analyze, and
interpret a culture’s characteristics. The qualitative research method and pragmatic inquiry
design were selected because I intended to understand how inefficient utilization of
management resources necessitates leadership to employ consultants to help reinstitute
value and expertise in healthcare organization business processes. Data, theoretical,
methodological, and investigator triangulation will reinforce the study’s validity through
discernment of the data. (Sabnis & Wolgemuth, 2024) compared the methodology of
confirmability to achieving objectivity in qualitative research and associated the concept
of consistency in research with confirming the data collected. The final product of the study
must result from the data presented by participants. Researchers must be careful not to
44
influence the data based on biases and personal beliefs. Data, theoretical, methodological,
and investigator triangulation reinforced the study’s validity through discernment of the
data. The final findings of the study must be the results from the data presented by
participants.
Data collection techniques are vital to achieving reliability and validity, and the
advantages enhance the reliability and validity of the study. All data will be protected and
stored in a safe that only I can access for at least five years; after this, all research records
will be destroyed. The disadvantage of integrating a formatted data collection technique is
providing accurate and valid data in a study that cannot be used to support the research
problem. Participants were integrated to avoid the issue of delivering invalid, inaccurate,
or biased data. (Brear, 2019) indicated that member checking aids the research in gauging
the participants’ priorities and helps structure a research agenda. Member checking guides
the process of data saturation. I summarized the data provided by participants to inquire
about validity and interpretation. Participants were provided a chance to explain, amend,
or expound for data clarification. Once I can no longer identify additional themes, data
saturation is achieved when it is no longer possible to code additional information, build
on the information presented in the research, and when the data in the research study can
be replicated (Naeem et al., 2024). Member checking guides the process of data saturation.
I will summarize the data provided by participants to inquire about validity and
interpretation.
45
Interview Questions
1. What human resource strategies assist you in identifying performance
problems?
2. What human resources strategies assist you in meeting performance goals and
expectations?
3. How do employees respond to your management techniques, including your
integration of human resources strategies?
4. What human resource strategies do you use for managing resources?
5. How do you utilize human resources strategies in managing staff, and what
human resources methods are most helpful in your management techniques?
Why?
6. How has utilizing human resources strategies in your management style
increased the quality of patient care?
7. How does utilizing human resources strategies in management demonstrate
improvement in patient quality of care?
8. What additional strategies or resources that we did not discuss could help
facilitate success in human resource management?
Data Organization and Analysis Techniques
The data organization and analysis entailed gathering interview information to
understand techniques to achieve organizational goals. Participants were asked to identify
strategic goals and methods for managing organizational resources using data collected and
46
information analysis to support the integration of human resources strategies to mitigate
management inefficiency. Thematic analysis was used in this qualitative research design to
analyze collected information and identify themes (Scharp & Sanders, 2019). As a
researcher, content should be reliable so others can utilize your research to create new
thoughts about a particular phenomenon or theory. NVivo was used to operate and identify
emerging themes in the study; this database will attribute reliability to homogeneity,
stability, and equivalence (Munthe-Kaas et al., 2019). To analyze data, notes, and journals
taken were used to ascertain information, recordings of interviews will be reviewed, and
details provided through member checking were analyzed.
A qualitative study can use three research designs to analyze management resources
and the benefits of employing human resources strategies in healthcare management:
pragmatic inquiry, ethnographic, and narrative. (Tomaszewski et al., 2020) asserted that
research is validated by triangulation between multiple resources and advised that there is
a direct link between triangulation and data saturation. Naeem et al. (2024) urged
researchers to focus on the depth of the presented information and ensure data saturation.
Various triangulations can be used during the research process (methodological, theoretical,
data, investigator, and environmental). Triangulation that emphasizes objectivity and
confirmability will reduce bias influence. Naeem et al. (2024) recommended organizing
data by taking notes and memos throughout the process; I will utilize a journal and
recordings to guarantee a stable process to code the data, analyze the information, and
interpret data for presentation. All data will be protected and stored in a safe that only I can
access for at least five years; after this, all research records will be destroyed.
47
Reliability and Validity
Reliability is essential as it references the suitability of the measurements being
used and poses the following questions: Do the measurements being used investigate the
phenomenon being studied, are the data and results of the research accurate, and what do
the results conclude, and do the data represent general issues and conclusions (Sabnis &
Wolgemuth, 2024)? Validity is also crucial as it has several aspects of validity to illustrate
the intention of the data presented. Reliability and validity are vital in research as both
define the credibility of a scholar’s research. Naeem et al. (2024) asserted that unreliable
research inevitably will be invalid and will not contribute to the research of the
phenomenon. There are distinct differences between the two measurements. Reliability
addresses dependability in a research study (Sabnis & Wolgemuth, 2024). This researcher
used member checking, triangulation, and data saturation measurements to ensure research
credibility.
Reliability
Sperling (2022) identified threats to reliability as participant error. These threats
were defined as any issue that negatively impacts how a participant interacted in the
research; another threat is participant bias, which was defined as any issue that affects an
accurate or true response from a participant; a third threat is researcher error, defined as
any issue that skews researcher interpretation of the data collected by the participants, and
researchers bias which is defined as any issue that persuades bias in Is’ data notation. This
researcher maintained awareness of biases and remained conscientious of leading during
the interview process to avoid threats that impact the quality and validity of participants.
48
Validity addresses how credible and transferable it is and confirms the data contained in
the presented data. Researchers conduct four tests to ensure quality, validity, and reliability
in a research project (Sabnis & Wolgemuth, 2024). Construct validity identifies the accurate
measurements in operation for the studied methods (Sabnis & Wolgemuth, 2024). Internal
validity assesses the relationships that are the catalysts for the next occurrence and
identifies the causal relationship; external validity assesses if data is in a pragmatic inquiry
in general; and reliability assesses the functioning of research and demonstrates that the
methods of collecting data can be repeated.
Member checking and triangulation are two methods used in this qualitative case
pragmatic inquiry to validate data and demonstrate reliability. In qualitative research,
credibility is defined as a measure to gauge perceived facts through approximation and
deduction of particulars provided by study participants (Sabnis, & Wolgemuth, 2024).
Assurance of the accuracy of the data through verification provided opposed
presumptions of data collected. Member checking is a method this research will use to
interpret data by checking the accuracy of interpreting the information when collecting
the data (Sabnis & Wolgemuth, 2024). Research credibility is defined as a measure to
gauge perceived facts through approximation and deduction of particulars provided by
study participants (Sabnis & Wolgemuth, 2024). Assurance of the accuracy of the data
through verification provided opposed presumptions of data collected. Member checking
is a method this research will use to interpret data by checking the accuracy of
interpreting the information when collecting the data (Sabnis & Wolgemuth, 2024),
2021). Following the interview protocol, clear and methodological triangulation are
49
additional measures that will be integrated to illustrate the credibility of data collected in
the study.
Validity
To achieve consistency, reliability, and validity this researcher will organize data by
taking notes and memos throughout the process through a journal. This researcher also
utilized recordings to guarantee a stable process to code the data, analyze the information,
and interpret data for presentation and assurance of research quality. Research quality is
the process of validating data collected. Grey et al., (2019) indicated that academic
institutions and research review boards must uphold research integrity. Validating research
is essential in maintaining quality and ensuring integrity in the information provided. Three
types of evidence that can be used for validity are homogeneity, convergence, and theory
evidence. (Sabnis, & Wolgemuth, 2024) added that the research process comprises
collecting data systematically, interpreting data systematically, and devising a purpose to
resolve a problem. The IRB is charged with oversight to ensure the research process has
integrity and validity. Sabnis and Wolgemuth, (2024) defined validity as the suitability of
measures used, precision of analyzed data, and universality of results.
In qualitative research, transferability is a notion parallel to reliability (Sabnis &
Wolgemuth, 2024). The concept supports the credibility of the data by illustrating the
relevance and unity of information provided by participants in the study. Sperling, 2022
asserts that the research must demonstrate the accurate perspectives of participants who
provided study specifics. This information can be used for integration in additional
settings to support future research. I presented various methodological evidence to
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contribute to subsequent studies. Naeem et al., 2024 compared the methodology of
confirmability to achieving objectivity in qualitative research. The final product of the
survey resulted from the data presented by participants.
Transition and Summary
In this pragmatic inquiry study, I examined the integration of human resource
management strategies to improve the quality of care in healthcare organizations.
Through semistructured interviews and public organizational information the findings in
this qualitative, pragmatic inquiry explored the techniques leaders in healthcare use to
integrate human resource strategies to benefit management practices and positively
influence the quality of care for patients. Naeem et al. (2024) asserted that research is
validated by triangulation between multiple resources and advised that there is a direct
link between triangulation and data saturation. Naeem et al. (2024) urged researchers to
focus on the depth of the presented information and ensure data saturation. Data,
theoretical, methodological, and investigator triangulation will reinforce the study’s
validity through discernment of the data.
I’s role is reinforced by identifying the purpose of this qualitative research study.
The role of I is analyzed through the identification of utilization of the standards and
protocols of research, including recruitment and selection of participants, ethical roles and
responsibilities of I, identification of the research method, and the research design utilized
for the studied sample population. Identifying details of the data collection proposed for
use in the study, processes to organize the data in the study, and measures of assurance for
analysis, reliability, validity, confirmability, transferability, and achieving data saturation
51
asserts the ethical guidelines to be followed in the study (Aqil et al., 2023). An explanation
of the data collection process is for evidence to support the research question.
In this pragmatic inquiry, I focused on the presentation of findings in section 4.
Outcomes were based on information received from participants interviewed in the study,
standard operating practices in the healthcare organizations studied, and the impact the
research data will have on social change and implications for future research
demonstrates the comprehensive research process that will be followed to provide a
recommendation for the business problem of some healthcare leaders who lack strategies
to use human resource functions to enhance organizational processes and systems for
improving performance. The section’s information will identify how the data contributes
to the business theory and provide professional practice recommendations.
Section 4: Findings and Conclusions
Introduction
This pragmatic inquiry study aimed to answer the research question: What human
resources strategies do healthcare leaders use to enhance organizational processes and
systems for improving performance? Semistructured interviews with seven leaders in
healthcare organizations in the northeastern and southeastern regions of the United States
who have implemented human resources strategies in management practices to improve
organizational performance were conducted for data analysis in the study. To maintain
anonymity, participants were assigned a numeric code throughout the interview process:
52
Participant 1, Participant 2, Participant 3, Participant 4, Participant 5, Participant 6, and
Participant 7. NVivo was utilized to verify manual codes ascertained and was
instrumental in qualifying and analyzing interview data.
The data analysis process included labeling transcripts, importing transcripts,
identifying patterns, assigning codes, utilizing NVivo for data analysis, containing codes
based on context, and reassigning codes. O’Callaghan et al. (2024) identified the
descriptive nature of themes, indicating a pattern of shared designs grouped to
demonstrate reliability. Three main themes materialized from the analysis: (a) analysis,
(b) approach, and (c) assessments. In this section, the data presented will illustrate a
correlation between themes, the conceptual framework, and supportive literature from
peer-reviewed articles.
Presentation of the Findings
Three main themes materialized through analyzing the data: (a) analysis, (b)
approach, and (c) assessments. The study’s conceptual framework is based on Kurt
Lewin’s change management theory. The change management theory aligns with the
study’s foundational premise as it assesses organizational change and its implementation
process change. In this pragmatic inquiry, the data obtained in the research outlines
strategies healthcare leaders use to integrate and influence change to improve
performance.
Participants emphasized the importance of assessing performance to determine if
an organizational change is needed, utilizing their management approach to influence
organizational change, and analyzing assessments to determine the success of the
53
implemented organizational change. Participants emphasized the importance of assessing
performance to determine if an organizational change is needed, utilizing their
management approach to influence organizational change, and analyzing assessments to
determine the success of the implemented organizational change. Concepts from
established human resources management literature emphasize internal data analysis,
humanistic managerial approaches, and an overall societal influence on patient quality of
care (Weiszbrod, 2020). Integrating Lewin’s change management theory in human
resources management strategies enhanced the evidence of improved performance in
healthcare organizations.
Theme 1: Analysis
Improving performance in healthcare organizations remains multi-layered as
leaders strategize to increase customer service to clients, employees, and external
constituents. Managing performance improvement challenges leaders in making
decisions and implementing change. Healthcare leaders act as change agents and devise
strategic plans for successful organizational transitions. Participants identified that
utilizing human resource strategies in developing a strategic plan is integral to
organizational evolution. Developing a strategic plan assists leaders in organizations in
formulating business strategies. The strategic plan can be a roadmap for organizational
growth and development. Organizational leaders use data analysis and performance
indicators to assess strengths and opportunities for improvement. Participants 1, 2, 3, 4,
and 6 indicated that data and analyzing the information rendered are imperative in
determining organizational needs.
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Performance analysis in healthcare is used to meet and exceed operational goals.
Utilizing performance-based competencies is instrumental in evaluating and measuring
goals (Golec & Karadeniz, 2020). Some participants agreed that data analysis tools
should be used to assess employee strengths, weaknesses, and needs. Participant 4
asserted that performance problems were identified “by a basic trend analysis.”
Participants 2 and 6 identified using a gap analysis to “assess if employees have what they
need to maximize productivity or if additional resources are needed. Participants 2,
3, 5, 6, and 7 emphasized the importance of performance assessments or appraisals to
“communicate job functions and expectations, provide feedback, receive input of needs,
rate strengths and opportunities for improvement, and goal setting. Participants 2, 3, 5, and
7 emphasized the importance of performance assessments or appraisals to
“communicate job functions and expectations, provide feedback, receive input of needs,
rate strengths and opportunities for improvement, and goal setting.”
Leaders in healthcare organizations use patient surveys to measure the
achievement of performance goals. Ogaji (2022) highlighted the ethical, unbiased, and
valuable significance of patient participation in identifying organizational goals in
healthcare. Patient feedback about the receipt of care allows them to play a role in
improvements in service delivery. It will enable leaders to identify areas of needed
improvement and organizational strengths (Ogaji, 2020). Participant 5 recognized the
importance of patient feedback, adding, “The clients have a sense of agency connectivity
and a belief that their needs are a priority.” Participant 4 and Participant 2 added, “It
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increases patient responsiveness and trust in the organization when clients and families
feel their concerns are a priority and addressed promptly.”
Associating Change Theory to Analysis
Kurt Lewin’s change management theory supports organizational leaders
integrating human resource strategies by identifying balancing forces that provoke
change. The theory of pretense assesses an organization’s driving and restraining forces.
Healthcare leaders are challenged to provide high-quality services by improving
performance. Bamonti (2021) identified an additional challenge that managers in a
clinical capacity lack the skills and knowledge base to assess capacity. Participants 1, 2,
3, 5, and 6 verbalized the importance of healthcare leaders understanding organizational
needs and what tools are needed to meet those needs. Participants identified a connection
between employee satisfaction and increased performance and identified that one of the
most critical steps in gauging the need for organizational change is analysis. Healthcare
leaders identified ongoing performance analysis, patient analysis, and gap analysis as the
most common tools of performance indicators.
Analysis can be linked to the initial stage of Lewin’s change management theory,
unfreeze. Analysis helps healthcare leaders identify why the change must take place.
Analyzing the data provides key indicators of what needs to change and substantiates why
change is necessary. Vendette and Thundiyil (2023) noted the importance of leaders
studying the implications of change by embracing the process and normalizing resistance
and other negative impacts of organizational change. Lewin (1944) asserted that the success
of group change depends on the nature of the process and the depth of the analysis and
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identified the planning phase and objectives to achieve as imperative for success.
Participant 4 noted, “People respond in one of three different ways; they fight, flight, or
accept the data.” Analyzing organizational problems and developing a plan to remedy these
issues is imperative to the success of the change process.
Theme 2: Approach
A managerial approach is critical to implementing change in an organization. The
current workforce has shifted from an environment of volatility, uncertainty, complexity,
and ambiguity to a performance-driven service delivery model (Gaule et al., 2023).
Healthcare leaders identify several groups classified as consumers that require a positive
customer experience. Healthcare leaders specifically identified patients as consumers.
Participants 1, 2, 3, 6, and 7 noted the importance of satisfied employees and their
positive impact on performance. The participants identified specific managerial
approaches they incorporated to achieve employee satisfaction, and all strategies were
rooted in human resource theory.
An organizational approach is critical to employee acceptance of change and
performance improvement. All participants identified managerial approaches that prove to
be successful with employee alignment as employee autonomy, effective communication
of goals and expectations, integrating positive feedback and rewards to employees who are
meetings and exceeding performance measures, providing training and learning spaces for
employees who require additional support, offering an open door approachable
management style, coaching employees as a leader, and avoiding being punitive Bamonti
et al. (2021) asserted the usefulness of capacity assessment and training in healthcare
57
organizations. The identified strategies were all rooted in human resource theory and noted
as remaining objective and non-punitive and implemented in daily practices. These leaders
indicated they provide competitive salaries, job flexibility, making employees a part of the
decision-making process, and active listening as managerial approaches that have been
successful with employee alignment.
Aligning Change Theory with Approach
This theme correlates to the conceptual framework by identifying leaders’ vital
role in establishing employee trust and influencing organizational change. The
managerial approach dictates the nature of the relationship between leadership and
employees. Gaule et al. (2023) emphasized the shift in managerial approach from a
volatile, uncertain, complex, and ambiguous focus to a performance and service
management concentration. Implementing human resource strategies in managing
organizational change and assessing success depends on communicating the execution
of the strategic plan. Leaders that prevail in change implementation are trusted by those
who adopt change. Those leaders communicate transitions within the organization and
understand their role in the change process in establishing employee trust and
influencing organizational change.
Lewin identified the second phase of this transitional process as the change phase.
Once employees resolve feelings of uncertainty and establish trust with organizational
leaders, they begin to adopt change and integrate organizational and new ways of doing
things to support the new direction (Vendette & Thundiyil, 2023). Healthcare leaders are
responsible for influencing organizational change, and in a trusting relationship with
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organizational leaders, they begin to adopt change that will benefit them. Participants 1, 2,
3, 5, 6, and 7 verbalized their approachable, empathetic, inclusive, non-punitive, and open
management styles. A managerial approach is essential in achieving positive
implementation changes in healthcare organizations and influencing performance
improvement.
Theme 3: Assessment
Healthcare leaders use various assessment tools to evaluate achieving goals for
implemented change. Healthcare leaders must assess and reassess organizational
operations to determine if modifications in strategy are needed. One strategy to evaluate
the progress of instituted change is patient satisfaction assessments and surveys, employee
satisfaction surveys, performance assessments, direct customer feedback, and direct
observation of services. Customers and employees of healthcare services want to have the
opportunity to provide honest and anonymous feedback without being inconvenienced or
risking retaliation. Nunes et al. (2023) surmised that an effective way of data collection
and assessment is using convenient external assessment tools for consumers and
employees to complete, direct observations of organization operations, and oversight and
feedback provided by regulatory agencies.
Healthcare leaders identified the value of assessments, assessment tools, collecting
data, and assessing data as an invaluable process in change management and performance
evaluation. Leaders added that utilizing the data to determine performance measures and
direct staff observation and documentation are necessary to evaluate processes that meet
organizational goals. Participants 1, 2, 3, and 5 identified the importance of staff
59
observations. Participants 1, 3, and 6 identified that they are hands-on managers who
perform frequent huddles and provide immediate feedback and support to
staff.
Aligning Change Theory to Assessment
Assessing the need for change through analysis is an essential step for maintaining
change in healthcare organizations. This theme connects with the conceptual framework
by associating Lewin’s assertion that it is vital to adopt, sustain, and assess change that is
implemented. Pettersen et al. (2024) identified the transformative nature of the successful
implementation of innovation in healthcare and the importance of continued evaluation for
change. Reassessment of integrated reform is equally important.
In the healthcare industry, leaders must remain innovative and adaptable to pivots in the
market. Direct catalysts for change are technology, shifts in work culture, environmental
shifts, and patients’ perceptions of needs.
Lewin referred to the final phase of change as the refreezing phase. The refreezing
phase aligns with assessment through observation of successful change implementation.
Lewin (1944) Asserted the importance of continued evaluation in the change process,
indicating the value of setting organizational goals and objectives to judge whether that
goal is moving forward or backward. He added that evaluating those goals’ achievement
is vital to preventing wrong conclusions (Lewin, 1944). Healthcare leaders consider all
factors when promoting shifts in the organization. Tonjang and Thaweaengskulthai
(2024) identified the use of total quality management and innovation in healthcare as a
valuable tool in integrating the organizational change process. The study considered the
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following factors when assessing and reassessing the need for organizational change:
environmental context, leader, planning, support, operation, tools and analysis method,
and improvements. Once the change has been integrated into the work culture, healthcare
leaders manage the shifts through ongoing assessment of operations, and the decision a
healthcare leader faces is to refreeze or unfreeze to re-initiate the change process.
Business Contributions and Recommendations for Professional Practice
The results of this pragmatic inquiry study illustrate significant determinants for
leaders in healthcare organizations seeking strategies to increase performance outcomes.
Song et al. (2023) asserted challenges with employee activity and engagement and their
negative effect on performance. The data collected from interviews with healthcare
leaders illustrate the correlation of the integration of human resources strategies in
management and performance improvement. Incorporating data from this study’s
outcomes may provide healthcare leaders insight into adopting human resource
techniques to improve employee satisfaction and direct patient care, which results in an
overall increase in organizational performance measures.
Implications for Social Change
Healthcare facilities identify a mission of providing health improvements (Wanser
& Luckel, 2021). Measuring performance and devising a successful strategic plan to meet
this mission is imperative to the medical field’s contribution to society. Healthcare
organizations that emphasize increasing patient care affect facility experiences positively.
Better patient experiences lead to increased facility outcomes. By leveraging the findings
presented in this study, healthcare leaders can improve the quality of care and patient
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confidence in medical providers. Organizations possess a unique opportunity to remedy
societal challenges in healthcare by implementing human resource strategies of shared
value and inclusive growth while instigating social change and stimulating economic
returns (Nandy, 2024). The results from this research may contribute to positive social
change by increasing the quality-of-care patients receive, increasing employee
engagement, and impacting customer satisfaction. These actions enhance the lives of
individual recipients on a micro level and the communities of those individuals on a macro
level.
Performance management in healthcare is a change agent catalyst in organizations.
Providing high-quality care is imperative to medical service delivery, impacts patient
confidence in healthcare providers, and results in community trust. Performance
management in healthcare facilities is result-driven due to the services provided and the
outcomes (Peixoto et al., 2020). Providing high-quality care is a goal leaders in healthcare
seek to attain. High-quality medical service delivery increases patient outcomes, impacts
patient confidence in healthcare providers, and results in community trust (Wanser &
Luckel, 2021). Trusting the change process in healthcare has a cyclical impact that
influences social impact while improving performance. This cycle of change in healthcare
organizations ultimately results in improved quality of care to customers in the
communities they serve.
Recommendations for Further Research
Human resource strategies used by seven leaders in healthcare organizations for
performance improvement and increasing patient quality of care were analyzed in this
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pragmatic inquiry. The study’s results suggest the utilization of human resource strategies
in management practices, such as performance analysis, managerial approach, and
employee and customer assessments, are essential to increasing performance in healthcare
organizations. This pragmatic inquiry strengthens the existing literature on change and
performance management in healthcare organizations. The study highlights the importance
of employee satisfaction and customer service and the techniques’ impact on performance
improvement.
Three central limitations were identified in this study. Research limitations are
defined as barriers that I cannot control. (Kaas et al., 2019) encourages using tools that
aid research in identifying limitations and systematically exposing vulnerabilities. Some
limitations while conducting research include challenges accessing participants,
participant objectivity, researcher and participant boundary issues, and participant
mistrust of the research process (Howard, 2021). One identified limitation is various
procedural and regulatory standards may restrict the various specialties of healthcare
organizations; alternative healthcare specialization may have different experiences. A
second identified limitation is leaders with medical experience who are managers may be
limited in utilizing human resources techniques and require support with human resource
strategies. Another identified limitation is all participants are from the United States;
other regions may present a varied experience.
To address the the limitations, the following recommendation are proposed to
enrich future research endeavors. First, the recommendation is aligning policy and
procedures with accreditation and state regulation standards to increase correlation of
63
regulatory standards and organizational processes. The second recommendation is to
provide management training highlighting the integration of human resource strategies in
managing employees and organizational processes. A third recommendation is to expand
beyond the northeastern and southeastern regions of the United States obtain unique
experiences beyond the regions of participants who provided data in this study.
Conclusion
Human resources strategies utilized by healthcare leaders to affect performance
was studied in this pragmatic inquiry. Data analysis demonstrates that using human
resources strategies results in employee satisfaction, which translates to a positive patient
experience and increased performance. Song et al. (2023) indicated that employees who
are motivated in the workplace positively influence individual and organizational
outcomes. In healthcare organizations, human resource strategies encompass more than
recruiting, hiring, and employment onboarding documentation; they are change agents and
a significant part of an organization’s strategic plan (Sunahwati, 2019). Challenges with
managing quality of care in healthcare facilities force leaders in healthcare organizations
to develop strategies to improve performance, employee satisfaction, and customer service
by providing better patient service.
A comprehensive understanding of human resource strategies’ impact on
performance improvement in healthcare organizations is vital to increasing the quality of
patient care. Data was collected through semistructured interviews and assessment of
procedural information, including healthcare organizations’ Facebook pages, LinkedIn
profiles, and organizations websites. Tomaszewski et al. (2020) recommended
64
methodological triangulation to assess and develop common themes from the various
sources obtained through data collection. The process containing data and identifying
patterns (Chitac, 2022) emphasized the importance of data saturation in a study, reaching
a point when no new information is presented. This central principle was obtained after
data collection from six participants.
The data analysis disclosed three critical themes: analysis, approach, and
assessment. These themes are rooted in Lewin’s change management theory, which
emphasizes human resource strategies leaders in healthcare organizations implement to
improve performance is rooted in Lewin’s change management theory analyzes the need
for organizational change for performance improvement, uses a practical managerial
approach to communicate and influence organizational shifts, and must continue to assess
the new strategies for continued organizational development. Through the integration of
human resource strategies, leaders in healthcare organizations can improve employee
satisfaction, patient customer service, and act as a conduit to influence performance to
increase patient quality of care for individuals and the community at large.
Human resource management strategies add unique value to healthcare
organizations by serving as a mechanism for managing and delivering quality through
expertise and creating functional organizational processes, policies, and procedures (van
Nisterlrooij & Homan, 2019). Inefficient use of management resources jeopardizes the
integrity and quality of services provided by healthcare professionals. Researchers study
how human resources practices improve quality and performance in healthcare
organizations. The leadership in healthcare organizations is responsible for developing
65
strategies to achieve the goal of increased patient care and implementing strategies for
quality assurance (Hamm et al., 2021). The initial step is to examine management
processes for integrating high-quality care and identify human resources practices that
positively impact management strategies and overall patient care.
Business Problem Focus and Project Purpose
The specific business problem was that some healthcare leaders lack strategies to
use human resource functions to enhance organizational processes and systems for
improving performance. Therefore, this qualitative, pragmatic inquiry explores human
resource functions healthcare leaders use to enhance organizational processes and systems
to improve performance. The population for this qualitative, pragmatic inquiry was
comprised of seven healthcare leaders in the Northeastern and Southeastern regions of the
United States who utilize human resources strategies to improve efficiency and improve
the quality of patient care. The data sources used were semistructured interviews with
healthcare leaders and publicly available documents. The purposive sampling method was
utilized for the study. Purposive sampling is a technique commonly used by researchers to
validate data collected that relates to a particular phenomenon (Denieffe, 2020). Using
purposive sampling allowed me to select experienced leaders from healthcare facilities that
have integrated human resources strategies to improve patient care. Participants’ eligibility
criteria included leaders in healthcare, specifically clinical directors, human resource
managers, director of nursing, and members of the chief executive leadership team. The
theory that grounds this pragmatic inquiry design is Kurt
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Lewin’s change management theory. Kurt Lewin’s concepts of original research in 1939
on organizational development inspired a movement of scholars to focus on
organizational change theory in 1947.
Research Question
What human resources strategies do healthcare leaders use to enhance
organizational processes and systems to improve performance?
Assumptions and Limitations
Assumptions
Assumptions are unverified facts (Sebele-Mpofu & Serpa, 2020). Several
assumptions exist when conducting research with managers. The initial assumption is that
healthcare managers possess a foundation in management techniques. The second
assumption is that healthcare managers and the employees in those departments are
interested in managing healthcare departments. The last assumption is that all managers are
interested in improving patients’ overall quality of care.
Limitations
Research limitations are barriers that I cannot control. It is recommended for
researchers to integrate tools while conducting research to identify limitations and
vulnerabilities systematically. (Munthe-Kaas et al., 2019). Limitations included accessing
participants, participant objectivity, researcher and participant boundary issues, and
participant mistrust of the research process (Howard, 2021). One limitation is that the
healthcare organizations in this study was restricted to a specialization in healthcare and
did not account for all types of healthcare practices; an alternative healthcare specialization
67
may have a different experience. Another limitation was leaders with experience managing
may be limited in utilizing human resources management. Another limitation is that all
participants are from the United States; other countries may present a varied experience.
Transition
In Section 1, the background of the study, business problem and purpose, research
question, assumptions, and limitations were discussed. Section 2 will consist of a review
of professional literature. Project ethics, the project’s nature, population, sampling, data
collection, analysis techniques, reliability, and validity will be covered in Section 3.
Findings will be presented in Section 4.
Section 2: The Literature Review
A Review of the Professional and Academic Literature
A review of professional and academic literature, including critical analysis and
synthesis, is vital to this study. This qualitative, pragmatic inquiry explores healthcare
leaders’ strategies to analyze performance while implementing human resources functions
to manage organizational processes and systems. The literature review included
professional and scholarly work on healthcare leaders’ human resources strategies to
enhance organizational processes and systems for improving performance. The alignment
of present data and varied research materials in the recommended pragmatic inquiry will
be demonstrated through data accumulation, research analysis, and synthesis. Several
academic resources were reviewed for this research, including ABI/Inform, Business
Source Complete, ProQuest, Google Scholar, Scholar Works, ScienceDirect, Academic
Search Complete, and Sage Journal. Key words being searched to guide this literature
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review include human resources, consultants, field change theory, field theory, Kurt
Lewin, performance in healthcare organizations, business process theory, organizational
change, strategic planning, and healthcare leader’s role.
The comprehensive literature review was systematic and exhaustive. First, the
conceptual framework was explained, and a critical analysis of supporting theories will be
provided. Second, the literature was critically analyzed and synthesized data on themes
relating to the study’s purpose: to examine human resources strategies to improve
performance in healthcare facilities. Lastly, a comparison of different perspectives was
completed that evaluated the relationship of this pragmatic inquiry to previous research and
findings. The study provided a vigorous, substantiated review of professional and academic
literature related to data on human resources strategies for quality improvement in
healthcare facilities.
The literature review contains 67 references published between 1939 and 2024.
Table 1 contains the sources accompanied by their respective publication years: (a) 97%
peer-reviewed journal articles, (b) 1% non-peer-reviewed journal articles, and (c) 2%
seminal works.
Table 1
Literature Review References
Reference
Total
Total Published After
2019
Percentage In Or
After 2019
Non-Peer Reviewed
1
1
100%
Peer Reviewed
64
64
100%
Seminal Works
2
0
0
Total
67
65
97%
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In this literature review, I explore the inefficient use of human resources
management strategies as an issue that plagues quality improvement in the healthcare
field. In a pragmatic inquiry, Burrell (2020) identified additional consequences in
organizational processes: negative organizational culture, decreased employee
satisfaction and motivation, a negative management perspective, increased operational
costs, and high employee turnover rates. A decrease in the quality of patient care is a
significant consequence of ineffective human resources management strategies.
Kurt Lewin’s Change Management Theory
In 1939, Kurt Lewin studied social and behavioral influences and their impact on
psychology, social facts, and social relationships (Lewin, 1939). The critical concepts of
Kurt Lewin’s change management theory are the process of change in organizational
processes intact, integrating a new process, also known as the change process, and
refreezing this process to influence organizational culture and develop a new cultural norm
(Khalfallah et al., 2023). The influence of an organizational cultural norm through
observation of physical and physiological processes (Lewin, 1939). The logical
connections between the framework presented and this pragmatic design include Lewin’s
organizational change management theory, which identifies the impact of organizational
change during process management implementation.
Identifying the most appropriate theory to support the research data is crucial when
conducting a study. Business process theory and change management theory are suitable
for this research topic. Housebane et al. (2020) indicated that business process analysis in
healthcare needs to be more utilized and that improvements within the healthcare system
70
will remain unrealized by analyzing and reviewing healthcare processes. The benefits of
evidence-based process improvement within healthcare organizations will remain
underdeveloped (Housebane et al., 2020). Containing costs while maintaining quality is
the dichotomy that healthcare organizations face. Business process analysis helps identify
processes that need a strategy change. Kurt Lewin’s change management theory is the
seminal research to support this pragmatic inquiry as it explains the process of change and
the stages leaders import to positively implement change. Khalfallah et al. (2023)
identified the importance of performance process improvement for success in healthcare
organizations. Increasing organizational performance using business process design helps
improve the quality of care of services. Housebane et al. (2020) also noted the importance
of the performance management process. They added that in healthcare, it has been used
in modeling, deployment, execution, monitoring, analysis, and optimization of business
processes. Therefore, this process analyzes strategies healthcare leaders use to effectively
utilize organizational resources to improve performance.
Research indicates the utilization of human resources management techniques to
improve healthcare quality. Various studies identify specific benefits of implementing
human resources strategies in management processes; there are challenges to aligning
present management goals with the goals of human resources leaders. However, there is an
illustrated need for alignment with human resources strategies to integrate the strategic
plan. Presenting perspectives of executives, management, and human resources leaders
provides a comprehensive analysis of the implications of improved performance and
quality when integrating human resources strategic goals.
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Supporting information included in the literature review consists of peer-reviewed
journal articles, books, and website content. The peer-reviewed and scholarly information
that supported this research was accessed using search engines, including ProQuest,
Google Scholar, JPNA, Scholar Works, ScienceDirect, Academic Search Complete, and
Sage Journal. Research articles utilized in this pragmatic inquiry provided contributing
information about business management practices in healthcare organizations and their
impact on improving patient quality and care. The literature demonstrates the significance
of incorporating business management theory, change management theory, and human
resource strategies into the strategic plan for healthcare leaders to increase patient care
quality.
Two theories that were researched but did not best support the basis of the research
were Neisser’s cognitive theory and Ludwig’s change theory. Both theories are key
concepts and vital in analyzing and devising organizational resolutions. As applied to this
study, the cognitive theory focuses on information processing limitations in using mental
models and decision-making processes (Van Rossem, 2021). The cognitive theory would
analyze the relationship between independent variables (human resources value creation
and improvement of organizational processes) measured by the Repertory Grid Technique
and a rating procedure for statistical data. The measurements will predict the appropriate
use of management resources. This design was suitable for my research as my study aimed
to explore the value created by integrating human resources management strategies to
improve performance by examining administrative processes, organizational systems, and
inefficient use of management resources.
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The literature review was used as a tool to analyze various assessment processes to
determine the implementation of human resource practices in management strategies and
the criteria for selecting subject matter experts to employ human resource practices (Van
Rossem, 2021). Delegation of standards for choosing a consultant contributes to the
validity of the expertise of human resources consultants. The illustration of the added value
that human resource strategies contribute to healthcare leaders provides evidence of the
need for human resource strategy implementation. The outcomes of the study provide the
perimeters for integrating human resource strategies with healthcare leaders. The literature
also presents a hypothesis of the benefits of integrating human resource strategies to
improve performance (Pemer et al., 2020); this hypothesis aligns with the research by
demonstrating the benefits of using these strategies in healthcare organizations to improve
the overall quality of patient care. The study’s data presented an analysis of the importance
of investigating the value of alignment in the human resource management and
organizational relationship in healthcare (Chudzikowski et al., 2020). Improper
implementation can result in a decrease in employee motivation and, ultimately, a failure
in performance, which results in a decreased quality of patient care.
All measures researched surrendered justifiable data that supported the addition of
human resource strategies in an organization but did not produce financial benefits to
organizations or the economic costs of additional resources. Companies are ultimately
interested in the bottom line. Future research will benefit by including a cost-value analysis
to support the benefits of employing human resources experts and its impact on quality of
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care and organizational growth against maintaining current management strategies and
employee and patient satisfaction.
Change Management Theory
Kurt Lewin’s influential research on organizational development inspired a
movement of scholars to focus on organizational change (Albrecht & Roughsedge, 2023).
Lewin studied behavioral influences in a workplace setting, the importance of change
processes, and the findings in the research conducted that shape today’s workforce.
Albrecht and Roughsedge (2023) identified that employees feel a part of the
decisionmaking process when they participate, and inclusion reduces workplace resistance
among employees. Research also connects the motivational interview technique and
Lewin’s organizational change management theory. Albrecht and Roughsedge (2023)
identified three grounds for an integrative framework for motivation through organizational
change. Healthcare leaders use motivational interview techniques to assess employee and
patient issues and use human resource strategies to motivate and provoke organizational
change.
Lewin’s change management theory identifies three stages in the organizational
process of transition: unfreeze, change, and refreeze. The unfreezing phase is preparing for
the desired change, implementing the desired change, and refreezing to solidify the desired
change. The three supporting grounds include Lewin’s suggestion that employees should
not be coerced or pressured when asking for feedback, which is the premise of motivational
interview theory. Lewin identified how processes in the workforce influence behavioral
change, and motivational interviews identified individuals in various stages of change and
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the behavioral changes that accompany the process (Lewin, 1939). Both frameworks are
based on cognitive dissonance and applied psychology (Albrecht &
Roughsedge, 2023). Lewin’s groundbreaking research on organizational change Lewin
(1944) specified standards for studying organizational production and performance.
Lewin asserted management’s role and responsibility in maintaining and increasing
productivity. This methodology correlates with this pragmatic inquiry as it provides
evidence-based theory to integrate practices for increasing productivity by increasing
employee satisfaction.
The study identified three management styles (autocratic, democratic, and
laissezfaire) and their impact on employee motivation (Lewin, 1944). The seminal work
concluded that setting performance measures to increase productivity is vital and proposed
that relaxing standards would decrease productivity. The research identified the benefit of
increasing standards and raising goals to increase employees’ internal motivation and
productivity (Lewin, 1944). Lewin’s foundational research demonstrates how human
resource strategies and organizational leaders can implement policies, develop change
initiatives, and influence positive performance improvement in a healthcare facility. This
background supports the data presented in this pragmatic inquiry through the illustration of
the value of assessing organizational change; Kurt Lewin’s seminal change management
theory is the grounds for the organizational change process as he is known as the “father of
organizational change.” The data presented in the study aligned with the research presented
to exemplify the influence of organizational change, employee motivation, the quality of
patient care, and increasing organizational performance.
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Organizational Change
Interrelationships guide the human resources strategic plan to support business
functions. Strategies and operations drive an organization’s business decisions. The
operating plan works in tandem with the strategic plan. Human resource strategies are
regarded as the backbone of sound business practices. The operating plan directs human
resources, focusing on developing initiatives through developing a mission, value
proposition, development goals and objectives, value chain, research evidence, timeline
and milestones, and budget (Cooke et al., 2021). Successful strategies to incorporate an
operating plan must contain organizational objectives, activities to be delivered, quality
standards, desired outcomes, staffing and resources requirements, implementation
requirements, and a monitoring process.
Human resources leaders who develop operating plans analyze existing successful
strategies. Assessing an organization’s mission, vision, and values is essential in aligning
the strategic and operating plans. Dyer et al. (2020) defined business strategy as a
company’s dynamic plan to gain and sustain competitive advantage. The strategic plan
identifies what markets to compete in, identifies the unique value the firm will offer in
those markets, connects the resources and capabilities required to provide that unique value
better than competitors, and indicates ways to sustain market advantage while increasing
performance. The study used the literature as evidence to support the theory of human
resources and the integral role devised in strategic planning by integrating the needs of the
stakeholders and employees to improve the value of care provided to patients.
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Strategic planning in business is instrumental to the success of implementation.
Developing a strategy for organizational sustainability is the responsibility of business
leaders. Human resources focus on the operating plan and identifying the organization’s
key activities to accomplish organizational goals. Human resources leaders can devise a
successful operating plan for their organization by analyzing an existing strategic plan and
examining current business needs. Dyer et al. (2020) described business strategy as a road
map to achieve market position and desirability over the competition. These strategies can
be translated by a leader directly into an active business operations plan.
Human resources analyze issues and develop an operating plan incorporating a
business’ mission, vision, and plan for future business strategies. Successful
implementation is dependent on the examination of organizational strategic goals and
implementing a plan to accomplish the mission and vision business goals, focusing on
value creation through examination of the workforce and positive change initiatives,
assessing the organization’s strengths, weaknesses, opportunities, and threats, and
examining a GAP analysis to devise an action plan to move from current position to
achievement of operational goals. This pragmatic design includes the evidence found in
this literature to highlight the effect of the absence of operational objectives, resulting in
the need to amend an organizational strategic plan in a healthcare facility and integrate
human resources roles.
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Organizational Change Alliance
The success or failure of a strategic plan depends on the effectiveness of
management’s communication of the strategy. Northouse (2019) indicated that leadership
is a process that involves influence, and in an organization, leadership works towards
common goals. The literature suggests that leaders in an organization should execute
business strategies well to prevent failure by integrating human resources practices. Dyer
et al. (2020) indicated that companies that fail to complete business strategies fail to
communicate clear objectives, do not have a transparent compensation system for
achieving goals, and fail to do so. Leadership needs a clear direction. Chmielewska et al.
(2022) asserted that leaders must understand the benefits of utilizing McKinsey’s 7S
framework and the importance of strategy, structure, and systems.
Human resource subject matter experts know the difficulty and time it takes to
develop staffing, shared values, skills, and style. Comprehending this framework
provides essential factors that help sustain market position (Chmielewska et al., 2022).
These strategies align with the study in providing a framework for healthcare leaders by
identifying leadership roles, executing intricacies, understanding organizational culture
influences, resolving execution challenges, and converting identified challenges into
opportunities to influence change and implement the vested requisites of patients and
employees. Using the literature in the pragmatic design should illustrate the importance
of satisfying all interests to improve quality in healthcare facilities.
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Dyer et al. (2020) identified eight steps to implementing successful strategic
change: act with urgency, build a team of experts and leaders to design and communicate
change, motivate the vision, empower individuals in the organization, celebrate
individual successes throughout the organization, consolidate gains and continue to
innovate and make change a part of the organization. Utilizing practices may enable
leaders to develop a strategy to distinguish market value, forming a relationship between
the organization and design (Dyer et al., 2020). The importance of creating a strategy map
and identifying the tools needed for strategic change is instrumental for plan
development; a strategy map and identifying the tools needed for strategic change is
instrumental for plan development, which is what this study will illustrate.
Using human resources functions enables leaders to determine the value creation
and divides strategic objectives into four perspectives: financial, customer, internal
process, and learning and growth (Jo et al., 2024). Healthcare leaders should understand
the vital role they have in the development and implementation of these processes.
Through an assessment of the literature, the research will demonstrate the focus of
strategic planning, the implementation and formulation phase, and the importance of
continuing to incorporate change in day-to-day operations, which is vital for continued
success. Assessing ongoing strategic change is challenging for management. The study
will support the assertion for an assessment tool to analyze differences and evaluate the
need for additional changes.
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Strategic Planning
Strategic planning is instrumental in identifying an organization’s goals. Boon et al.
(2024) indicated that the strategic vision is the organization’s plan that predicts all current
variables in the future and added that the strategic vision would be realistically efficient
and effective in organizations if technological standards were adopted. There are numerous
benefits to developing strategic planning. The advantages are a good understanding of
administrative function, development of human capabilities and skills, and improvement
in an organization’s competitive advantage. A successful strategic plan determines long-
term sustainability. The study will support the literature’s findings on the importance of
strategic planning for an organization to meet and exceed quality goals. Strategic planning
and the integration of human resources strategies in developing the goals in a healthcare
facility are instrumental to accomplishing the goals.
Variables and indicators measure sustainability. Boon et al. (2024) indicated that
variables of successful strategic planning are analysis, technological knowledge
management, electronic training, and cost management. The outcomes connected to the
variables include innovation management, research and development, value-added,
efficiency, and performance effectiveness. Measuring indicators is an integral part of the
strategic planning process. The outcome of measuring indicators results in sustainable
competitive advantage, which produces increases in the following areas: innovation rate,
quality, development rate, budget for development, standard and effectiveness of
performance and efficiency, job satisfaction, and value-added (Ali Albaz, 2019). The
literature aligns with the goals of the pragmatic study as it is imperative to measure
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variables in a healthcare facility like innovation rate, quality, development rate, job
satisfaction, and value standards to understand the impact each variable has on the quality
of care for patients.
Steps of Strategic Planning Cycle
Formulating a strategy involves selecting the company’s actions to gain and
sustain a competitive advantage (Cooke et al, 2021). Strategic goals provide unique value
to customers in the appropriate markets, developing a set of resources and capabilities
that allows organizations to deliver unique value to customers better than competitors and
sustain the competitive advantage by figuring out how to prevent imitation of the chosen
strategy. Dyer et al. (2020) proposed four phases in strategic planning: the organization’s
mission, SWOT analysis, strategy formulation, and strategy implementation. Dyer et al.
(2020) indicated that external analysis involves examining the competition and the forces
that shape industry competition and profitability, as well as customer analysis, to
understand what customers want. The study will attempt to understand what patients want
in healthcare facilities, what employees want, and the role human resources strategies
play in achieving these goals.
Shamuratovna et al. (2024) identified the steps of the strategic planning process
include setting strategic direction, strategic gap analysis, documenting the plan, executing
the plan, and monitoring the plan. After the monitoring and planning phases, leaders
continuously inform and reassess the Strategic Planning Process. Responsible parties
document the planning phase, followed by executing the planning phase, progress, outlook,
and feedback to monitor the planning phase. The study aims to identify the imperative
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nature of the planning process and understand the stages of planning and execution that
exhibit the correlation between human resources as a strategic planner, management
processes, and assurance of quality improvement.
Long-Term Benefits of Strategic Planning
There are several long-term benefits of strategic planning. Successful strategic
planning includes business sustainability and financial success. Companies that achieve a
successful strategic plan meet organizational goals. Shamuratovna et al. (2024) asserted
that strategic planning benefits include clear directives by describing the essence of what
an organization does, the value it wishes to create, how future stakeholders if the
organization is booming, and what the organization intends to do going forward.
Effective risk management is another long-term benefit of the strategic planning process.
Shamuratovna et al. (2024) defined effective risk management as the process companies
use to identify and assess as many risks as possible to affect the organization’s success.
Motivation is another long-term benefit of strategic planning. The study will use
this literature to demonstrate the long-term benefits of strategic planning and aims to
explain the consequences of change strategies and the implications of a structured
organizational strategy. Shamuratovna et al. (2024) defined this phase by providing a
clear direction that ties the needs of stakeholders and the environment in which the plan
operates. A strategic plan can energize, motivate, and focus on every level of the
organization.
Aburmishan and Baum (2022) asserted that a completed strategic plan is not
effective if it has myriad goals and objectives connected to functional areas of leadership.
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For strategic planning to be influential, leaders must successfully balance critical missions
and evolving cultures (Aburmishan & Baum, 2022). Despite being committed to change,
leaders must overcome the plagues of strategic planning. Leaders face deeprooted cultural
expectations, conflicts with entrenched institutional values, and institutional inertia that
will fight change long after the need. When faced with challenges among employees,
leaders can produce a commonly overlooked challenge in creating a culture of inclusion
(Aburmishan & Baum, 2022). This study highlighted consequences and challenges in
existing organizational processes, the value of communicating change, resistance to
change, influencing transition, change implementation, and continued reassessment
through the change management process through utilizing human resources
strategies.
The role that human resources play in an organization continues to
evolve.
Nyfoudi et al. (2024) associated the evolution of the human resources function from
staffing and training to an instrumental role as a leader with a critical role as a strategic
planner, illustrating a tremendous progression. The evolution began as staffing and
training expanded to an indispensable role in the National Labor Relations Act of 1935,
evolving further to adopt the scientific management approach based on productivity, to
the role of a company advocate, and development of a focus on the organization’s human
capital (the people), marketing, communications, and public relations (Jo et al., 2024).
Human Resources functions are not limited to supporting business goals but include
organizational development across multiple areas of the organization.
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Another phase is to include more educated managers who continued to focus on the
human dimensions but also included more significant facets of the business, such as the
influence of employees on the marketing, communications, and public relations of the
organization, inclusive of a strategic business partner developing tactics for organizational
goals, planning, and implementation through the employees of the organization. This
pragmatic inquiry used the literature’s contribution to show the emphasis human resource
strategies have on employee relations and improvement in employee satisfaction. This
study supported the connection between employee satisfaction and improving patient care
in healthcare facilities through existing literature.
Human Resources Management
Prabowo et al. (2020) advised the importance of human resources in an
organization despite the company’s design. The authors asserted that the Human
Resources entity focuses on the idea and helps the establishment’s employees (Prabowo
et al., 2020). Human Resources recognizes the importance of human capital and will
demand and advocate for the most qualified candidate for the organization despite all
factors adding to the firm’s integrity, innovation, and quality. Cooke et al. (2021)
indicated that the collaborative relationship triggers significant organizational change,
and these changes impact the employees, resulting in perceived trauma and stress in the
workforce. Elgoibar et al. (2021) identified additional unequivocal strengths of human
resource strategies that are beneficial to remedy perceptions during a transitional phase
and emphasized trustworthiness, relationship resolution of conflicts, well-being, and
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influence of parties. These attributes contribute to the positive inception of an alliance
and partnership.
Human resource strategies emphasize the value of alliance as it enables a smooth
transition where mutual trust is achieved. The benefit is a culture of overall organizational
support while possessing the ability to resolve conflicts and accomplish organizational
objectives (Elgoibar et al, 2021). This is a necessary step in the strategic process when there
is an adversarial display of conflicting issues and rewards, and losses are high throughout
the change process. The literature demonstrated the emphasis healthcare organizations
place on medical technologies and evidenced-based medical theories in management while
not emphasizing human resource practices in managing employees. Healthcare
organizations routinely focus on the hierarchy of employees, the highest being the medical
director. However, the literature exhibited the importance of all employees in healthcare
organizations and the impact each has on increasing performance and overall quality of
patient care through the integration of human resource practices.
Human resource involvement in developing policies and procedures is essential to
help leaders implement processes to manage organizational resources most efficiently.
Prabowo et al. (2020) defined the role of human resources as crucial and urgent in an
organization. Is offered human resources roles to maintain organizational continuity, build
community trust, and sustain organizational credibility (Prabowo et al., 2020). Human
resources aim to develop long-term and short-term goals for the organization while playing
an instrumental role in strategic plan development.
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One focus of human resources is to utilize human capital to maximize performance
and result in maximum employee contribution. Prabowo et al. (2020) asserted that human
resources’ performance assessment factors include recruitment or procurement of
employees, training and development, mutation of tasks, and compensation. The
department is also instrumental in healthcare organizations. They assess the current
environment and adapt, improve the organization’s quality by developing and
implementing policies, maintain the integrity of services by implementing organizational
competence, and identify and monitor the work of everyone (Prabowo et al., 2020).
Human resources can assess organizational processes and assist with devising a
strategic plan to improve those processes. Kim (2019) advises that human resources
achieve quantum innovations while enhancing business and being ambidextrous.
Organizational ambidexterity has been acknowledged as a source of sustainable
competitive advantage, and the outcomes include performance growth, perpetual
performance, innovation, and market valuation (Kim, 2019). Ambidexterity is “the
organizational capability to simultaneously achieve exploitation and exploration (Kim,
2019). This strategy is helpful when deciding to implement consultants in healthcare,
identifying creative strategies that improve patient quality.
Another strategy that is instrumental in the role of human resources to help
management effectively manage resources through the strategic plan is ensuring quality in
human resource quality as the critical aspect of achieving optimal organizational
performance. Song et al. (2023) advised that the human resources strategic plan is to nurture
and develop the organizational competence necessary to thrive in a competitive
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environment. Research shows that human resource management and knowledge
management influence organizational performance. Human resources strategies that impact
organizational performance include a focus on improvement strategies, factors including
human resources management, organizational learning, knowledge management,
leadership, organizational culture, actors, alternative approach with the development of
human resources policies, organizational infrastructure, and knowledge management
development of policies, and sub-alternative strategies including conducting recruitment
and selection processes, budgetary support, facilitative leadership, and building a shared
vision. (Song et al., 2023).
Organizational Leadership
Transparency is an essential concept in an organization. Transparency produces a
cohesive relationship between leaders and members of an organization. Employees feel a
part of the decision-making process when there is transparency coupled with providing
feedback. The literature explores the correlation between transparency and an increase in
employee motivation. The literature supports the outcomes of better patient care in
healthcare facilities and an increase in employee motivation. DeVito and Goldacre (2023)
defined transparency as the lack of hidden agendas and conditions and the availability of
complete information required for collaboration, cooperation, and collective
decisionmaking.
Transformational leaders emphasize relationship-building connectivity and
transparency while leading. Northouse (2019) defines transformational leadership as
engaging with others and creating a connection that raises motivation. Moore and Ahmed
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(2021) indicated that transformational leaders motivate people to make organizational
transitions. Moore and Ahmed (2021) showed that leadership and motivation are mutual
interactions, and followers have the most motivated leadership. Employees can be
stimulated when they feel part of the process and when leadership is transparent about
strategic plans.
DeVito and Goldocre (2023) identified that although transparency is ideal within
an organization, not all decisions should be made in the open and stated that stated decisions
should be personal, salary, and performance. The processes for these issues should be
transparent to employees, but the individual information should remain confidential.
Information that may cause high anxiety or make employees question the organization’s
stability may also be considered information carefully shared. Albrecht and Roughsedge
(2023) asserted that staff should know and understand the context of decisions and the
happenings as they react negatively when they do not know or understand the context.
Leaders can exert influence using transparency with employees as they establish trust.
Employees feel free to communicate issues and be part of the resolution openly. DeVito
and Goldacre (2023) noted that the relationship is a building block that allows a more open,
honest flow of ideas where staff and constituents are valued.
Management strategies are an essential theme in the research. For healthcare
consultants to be beneficial in helping management processes for the long term, policies
and procedures must be developed outlining their utilization. Human Resources
departments are instrumental in developing organizational policies that enable employees
to produce efficiency in identified roles. The issue of ethics in healthcare with consultants
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and transparency has been an issue of concern. The literature for implementing the strategy
of using consultants in healthcare while having a plan to protect patients and their medical
information must also be researched. Endalamaw et al. (2023) inquired about how some
healthcare organizations need to improve quality processes and studied the improvement
efforts and implementation despite barriers.
The methodology of organizational systems has become a more significant focus
as it studies the when, why, and where organizations can be successful. Research illustrates
evidence of improving quality in healthcare through building community alliances and trust
in the healthcare system (Endalamaw et al., 2023). The current trend of emphasizing quality
improvement and quality identifiers impacting healthcare demonstrates a needed shift in
performance improvement and implementation.
Change in Organizational Culture
Culture and leadership are purposely connected in organizations. Saeed et al.
(2023) stated that leaders must understand the importance of strategy and culture in
building a successful organization and prioritize both in their decision-making practices.
Saeed et al. (2023) stressed the importance of culture. They indicated that culture is
recognized as such a significant factor in an organization’s success that Fortune’s annual
Best Companies to Work for are based on anonymous reports about workplace culture.
Northouse (2019) defined culture as learned beliefs, values, rules, norms, symbols,
and traditions common to a group of people. Creating a cohesive organizational culture is
a high priority for organizational leaders. The literature correlates exhibitions of the impact
employee satisfaction in healthcare have on the quality of patient care. This assertion also
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supports theories of the impact of culture and group thinking. Focusing on connectivity and
accessibility to leadership while creating a culture of cohesion is a strategy for success.
Highlighting the leadership’s desire to be a part of the team and connect with
management and those on the front line with the customers is an important message. Staff
should know they have support from leadership and direct access to the support.
Leadership’s ability to create cohesion and trust in the culture is instrumental to this
strategy’s success. Mohammed and Al-Abrrow (2023) stated that bringing a team together
and giving them a shared purpose helps employees determine what the group stands for
and how to better deliver on their business goals by working toward the desired culture.
Strategic Planning of Human Resources
Research suggests that developing the leading management team in a buy-build
circumstance is vital to the organization’s growth. The human resources strategic partner
plays an instrumental role in communicating with staff and advocating for staff through
situations of transition and change. Through outsourcing or a business partnership, an
organization’s ability to recognize the value of new information, assimilate it, and apply
it is vital to achieving organizational goals (Andrieiev et al., 2023). The study will support
the imperative nature of employees having an avenue they trust to express grievances,
make suggestions, and feel empowered as change agents.
Absorption capacity is the key to organizational growth, and the building blocks
of strategic plans depend on core processes and strategic capabilities (Andrieiev et al.,
2023). This pragmatic design will suggest strategies to integrate into a healthcare facility’s
strategic plan by exploring leadership practices in a healthcare facility. Malvestiti et al.
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(2021) identified integrating organizational capacity with knowledge from external
sources, education, and the accessibility of additional information. An indestructible
human resources strategic partner will introduce and maintain the motivation to achieve
organizational goals through outsourcing processes and absorption capacity from external
sources. Innovation is the key to growth in an ever-changing global society and indicates
sustainability in an organization’s capacity absorption.
Malvestiti et al. (2021) identified organizations’ multifaceted responsibilities and
noted the social, environmental, and economic factors. Sustainability includes
profitability, human capital, business assets, internal organization culture, and external
financial, ecological, and social issues. Human resources strategic partners must possess
a solid plan for absorption capacity and seek knowledge and innovation from other
sources to maintain a competitive market position (Malvestiti et al., 2021). Through the
guidance of a strategic alliance, the strategic plan positions the organization to identify
and obtain new knowledge and innovation to assimilate current practices and resolve
organizational issues that affect society at large.
The results from this research may contribute to positive social change by
increasing the quality-of-care patients receive, as this action enhances the lives of
individual recipients on a micro level and the communities of those individuals on a macro
level. Organizations possess a unique opportunity to remedy societal challenges in
healthcare by implementing human resource strategies of shared value and inclusive
growth while instigating social change and stimulating economic returns (Malhotra et al.,
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2021). This study will show the impact of positive social change with support from
peerreviewed literature.
The steps utilized for a successful collaboration include the participation of all
parties in creating a plan for organizational capacity, taking advantage, and using the
existing talent internally. This study assesses resources and managerial capacity, a
reconceptualization of an organization’s objectives, and how they sustain the business
and stay with the flow of innovation in health care. The study supports the recognition
that employees are a vital organizational resource and create the capacity to assess and
grow employees’ cognitive abilities to develop innovations.
Policymakers can also create organizational capacity; strategic partners and
organizational policymakers such as HR and government policymakers withhold this
power. Human resources leadership is integral to developing policies that impact a
managerial process. Jo et al. (2024) indicated that strategic partnerships are essential in the
strategic construction of operations and the organization’s perceptions by the staff. Human
resources strategic partners can shape the outcome of an alliance as they are a direct line to
the staff. The process will only succeed if the employees support an organization’s
development, growth, and sustainability efforts. Goggins and Rau (2021) identified that
sustainability is an organizational objective and consistent and that systems and
productions of consumption in organizations play a significant role in accomplishing
sustainability.
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Embracing Organizational Change
Strasek et al. (2020) identified that the objective of relationships in businesses is
to relate to resolving organizational issues by exploiting organizational opportunities.
Connectivity is such an important concept in organizations. Showing interest in the
people who support the organization is essential. Leaders need to be more careful when
they believe their position as leaders is an automatic relationship of loyalty and trust.
These relationships must be developed and cultivated. Leaders also need to consider
work-related and, at times, life issues that negatively impact operations and cause
employees to be unhappy. This failure results in a lack of support from human capital.
This inevitably impacts organizational productivity, and employees are likely not
motivated to produce the best results.
Human resources strategic partners can help cultivate this organizational culture by
leading by example and connecting with all levels of employees within the workforce,
training and developing leaders and managers to promote this organizational culture, and
developing policies and procedures to ensure this is an organizational expectation. Strasek
et al. (2020) indicated that the objectives of strategic business relations relate to resolving
development problems and exploiting organizational opportunities. Eliminating the deficits
of available funds and exploiting available resources is a common goal between strategic
allies.
Strasek et al. (2020) stated that the success of the strategic alliance is determined
by developing cooperation with partners that focus on the success of the future business.
The study will illustrate through the literature that success is measured by total
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performance, profit, sales, company growth, market share, growth, and potential capital
(Strasek et al., 2020). Healthcare facilities can demonstrate an increase in quality of care
while improving profitability by implementing human resources strategies in
management.
Benefits and Consequences of Organizational Change
Positive change initiatives are essential to the core of an operating plan; the study
will define the importance of a successful operational plan and roles delineated by
healthcare leaders using human resources functions. Organizations strive to develop
initiatives or base business on positive social change, focusing on promoting positive
change in the external environment. The agendas are not driven solely by profitability but
focus on results that positively impact people or the environment.
Malvestiti et al. (2021) identified the importance of positive social change through
actions of changing thoughts, behaviors, and the domain to benefit outcomes locally and
globally. An operating plan should examine the risks and benefits of integrating a positive
social change into an organization’s operating strategy. Another key to the successful
implementation of an operational plan is strategic alignment. The consequences of failed
social change initiatives include neglecting to align with the organization’s strategic plan,
loss of profits, and decline in stakeholder support.
Aburmishan and Baum (2022) identified benefits as alignment with the
organization’s strategy and motive and stakeholder involvement and motivation. Other
services include positive profitability, enacting global change, and influencing the market
and industry. The operational plan must align with the organization’s missions, values, and
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philosophy. This study will illustrate the advantages of healthcare facilities’ alignment of
the relationship with employees and stakeholders.
Increasing Performance Improvement
The literature will support the study by demonstrating the successful
implementation in a healthcare organization. The literature suggests a total synthesis of the
healthcare market, including profit analysis, analysis of competitors, and potential growth
assessment. This process is completed during the strategy formulation phase, but leaders
must know that the implementation phase is equally important to ensure effective business
strategy execution. Dyer et al. (2020) identified the three strategic change tools as building
alignment between the organization’s segments, strong leadership for effective
implementation and cohesion, and measuring strategic performance by developing a
measurement system. These tools ensure the carry-over of strategy formulation and
development to strategy implementation. Successful implementation depends on
leadership to ensure proper alignment between the strategy, communicating the process to
the followers, and using strategic change tools. Using the tools recommended in the
literature will exhibit positive change and organizational growth in healthcare facilities.
Implications of Change on Employees
The literature suggests the need for a healthcare organization to assess the
company’s strategic plan continuously. Remaining in sync with changes in the
environment, technology, the work environment, and societal changes may require a shift
in strategic planning. Developing a new strategic plan is also necessary to ensure the
organization is not operating under antiquated and inefficient systems. This pragmatic
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design will use the literature to assert the benefits of utilizing the five phases of strategic
planning for successful change implementation. There are five phases to strategic planning.
Shamuratovna et al. (2024) identified the five phases of strategic planning: developing the
strategic planning position, analyzing the strategic plan, gap analysis, formulating a written
strategic plan, and continuing to review and track the strategic plan. These steps are
essential in assessing the need to shift a strategic plan in an organization.
Another critical phase to be highlighted and included as a strategic planning phase
is communicating the plan to the stakeholders. Devising a strategic plan but failing to
communicate the plan effectively will fail the plan. With appropriate communication of
the plan, stakeholders will be aware of the organization’s goals and the plan to
accomplish the goals. Freudenreich et al. (2020) indicated that stakeholder relationships
are vital to the functionality of an organization, as the withdrawal of support from
stakeholders directly affects the sustainability of an organization. This proves why
communication and stakeholder buy-in are instrumental to shifting an organization’s
strategic plan. Reviewing and tracking the strategic plan for success is another crucial
step. It provides information to planners of strategy in an organization if changes in the
strategic plan are necessary.
Measuring Performance Improvement and Outcomes
The study will use literature to support the theory of integrating human resources
strategies in management practices in healthcare facilities to improve the quality of patient
care. Strategic change and developing cohesion with the change is an act that does not
occur overnight and is a time-consuming process. During this process, management must
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assess progress toward organizational goals and strategy (Dyer et al., 2020). Measuring
tools are practical in gauging progress toward goals and evaluating progress in strategic
organizational change. Dyer et al. (2020) defined line of sight as the principle that followers
and leaders in a company should connect their respective duties and overall organizational
goals. Another measurement tool is the balanced scorecard. Dyer et al. (2020) define a
balanced scorecard as a tool that measures equally aspects of an organization to meter;
these measurement areas are devised from the organization’s strategic plan: financial and
profitability goals, consumer goals, systems and process goals, and innovation and growth
goals.
Measurement is an essential tool to focus on. It helps leadership make instrumental
decisions about implementing continued change, implementing innovation when to enter
another market, how to do so, and the projected time (Dyer et al., 2020). The study will
use the literature recommendations to adequately measure quality outcomes for patients
through an examination of strategic influence. These strategic influences include
environmental technological advances and impact measurement tools. Other geographic
regions may have various supply and demand needs, which affects the measuring tool, and
there will be a need for a varied tool.
External and internal factors impact the implementation of strategic changes but do
not impact the measurement tool, as it is necessary for all organizations to assess the
performance of strategic goals and changes. Jo et al. (2024) indicated that the usefulness of
a measuring tool would include teamwork between departments and with followers and
leaders, a high level of communication within the organization and externally with
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consumers and stakeholders, built on the strategy of the organization, clear understanding
and transmission of the relationship between strategic objectives and tasks, compensation
initiative linking compensation and attaining organizational goals, and continuous
assessment, reassessment, and revision of the measuring tool. Utilizing a measuring tool
when integrating human resources strategies in a healthcare facility is imperative to
deciphering successful integration, amending the strategic plan to ensure successful
implementation of the approach, and identifying opportunities for improvement in the
inception of these functions.
Exploring organizational strategic plans healthcare leadership utilizes to improve
organizational performance. Human resources leaders create unique value in healthcare
organizations, delivering quality and expertise to develop and maintain an organization’s
processes and systems (van Nisterlrooij & Homan, 2019). The research identified that
sixty-eight percent of organizational leaders identified specialized skills as a benefit to
employing consultants, and sixty-two percent of leaders noted quality as an additional
benefit (Van Rossem, 2021). The background and overview of the general and specific
problem were identified in the pragmatic inquiry design.
The literature provided evidence of the benefits of integrating human resources
functions in strategic planning and the impact of positive change integration in healthcare
facilities. Reviewing the theoretical framework as a guide to the research identified critical
concepts in Lewin’s change management theory to identify strategies to improve medical
practices and the quality of care, which helped illustrate the research’s underlying focus.
Identifying areas of needed improvement for management in healthcare, identifying
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strategies that have been successful in the integration of implementing change management
processes in healthcare organizations, and identifying ineffective management practices
will help with recommending the incorporation of strategies for successful incorporation
of human resources management techniques to increase quality in patient care.
Assumptions and limitations in the literature were identified as unidentified beliefs and
circumstances in the study beyond the researcher’s control.
Transition
A critical analysis of supportive literature was introduced in section 2, and the
data was synthesized to identify common themes and phenomena in this pragmatic
inquiry. In Section 3, the use of ethical research codes to identify the researcher’s role,
participants’ eligibility, and the interview protocol was highlighted. In Section 4, the
findings are presented.
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Section 3: Research Project Methodology
The research supports the benefits of human resource function implementation in
healthcare management by examining human resources’ role in strategic planning,
illustrating the long-term benefits and challenges of implementing strategic planning in
healthcare facilities. Comprehending the role of human resources and leadership in
healthcare facilities is instrumental in assessing human resources strategies in management
practices. Weighing the benefits and consequences of moving to a human resources-based
management style is imperative to increase performance and the quality of care in
healthcare facilities. Once a change has been embraced and implemented in the
organization, outcomes and performance measurements of the success of the integration
can identify successful integration and opportunities for improvement.
Presenting literature to support the business problem in this pragmatic study and
grounding study design with Kurt Lewin’s change management theory contributes to
qualifying the impact implementation of human resources in healthcare to improve the
quality of patient care. The qualitative study design will outline the research process of
the pragmatic inquiry, explicitly describing the role of the practitioner in the data
collection process and the practitioner’s relationship with the topic and participants. The
study’s data will also explain the research method, design, population, sampling,
participants, data collection activities, data organization analysis techniques, reliability,
and quality indicators.
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Project Ethics
Researchers in qualitative studies act as a tool for collecting and implementing data
to introduce research (Howard, 2021). I qualified the data presented by assessing the
information gathered, incorporating data to support the research question, identifying
appropriate participants for data collection, and providing instruction on the direction for
the data collection strategy (Subedi, 2024). One data source in this study is open-ended
interviews with human resources managers and senior managers designated in an
organization. Another source is supportive data from public information about policies and
procedures on organizations.
Healthcare leaders are faced with maximizing standards of care. Many healthcare
leaders are faced with analyzing strategies for efficiency for management resources. Pemer
et al. (2020) indicated that top leadership has the discretion to fundamentally affect
organizations’ outcomes and actions. This pragmatic inquiry solicited participants from
healthcare leaders from organizations in the Southeastern and Northeastern regions of the
United States with experience implementing human resource strategies in management
practices. Potential participants were identified through research by gathering a list of
healthcare leaders to be emailed an inquiry for participation. There was no previous
relationship with this study’s topic or potential participants.
Establishing initial communication with potential participants is imperative, and
communicating the importance of maintaining confidentiality is imperative in
establishing rapport with participants (Sperling, 2022). The Belmont process provides a
road map that researchers can follow to meet the moral requirements of respecting
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participants in a translational and understandable study. This pragmatic study followed
the framework of the Belmont process. Participants had the option of open flexibility in
scheduling and location for the interviews; this practical design further strengthened the
relationship with participants by soliciting healthcare leaders to provide a lived
experience as leaders in healthcare facilities who utilize human resources strategies for
quality improvement. Guaranteeing participants understanding of the research protocol,
the interview process, their role in the process, and the procedure to withdraw from the
process was the base of this pragmatic inquiry. The IRB’s informed consent form, which
is included in Appendix A, was reviewed and used with participants to guarantee their
understanding of the research process. Consent was obtained from leaders who agreed to
participate. Once consent was obtained, participants received an explanation of the
interview protocol in Appendix B, ethical protection, and ways to withdraw. Ethical
protection and anonymity of participants were clarified. The method of data storage was
reinforced for the protection of participants.
Specific characteristics for the selection of leaders in an organization to provide an
analysis process for the efficiency of management resources for business processes and
systems is imperative. Participants’ roles aligned with the analysis process to aid
healthcare leaders in maintaining management activities, strategic development, business
processes, and systems. In qualitative research, information from participants through
shared experiences provides invaluable data specific to the individual’s encounter.
Healthcare facilities and providing significant knowledge to organizational leaders
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conducive to utilizing human resources strategies for management activities, providing
opportunities to focus on patient-specific needs.
Nature of the Project
The three research methods are qualitative, quantitative, and mixed (Park et al.,
2021). Qualitative research methods are used for data collection and interpretation of
results provided by participants’ lived experiences. A qualitative methodology enables a
researcher to collect data in an interview or a non-numeric data analysis procedure
(Subedi, 2024). Qualitative research also allows the comparison of themes across groups
(Munthe-Kaas et al., 2019). In contrast, quantitative researchers use data collection
through a questionnaire or data analysis through graphs or statistics (Subedi, 2024).
Mixed methods research includes qualitative and quantitative components (Park et al.,
2021). Qualitative research methodology is the most appropriate for this study as it
provides lived experience from healthcare providers to observe this research phenomenon.
This qualitative, pragmatic inquiry targeted leaders in healthcare facilities and the
integration of human resources strategies to benefit management practices and positively
influence the quality of care for patients. This qualitative, pragmatic inquiry scouted
leaders in healthcare facilities who integrate human resource strategies to benefit
management practices and positively influence the quality of care for patients.
The research design is a pragmatic inquiry to address the research question in this
qualitative study. Semistructured interviews are appropriate for this study because, in
qualitative studies, is explore observations of the behaviors from the participants’
perspective. By utilizing a qualitative research design, I was provided the opportunity to
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gather data and accomplish data saturation, examine fieldwork, and use reflexive
interpretation (Chitac, 2022). Data will be utilized to address the research question, and
various strategies to improve performance in a healthcare facility will be identified and
explored using a qualitative case design approach. Qualitative research also enables the
comparison of themes across groups (Munthe-Kaas et al., 2019).
The benefit of pragmatic inquiry is that it is a research design that can be utilized
in a qualitative study to analyze human resources strategies by analyzing various research
theories. Pragmatic designs incorporate reflexivity with research literature to solve a
business problem (Levitt et al., 2021). The qualitative research method and pragmatic
inquiry design were selected because I intended to understand how inefficient utilization
of management resources necessitates leadership to employ human resources management
strategies to help re-institute value and expertise
Population, Sampling, and Participants
The targeted population was purposely selected to comprise healthcare leaders
from the Northeastern and Southeastern regions of the United States who work in
healthcare facilities and have facilitated strategies to analyze the efficient use of
management resources. I gained leadership access through email and inquiry about
participation in a study focusing on management practices and patient outcomes. Then, I
followed up with a phone call to affirm participation and clarify questions about
participation. The final step was for the participants to provide written consent for
participation. I completed several actions before beginning the data collection process,
inclusive of the identification of healthcare facilities to participate in research, recruitment
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of organizations through communication, an explanation of the research question,
agreement from organization to participate, completion of affiliation agreement,
identification of individual participants, and submission to university for request to begin
collecting data. Participants recruited for this pragmatic inquiry were 20 leaders in
healthcare facilities from healthcare facilities in the Northeastern and Southeastern
regions of the United States. Purposeful sampling was used to recruit for participation in
semistructured interviews to provide a lived experience of utilizing human resources
strategies to improve patient quality of care. Each participant was interviewed with a set
of research questions. The answers provided were analyzed to identify themes. I ensured
data saturation by analyzing the data obtained in interviews. The interview process was
conducted virtually via Zoom. I established a working relationship with participants
through open, transparent, and ongoing communication efforts, reassurance of
confidentiality and protection from organizational retaliation, and assurance of flexibility
with the interview time and place.
The research development process rendered 11 potential healthcare leaders to
participate in the study. Nine participants responded, and one leader needed to meet the
participant criteria due to limited employees and unstructured and documented
management practices. Two of the requested participants declined due to new management
and a lack of willingness to provide to be interviewed. Seven participants agreed to
participate in the study. Purposeful sampling was used to assess if participants are qualified
to participate in the research meeting standards. Qualitative research enables a researcher
to conduct a thorough and in-depth analysis of data provided by participants in the study
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(Munthe-Kaas et al., 2019). Using fewer participants allowed me to provide an in-depth
analysis of an organization’s standards, operating procedures, and processes instead of
solely using numerical probability (Howard, 2021). A smaller population supports evidence
to answer the research question and allows a researcher to obtain information for the study
through observation and participants’ lived experiences,
Recordings helped with facilitating reliability and validity in the study. In
qualitative studies, data saturation strengthens scientific accuracy (Levitt et al., 2021).
The method of data saturation provides an ethical guarantee that the participants in the
research and the data analyzed meet ethical transparency and give depth of information
based on sound research practice. McGill et al. (2021) define the concept of data
saturation as the process of guaranteeing that the data collection process renders no
additional information or themes. Interviews will be conducted with leaders from
healthcare facilities in the Northeastern and Southeastern regions of the United States. to
seek data saturation actively. Data saturation will be ensured by clarifying information
when questions are asked, expanding the information provided by participants, and
identifying all codes and themes. Methodological triangulation will be utilized to
guarantee the level of depth in data and to illustrate that data saturation is met.
The quality of data collected is essential in research. Data saturation in pragmatic
inquiries does not have a minimum or maximum requirement but is focused on the quality
and depth of information obtained (Tomaszewski et al., 2020). The varied experiences of
healthcare leaders and their individualized management perspective will enrich and
support the research provided in the study.
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Data Collection Activities
This researcher was the primary data collection instrument. Semistructured
interviews, policies and procedures from organizations, and public information on the
organization’s website were utilized in the data collection process. It is vital to have an
interview protocol as it is essential to have a road map to guide the interview process.
Ensuring neutrality in research is imperative; I followed the research protocol, and the
ethical guidelines provided by the IRB, utilizing the triangulation method, member
checking, and providing an in-depth analysis of the data through a review of interview
notes. Participants received verbal and written explanations of the interview protocol (see
Appendix B).
Researchers facilitating pragmatic inquiry studies use data obtained from
participants’ lived experiences and data provided about the organization to develop a more
in-depth understanding of phenomena; ethnographic studies describe, analyze, and
interpret a culture’s characteristics. The qualitative research method and pragmatic inquiry
design were selected because I intended to understand how inefficient utilization of
management resources necessitates leadership to employ consultants to help reinstitute
value and expertise in healthcare organization business processes. Data, theoretical,
methodological, and investigator triangulation will reinforce the study’s validity through
discernment of the data. (Sabnis & Wolgemuth, 2024) compared the methodology of
confirmability to achieving objectivity in qualitative research and associated the concept
of consistency in research with confirming the data collected. The final product of the study
must result from the data presented by participants. Researchers must be careful not to
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influence the data based on biases and personal beliefs. Data, theoretical, methodological,
and investigator triangulation reinforced the study’s validity through discernment of the
data. The final findings of the study must be the results from the data presented by
participants.
Data collection techniques are vital to achieving reliability and validity, and the
advantages enhance the reliability and validity of the study. All data will be protected and
stored in a safe that only I can access for at least five years; after this, all research records
will be destroyed. The disadvantage of integrating a formatted data collection technique is
providing accurate and valid data in a study that cannot be used to support the research
problem. Participants were integrated to avoid the issue of delivering invalid, inaccurate,
or biased data. (Brear, 2019) indicated that member checking aids the research in gauging
the participants’ priorities and helps structure a research agenda. Member checking guides
the process of data saturation. I summarized the data provided by participants to inquire
about validity and interpretation. Participants were provided a chance to explain, amend,
or expound for data clarification. Once I can no longer identify additional themes, data
saturation is achieved when it is no longer possible to code additional information, build
on the information presented in the research, and when the data in the research study can
be replicated (Naeem et al., 2024). Member checking guides the process of data saturation.
I will summarize the data provided by participants to inquire about validity and
interpretation.
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Interview Questions
1. What human resource strategies assist you in identifying performance
problems?
2. What human resources strategies assist you in meeting performance goals and
expectations?
3. How do employees respond to your management techniques, including your
integration of human resources strategies?
4. What human resource strategies do you use for managing resources?
5. How do you utilize human resources strategies in managing staff, and what
human resources methods are most helpful in your management techniques?
Why?
6. How has utilizing human resources strategies in your management style
increased the quality of patient care?
7. How does utilizing human resources strategies in management demonstrate
improvement in patient quality of care?
8. What additional strategies or resources that we did not discuss could help
facilitate success in human resource management?
Data Organization and Analysis Techniques
The data organization and analysis entailed gathering interview information to
understand techniques to achieve organizational goals. Participants were asked to identify
strategic goals and methods for managing organizational resources using data collected and
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information analysis to support the integration of human resources strategies to mitigate
management inefficiency. Thematic analysis was used in this qualitative research design to
analyze collected information and identify themes (Scharp & Sanders, 2019). As a
researcher, content should be reliable so others can utilize your research to create new
thoughts about a particular phenomenon or theory. NVivo was used to operate and identify
emerging themes in the study; this database will attribute reliability to homogeneity,
stability, and equivalence (Munthe-Kaas et al., 2019). To analyze data, notes, and journals
taken were used to ascertain information, recordings of interviews will be reviewed, and
details provided through member checking were analyzed.
A qualitative study can use three research designs to analyze management resources
and the benefits of employing human resources strategies in healthcare management:
pragmatic inquiry, ethnographic, and narrative. (Tomaszewski et al., 2020) asserted that
research is validated by triangulation between multiple resources and advised that there is
a direct link between triangulation and data saturation. Naeem et al. (2024) urged
researchers to focus on the depth of the presented information and ensure data saturation.
Various triangulations can be used during the research process (methodological, theoretical,
data, investigator, and environmental). Triangulation that emphasizes objectivity and
confirmability will reduce bias influence. Naeem et al. (2024) recommended organizing
data by taking notes and memos throughout the process; I will utilize a journal and
recordings to guarantee a stable process to code the data, analyze the information, and
interpret data for presentation. All data will be protected and stored in a safe that only I can
access for at least five years; after this, all research records will be destroyed.
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Reliability and Validity
Reliability is essential as it references the suitability of the measurements being
used and poses the following questions: Do the measurements being used investigate the
phenomenon being studied, are the data and results of the research accurate, and what do
the results conclude, and do the data represent general issues and conclusions (Sabnis &
Wolgemuth, 2024)? Validity is also crucial as it has several aspects of validity to illustrate
the intention of the data presented. Reliability and validity are vital in research as both
define the credibility of a scholar’s research. Naeem et al. (2024) asserted that unreliable
research inevitably will be invalid and will not contribute to the research of the
phenomenon. There are distinct differences between the two measurements. Reliability
addresses dependability in a research study (Sabnis & Wolgemuth, 2024). This researcher
used member checking, triangulation, and data saturation measurements to ensure research
credibility.
Reliability
Sperling (2022) identified threats to reliability as participant error. These threats
were defined as any issue that negatively impacts how a participant interacted in the
research; another threat is participant bias, which was defined as any issue that affects an
accurate or true response from a participant; a third threat is researcher error, defined as
any issue that skews researcher interpretation of the data collected by the participants, and
researchers bias which is defined as any issue that persuades bias in Is’ data notation. This
researcher maintained awareness of biases and remained conscientious of leading during
the interview process to avoid threats that impact the quality and validity of participants.
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Validity addresses how credible and transferable it is and confirms the data contained in
the presented data. Researchers conduct four tests to ensure quality, validity, and reliability
in a research project (Sabnis & Wolgemuth, 2024). Construct validity identifies the accurate
measurements in operation for the studied methods (Sabnis & Wolgemuth, 2024). Internal
validity assesses the relationships that are the catalysts for the next occurrence and
identifies the causal relationship; external validity assesses if data is in a pragmatic inquiry
in general; and reliability assesses the functioning of research and demonstrates that the
methods of collecting data can be repeated.
Member checking and triangulation are two methods used in this qualitative case
pragmatic inquiry to validate data and demonstrate reliability. In qualitative research,
credibility is defined as a measure to gauge perceived facts through approximation and
deduction of particulars provided by study participants (Sabnis, & Wolgemuth, 2024).
Assurance of the accuracy of the data through verification provided opposed
presumptions of data collected. Member checking is a method this research will use to
interpret data by checking the accuracy of interpreting the information when collecting
the data (Sabnis & Wolgemuth, 2024). Research credibility is defined as a measure to
gauge perceived facts through approximation and deduction of particulars provided by
study participants (Sabnis & Wolgemuth, 2024). Assurance of the accuracy of the data
through verification provided opposed presumptions of data collected. Member checking
is a method this research will use to interpret data by checking the accuracy of
interpreting the information when collecting the data (Sabnis & Wolgemuth, 2024),
2021). Following the interview protocol, clear and methodological triangulation are
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additional measures that will be integrated to illustrate the credibility of data collected in
the study.
Validity
To achieve consistency, reliability, and validity this researcher will organize data by
taking notes and memos throughout the process through a journal. This researcher also
utilized recordings to guarantee a stable process to code the data, analyze the information,
and interpret data for presentation and assurance of research quality. Research quality is
the process of validating data collected. Grey et al., (2019) indicated that academic
institutions and research review boards must uphold research integrity. Validating research
is essential in maintaining quality and ensuring integrity in the information provided. Three
types of evidence that can be used for validity are homogeneity, convergence, and theory
evidence. (Sabnis, & Wolgemuth, 2024) added that the research process comprises
collecting data systematically, interpreting data systematically, and devising a purpose to
resolve a problem. The IRB is charged with oversight to ensure the research process has
integrity and validity. Sabnis and Wolgemuth, (2024) defined validity as the suitability of
measures used, precision of analyzed data, and universality of results.
In qualitative research, transferability is a notion parallel to reliability (Sabnis &
Wolgemuth, 2024). The concept supports the credibility of the data by illustrating the
relevance and unity of information provided by participants in the study. Sperling, 2022
asserts that the research must demonstrate the accurate perspectives of participants who
provided study specifics. This information can be used for integration in additional
settings to support future research. I presented various methodological evidence to
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contribute to subsequent studies. Naeem et al., 2024 compared the methodology of
confirmability to achieving objectivity in qualitative research. The final product of the
survey resulted from the data presented by participants.
Transition and Summary
In this pragmatic inquiry study, I examined the integration of human resource
management strategies to improve the quality of care in healthcare organizations.
Through semistructured interviews and public organizational information the findings in
this qualitative, pragmatic inquiry explored the techniques leaders in healthcare use to
integrate human resource strategies to benefit management practices and positively
influence the quality of care for patients. Naeem et al. (2024) asserted that research is
validated by triangulation between multiple resources and advised that there is a direct
link between triangulation and data saturation. Naeem et al. (2024) urged researchers to
focus on the depth of the presented information and ensure data saturation. Data,
theoretical, methodological, and investigator triangulation will reinforce the study’s
validity through discernment of the data.
I’s role is reinforced by identifying the purpose of this qualitative research study.
The role of I is analyzed through the identification of utilization of the standards and
protocols of research, including recruitment and selection of participants, ethical roles and
responsibilities of I, identification of the research method, and the research design utilized
for the studied sample population. Identifying details of the data collection proposed for
use in the study, processes to organize the data in the study, and measures of assurance for
analysis, reliability, validity, confirmability, transferability, and achieving data saturation
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asserts the ethical guidelines to be followed in the study (Aqil et al., 2023). An explanation
of the data collection process is for evidence to support the research question.
In this pragmatic inquiry, I focused on the presentation of findings in section 4.
Outcomes were based on information received from participants interviewed in the study,
standard operating practices in the healthcare organizations studied, and the impact the
research data will have on social change and implications for future research
demonstrates the comprehensive research process that will be followed to provide a
recommendation for the business problem of some healthcare leaders who lack strategies
to use human resource functions to enhance organizational processes and systems for
improving performance. The section’s information will identify how the data contributes
to the business theory and provide professional practice recommendations.
Section 4: Findings and Conclusions
Introduction
This pragmatic inquiry study aimed to answer the research question: What human
resources strategies do healthcare leaders use to enhance organizational processes and
systems for improving performance? Semistructured interviews with seven leaders in
healthcare organizations in the northeastern and southeastern regions of the United States
who have implemented human resources strategies in management practices to improve
organizational performance were conducted for data analysis in the study. To maintain
anonymity, participants were assigned a numeric code throughout the interview process:
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Participant 1, Participant 2, Participant 3, Participant 4, Participant 5, Participant 6, and
Participant 7. NVivo was utilized to verify manual codes ascertained and was
instrumental in qualifying and analyzing interview data.
The data analysis process included labeling transcripts, importing transcripts,
identifying patterns, assigning codes, utilizing NVivo for data analysis, containing codes
based on context, and reassigning codes. O’Callaghan et al. (2024) identified the
descriptive nature of themes, indicating a pattern of shared designs grouped to
demonstrate reliability. Three main themes materialized from the analysis: (a) analysis,
(b) approach, and (c) assessments. In this section, the data presented will illustrate a
correlation between themes, the conceptual framework, and supportive literature from
peer-reviewed articles.
Presentation of the Findings
Three main themes materialized through analyzing the data: (a) analysis, (b)
approach, and (c) assessments. The study’s conceptual framework is based on Kurt
Lewin’s change management theory. The change management theory aligns with the
study’s foundational premise as it assesses organizational change and its implementation
process change. In this pragmatic inquiry, the data obtained in the research outlines
strategies healthcare leaders use to integrate and influence change to improve
performance.
Participants emphasized the importance of assessing performance to determine if
an organizational change is needed, utilizing their management approach to influence
organizational change, and analyzing assessments to determine the success of the
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implemented organizational change. Participants emphasized the importance of assessing
performance to determine if an organizational change is needed, utilizing their
management approach to influence organizational change, and analyzing assessments to
determine the success of the implemented organizational change. Concepts from
established human resources management literature emphasize internal data analysis,
humanistic managerial approaches, and an overall societal influence on patient quality of
care (Weiszbrod, 2020). Integrating Lewin’s change management theory in human
resources management strategies enhanced the evidence of improved performance in
healthcare organizations.
Theme 1: Analysis
Improving performance in healthcare organizations remains multi-layered as
leaders strategize to increase customer service to clients, employees, and external
constituents. Managing performance improvement challenges leaders in making
decisions and implementing change. Healthcare leaders act as change agents and devise
strategic plans for successful organizational transitions. Participants identified that
utilizing human resource strategies in developing a strategic plan is integral to
organizational evolution. Developing a strategic plan assists leaders in organizations in
formulating business strategies. The strategic plan can be a roadmap for organizational
growth and development. Organizational leaders use data analysis and performance
indicators to assess strengths and opportunities for improvement. Participants 1, 2, 3, 4,
and 6 indicated that data and analyzing the information rendered are imperative in
determining organizational needs.
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Performance analysis in healthcare is used to meet and exceed operational goals.
Utilizing performance-based competencies is instrumental in evaluating and measuring
goals (Golec & Karadeniz, 2020). Some participants agreed that data analysis tools
should be used to assess employee strengths, weaknesses, and needs. Participant 4
asserted that performance problems were identified “by a basic trend analysis.”
Participants 2 and 6 identified using a gap analysis to “assess if employees have what they
need to maximize productivity or if additional resources are needed. Participants 2,
3, 5, 6, and 7 emphasized the importance of performance assessments or appraisals to
“communicate job functions and expectations, provide feedback, receive input of needs,
rate strengths and opportunities for improvement, and goal setting. Participants 2, 3, 5, and
7 emphasized the importance of performance assessments or appraisals to
“communicate job functions and expectations, provide feedback, receive input of needs,
rate strengths and opportunities for improvement, and goal setting.”
Leaders in healthcare organizations use patient surveys to measure the
achievement of performance goals. Ogaji (2022) highlighted the ethical, unbiased, and
valuable significance of patient participation in identifying organizational goals in
healthcare. Patient feedback about the receipt of care allows them to play a role in
improvements in service delivery. It will enable leaders to identify areas of needed
improvement and organizational strengths (Ogaji, 2020). Participant 5 recognized the
importance of patient feedback, adding, “The clients have a sense of agency connectivity
and a belief that their needs are a priority.” Participant 4 and Participant 2 added, “It
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increases patient responsiveness and trust in the organization when clients and families
feel their concerns are a priority and addressed promptly.”
Associating Change Theory to Analysis
Kurt Lewin’s change management theory supports organizational leaders
integrating human resource strategies by identifying balancing forces that provoke
change. The theory of pretense assesses an organization’s driving and restraining forces.
Healthcare leaders are challenged to provide high-quality services by improving
performance. Bamonti (2021) identified an additional challenge that managers in a
clinical capacity lack the skills and knowledge base to assess capacity. Participants 1, 2,
3, 5, and 6 verbalized the importance of healthcare leaders understanding organizational
needs and what tools are needed to meet those needs. Participants identified a connection
between employee satisfaction and increased performance and identified that one of the
most critical steps in gauging the need for organizational change is analysis. Healthcare
leaders identified ongoing performance analysis, patient analysis, and gap analysis as the
most common tools of performance indicators.
Analysis can be linked to the initial stage of Lewin’s change management theory,
unfreeze. Analysis helps healthcare leaders identify why the change must take place.
Analyzing the data provides key indicators of what needs to change and substantiates why
change is necessary. Vendette and Thundiyil (2023) noted the importance of leaders
studying the implications of change by embracing the process and normalizing resistance
and other negative impacts of organizational change. Lewin (1944) asserted that the success
of group change depends on the nature of the process and the depth of the analysis and
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identified the planning phase and objectives to achieve as imperative for success.
Participant 4 noted, “People respond in one of three different ways; they fight, flight, or
accept the data.” Analyzing organizational problems and developing a plan to remedy these
issues is imperative to the success of the change process.
Theme 2: Approach
A managerial approach is critical to implementing change in an organization. The
current workforce has shifted from an environment of volatility, uncertainty, complexity,
and ambiguity to a performance-driven service delivery model (Gaule et al., 2023).
Healthcare leaders identify several groups classified as consumers that require a positive
customer experience. Healthcare leaders specifically identified patients as consumers.
Participants 1, 2, 3, 6, and 7 noted the importance of satisfied employees and their
positive impact on performance. The participants identified specific managerial
approaches they incorporated to achieve employee satisfaction, and all strategies were
rooted in human resource theory.
An organizational approach is critical to employee acceptance of change and
performance improvement. All participants identified managerial approaches that prove to
be successful with employee alignment as employee autonomy, effective communication
of goals and expectations, integrating positive feedback and rewards to employees who are
meetings and exceeding performance measures, providing training and learning spaces for
employees who require additional support, offering an open door approachable
management style, coaching employees as a leader, and avoiding being punitive Bamonti
et al. (2021) asserted the usefulness of capacity assessment and training in healthcare
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organizations. The identified strategies were all rooted in human resource theory and noted
as remaining objective and non-punitive and implemented in daily practices. These leaders
indicated they provide competitive salaries, job flexibility, making employees a part of the
decision-making process, and active listening as managerial approaches that have been
successful with employee alignment.
Aligning Change Theory with Approach
This theme correlates to the conceptual framework by identifying leaders’ vital
role in establishing employee trust and influencing organizational change. The
managerial approach dictates the nature of the relationship between leadership and
employees. Gaule et al. (2023) emphasized the shift in managerial approach from a
volatile, uncertain, complex, and ambiguous focus to a performance and service
management concentration. Implementing human resource strategies in managing
organizational change and assessing success depends on communicating the execution
of the strategic plan. Leaders that prevail in change implementation are trusted by those
who adopt change. Those leaders communicate transitions within the organization and
understand their role in the change process in establishing employee trust and
influencing organizational change.
Lewin identified the second phase of this transitional process as the change phase.
Once employees resolve feelings of uncertainty and establish trust with organizational
leaders, they begin to adopt change and integrate organizational and new ways of doing
things to support the new direction (Vendette & Thundiyil, 2023). Healthcare leaders are
responsible for influencing organizational change, and in a trusting relationship with
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organizational leaders, they begin to adopt change that will benefit them. Participants 1, 2,
3, 5, 6, and 7 verbalized their approachable, empathetic, inclusive, non-punitive, and open
management styles. A managerial approach is essential in achieving positive
implementation changes in healthcare organizations and influencing performance
improvement.
Theme 3: Assessment
Healthcare leaders use various assessment tools to evaluate achieving goals for
implemented change. Healthcare leaders must assess and reassess organizational
operations to determine if modifications in strategy are needed. One strategy to evaluate
the progress of instituted change is patient satisfaction assessments and surveys, employee
satisfaction surveys, performance assessments, direct customer feedback, and direct
observation of services. Customers and employees of healthcare services want to have the
opportunity to provide honest and anonymous feedback without being inconvenienced or
risking retaliation. Nunes et al. (2023) surmised that an effective way of data collection
and assessment is using convenient external assessment tools for consumers and
employees to complete, direct observations of organization operations, and oversight and
feedback provided by regulatory agencies.
Healthcare leaders identified the value of assessments, assessment tools, collecting
data, and assessing data as an invaluable process in change management and performance
evaluation. Leaders added that utilizing the data to determine performance measures and
direct staff observation and documentation are necessary to evaluate processes that meet
organizational goals. Participants 1, 2, 3, and 5 identified the importance of staff
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observations. Participants 1, 3, and 6 identified that they are hands-on managers who
perform frequent huddles and provide immediate feedback and support to
staff.
Aligning Change Theory to Assessment
Assessing the need for change through analysis is an essential step for maintaining
change in healthcare organizations. This theme connects with the conceptual framework
by associating Lewin’s assertion that it is vital to adopt, sustain, and assess change that is
implemented. Pettersen et al. (2024) identified the transformative nature of the successful
implementation of innovation in healthcare and the importance of continued evaluation for
change. Reassessment of integrated reform is equally important.
In the healthcare industry, leaders must remain innovative and adaptable to pivots in the
market. Direct catalysts for change are technology, shifts in work culture, environmental
shifts, and patients’ perceptions of needs.
Lewin referred to the final phase of change as the refreezing phase. The refreezing
phase aligns with assessment through observation of successful change implementation.
Lewin (1944) Asserted the importance of continued evaluation in the change process,
indicating the value of setting organizational goals and objectives to judge whether that
goal is moving forward or backward. He added that evaluating those goals’ achievement
is vital to preventing wrong conclusions (Lewin, 1944). Healthcare leaders consider all
factors when promoting shifts in the organization. Tonjang and Thaweaengskulthai
(2024) identified the use of total quality management and innovation in healthcare as a
valuable tool in integrating the organizational change process. The study considered the
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following factors when assessing and reassessing the need for organizational change:
environmental context, leader, planning, support, operation, tools and analysis method,
and improvements. Once the change has been integrated into the work culture, healthcare
leaders manage the shifts through ongoing assessment of operations, and the decision a
healthcare leader faces is to refreeze or unfreeze to re-initiate the change process.
Business Contributions and Recommendations for Professional Practice
The results of this pragmatic inquiry study illustrate significant determinants for
leaders in healthcare organizations seeking strategies to increase performance outcomes.
Song et al. (2023) asserted challenges with employee activity and engagement and their
negative effect on performance. The data collected from interviews with healthcare
leaders illustrate the correlation of the integration of human resources strategies in
management and performance improvement. Incorporating data from this study’s
outcomes may provide healthcare leaders insight into adopting human resource
techniques to improve employee satisfaction and direct patient care, which results in an
overall increase in organizational performance measures.
Implications for Social Change
Healthcare facilities identify a mission of providing health improvements (Wanser
& Luckel, 2021). Measuring performance and devising a successful strategic plan to meet
this mission is imperative to the medical field’s contribution to society. Healthcare
organizations that emphasize increasing patient care affect facility experiences positively.
Better patient experiences lead to increased facility outcomes. By leveraging the findings
presented in this study, healthcare leaders can improve the quality of care and patient
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confidence in medical providers. Organizations possess a unique opportunity to remedy
societal challenges in healthcare by implementing human resource strategies of shared
value and inclusive growth while instigating social change and stimulating economic
returns (Nandy, 2024). The results from this research may contribute to positive social
change by increasing the quality-of-care patients receive, increasing employee
engagement, and impacting customer satisfaction. These actions enhance the lives of
individual recipients on a micro level and the communities of those individuals on a macro
level.
Performance management in healthcare is a change agent catalyst in organizations.
Providing high-quality care is imperative to medical service delivery, impacts patient
confidence in healthcare providers, and results in community trust. Performance
management in healthcare facilities is result-driven due to the services provided and the
outcomes (Peixoto et al., 2020). Providing high-quality care is a goal leaders in healthcare
seek to attain. High-quality medical service delivery increases patient outcomes, impacts
patient confidence in healthcare providers, and results in community trust (Wanser &
Luckel, 2021). Trusting the change process in healthcare has a cyclical impact that
influences social impact while improving performance. This cycle of change in healthcare
organizations ultimately results in improved quality of care to customers in the
communities they serve.
Recommendations for Further Research
Human resource strategies used by seven leaders in healthcare organizations for
performance improvement and increasing patient quality of care were analyzed in this
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pragmatic inquiry. The study’s results suggest the utilization of human resource strategies
in management practices, such as performance analysis, managerial approach, and
employee and customer assessments, are essential to increasing performance in healthcare
organizations. This pragmatic inquiry strengthens the existing literature on change and
performance management in healthcare organizations. The study highlights the importance
of employee satisfaction and customer service and the techniques’ impact on performance
improvement.
Three central limitations were identified in this study. Research limitations are
defined as barriers that I cannot control. (Kaas et al., 2019) encourages using tools that
aid research in identifying limitations and systematically exposing vulnerabilities. Some
limitations while conducting research include challenges accessing participants,
participant objectivity, researcher and participant boundary issues, and participant
mistrust of the research process (Howard, 2021). One identified limitation is various
procedural and regulatory standards may restrict the various specialties of healthcare
organizations; alternative healthcare specialization may have different experiences. A
second identified limitation is leaders with medical experience who are managers may be
limited in utilizing human resources techniques and require support with human resource
strategies. Another identified limitation is all participants are from the United States;
other regions may present a varied experience.
To address the the limitations, the following recommendation are proposed to
enrich future research endeavors. First, the recommendation is aligning policy and
procedures with accreditation and state regulation standards to increase correlation of
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regulatory standards and organizational processes. The second recommendation is to
provide management training highlighting the integration of human resource strategies in
managing employees and organizational processes. A third recommendation is to expand
beyond the northeastern and southeastern regions of the United States obtain unique
experiences beyond the regions of participants who provided data in this study.
Conclusion
Human resources strategies utilized by healthcare leaders to affect performance
was studied in this pragmatic inquiry. Data analysis demonstrates that using human
resources strategies results in employee satisfaction, which translates to a positive patient
experience and increased performance. Song et al. (2023) indicated that employees who
are motivated in the workplace positively influence individual and organizational
outcomes. In healthcare organizations, human resource strategies encompass more than
recruiting, hiring, and employment onboarding documentation; they are change agents and
a significant part of an organization’s strategic plan (Sunahwati, 2019). Challenges with
managing quality of care in healthcare facilities force leaders in healthcare organizations
to develop strategies to improve performance, employee satisfaction, and customer service
by providing better patient service.
A comprehensive understanding of human resource strategies’ impact on
performance improvement in healthcare organizations is vital to increasing the quality of
patient care. Data was collected through semistructured interviews and assessment of
procedural information, including healthcare organizations’ Facebook pages, LinkedIn
profiles, and organizations websites. Tomaszewski et al. (2020) recommended
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methodological triangulation to assess and develop common themes from the various
sources obtained through data collection. The process containing data and identifying
patterns (Chitac, 2022) emphasized the importance of data saturation in a study, reaching
a point when no new information is presented. This central principle was obtained after
data collection from six participants.
The data analysis disclosed three critical themes: analysis, approach, and
assessment. These themes are rooted in Lewin’s change management theory, which
emphasizes human resource strategies leaders in healthcare organizations implement to
improve performance is rooted in Lewin’s change management theory analyzes the need
for organizational change for performance improvement, uses a practical managerial
approach to communicate and influence organizational shifts, and must continue to assess
the new strategies for continued organizational development. Through the integration of
human resource strategies, leaders in healthcare organizations can improve employee
satisfaction, patient customer service, and act as a conduit to influence performance to
increase patient quality of care for individuals and the community at large.
Human resource management strategies add unique value to healthcare organizations by
serving as a mechanism for managing and delivering quality through expertise and
creating functional organizational processes, policies, and procedures (van Nisterlrooij &
Homan, 2019). Inefficient use of management resources jeopardizes the integrity and
quality of services provided by healthcare professionals. Researchers study how human
resources practices improve quality and performance in healthcare organizations. The
leadership in healthcare organizations is responsible for developing strategies to achieve
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the goal of increased patient care and implementing strategies for quality assurance
(Hamm et al., 2021). The initial step is to examine management processes for integrating
high-quality care and identify human resources practices that positively impact
management strategies and overall patient care.
Business Problem Focus and Project Purpose
The specific business problem was that some healthcare leaders lack strategies to
use human resource functions to enhance organizational processes and systems for
improving performance. Therefore, this qualitative, pragmatic inquiry explores human
resource functions healthcare leaders use to enhance organizational processes and systems
to improve performance. The population for this qualitative, pragmatic inquiry was
comprised of seven healthcare leaders in the Northeastern and Southeastern regions of the
United States who utilize human resources strategies to improve efficiency and improve
the quality of patient care. The data sources used were semistructured interviews with
healthcare leaders and publicly available documents. The purposive sampling method was
utilized for the study. Purposive sampling is a technique commonly used by researchers to
validate data collected that relates to a particular phenomenon (Denieffe, 2020). Using
purposive sampling allowed me to select experienced leaders from healthcare facilities that
have integrated human resources strategies to improve patient care. Participants’ eligibility
criteria included leaders in healthcare, specifically clinical directors, human resource
managers, director of nursing, and members of the chief executive leadership team. The
theory that grounds this pragmatic inquiry design is Kurt
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Lewin’s change management theory. Kurt Lewin’s concepts of original research in 1939
on organizational development inspired a movement of scholars to focus on
organizational change theory in 1947.
Research Question
What human resources strategies do healthcare leaders use to enhance
organizational processes and systems to improve performance?
Assumptions and Limitations
Assumptions
Assumptions are unverified facts (Sebele-Mpofu & Serpa, 2020). Several
assumptions exist when conducting research with managers. The initial assumption is that
healthcare managers possess a foundation in management techniques. The second
assumption is that healthcare managers and the employees in those departments are
interested in managing healthcare departments. The last assumption is that all managers are
interested in improving patients’ overall quality of care.
Limitations
Research limitations are barriers that I cannot control. It is recommended for
researchers to integrate tools while conducting research to identify limitations and
vulnerabilities systematically. (Munthe-Kaas et al., 2019). Limitations included accessing
participants, participant objectivity, researcher and participant boundary issues, and
participant mistrust of the research process (Howard, 2021). One limitation is that the
healthcare organizations in this study was restricted to a specialization in healthcare and
did not account for all types of healthcare practices; an alternative healthcare specialization
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may have a different experience. Another limitation was leaders with experience managing
may be limited in utilizing human resources management. Another limitation is that all
participants are from the United States; other countries may present a varied experience.
Transition
In Section 1, the background of the study, business problem and purpose, research
question, assumptions, and limitations were discussed. Section 2 will consist of a review
of professional literature. Project ethics, the project’s nature, population, sampling, data
collection, analysis techniques, reliability, and validity will be covered in Section 3.
Findings will be presented in Section 4.
Section 2: The Literature Review
A Review of the Professional and Academic Literature
A review of professional and academic literature, including critical analysis and
synthesis, is vital to this study. This qualitative, pragmatic inquiry explores healthcare
leaders’ strategies to analyze performance while implementing human resources functions
to manage organizational processes and systems. The literature review included
professional and scholarly work on healthcare leaders’ human resources strategies to
enhance organizational processes and systems for improving performance. The alignment
of present data and varied research materials in the recommended pragmatic inquiry will
be demonstrated through data accumulation, research analysis, and synthesis. Several
academic resources were reviewed for this research, including ABI/Inform, Business
Source Complete, ProQuest, Google Scholar, Scholar Works, ScienceDirect, Academic
Search Complete, and Sage Journal. Key words being searched to guide this literature
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review include human resources, consultants, field change theory, field theory, Kurt
Lewin, performance in healthcare organizations, business process theory, organizational
change, strategic planning, and healthcare leader’s role.
The comprehensive literature review was systematic and exhaustive. First, the
conceptual framework was explained, and a critical analysis of supporting theories will be
provided. Second, the literature was critically analyzed and synthesized data on themes
relating to the study’s purpose: to examine human resources strategies to improve
performance in healthcare facilities. Lastly, a comparison of different perspectives was
completed that evaluated the relationship of this pragmatic inquiry to previous research and
findings. The study provided a vigorous, substantiated review of professional and academic
literature related to data on human resources strategies for quality improvement in
healthcare facilities.
The literature review contains 67 references published between 1939 and 2024.
Table 1 contains the sources accompanied by their respective publication years: (a) 97%
peer-reviewed journal articles, (b) 1% non-peer-reviewed journal articles, and (c) 2%
seminal works.
Table 1
Literature Review References
Reference
Total
Total Published After
2019
Percentage In Or
After 2019
Non-Peer Reviewed
1
1
100%
Peer Reviewed
64
64
100%
Seminal Works
2
0
0
Total
67
65
97%
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In this literature review, I explore the inefficient use of human resources
management strategies as an issue that plagues quality improvement in the healthcare
field. In a pragmatic inquiry, Burrell (2020) identified additional consequences in
organizational processes: negative organizational culture, decreased employee
satisfaction and motivation, a negative management perspective, increased operational
costs, and high employee turnover rates. A decrease in the quality of patient care is a
significant consequence of ineffective human resources management strategies.
Kurt Lewin’s Change Management Theory
In 1939, Kurt Lewin studied social and behavioral influences and their impact on
psychology, social facts, and social relationships (Lewin, 1939). The critical concepts of
Kurt Lewin’s change management theory are the process of change in organizational
processes intact, integrating a new process, also known as the change process, and
refreezing this process to influence organizational culture and develop a new cultural norm
(Khalfallah et al., 2023). The influence of an organizational cultural norm through
observation of physical and physiological processes (Lewin, 1939). The logical
connections between the framework presented and this pragmatic design include Lewin’s
organizational change management theory, which identifies the impact of organizational
change during process management implementation.
Identifying the most appropriate theory to support the research data is crucial when
conducting a study. Business process theory and change management theory are suitable
for this research topic. Housebane et al. (2020) indicated that business process analysis in
healthcare needs to be more utilized and that improvements within the healthcare system
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will remain unrealized by analyzing and reviewing healthcare processes. The benefits of
evidence-based process improvement within healthcare organizations will remain
underdeveloped (Housebane et al., 2020). Containing costs while maintaining quality is
the dichotomy that healthcare organizations face. Business process analysis helps identify
processes that need a strategy change. Kurt Lewin’s change management theory is the
seminal research to support this pragmatic inquiry as it explains the process of change and
the stages leaders import to positively implement change. Khalfallah et al. (2023)
identified the importance of performance process improvement for success in healthcare
organizations. Increasing organizational performance using business process design helps
improve the quality of care of services. Housebane et al. (2020) also noted the importance
of the performance management process. They added that in healthcare, it has been used
in modeling, deployment, execution, monitoring, analysis, and optimization of business
processes. Therefore, this process analyzes strategies healthcare leaders use to effectively
utilize organizational resources to improve performance.
Research indicates the utilization of human resources management techniques to
improve healthcare quality. Various studies identify specific benefits of implementing
human resources strategies in management processes; there are challenges to aligning
present management goals with the goals of human resources leaders. However, there is an
illustrated need for alignment with human resources strategies to integrate the strategic
plan. Presenting perspectives of executives, management, and human resources leaders
provides a comprehensive analysis of the implications of improved performance and
quality when integrating human resources strategic goals.
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Supporting information included in the literature review consists of peer-reviewed
journal articles, books, and website content. The peer-reviewed and scholarly information
that supported this research was accessed using search engines, including ProQuest,
Google Scholar, JPNA, Scholar Works, ScienceDirect, Academic Search Complete, and
Sage Journal. Research articles utilized in this pragmatic inquiry provided contributing
information about business management practices in healthcare organizations and their
impact on improving patient quality and care. The literature demonstrates the significance
of incorporating business management theory, change management theory, and human
resource strategies into the strategic plan for healthcare leaders to increase patient care
quality.
Two theories that were researched but did not best support the basis of the research
were Neisser’s cognitive theory and Ludwig’s change theory. Both theories are key
concepts and vital in analyzing and devising organizational resolutions. As applied to this
study, the cognitive theory focuses on information processing limitations in using mental
models and decision-making processes (Van Rossem, 2021). The cognitive theory would
analyze the relationship between independent variables (human resources value creation
and improvement of organizational processes) measured by the Repertory Grid Technique
and a rating procedure for statistical data. The measurements will predict the appropriate
use of management resources. This design was suitable for my research as my study aimed
to explore the value created by integrating human resources management strategies to
improve performance by examining administrative processes, organizational systems, and
inefficient use of management resources.
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The literature review was used as a tool to analyze various assessment processes to
determine the implementation of human resource practices in management strategies and
the criteria for selecting subject matter experts to employ human resource practices (Van
Rossem, 2021). Delegation of standards for choosing a consultant contributes to the
validity of the expertise of human resources consultants. The illustration of the added value
that human resource strategies contribute to healthcare leaders provides evidence of the
need for human resource strategy implementation. The outcomes of the study provide the
perimeters for integrating human resource strategies with healthcare leaders. The literature
also presents a hypothesis of the benefits of integrating human resource strategies to
improve performance (Pemer et al., 2020); this hypothesis aligns with the research by
demonstrating the benefits of using these strategies in healthcare organizations to improve
the overall quality of patient care. The study’s data presented an analysis of the importance
of investigating the value of alignment in the human resource management and
organizational relationship in healthcare (Chudzikowski et al., 2020). Improper
implementation can result in a decrease in employee motivation and, ultimately, a failure
in performance, which results in a decreased quality of patient care.
All measures researched surrendered justifiable data that supported the addition of
human resource strategies in an organization but did not produce financial benefits to
organizations or the economic costs of additional resources. Companies are ultimately
interested in the bottom line. Future research will benefit by including a cost-value analysis
to support the benefits of employing human resources experts and its impact on quality of
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care and organizational growth against maintaining current management strategies and
employee and patient satisfaction.
Change Management Theory
Kurt Lewin’s influential research on organizational development inspired a
movement of scholars to focus on organizational change (Albrecht & Roughsedge, 2023).
Lewin studied behavioral influences in a workplace setting, the importance of change
processes, and the findings in the research conducted that shape today’s workforce.
Albrecht and Roughsedge (2023) identified that employees feel a part of the
decisionmaking process when they participate, and inclusion reduces workplace resistance
among employees. Research also connects the motivational interview technique and
Lewin’s organizational change management theory. Albrecht and Roughsedge (2023)
identified three grounds for an integrative framework for motivation through organizational
change. Healthcare leaders use motivational interview techniques to assess employee and
patient issues and use human resource strategies to motivate and provoke organizational
change.
Lewin’s change management theory identifies three stages in the organizational
process of transition: unfreeze, change, and refreeze. The unfreezing phase is preparing for
the desired change, implementing the desired change, and refreezing to solidify the desired
change. The three supporting grounds include Lewin’s suggestion that employees should
not be coerced or pressured when asking for feedback, which is the premise of motivational
interview theory. Lewin identified how processes in the workforce influence behavioral
change, and motivational interviews identified individuals in various stages of change and
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the behavioral changes that accompany the process (Lewin, 1939). Both frameworks are
based on cognitive dissonance and applied psychology (Albrecht &
Roughsedge, 2023). Lewin’s groundbreaking research on organizational change Lewin
(1944) specified standards for studying organizational production and performance.
Lewin asserted management’s role and responsibility in maintaining and increasing
productivity. This methodology correlates with this pragmatic inquiry as it provides
evidence-based theory to integrate practices for increasing productivity by increasing
employee satisfaction.
The study identified three management styles (autocratic, democratic, and
laissezfaire) and their impact on employee motivation (Lewin, 1944). The seminal work
concluded that setting performance measures to increase productivity is vital and proposed
that relaxing standards would decrease productivity. The research identified the benefit of
increasing standards and raising goals to increase employees’ internal motivation and
productivity (Lewin, 1944). Lewin’s foundational research demonstrates how human
resource strategies and organizational leaders can implement policies, develop change
initiatives, and influence positive performance improvement in a healthcare facility. This
background supports the data presented in this pragmatic inquiry through the illustration of
the value of assessing organizational change; Kurt Lewin’s seminal change management
theory is the grounds for the organizational change process as he is known as the “father of
organizational change.” The data presented in the study aligned with the research presented
to exemplify the influence of organizational change, employee motivation, the quality of
patient care, and increasing organizational performance.
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Organizational Change
Interrelationships guide the human resources strategic plan to support business
functions. Strategies and operations drive an organization’s business decisions. The
operating plan works in tandem with the strategic plan. Human resource strategies are
regarded as the backbone of sound business practices. The operating plan directs human
resources, focusing on developing initiatives through developing a mission, value
proposition, development goals and objectives, value chain, research evidence, timeline
and milestones, and budget (Cooke et al., 2021). Successful strategies to incorporate an
operating plan must contain organizational objectives, activities to be delivered, quality
standards, desired outcomes, staffing and resources requirements, implementation
requirements, and a monitoring process.
Human resources leaders who develop operating plans analyze existing successful
strategies. Assessing an organization’s mission, vision, and values is essential in aligning
the strategic and operating plans. Dyer et al. (2020) defined business strategy as a
company’s dynamic plan to gain and sustain competitive advantage. The strategic plan
identifies what markets to compete in, identifies the unique value the firm will offer in
those markets, connects the resources and capabilities required to provide that unique value
better than competitors, and indicates ways to sustain market advantage while increasing
performance. The study used the literature as evidence to support the theory of human
resources and the integral role devised in strategic planning by integrating the needs of the
stakeholders and employees to improve the value of care provided to patients.
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Strategic planning in business is instrumental to the success of implementation.
Developing a strategy for organizational sustainability is the responsibility of business
leaders. Human resources focus on the operating plan and identifying the organization’s
key activities to accomplish organizational goals. Human resources leaders can devise a
successful operating plan for their organization by analyzing an existing strategic plan and
examining current business needs. Dyer et al. (2020) described business strategy as a road
map to achieve market position and desirability over the competition. These strategies can
be translated by a leader directly into an active business operations plan.
Human resources analyze issues and develop an operating plan incorporating a
business’ mission, vision, and plan for future business strategies. Successful
implementation is dependent on the examination of organizational strategic goals and
implementing a plan to accomplish the mission and vision business goals, focusing on
value creation through examination of the workforce and positive change initiatives,
assessing the organization’s strengths, weaknesses, opportunities, and threats, and
examining a GAP analysis to devise an action plan to move from current position to
achievement of operational goals. This pragmatic design includes the evidence found in
this literature to highlight the effect of the absence of operational objectives, resulting in
the need to amend an organizational strategic plan in a healthcare facility and integrate
human resources roles.
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Organizational Change Alliance
The success or failure of a strategic plan depends on the effectiveness of
management’s communication of the strategy. Northouse (2019) indicated that leadership
is a process that involves influence, and in an organization, leadership works towards
common goals. The literature suggests that leaders in an organization should execute
business strategies well to prevent failure by integrating human resources practices. Dyer
et al. (2020) indicated that companies that fail to complete business strategies fail to
communicate clear objectives, do not have a transparent compensation system for
achieving goals, and fail to do so. Leadership needs a clear direction. Chmielewska et al.
(2022) asserted that leaders must understand the benefits of utilizing McKinsey’s 7S
framework and the importance of strategy, structure, and systems.
Human resource subject matter experts know the difficulty and time it takes to
develop staffing, shared values, skills, and style. Comprehending this framework
provides essential factors that help sustain market position (Chmielewska et al., 2022).
These strategies align with the study in providing a framework for healthcare leaders by
identifying leadership roles, executing intricacies, understanding organizational culture
influences, resolving execution challenges, and converting identified challenges into
opportunities to influence change and implement the vested requisites of patients and
employees. Using the literature in the pragmatic design should illustrate the importance
of satisfying all interests to improve quality in healthcare facilities.
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Dyer et al. (2020) identified eight steps to implementing successful strategic
change: act with urgency, build a team of experts and leaders to design and communicate
change, motivate the vision, empower individuals in the organization, celebrate
individual successes throughout the organization, consolidate gains and continue to
innovate and make change a part of the organization. Utilizing practices may enable
leaders to develop a strategy to distinguish market value, forming a relationship between
the organization and design (Dyer et al., 2020). The importance of creating a strategy map
and identifying the tools needed for strategic change is instrumental for plan
development; a strategy map and identifying the tools needed for strategic change is
instrumental for plan development, which is what this study will illustrate.
Using human resources functions enables leaders to determine the value creation
and divides strategic objectives into four perspectives: financial, customer, internal
process, and learning and growth (Jo et al., 2024). Healthcare leaders should understand
the vital role they have in the development and implementation of these processes.
Through an assessment of the literature, the research will demonstrate the focus of
strategic planning, the implementation and formulation phase, and the importance of
continuing to incorporate change in day-to-day operations, which is vital for continued
success. Assessing ongoing strategic change is challenging for management. The study
will support the assertion for an assessment tool to analyze differences and evaluate the
need for additional changes.
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Strategic Planning
Strategic planning is instrumental in identifying an organization’s goals. Boon et al.
(2024) indicated that the strategic vision is the organization’s plan that predicts all current
variables in the future and added that the strategic vision would be realistically efficient
and effective in organizations if technological standards were adopted. There are numerous
benefits to developing strategic planning. The advantages are a good understanding of
administrative function, development of human capabilities and skills, and improvement
in an organization’s competitive advantage. A successful strategic plan determines long-
term sustainability. The study will support the literature’s findings on the importance of
strategic planning for an organization to meet and exceed quality goals. Strategic planning
and the integration of human resources strategies in developing the goals in a healthcare
facility are instrumental to accomplishing the goals.
Variables and indicators measure sustainability. Boon et al. (2024) indicated that
variables of successful strategic planning are analysis, technological knowledge
management, electronic training, and cost management. The outcomes connected to the
variables include innovation management, research and development, value-added,
efficiency, and performance effectiveness. Measuring indicators is an integral part of the
strategic planning process. The outcome of measuring indicators results in sustainable
competitive advantage, which produces increases in the following areas: innovation rate,
quality, development rate, budget for development, standard and effectiveness of
performance and efficiency, job satisfaction, and value-added (Ali Albaz, 2019). The
literature aligns with the goals of the pragmatic study as it is imperative to measure
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variables in a healthcare facility like innovation rate, quality, development rate, job
satisfaction, and value standards to understand the impact each variable has on the quality
of care for patients.
Steps of Strategic Planning Cycle
Formulating a strategy involves selecting the company’s actions to gain and
sustain a competitive advantage (Cooke et al, 2021). Strategic goals provide unique value
to customers in the appropriate markets, developing a set of resources and capabilities
that allows organizations to deliver unique value to customers better than competitors and
sustain the competitive advantage by figuring out how to prevent imitation of the chosen
strategy. Dyer et al. (2020) proposed four phases in strategic planning: the organization’s
mission, SWOT analysis, strategy formulation, and strategy implementation. Dyer et al.
(2020) indicated that external analysis involves examining the competition and the forces
that shape industry competition and profitability, as well as customer analysis, to
understand what customers want. The study will attempt to understand what patients want
in healthcare facilities, what employees want, and the role human resources strategies
play in achieving these goals.
Shamuratovna et al. (2024) identified the steps of the strategic planning process
include setting strategic direction, strategic gap analysis, documenting the plan, executing
the plan, and monitoring the plan. After the monitoring and planning phases, leaders
continuously inform and reassess the Strategic Planning Process. Responsible parties
document the planning phase, followed by executing the planning phase, progress, outlook,
and feedback to monitor the planning phase. The study aims to identify the imperative
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nature of the planning process and understand the stages of planning and execution that
exhibit the correlation between human resources as a strategic planner, management
processes, and assurance of quality improvement.
Long-Term Benefits of Strategic Planning
There are several long-term benefits of strategic planning. Successful strategic
planning includes business sustainability and financial success. Companies that achieve a
successful strategic plan meet organizational goals. Shamuratovna et al. (2024) asserted
that strategic planning benefits include clear directives by describing the essence of what
an organization does, the value it wishes to create, how future stakeholders if the
organization is booming, and what the organization intends to do going forward.
Effective risk management is another long-term benefit of the strategic planning process.
Shamuratovna et al. (2024) defined effective risk management as the process companies
use to identify and assess as many risks as possible to affect the organization’s success.
Motivation is another long-term benefit of strategic planning. The study will use
this literature to demonstrate the long-term benefits of strategic planning and aims to
explain the consequences of change strategies and the implications of a structured
organizational strategy. Shamuratovna et al. (2024) defined this phase by providing a
clear direction that ties the needs of stakeholders and the environment in which the plan
operates. A strategic plan can energize, motivate, and focus on every level of the
organization.
Aburmishan and Baum (2022) asserted that a completed strategic plan is not
effective if it has myriad goals and objectives connected to functional areas of leadership.
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For strategic planning to be influential, leaders must successfully balance critical missions
and evolving cultures (Aburmishan & Baum, 2022). Despite being committed to change,
leaders must overcome the plagues of strategic planning. Leaders face deeprooted cultural
expectations, conflicts with entrenched institutional values, and institutional inertia that
will fight change long after the need. When faced with challenges among employees,
leaders can produce a commonly overlooked challenge in creating a culture of inclusion
(Aburmishan & Baum, 2022). This study highlighted consequences and challenges in
existing organizational processes, the value of communicating change, resistance to
change, influencing transition, change implementation, and continued reassessment
through the change management process through utilizing human resources
strategies.
The role that human resources play in an organization continues to
evolve.
Nyfoudi et al. (2024) associated the evolution of the human resources function from
staffing and training to an instrumental role as a leader with a critical role as a strategic
planner, illustrating a tremendous progression. The evolution began as staffing and
training expanded to an indispensable role in the National Labor Relations Act of 1935,
evolving further to adopt the scientific management approach based on productivity, to
the role of a company advocate, and development of a focus on the organization’s human
capital (the people), marketing, communications, and public relations (Jo et al., 2024).
Human Resources functions are not limited to supporting business goals but include
organizational development across multiple areas of the organization.
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Another phase is to include more educated managers who continued to focus on the
human dimensions but also included more significant facets of the business, such as the
influence of employees on the marketing, communications, and public relations of the
organization, inclusive of a strategic business partner developing tactics for organizational
goals, planning, and implementation through the employees of the organization. This
pragmatic inquiry used the literature’s contribution to show the emphasis human resource
strategies have on employee relations and improvement in employee satisfaction. This
study supported the connection between employee satisfaction and improving patient care
in healthcare facilities through existing literature.
Human Resources Management
Prabowo et al. (2020) advised the importance of human resources in an
organization despite the company’s design. The authors asserted that the Human
Resources entity focuses on the idea and helps the establishment’s employees (Prabowo
et al., 2020). Human Resources recognizes the importance of human capital and will
demand and advocate for the most qualified candidate for the organization despite all
factors adding to the firm’s integrity, innovation, and quality. Cooke et al. (2021)
indicated that the collaborative relationship triggers significant organizational change,
and these changes impact the employees, resulting in perceived trauma and stress in the
workforce. Elgoibar et al. (2021) identified additional unequivocal strengths of human
resource strategies that are beneficial to remedy perceptions during a transitional phase
and emphasized trustworthiness, relationship resolution of conflicts, well-being, and
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influence of parties. These attributes contribute to the positive inception of an alliance
and partnership.
Human resource strategies emphasize the value of alliance as it enables a smooth
transition where mutual trust is achieved. The benefit is a culture of overall organizational
support while possessing the ability to resolve conflicts and accomplish organizational
objectives (Elgoibar et al, 2021). This is a necessary step in the strategic process when there
is an adversarial display of conflicting issues and rewards, and losses are high throughout
the change process. The literature demonstrated the emphasis healthcare organizations
place on medical technologies and evidenced-based medical theories in management while
not emphasizing human resource practices in managing employees. Healthcare
organizations routinely focus on the hierarchy of employees, the highest being the medical
director. However, the literature exhibited the importance of all employees in healthcare
organizations and the impact each has on increasing performance and overall quality of
patient care through the integration of human resource practices.
Human resource involvement in developing policies and procedures is essential to
help leaders implement processes to manage organizational resources most efficiently.
Prabowo et al. (2020) defined the role of human resources as crucial and urgent in an
organization. Is offered human resources roles to maintain organizational continuity, build
community trust, and sustain organizational credibility (Prabowo et al., 2020). Human
resources aim to develop long-term and short-term goals for the organization while playing
an instrumental role in strategic plan development.
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One focus of human resources is to utilize human capital to maximize performance
and result in maximum employee contribution. Prabowo et al. (2020) asserted that human
resources’ performance assessment factors include recruitment or procurement of
employees, training and development, mutation of tasks, and compensation. The
department is also instrumental in healthcare organizations. They assess the current
environment and adapt, improve the organization’s quality by developing and
implementing policies, maintain the integrity of services by implementing organizational
competence, and identify and monitor the work of everyone (Prabowo et al., 2020).
Human resources can assess organizational processes and assist with devising a
strategic plan to improve those processes. Kim (2019) advises that human resources
achieve quantum innovations while enhancing business and being ambidextrous.
Organizational ambidexterity has been acknowledged as a source of sustainable
competitive advantage, and the outcomes include performance growth, perpetual
performance, innovation, and market valuation (Kim, 2019). Ambidexterity is “the
organizational capability to simultaneously achieve exploitation and exploration (Kim,
2019). This strategy is helpful when deciding to implement consultants in healthcare,
identifying creative strategies that improve patient quality.
Another strategy that is instrumental in the role of human resources to help
management effectively manage resources through the strategic plan is ensuring quality in
human resource quality as the critical aspect of achieving optimal organizational
performance. Song et al. (2023) advised that the human resources strategic plan is to nurture
and develop the organizational competence necessary to thrive in a competitive
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environment. Research shows that human resource management and knowledge
management influence organizational performance. Human resources strategies that impact
organizational performance include a focus on improvement strategies, factors including
human resources management, organizational learning, knowledge management,
leadership, organizational culture, actors, alternative approach with the development of
human resources policies, organizational infrastructure, and knowledge management
development of policies, and sub-alternative strategies including conducting recruitment
and selection processes, budgetary support, facilitative leadership, and building a shared
vision. (Song et al., 2023).
Organizational Leadership
Transparency is an essential concept in an organization. Transparency produces a
cohesive relationship between leaders and members of an organization. Employees feel a
part of the decision-making process when there is transparency coupled with providing
feedback. The literature explores the correlation between transparency and an increase in
employee motivation. The literature supports the outcomes of better patient care in
healthcare facilities and an increase in employee motivation. DeVito and Goldacre (2023)
defined transparency as the lack of hidden agendas and conditions and the availability of
complete information required for collaboration, cooperation, and collective
decisionmaking.
Transformational leaders emphasize relationship-building connectivity and
transparency while leading. Northouse (2019) defines transformational leadership as
engaging with others and creating a connection that raises motivation. Moore and Ahmed
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(2021) indicated that transformational leaders motivate people to make organizational
transitions. Moore and Ahmed (2021) showed that leadership and motivation are mutual
interactions, and followers have the most motivated leadership. Employees can be
stimulated when they feel part of the process and when leadership is transparent about
strategic plans.
DeVito and Goldocre (2023) identified that although transparency is ideal within
an organization, not all decisions should be made in the open and stated that stated decisions
should be personal, salary, and performance. The processes for these issues should be
transparent to employees, but the individual information should remain confidential.
Information that may cause high anxiety or make employees question the organization’s
stability may also be considered information carefully shared. Albrecht and Roughsedge
(2023) asserted that staff should know and understand the context of decisions and the
happenings as they react negatively when they do not know or understand the context.
Leaders can exert influence using transparency with employees as they establish trust.
Employees feel free to communicate issues and be part of the resolution openly. DeVito
and Goldacre (2023) noted that the relationship is a building block that allows a more open,
honest flow of ideas where staff and constituents are valued.
Management strategies are an essential theme in the research. For healthcare
consultants to be beneficial in helping management processes for the long term, policies
and procedures must be developed outlining their utilization. Human Resources
departments are instrumental in developing organizational policies that enable employees
to produce efficiency in identified roles. The issue of ethics in healthcare with consultants
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and transparency has been an issue of concern. The literature for implementing the strategy
of using consultants in healthcare while having a plan to protect patients and their medical
information must also be researched. Endalamaw et al. (2023) inquired about how some
healthcare organizations need to improve quality processes and studied the improvement
efforts and implementation despite barriers.
The methodology of organizational systems has become a more significant focus
as it studies the when, why, and where organizations can be successful. Research illustrates
evidence of improving quality in healthcare through building community alliances and trust
in the healthcare system (Endalamaw et al., 2023). The current trend of emphasizing quality
improvement and quality identifiers impacting healthcare demonstrates a needed shift in
performance improvement and implementation.
Change in Organizational Culture
Culture and leadership are purposely connected in organizations. Saeed et al.
(2023) stated that leaders must understand the importance of strategy and culture in
building a successful organization and prioritize both in their decision-making practices.
Saeed et al. (2023) stressed the importance of culture. They indicated that culture is
recognized as such a significant factor in an organization’s success that Fortune’s annual
Best Companies to Work for are based on anonymous reports about workplace culture.
Northouse (2019) defined culture as learned beliefs, values, rules, norms, symbols,
and traditions common to a group of people. Creating a cohesive organizational culture is
a high priority for organizational leaders. The literature correlates exhibitions of the impact
employee satisfaction in healthcare have on the quality of patient care. This assertion also
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supports theories of the impact of culture and group thinking. Focusing on connectivity and
accessibility to leadership while creating a culture of cohesion is a strategy for success.
Highlighting the leadership’s desire to be a part of the team and connect with
management and those on the front line with the customers is an important message. Staff
should know they have support from leadership and direct access to the support.
Leadership’s ability to create cohesion and trust in the culture is instrumental to this
strategy’s success. Mohammed and Al-Abrrow (2023) stated that bringing a team together
and giving them a shared purpose helps employees determine what the group stands for
and how to better deliver on their business goals by working toward the desired culture.
Strategic Planning of Human Resources
Research suggests that developing the leading management team in a buy-build
circumstance is vital to the organization’s growth. The human resources strategic partner
plays an instrumental role in communicating with staff and advocating for staff through
situations of transition and change. Through outsourcing or a business partnership, an
organization’s ability to recognize the value of new information, assimilate it, and apply
it is vital to achieving organizational goals (Andrieiev et al., 2023). The study will support
the imperative nature of employees having an avenue they trust to express grievances,
make suggestions, and feel empowered as change agents.
Absorption capacity is the key to organizational growth, and the building blocks
of strategic plans depend on core processes and strategic capabilities (Andrieiev et al.,
2023). This pragmatic design will suggest strategies to integrate into a healthcare facility’s
strategic plan by exploring leadership practices in a healthcare facility. Malvestiti et al.
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(2021) identified integrating organizational capacity with knowledge from external
sources, education, and the accessibility of additional information. An indestructible
human resources strategic partner will introduce and maintain the motivation to achieve
organizational goals through outsourcing processes and absorption capacity from external
sources. Innovation is the key to growth in an ever-changing global society and indicates
sustainability in an organization’s capacity absorption.
Malvestiti et al. (2021) identified organizations’ multifaceted responsibilities and
noted the social, environmental, and economic factors. Sustainability includes
profitability, human capital, business assets, internal organization culture, and external
financial, ecological, and social issues. Human resources strategic partners must possess
a solid plan for absorption capacity and seek knowledge and innovation from other
sources to maintain a competitive market position (Malvestiti et al., 2021). Through the
guidance of a strategic alliance, the strategic plan positions the organization to identify
and obtain new knowledge and innovation to assimilate current practices and resolve
organizational issues that affect society at large.
The results from this research may contribute to positive social change by
increasing the quality-of-care patients receive, as this action enhances the lives of
individual recipients on a micro level and the communities of those individuals on a macro
level. Organizations possess a unique opportunity to remedy societal challenges in
healthcare by implementing human resource strategies of shared value and inclusive
growth while instigating social change and stimulating economic returns (Malhotra et al.,
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2021). This study will show the impact of positive social change with support from
peerreviewed literature.
The steps utilized for a successful collaboration include the participation of all
parties in creating a plan for organizational capacity, taking advantage, and using the
existing talent internally. This study assesses resources and managerial capacity, a
reconceptualization of an organization’s objectives, and how they sustain the business
and stay with the flow of innovation in health care. The study supports the recognition
that employees are a vital organizational resource and create the capacity to assess and
grow employees’ cognitive abilities to develop innovations.
Policymakers can also create organizational capacity; strategic partners and
organizational policymakers such as HR and government policymakers withhold this
power. Human resources leadership is integral to developing policies that impact a
managerial process. Jo et al. (2024) indicated that strategic partnerships are essential in the
strategic construction of operations and the organization’s perceptions by the staff. Human
resources strategic partners can shape the outcome of an alliance as they are a direct line to
the staff. The process will only succeed if the employees support an organization’s
development, growth, and sustainability efforts. Goggins and Rau (2021) identified that
sustainability is an organizational objective and consistent and that systems and
productions of consumption in organizations play a significant role in accomplishing
sustainability.
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Embracing Organizational Change
Strasek et al. (2020) identified that the objective of relationships in businesses is
to relate to resolving organizational issues by exploiting organizational opportunities.
Connectivity is such an important concept in organizations. Showing interest in the
people who support the organization is essential. Leaders need to be more careful when
they believe their position as leaders is an automatic relationship of loyalty and trust.
These relationships must be developed and cultivated. Leaders also need to consider
work-related and, at times, life issues that negatively impact operations and cause
employees to be unhappy. This failure results in a lack of support from human capital.
This inevitably impacts organizational productivity, and employees are likely not
motivated to produce the best results.
Human resources strategic partners can help cultivate this organizational culture by
leading by example and connecting with all levels of employees within the workforce,
training and developing leaders and managers to promote this organizational culture, and
developing policies and procedures to ensure this is an organizational expectation. Strasek
et al. (2020) indicated that the objectives of strategic business relations relate to resolving
development problems and exploiting organizational opportunities. Eliminating the deficits
of available funds and exploiting available resources is a common goal between strategic
allies.
Strasek et al. (2020) stated that the success of the strategic alliance is determined
by developing cooperation with partners that focus on the success of the future business.
The study will illustrate through the literature that success is measured by total
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performance, profit, sales, company growth, market share, growth, and potential capital
(Strasek et al., 2020). Healthcare facilities can demonstrate an increase in quality of care
while improving profitability by implementing human resources strategies in
management.
Benefits and Consequences of Organizational Change
Positive change initiatives are essential to the core of an operating plan; the study
will define the importance of a successful operational plan and roles delineated by
healthcare leaders using human resources functions. Organizations strive to develop
initiatives or base business on positive social change, focusing on promoting positive
change in the external environment. The agendas are not driven solely by profitability but
focus on results that positively impact people or the environment.
Malvestiti et al. (2021) identified the importance of positive social change through
actions of changing thoughts, behaviors, and the domain to benefit outcomes locally and
globally. An operating plan should examine the risks and benefits of integrating a positive
social change into an organization’s operating strategy. Another key to the successful
implementation of an operational plan is strategic alignment. The consequences of failed
social change initiatives include neglecting to align with the organization’s strategic plan,
loss of profits, and decline in stakeholder support.
Aburmishan and Baum (2022) identified benefits as alignment with the
organization’s strategy and motive and stakeholder involvement and motivation. Other
services include positive profitability, enacting global change, and influencing the market
and industry. The operational plan must align with the organization’s missions, values, and
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philosophy. This study will illustrate the advantages of healthcare facilities’ alignment of
the relationship with employees and stakeholders.
Increasing Performance Improvement
The literature will support the study by demonstrating the successful
implementation in a healthcare organization. The literature suggests a total synthesis of the
healthcare market, including profit analysis, analysis of competitors, and potential growth
assessment. This process is completed during the strategy formulation phase, but leaders
must know that the implementation phase is equally important to ensure effective business
strategy execution. Dyer et al. (2020) identified the three strategic change tools as building
alignment between the organization’s segments, strong leadership for effective
implementation and cohesion, and measuring strategic performance by developing a
measurement system. These tools ensure the carry-over of strategy formulation and
development to strategy implementation. Successful implementation depends on
leadership to ensure proper alignment between the strategy, communicating the process to
the followers, and using strategic change tools. Using the tools recommended in the
literature will exhibit positive change and organizational growth in healthcare facilities.
Implications of Change on Employees
The literature suggests the need for a healthcare organization to assess the
company’s strategic plan continuously. Remaining in sync with changes in the
environment, technology, the work environment, and societal changes may require a shift
in strategic planning. Developing a new strategic plan is also necessary to ensure the
organization is not operating under antiquated and inefficient systems. This pragmatic
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design will use the literature to assert the benefits of utilizing the five phases of strategic
planning for successful change implementation. There are five phases to strategic planning.
Shamuratovna et al. (2024) identified the five phases of strategic planning: developing the
strategic planning position, analyzing the strategic plan, gap analysis, formulating a written
strategic plan, and continuing to review and track the strategic plan. These steps are
essential in assessing the need to shift a strategic plan in an organization.
Another critical phase to be highlighted and included as a strategic planning phase
is communicating the plan to the stakeholders. Devising a strategic plan but failing to
communicate the plan effectively will fail the plan. With appropriate communication of
the plan, stakeholders will be aware of the organization’s goals and the plan to
accomplish the goals. Freudenreich et al. (2020) indicated that stakeholder relationships
are vital to the functionality of an organization, as the withdrawal of support from
stakeholders directly affects the sustainability of an organization. This proves why
communication and stakeholder buy-in are instrumental to shifting an organization’s
strategic plan. Reviewing and tracking the strategic plan for success is another crucial
step. It provides information to planners of strategy in an organization if changes in the
strategic plan are necessary.
Measuring Performance Improvement and Outcomes
The study will use literature to support the theory of integrating human resources
strategies in management practices in healthcare facilities to improve the quality of patient
care. Strategic change and developing cohesion with the change is an act that does not
occur overnight and is a time-consuming process. During this process, management must
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assess progress toward organizational goals and strategy (Dyer et al., 2020). Measuring
tools are practical in gauging progress toward goals and evaluating progress in strategic
organizational change. Dyer et al. (2020) defined line of sight as the principle that followers
and leaders in a company should connect their respective duties and overall organizational
goals. Another measurement tool is the balanced scorecard. Dyer et al. (2020) define a
balanced scorecard as a tool that measures equally aspects of an organization to meter;
these measurement areas are devised from the organization’s strategic plan: financial and
profitability goals, consumer goals, systems and process goals, and innovation and growth
goals.
Measurement is an essential tool to focus on. It helps leadership make instrumental
decisions about implementing continued change, implementing innovation when to enter
another market, how to do so, and the projected time (Dyer et al., 2020). The study will
use the literature recommendations to adequately measure quality outcomes for patients
through an examination of strategic influence. These strategic influences include
environmental technological advances and impact measurement tools. Other geographic
regions may have various supply and demand needs, which affects the measuring tool, and
there will be a need for a varied tool.
External and internal factors impact the implementation of strategic changes but do
not impact the measurement tool, as it is necessary for all organizations to assess the
performance of strategic goals and changes. Jo et al. (2024) indicated that the usefulness of
a measuring tool would include teamwork between departments and with followers and
leaders, a high level of communication within the organization and externally with
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consumers and stakeholders, built on the strategy of the organization, clear understanding
and transmission of the relationship between strategic objectives and tasks, compensation
initiative linking compensation and attaining organizational goals, and continuous
assessment, reassessment, and revision of the measuring tool. Utilizing a measuring tool
when integrating human resources strategies in a healthcare facility is imperative to
deciphering successful integration, amending the strategic plan to ensure successful
implementation of the approach, and identifying opportunities for improvement in the
inception of these functions.
Exploring organizational strategic plans healthcare leadership utilizes to improve
organizational performance. Human resources leaders create unique value in healthcare
organizations, delivering quality and expertise to develop and maintain an organization’s
processes and systems (van Nisterlrooij & Homan, 2019). The research identified that
sixty-eight percent of organizational leaders identified specialized skills as a benefit to
employing consultants, and sixty-two percent of leaders noted quality as an additional
benefit (Van Rossem, 2021). The background and overview of the general and specific
problem were identified in the pragmatic inquiry design.
The literature provided evidence of the benefits of integrating human resources
functions in strategic planning and the impact of positive change integration in healthcare
facilities. Reviewing the theoretical framework as a guide to the research identified critical
concepts in Lewin’s change management theory to identify strategies to improve medical
practices and the quality of care, which helped illustrate the research’s underlying focus.
Identifying areas of needed improvement for management in healthcare, identifying
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strategies that have been successful in the integration of implementing change management
processes in healthcare organizations, and identifying ineffective management practices
will help with recommending the incorporation of strategies for successful incorporation
of human resources management techniques to increase quality in patient care.
Assumptions and limitations in the literature were identified as unidentified beliefs and
circumstances in the study beyond the researcher’s control.
Transition
A critical analysis of supportive literature was introduced in section 2, and the
data was synthesized to identify common themes and phenomena in this pragmatic
inquiry. In Section 3, the use of ethical research codes to identify the researcher’s role,
participants’ eligibility, and the interview protocol was highlighted. In Section 4, the
findings are presented.
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Section 3: Research Project Methodology
The research supports the benefits of human resource function implementation in
healthcare management by examining human resources’ role in strategic planning,
illustrating the long-term benefits and challenges of implementing strategic planning in
healthcare facilities. Comprehending the role of human resources and leadership in
healthcare facilities is instrumental in assessing human resources strategies in management
practices. Weighing the benefits and consequences of moving to a human resources-based
management style is imperative to increase performance and the quality of care in
healthcare facilities. Once a change has been embraced and implemented in the
organization, outcomes and performance measurements of the success of the integration
can identify successful integration and opportunities for improvement.
Presenting literature to support the business problem in this pragmatic study and
grounding study design with Kurt Lewin’s change management theory contributes to
qualifying the impact implementation of human resources in healthcare to improve the
quality of patient care. The qualitative study design will outline the research process of
the pragmatic inquiry, explicitly describing the role of the practitioner in the data
collection process and the practitioner’s relationship with the topic and participants. The
study’s data will also explain the research method, design, population, sampling,
participants, data collection activities, data organization analysis techniques, reliability,
and quality indicators.
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Project Ethics
Researchers in qualitative studies act as a tool for collecting and implementing data
to introduce research (Howard, 2021). I qualified the data presented by assessing the
information gathered, incorporating data to support the research question, identifying
appropriate participants for data collection, and providing instruction on the direction for
the data collection strategy (Subedi, 2024). One data source in this study is open-ended
interviews with human resources managers and senior managers designated in an
organization. Another source is supportive data from public information about policies and
procedures on organizations.
Healthcare leaders are faced with maximizing standards of care. Many healthcare
leaders are faced with analyzing strategies for efficiency for management resources. Pemer
et al. (2020) indicated that top leadership has the discretion to fundamentally affect
organizations’ outcomes and actions. This pragmatic inquiry solicited participants from
healthcare leaders from organizations in the Southeastern and Northeastern regions of the
United States with experience implementing human resource strategies in management
practices. Potential participants were identified through research by gathering a list of
healthcare leaders to be emailed an inquiry for participation. There was no previous
relationship with this study’s topic or potential participants.
Establishing initial communication with potential participants is imperative, and
communicating the importance of maintaining confidentiality is imperative in
establishing rapport with participants (Sperling, 2022). The Belmont process provides a
road map that researchers can follow to meet the moral requirements of respecting
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participants in a translational and understandable study. This pragmatic study followed
the framework of the Belmont process. Participants had the option of open flexibility in
scheduling and location for the interviews; this practical design further strengthened the
relationship with participants by soliciting healthcare leaders to provide a lived
experience as leaders in healthcare facilities who utilize human resources strategies for
quality improvement. Guaranteeing participants understanding of the research protocol,
the interview process, their role in the process, and the procedure to withdraw from the
process was the base of this pragmatic inquiry. The IRB’s informed consent form, which
is included in Appendix A, was reviewed and used with participants to guarantee their
understanding of the research process. Consent was obtained from leaders who agreed to
participate. Once consent was obtained, participants received an explanation of the
interview protocol in Appendix B, ethical protection, and ways to withdraw. Ethical
protection and anonymity of participants were clarified. The method of data storage was
reinforced for the protection of participants.
Specific characteristics for the selection of leaders in an organization to provide an
analysis process for the efficiency of management resources for business processes and
systems is imperative. Participants’ roles aligned with the analysis process to aid
healthcare leaders in maintaining management activities, strategic development, business
processes, and systems. In qualitative research, information from participants through
shared experiences provides invaluable data specific to the individual’s encounter.
Healthcare facilities and providing significant knowledge to organizational leaders
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conducive to utilizing human resources strategies for management activities, providing
opportunities to focus on patient-specific needs.
Nature of the Project
The three research methods are qualitative, quantitative, and mixed (Park et al.,
2021). Qualitative research methods are used for data collection and interpretation of
results provided by participants’ lived experiences. A qualitative methodology enables a
researcher to collect data in an interview or a non-numeric data analysis procedure
(Subedi, 2024). Qualitative research also allows the comparison of themes across groups
(Munthe-Kaas et al., 2019). In contrast, quantitative researchers use data collection
through a questionnaire or data analysis through graphs or statistics (Subedi, 2024).
Mixed methods research includes qualitative and quantitative components (Park et al.,
2021). Qualitative research methodology is the most appropriate for this study as it
provides lived experience from healthcare providers to observe this research phenomenon.
This qualitative, pragmatic inquiry targeted leaders in healthcare facilities and the
integration of human resources strategies to benefit management practices and positively
influence the quality of care for patients. This qualitative, pragmatic inquiry scouted
leaders in healthcare facilities who integrate human resource strategies to benefit
management practices and positively influence the quality of care for patients.
The research design is a pragmatic inquiry to address the research question in this
qualitative study. Semistructured interviews are appropriate for this study because, in
qualitative studies, is explore observations of the behaviors from the participants’
perspective. By utilizing a qualitative research design, I was provided the opportunity to
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gather data and accomplish data saturation, examine fieldwork, and use reflexive
interpretation (Chitac, 2022). Data will be utilized to address the research question, and
various strategies to improve performance in a healthcare facility will be identified and
explored using a qualitative case design approach. Qualitative research also enables the
comparison of themes across groups (Munthe-Kaas et al., 2019).
The benefit of pragmatic inquiry is that it is a research design that can be utilized
in a qualitative study to analyze human resources strategies by analyzing various research
theories. Pragmatic designs incorporate reflexivity with research literature to solve a
business problem (Levitt et al., 2021). The qualitative research method and pragmatic
inquiry design were selected because I intended to understand how inefficient utilization
of management resources necessitates leadership to employ human resources management
strategies to help re-institute value and expertise
Population, Sampling, and Participants
The targeted population was purposely selected to comprise healthcare leaders
from the Northeastern and Southeastern regions of the United States who work in
healthcare facilities and have facilitated strategies to analyze the efficient use of
management resources. I gained leadership access through email and inquiry about
participation in a study focusing on management practices and patient outcomes. Then, I
followed up with a phone call to affirm participation and clarify questions about
participation. The final step was for the participants to provide written consent for
participation. I completed several actions before beginning the data collection process,
inclusive of the identification of healthcare facilities to participate in research, recruitment
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of organizations through communication, an explanation of the research question,
agreement from organization to participate, completion of affiliation agreement,
identification of individual participants, and submission to university for request to begin
collecting data. Participants recruited for this pragmatic inquiry were 20 leaders in
healthcare facilities from healthcare facilities in the Northeastern and Southeastern
regions of the United States. Purposeful sampling was used to recruit for participation in
semistructured interviews to provide a lived experience of utilizing human resources
strategies to improve patient quality of care. Each participant was interviewed with a set
of research questions. The answers provided were analyzed to identify themes. I ensured
data saturation by analyzing the data obtained in interviews. The interview process was
conducted virtually via Zoom. I established a working relationship with participants
through open, transparent, and ongoing communication efforts, reassurance of
confidentiality and protection from organizational retaliation, and assurance of flexibility
with the interview time and place.
The research development process rendered 11 potential healthcare leaders to
participate in the study. Nine participants responded, and one leader needed to meet the
participant criteria due to limited employees and unstructured and documented
management practices. Two of the requested participants declined due to new management
and a lack of willingness to provide to be interviewed. Seven participants agreed to
participate in the study. Purposeful sampling was used to assess if participants are qualified
to participate in the research meeting standards. Qualitative research enables a researcher
to conduct a thorough and in-depth analysis of data provided by participants in the study
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(Munthe-Kaas et al., 2019). Using fewer participants allowed me to provide an in-depth
analysis of an organization’s standards, operating procedures, and processes instead of
solely using numerical probability (Howard, 2021). A smaller population supports evidence
to answer the research question and allows a researcher to obtain information for the study
through observation and participants’ lived experiences,
Recordings helped with facilitating reliability and validity in the study. In
qualitative studies, data saturation strengthens scientific accuracy (Levitt et al., 2021).
The method of data saturation provides an ethical guarantee that the participants in the
research and the data analyzed meet ethical transparency and give depth of information
based on sound research practice. McGill et al. (2021) define the concept of data
saturation as the process of guaranteeing that the data collection process renders no
additional information or themes. Interviews will be conducted with leaders from
healthcare facilities in the Northeastern and Southeastern regions of the United States. to
seek data saturation actively. Data saturation will be ensured by clarifying information
when questions are asked, expanding the information provided by participants, and
identifying all codes and themes. Methodological triangulation will be utilized to
guarantee the level of depth in data and to illustrate that data saturation is met.
The quality of data collected is essential in research. Data saturation in pragmatic
inquiries does not have a minimum or maximum requirement but is focused on the quality
and depth of information obtained (Tomaszewski et al., 2020). The varied experiences of
healthcare leaders and their individualized management perspective will enrich and
support the research provided in the study.
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Data Collection Activities
This researcher was the primary data collection instrument. Semistructured
interviews, policies and procedures from organizations, and public information on the
organization’s website were utilized in the data collection process. It is vital to have an
interview protocol as it is essential to have a road map to guide the interview process.
Ensuring neutrality in research is imperative; I followed the research protocol, and the
ethical guidelines provided by the IRB, utilizing the triangulation method, member
checking, and providing an in-depth analysis of the data through a review of interview
notes. Participants received verbal and written explanations of the interview protocol (see
Appendix B).
Researchers facilitating pragmatic inquiry studies use data obtained from
participants’ lived experiences and data provided about the organization to develop a more
in-depth understanding of phenomena; ethnographic studies describe, analyze, and
interpret a culture’s characteristics. The qualitative research method and pragmatic inquiry
design were selected because I intended to understand how inefficient utilization of
management resources necessitates leadership to employ consultants to help reinstitute
value and expertise in healthcare organization business processes. Data, theoretical,
methodological, and investigator triangulation will reinforce the study’s validity through
discernment of the data. (Sabnis & Wolgemuth, 2024) compared the methodology of
confirmability to achieving objectivity in qualitative research and associated the concept
of consistency in research with confirming the data collected. The final product of the study
must result from the data presented by participants. Researchers must be careful not to
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influence the data based on biases and personal beliefs. Data, theoretical, methodological,
and investigator triangulation reinforced the study’s validity through discernment of the
data. The final findings of the study must be the results from the data presented by
participants.
Data collection techniques are vital to achieving reliability and validity, and the
advantages enhance the reliability and validity of the study. All data will be protected and
stored in a safe that only I can access for at least five years; after this, all research records
will be destroyed. The disadvantage of integrating a formatted data collection technique is
providing accurate and valid data in a study that cannot be used to support the research
problem. Participants were integrated to avoid the issue of delivering invalid, inaccurate,
or biased data. (Brear, 2019) indicated that member checking aids the research in gauging
the participants’ priorities and helps structure a research agenda. Member checking guides
the process of data saturation. I summarized the data provided by participants to inquire
about validity and interpretation. Participants were provided a chance to explain, amend,
or expound for data clarification. Once I can no longer identify additional themes, data
saturation is achieved when it is no longer possible to code additional information, build
on the information presented in the research, and when the data in the research study can
be replicated (Naeem et al., 2024). Member checking guides the process of data saturation.
I will summarize the data provided by participants to inquire about validity and
interpretation.
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Interview Questions
1. What human resource strategies assist you in identifying performance
problems?
2. What human resources strategies assist you in meeting performance goals and
expectations?
3. How do employees respond to your management techniques, including your
integration of human resources strategies?
4. What human resource strategies do you use for managing resources?
5. How do you utilize human resources strategies in managing staff, and what
human resources methods are most helpful in your management techniques?
Why?
6. How has utilizing human resources strategies in your management style
increased the quality of patient care?
7. How does utilizing human resources strategies in management demonstrate
improvement in patient quality of care?
8. What additional strategies or resources that we did not discuss could help
facilitate success in human resource management?
Data Organization and Analysis Techniques
The data organization and analysis entailed gathering interview information to
understand techniques to achieve organizational goals. Participants were asked to identify
strategic goals and methods for managing organizational resources using data collected and
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information analysis to support the integration of human resources strategies to mitigate
management inefficiency. Thematic analysis was used in this qualitative research design to
analyze collected information and identify themes (Scharp & Sanders, 2019). As a
researcher, content should be reliable so others can utilize your research to create new
thoughts about a particular phenomenon or theory. NVivo was used to operate and identify
emerging themes in the study; this database will attribute reliability to homogeneity,
stability, and equivalence (Munthe-Kaas et al., 2019). To analyze data, notes, and journals
taken were used to ascertain information, recordings of interviews will be reviewed, and
details provided through member checking were analyzed.
A qualitative study can use three research designs to analyze management resources
and the benefits of employing human resources strategies in healthcare management:
pragmatic inquiry, ethnographic, and narrative. (Tomaszewski et al., 2020) asserted that
research is validated by triangulation between multiple resources and advised that there is
a direct link between triangulation and data saturation. Naeem et al. (2024) urged
researchers to focus on the depth of the presented information and ensure data saturation.
Various triangulations can be used during the research process (methodological, theoretical,
data, investigator, and environmental). Triangulation that emphasizes objectivity and
confirmability will reduce bias influence. Naeem et al. (2024) recommended organizing
data by taking notes and memos throughout the process; I will utilize a journal and
recordings to guarantee a stable process to code the data, analyze the information, and
interpret data for presentation. All data will be protected and stored in a safe that only I can
access for at least five years; after this, all research records will be destroyed.
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Reliability and Validity
Reliability is essential as it references the suitability of the measurements being
used and poses the following questions: Do the measurements being used investigate the
phenomenon being studied, are the data and results of the research accurate, and what do
the results conclude, and do the data represent general issues and conclusions (Sabnis &
Wolgemuth, 2024)? Validity is also crucial as it has several aspects of validity to illustrate
the intention of the data presented. Reliability and validity are vital in research as both
define the credibility of a scholar’s research. Naeem et al. (2024) asserted that unreliable
research inevitably will be invalid and will not contribute to the research of the
phenomenon. There are distinct differences between the two measurements. Reliability
addresses dependability in a research study (Sabnis & Wolgemuth, 2024). This researcher
used member checking, triangulation, and data saturation measurements to ensure research
credibility.
Reliability
Sperling (2022) identified threats to reliability as participant error. These threats
were defined as any issue that negatively impacts how a participant interacted in the
research; another threat is participant bias, which was defined as any issue that affects an
accurate or true response from a participant; a third threat is researcher error, defined as
any issue that skews researcher interpretation of the data collected by the participants, and
researchers bias which is defined as any issue that persuades bias in Is’ data notation. This
researcher maintained awareness of biases and remained conscientious of leading during
the interview process to avoid threats that impact the quality and validity of participants.
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Validity addresses how credible and transferable it is and confirms the data contained in
the presented data. Researchers conduct four tests to ensure quality, validity, and reliability
in a research project (Sabnis & Wolgemuth, 2024). Construct validity identifies the accurate
measurements in operation for the studied methods (Sabnis & Wolgemuth, 2024). Internal
validity assesses the relationships that are the catalysts for the next occurrence and
identifies the causal relationship; external validity assesses if data is in a pragmatic inquiry
in general; and reliability assesses the functioning of research and demonstrates that the
methods of collecting data can be repeated.
Member checking and triangulation are two methods used in this qualitative case
pragmatic inquiry to validate data and demonstrate reliability. In qualitative research,
credibility is defined as a measure to gauge perceived facts through approximation and
deduction of particulars provided by study participants (Sabnis, & Wolgemuth, 2024).
Assurance of the accuracy of the data through verification provided opposed
presumptions of data collected. Member checking is a method this research will use to
interpret data by checking the accuracy of interpreting the information when collecting
the data (Sabnis & Wolgemuth, 2024). Research credibility is defined as a measure to
gauge perceived facts through approximation and deduction of particulars provided by
study participants (Sabnis & Wolgemuth, 2024). Assurance of the accuracy of the data
through verification provided opposed presumptions of data collected. Member checking
is a method this research will use to interpret data by checking the accuracy of
interpreting the information when collecting the data (Sabnis & Wolgemuth, 2024),
2021). Following the interview protocol, clear and methodological triangulation are
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additional measures that will be integrated to illustrate the credibility of data collected in
the study.
Validity
To achieve consistency, reliability, and validity this researcher will organize data by
taking notes and memos throughout the process through a journal. This researcher also
utilized recordings to guarantee a stable process to code the data, analyze the information,
and interpret data for presentation and assurance of research quality. Research quality is
the process of validating data collected. Grey et al., (2019) indicated that academic
institutions and research review boards must uphold research integrity. Validating research
is essential in maintaining quality and ensuring integrity in the information provided. Three
types of evidence that can be used for validity are homogeneity, convergence, and theory
evidence. (Sabnis, & Wolgemuth, 2024) added that the research process comprises
collecting data systematically, interpreting data systematically, and devising a purpose to
resolve a problem. The IRB is charged with oversight to ensure the research process has
integrity and validity. Sabnis and Wolgemuth, (2024) defined validity as the suitability of
measures used, precision of analyzed data, and universality of results.
In qualitative research, transferability is a notion parallel to reliability (Sabnis &
Wolgemuth, 2024). The concept supports the credibility of the data by illustrating the
relevance and unity of information provided by participants in the study. Sperling, 2022
asserts that the research must demonstrate the accurate perspectives of participants who
provided study specifics. This information can be used for integration in additional
settings to support future research. I presented various methodological evidence to
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contribute to subsequent studies. Naeem et al., 2024 compared the methodology of
confirmability to achieving objectivity in qualitative research. The final product of the
survey resulted from the data presented by participants.
Transition and Summary
In this pragmatic inquiry study, I examined the integration of human resource
management strategies to improve the quality of care in healthcare organizations.
Through semistructured interviews and public organizational information the findings in
this qualitative, pragmatic inquiry explored the techniques leaders in healthcare use to
integrate human resource strategies to benefit management practices and positively
influence the quality of care for patients. Naeem et al. (2024) asserted that research is
validated by triangulation between multiple resources and advised that there is a direct
link between triangulation and data saturation. Naeem et al. (2024) urged researchers to
focus on the depth of the presented information and ensure data saturation. Data,
theoretical, methodological, and investigator triangulation will reinforce the study’s
validity through discernment of the data.
I’s role is reinforced by identifying the purpose of this qualitative research study.
The role of I is analyzed through the identification of utilization of the standards and
protocols of research, including recruitment and selection of participants, ethical roles and
responsibilities of I, identification of the research method, and the research design utilized
for the studied sample population. Identifying details of the data collection proposed for
use in the study, processes to organize the data in the study, and measures of assurance for
analysis, reliability, validity, confirmability, transferability, and achieving data saturation
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asserts the ethical guidelines to be followed in the study (Aqil et al., 2023). An explanation
of the data collection process is for evidence to support the research question.
In this pragmatic inquiry, I focused on the presentation of findings in section 4.
Outcomes were based on information received from participants interviewed in the study,
standard operating practices in the healthcare organizations studied, and the impact the
research data will have on social change and implications for future research
demonstrates the comprehensive research process that will be followed to provide a
recommendation for the business problem of some healthcare leaders who lack strategies
to use human resource functions to enhance organizational processes and systems for
improving performance. The section’s information will identify how the data contributes
to the business theory and provide professional practice recommendations.
Section 4: Findings and Conclusions
Introduction
This pragmatic inquiry study aimed to answer the research question: What human
resources strategies do healthcare leaders use to enhance organizational processes and
systems for improving performance? Semistructured interviews with seven leaders in
healthcare organizations in the northeastern and southeastern regions of the United States
who have implemented human resources strategies in management practices to improve
organizational performance were conducted for data analysis in the study. To maintain
anonymity, participants were assigned a numeric code throughout the interview process:
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Participant 1, Participant 2, Participant 3, Participant 4, Participant 5, Participant 6, and
Participant 7. NVivo was utilized to verify manual codes ascertained and was
instrumental in qualifying and analyzing interview data.
The data analysis process included labeling transcripts, importing transcripts,
identifying patterns, assigning codes, utilizing NVivo for data analysis, containing codes
based on context, and reassigning codes. O’Callaghan et al. (2024) identified the
descriptive nature of themes, indicating a pattern of shared designs grouped to
demonstrate reliability. Three main themes materialized from the analysis: (a) analysis,
(b) approach, and (c) assessments. In this section, the data presented will illustrate a
correlation between themes, the conceptual framework, and supportive literature from
peer-reviewed articles.
Presentation of the Findings
Three main themes materialized through analyzing the data: (a) analysis, (b)
approach, and (c) assessments. The study’s conceptual framework is based on Kurt
Lewin’s change management theory. The change management theory aligns with the
study’s foundational premise as it assesses organizational change and its implementation
process change. In this pragmatic inquiry, the data obtained in the research outlines
strategies healthcare leaders use to integrate and influence change to improve
performance.
Participants emphasized the importance of assessing performance to determine if
an organizational change is needed, utilizing their management approach to influence
organizational change, and analyzing assessments to determine the success of the
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implemented organizational change. Participants emphasized the importance of assessing
performance to determine if an organizational change is needed, utilizing their
management approach to influence organizational change, and analyzing assessments to
determine the success of the implemented organizational change. Concepts from
established human resources management literature emphasize internal data analysis,
humanistic managerial approaches, and an overall societal influence on patient quality of
care (Weiszbrod, 2020). Integrating Lewin’s change management theory in human
resources management strategies enhanced the evidence of improved performance in
healthcare organizations.
Theme 1: Analysis
Improving performance in healthcare organizations remains multi-layered as
leaders strategize to increase customer service to clients, employees, and external
constituents. Managing performance improvement challenges leaders in making
decisions and implementing change. Healthcare leaders act as change agents and devise
strategic plans for successful organizational transitions. Participants identified that
utilizing human resource strategies in developing a strategic plan is integral to
organizational evolution. Developing a strategic plan assists leaders in organizations in
formulating business strategies. The strategic plan can be a roadmap for organizational
growth and development. Organizational leaders use data analysis and performance
indicators to assess strengths and opportunities for improvement. Participants 1, 2, 3, 4,
and 6 indicated that data and analyzing the information rendered are imperative in
determining organizational needs.
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Performance analysis in healthcare is used to meet and exceed operational goals.
Utilizing performance-based competencies is instrumental in evaluating and measuring
goals (Golec & Karadeniz, 2020). Some participants agreed that data analysis tools
should be used to assess employee strengths, weaknesses, and needs. Participant 4
asserted that performance problems were identified “by a basic trend analysis.”
Participants 2 and 6 identified using a gap analysis to “assess if employees have what they
need to maximize productivity or if additional resources are needed. Participants 2,
3, 5, 6, and 7 emphasized the importance of performance assessments or appraisals to
“communicate job functions and expectations, provide feedback, receive input of needs,
rate strengths and opportunities for improvement, and goal setting. Participants 2, 3, 5, and
7 emphasized the importance of performance assessments or appraisals to
“communicate job functions and expectations, provide feedback, receive input of needs,
rate strengths and opportunities for improvement, and goal setting.”
Leaders in healthcare organizations use patient surveys to measure the
achievement of performance goals. Ogaji (2022) highlighted the ethical, unbiased, and
valuable significance of patient participation in identifying organizational goals in
healthcare. Patient feedback about the receipt of care allows them to play a role in
improvements in service delivery. It will enable leaders to identify areas of needed
improvement and organizational strengths (Ogaji, 2020). Participant 5 recognized the
importance of patient feedback, adding, “The clients have a sense of agency connectivity
and a belief that their needs are a priority.” Participant 4 and Participant 2 added, “It
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increases patient responsiveness and trust in the organization when clients and families
feel their concerns are a priority and addressed promptly.”
Associating Change Theory to Analysis
Kurt Lewin’s change management theory supports organizational leaders
integrating human resource strategies by identifying balancing forces that provoke
change. The theory of pretense assesses an organization’s driving and restraining forces.
Healthcare leaders are challenged to provide high-quality services by improving
performance. Bamonti (2021) identified an additional challenge that managers in a
clinical capacity lack the skills and knowledge base to assess capacity. Participants 1, 2,
3, 5, and 6 verbalized the importance of healthcare leaders understanding organizational
needs and what tools are needed to meet those needs. Participants identified a connection
between employee satisfaction and increased performance and identified that one of the
most critical steps in gauging the need for organizational change is analysis. Healthcare
leaders identified ongoing performance analysis, patient analysis, and gap analysis as the
most common tools of performance indicators.
Analysis can be linked to the initial stage of Lewin’s change management theory,
unfreeze. Analysis helps healthcare leaders identify why the change must take place.
Analyzing the data provides key indicators of what needs to change and substantiates why
change is necessary. Vendette and Thundiyil (2023) noted the importance of leaders
studying the implications of change by embracing the process and normalizing resistance
and other negative impacts of organizational change. Lewin (1944) asserted that the success
of group change depends on the nature of the process and the depth of the analysis and
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identified the planning phase and objectives to achieve as imperative for success.
Participant 4 noted, “People respond in one of three different ways; they fight, flight, or
accept the data.” Analyzing organizational problems and developing a plan to remedy these
issues is imperative to the success of the change process.
Theme 2: Approach
A managerial approach is critical to implementing change in an organization. The
current workforce has shifted from an environment of volatility, uncertainty, complexity,
and ambiguity to a performance-driven service delivery model (Gaule et al., 2023).
Healthcare leaders identify several groups classified as consumers that require a positive
customer experience. Healthcare leaders specifically identified patients as consumers.
Participants 1, 2, 3, 6, and 7 noted the importance of satisfied employees and their
positive impact on performance. The participants identified specific managerial
approaches they incorporated to achieve employee satisfaction, and all strategies were
rooted in human resource theory.
An organizational approach is critical to employee acceptance of change and
performance improvement. All participants identified managerial approaches that prove to
be successful with employee alignment as employee autonomy, effective communication
of goals and expectations, integrating positive feedback and rewards to employees who are
meetings and exceeding performance measures, providing training and learning spaces for
employees who require additional support, offering an open door approachable
management style, coaching employees as a leader, and avoiding being punitive Bamonti
et al. (2021) asserted the usefulness of capacity assessment and training in healthcare
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organizations. The identified strategies were all rooted in human resource theory and noted
as remaining objective and non-punitive and implemented in daily practices. These leaders
indicated they provide competitive salaries, job flexibility, making employees a part of the
decision-making process, and active listening as managerial approaches that have been
successful with employee alignment.
Aligning Change Theory with Approach
This theme correlates to the conceptual framework by identifying leaders’ vital
role in establishing employee trust and influencing organizational change. The
managerial approach dictates the nature of the relationship between leadership and
employees. Gaule et al. (2023) emphasized the shift in managerial approach from a
volatile, uncertain, complex, and ambiguous focus to a performance and service
management concentration. Implementing human resource strategies in managing
organizational change and assessing success depends on communicating the execution
of the strategic plan. Leaders that prevail in change implementation are trusted by those
who adopt change. Those leaders communicate transitions within the organization and
understand their role in the change process in establishing employee trust and
influencing organizational change.
Lewin identified the second phase of this transitional process as the change phase.
Once employees resolve feelings of uncertainty and establish trust with organizational
leaders, they begin to adopt change and integrate organizational and new ways of doing
things to support the new direction (Vendette & Thundiyil, 2023). Healthcare leaders are
responsible for influencing organizational change, and in a trusting relationship with
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organizational leaders, they begin to adopt change that will benefit them. Participants 1, 2,
3, 5, 6, and 7 verbalized their approachable, empathetic, inclusive, non-punitive, and open
management styles. A managerial approach is essential in achieving positive
implementation changes in healthcare organizations and influencing performance
improvement.
Theme 3: Assessment
Healthcare leaders use various assessment tools to evaluate achieving goals for
implemented change. Healthcare leaders must assess and reassess organizational
operations to determine if modifications in strategy are needed. One strategy to evaluate
the progress of instituted change is patient satisfaction assessments and surveys, employee
satisfaction surveys, performance assessments, direct customer feedback, and direct
observation of services. Customers and employees of healthcare services want to have the
opportunity to provide honest and anonymous feedback without being inconvenienced or
risking retaliation. Nunes et al. (2023) surmised that an effective way of data collection
and assessment is using convenient external assessment tools for consumers and
employees to complete, direct observations of organization operations, and oversight and
feedback provided by regulatory agencies.
Healthcare leaders identified the value of assessments, assessment tools, collecting
data, and assessing data as an invaluable process in change management and performance
evaluation. Leaders added that utilizing the data to determine performance measures and
direct staff observation and documentation are necessary to evaluate processes that meet
organizational goals. Participants 1, 2, 3, and 5 identified the importance of staff
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observations. Participants 1, 3, and 6 identified that they are hands-on managers who
perform frequent huddles and provide immediate feedback and support to
staff.
Aligning Change Theory to Assessment
Assessing the need for change through analysis is an essential step for maintaining
change in healthcare organizations. This theme connects with the conceptual framework
by associating Lewin’s assertion that it is vital to adopt, sustain, and assess change that is
implemented. Pettersen et al. (2024) identified the transformative nature of the successful
implementation of innovation in healthcare and the importance of continued evaluation for
change. Reassessment of integrated reform is equally important.
In the healthcare industry, leaders must remain innovative and adaptable to pivots in the
market. Direct catalysts for change are technology, shifts in work culture, environmental
shifts, and patients’ perceptions of needs.
Lewin referred to the final phase of change as the refreezing phase. The refreezing
phase aligns with assessment through observation of successful change implementation.
Lewin (1944) Asserted the importance of continued evaluation in the change process,
indicating the value of setting organizational goals and objectives to judge whether that
goal is moving forward or backward. He added that evaluating those goals’ achievement
is vital to preventing wrong conclusions (Lewin, 1944). Healthcare leaders consider all
factors when promoting shifts in the organization. Tonjang and Thaweaengskulthai
(2024) identified the use of total quality management and innovation in healthcare as a
valuable tool in integrating the organizational change process. The study considered the
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following factors when assessing and reassessing the need for organizational change:
environmental context, leader, planning, support, operation, tools and analysis method,
and improvements. Once the change has been integrated into the work culture, healthcare
leaders manage the shifts through ongoing assessment of operations, and the decision a
healthcare leader faces is to refreeze or unfreeze to re-initiate the change process.
Business Contributions and Recommendations for Professional Practice
The results of this pragmatic inquiry study illustrate significant determinants for
leaders in healthcare organizations seeking strategies to increase performance outcomes.
Song et al. (2023) asserted challenges with employee activity and engagement and their
negative effect on performance. The data collected from interviews with healthcare
leaders illustrate the correlation of the integration of human resources strategies in
management and performance improvement. Incorporating data from this study’s
outcomes may provide healthcare leaders insight into adopting human resource
techniques to improve employee satisfaction and direct patient care, which results in an
overall increase in organizational performance measures.
Implications for Social Change
Healthcare facilities identify a mission of providing health improvements (Wanser
& Luckel, 2021). Measuring performance and devising a successful strategic plan to meet
this mission is imperative to the medical field’s contribution to society. Healthcare
organizations that emphasize increasing patient care affect facility experiences positively.
Better patient experiences lead to increased facility outcomes. By leveraging the findings
presented in this study, healthcare leaders can improve the quality of care and patient
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confidence in medical providers. Organizations possess a unique opportunity to remedy
societal challenges in healthcare by implementing human resource strategies of shared
value and inclusive growth while instigating social change and stimulating economic
returns (Nandy, 2024). The results from this research may contribute to positive social
change by increasing the quality-of-care patients receive, increasing employee
engagement, and impacting customer satisfaction. These actions enhance the lives of
individual recipients on a micro level and the communities of those individuals on a macro
level.
Performance management in healthcare is a change agent catalyst in organizations.
Providing high-quality care is imperative to medical service delivery, impacts patient
confidence in healthcare providers, and results in community trust. Performance
management in healthcare facilities is result-driven due to the services provided and the
outcomes (Peixoto et al., 2020). Providing high-quality care is a goal leaders in healthcare
seek to attain. High-quality medical service delivery increases patient outcomes, impacts
patient confidence in healthcare providers, and results in community trust (Wanser &
Luckel, 2021). Trusting the change process in healthcare has a cyclical impact that
influences social impact while improving performance. This cycle of change in healthcare
organizations ultimately results in improved quality of care to customers in the
communities they serve.
Recommendations for Further Research
Human resource strategies used by seven leaders in healthcare organizations for
performance improvement and increasing patient quality of care were analyzed in this
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pragmatic inquiry. The study’s results suggest the utilization of human resource strategies
in management practices, such as performance analysis, managerial approach, and
employee and customer assessments, are essential to increasing performance in healthcare
organizations. This pragmatic inquiry strengthens the existing literature on change and
performance management in healthcare organizations. The study highlights the importance
of employee satisfaction and customer service and the techniques’ impact on performance
improvement.
Three central limitations were identified in this study. Research limitations are
defined as barriers that I cannot control. (Kaas et al., 2019) encourages using tools that
aid research in identifying limitations and systematically exposing vulnerabilities. Some
limitations while conducting research include challenges accessing participants,
participant objectivity, researcher and participant boundary issues, and participant
mistrust of the research process (Howard, 2021). One identified limitation is various
procedural and regulatory standards may restrict the various specialties of healthcare
organizations; alternative healthcare specialization may have different experiences. A
second identified limitation is leaders with medical experience who are managers may be
limited in utilizing human resources techniques and require support with human resource
strategies. Another identified limitation is all participants are from the United States;
other regions may present a varied experience.
To address the the limitations, the following recommendation are proposed to
enrich future research endeavors. First, the recommendation is aligning policy and
procedures with accreditation and state regulation standards to increase correlation of
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regulatory standards and organizational processes. The second recommendation is to
provide management training highlighting the integration of human resource strategies in
managing employees and organizational processes. A third recommendation is to expand
beyond the northeastern and southeastern regions of the United States obtain unique
experiences beyond the regions of participants who provided data in this study.
Conclusion
Human resources strategies utilized by healthcare leaders to affect performance
was studied in this pragmatic inquiry. Data analysis demonstrates that using human
resources strategies results in employee satisfaction, which translates to a positive patient
experience and increased performance. Song et al. (2023) indicated that employees who
are motivated in the workplace positively influence individual and organizational
outcomes. In healthcare organizations, human resource strategies encompass more than
recruiting, hiring, and employment onboarding documentation; they are change agents and
a significant part of an organization’s strategic plan (Sunahwati, 2019). Challenges with
managing quality of care in healthcare facilities force leaders in healthcare organizations
to develop strategies to improve performance, employee satisfaction, and customer service
by providing better patient service.
A comprehensive understanding of human resource strategies’ impact on
performance improvement in healthcare organizations is vital to increasing the quality of
patient care. Data was collected through semistructured interviews and assessment of
procedural information, including healthcare organizations’ Facebook pages, LinkedIn
profiles, and organizations websites. Tomaszewski et al. (2020) recommended
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methodological triangulation to assess and develop common themes from the various
sources obtained through data collection. The process containing data and identifying
patterns (Chitac, 2022) emphasized the importance of data saturation in a study, reaching
a point when no new information is presented. This central principle was obtained after
data collection from six participants.
The data analysis disclosed three critical themes: analysis, approach, and
assessment. These themes are rooted in Lewin’s change management theory, which
emphasizes human resource strategies leaders in healthcare organizations implement to
improve performance is rooted in Lewin’s change management theory analyzes the need
for organizational change for performance improvement, uses a practical managerial
approach to communicate and influence organizational shifts, and must continue to assess
the new strategies for continued organizational development. Through the integration of
human resource strategies, leaders in healthcare organizations can improve employee
satisfaction, patient customer service, and act as a conduit to influence performance to
increase patient quality of care for individuals and the community at large.
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