Challenges And Strategies For Implementing High-performance Work Systems In Healthcare

Challenges faced by the HR department in healthcare organizations

A high performance work system may be defined as a specific set of practices in human resource management which ensures a positive and favorable working environment in the workplace. It strives to pave the way the way for greater employee engagement and responsibility towards the organization. High performance work systems, or HPWS as it is known in common parlance, is all encompassing and entails all the myriad facets of the human resource department. This is all the more poignant in the case of a healthcare organization, because the quality of employee performance would have a direct impact on the well being of the stakeholders, the patients in this case. HPWS in healthcare takes into consideration recruitment, job description and profile, evaluation of employee performance and rewards and recognition programs as well (Ang et al. 2013).

The case study provided considers the research conducted by Leggat, Bartram and Stanton in the year 2011. The research attempted to study the various healthcare practices and strategic management within healthcare organizations in Australia. Three healthcare organizations were examined, which comprised of 201 nurses, human resources, senior managers and also policy documents. The main purpose of the research was to place these organizations under scrutiny and analyze if HPWS systems were in place. The research also attempted to identify the gap between policy and practice. Various issues related to human resource management, HPWS, organizational and employee performance and the quality of patient care delivered were also studied.

The process of human resource management in healthcare organizations is of utmost importance, because it would directly affect the quality of medical services offered to the patient. Human resources in healthcare would determine the effectiveness and efficiency of medical services and optimize patient satisfaction. Effective management of human resources plays a vital role in the quality of medical care offered to patients. As such, it can be said that human resources does not simply entail recruitment and training of individual employees. It also involves the implementation of programs which would enhance communication between employees and facilitate coordination and collaboration between them. Consequently, this would nurture the development of the organization as a whole. However, it must be asserted that healthcare professionals are under tremendous pressure, with lives of countless people depending on their work. At present, there are numerous challenges which prove to be a hindrance for the HR department in healthcare organizations. Some of them may be discussed as follows:

• Staffing shortages– HR professionals in this field face numerous challenges related to the recruitment and retention of nurses and doctors in healthcare organizations. One of the major reasons for this is the plethora of opportunities that the employees have. Nurses and doctors in Australia have a wide range of options to choose from, and if they happen to be dissatisfied with the working conditions at one organization, they can immediately switch to a better one (Rosseter 2014). As a result, the employee turnover rate is quite high with employee retention facing an all time low in Australia. It is estimated that by the year 2022, there will be almost a million vacancies in nursing positions in Australia (North et al. 2013). Another factor contributing to staffing shortage is the ageing baby boomer generation. As this generation grows older, the workload for the medical professionals is increasing. Similarly, the medial professionals from this generation are on the verge of retirement, thus leading to vacancies in the workforce. The need of the hour is for HR professionals in healthcare to devise effective employee retention and engagement strategies that would retain existing employees and lure in potential candidates.
• High turnover rates– Apart from dearth of available human resources, the HR department in healthcare organizations are finding it increasingly difficult to retain their talented staff members. In the last few years, the turnover rates for the nurses in Australian healthcare organizations have increased from 11 per cent to 17 per cent. Such turnover rates could cost the organization in millions of dollars. This is because the expenses involved in replacing a medical professional is almost equal (if not more) than their average salary (Hairr et al. 2014).
• Employee burnout– Employee burnout is a relatively common phenomenon, especially in high pressure jobs like that of medical professionals. Since an employee spends a majority of his day at work, his job and the working conditions at his organization would have an impact on the physical and mental well being of the employee itself (Salyers et al. 2017). More than any other industry, employee burnout would have an adverse effect on the quality of service provided by the healthcare professionals (Humphries et al. 2014). Research also shows that nearly seventy per cent of nurses working in healthcare facilities experience burnout at some point in their careers. Medical professionals who are mentally and physically exhausted would be incapable of performing their best (Montgomery 2014).
• Lack of training– Most healthcare facilities in Australia lack the infrastructure and resources required to provide adequate training to the nurses and other medical professionals. In order to progress in their careers, the medical professionals would need to acquire new skills and hone existing ones. However, most organizations are not willing to invest in career development and professional training for their employees.

Implementing HPWS in hospitals and healthcare facilities

In the past few decades, there has been intense discussion about the appropriate practices for human resources in healthcare, so as to maximize the efficiency and performance of the employees and simultaneously promote their mental and physical well being. High performance work systems or HPWS may be explained as a theory in human resources which would combine HR practices, processes, work structures and other aspects which would together enhance the commitment, engagement and knowledge or skills of the employees (Carvalho and Chambel 2014). The case study demonstrates that HPWS would include recruitment and training, transformational leadership practices, decentralized decision making, effective job characteristics and so on. Such human resource management practices would yield desirable outcomes and improve the quality of service provided to the patient. HPWS also takes into consideration staff turnover, employee grievances and hails psychological empowerment of employees as a determinant of patient satisfaction (Huang et al. 2016). The following are some measures that a healthcare organization can take to implement HPWS:

• The working environment at healthcare organizations should be inclusive and diverse. Every member of the organization should be invited to voice their opinions and raise their concerns. Encouraging the active participation of employees in the decision making process is an important aspect of HPWS (Kehoe and Wright 2013). This is because employees would be able to take decisions that are subjective and affect their immediate working environment, thus allowing for smoother implementation. It would also increase the dedication and commitment levels of the employees, leaving them feeling more empowered (García-Chas, Neira-Fontela and Castro-Casal 2014).
• HPWS also stresses on the importance of training and skill development. Healthcare organizations need to implement training programs which would equip employees with more advanced skills, thus preparing them for future roles (Tregaskis et al. 2013).
• Another way of ensuring that HPWS is in place is implementing a system of rewards and recognition. Incentives and privileges are critical for boosting the morale of the employees and enhancing employee performance (Twigg and McCullough 2014).

The above principles represent the policies pertaining to HPWS, and theoretical measures that an organization can adopt to maintain high levels of efficiency and performance. However, as the case study shows, there is often a gap between policy and practice. For instance, a large number of healthcare organizations in Australia show inconsistencies in managerial strategies and the use of outdated management principles. The list is below consists of few principles which can be used to ensure that HPWS is in place at a healthcare organization:

• HPWS should be patient centric and the organizational structures and work process at the healthcare facility should revolve around patient requirements.
• The presence of self managed teams in the workplace would enhance the rate of employee engagement and promote commitment and dedication on part of the employees.
• HPWS can be evaluated on the basis of organization goals and objectives. Every member of the organization should be aware of the business mission and objectives, adherence to which is imperative for promoting high performance (Weinberg et al. 2013).
• A high performance work system would identify staff shortages and high turnover rates and attempt to control the issue at the very source of it.
• One major way of ensuring HPWS in a healthcare facility is by evaluating the level of employee motivation and satisfaction. Workplaces that demonstrate higher levels of empowerment of staff members would have a higher HPWS.

A HR manager at a hospital would be entrusted with the management and coordination of every staff member within the organization. As such, an individual in such a pivotal role would be required to have certain attributes. These include organizational skills (the ability to organize, manage and work in an efficient manner), ethics (an HR manager should have a sense of ethics and be able to distinguish between right and wrong), communication skills (the ability to effectively communicate his or her perspective and at the same time consider the points of view of the employees as well) and problem solving skills (the ability to resolve conflicts in a quick and efficient manner). The hospital sector is a volatile industry and the HR manager is expected to be flexible enough to adapt to changing situations (Parkes and Davis 2013). The primary role of the HR manager is to ensure the optimum delivery of medical services and improving patient outcomes. The roles of a HR manager can be dissected using the Ulrich model. This model was introduced by strategist Dave Ulrich, who claimed that the responsibility of a HR manager can broadly be segregated into four aspects – advocate for employees, administrator, business partner and change agent (Bratton and Gold 2017). They may be elaborated as follows:

• Management of hospital personnel– The HR manager would be responsible for hiring and recruitment of all personnel at the hospital. The entire recruitment process, beginning from the shortlisting of candidates, interviews and final selection, would be supervised by the HR manager. He would also be in charge of orientation and training programs. Termination of employment is another responsibility of the HR manager (Sikora and Ferris 2014). He would be responsible for terminating employees if they fail to perform according to accepted standards or if they commit grave errors.
• Performance monitoring– The HR manager would also be responsible for quality control in the hospital. He is expected to monitor the performance of each staff member and evaluate the quality of service provided. Failure to abide by performance standards could result in severe consequences for the concerned staff members. The HR manager is also expected to make recommendations and guide the staff members so as to optimize performance (Mitchell, Obeidat and Bray 2013).
• Legal research– Every hospital or healthcare facility is regulated by a set of stern rules and norms, which every member of the organization must adhere to. As the manager of human resources, one would be expected to have complete knowledge of these regulations and legal factors related to the healthcare system. For instance, there are a number of laws like Medicaid Patient Protection Act of 1987 which determine the quality of medical services provided to patients. The HR manager is expected to be well versed in these legal policies.
• Decision making– Decision making and problem solving are two of the most important functions of a HR manager. In a hospital, the HR manager would have to deal with a variety of situations and take decisions under extreme high pressure situations. He should thus be able to take decision in a quick and efficient manner. Conflict management is another responsibility of the HR manager. A hospital can be called a kind of microcosmic community, consisting of several departments and diverse individuals. As a result, disputes and conflicts are common between departments or between individuals within the same department. The HR manager would therefore be responsible for the effective resolution of such conflicts (Collings, Wood and Szamosi 2018).

Role and attributes of HR managers in hospitals

Conclusion

To conclude, it can be said that in a healthcare organization, the management of human resources plays a crucial role. The HR department in a hospital would be responsible for a number of activities, as mentioned above. For example, recruitment, training, skill development, personnel management, catering to the needs of the employees and ensuring optimal delivery of medical services to the patient are just some of the important functions of a HR manager. The case study presented emphasizes on the importance for high performance work systems or HPWS in hospitals. Such work systems, as shown above, would not only improve the quality of service provided to patients, but would also empower the employees and keep them motivated.

References:

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