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Covid-19, stress, crisis and technologies: How HR Managers in healthcare are facing new challenges.

The world is currently facing a major crisis with the spread of the COVID-19. In the same time, increasing technologies in our lives brings many changes in the labor market. The raise of these technologies, for instance AI, has a strong impact in healthcare. The constant evolution of law also invites healthcare actors to adapt themselves always faster and sometimes push pressure beyond boundaries.


In 2011, in a large-scale questionnaire about nurses’ satisfaction levels at work, 43% of them were replying « not recommending nursing as a profession », and 25% were mentioning their ambition to change of employer (AMN Healthcare, 2011). In the same year, another study was revealing the link between the pressure faced by nurses and the patient satisfaction ratings (McHugh, Kutney-Lee, Cimiotti, Sloane, & Aiken, 2011). The study was measuring the impact of poor human resources management of nurses on the unsatisfaction of their patients.


We could argue that nurses are only a part of the healthcare workforce but such indicators seem alarming when thinking about their importance in their patients’ life. In regard to these results, employers need to understand this situation and take concrete actions to avoid a crisis that could be terrible for the healthcare sector.


Nowadays, the workforce has to face many new challenges related to the lack of investments, difficult working conditions, regulations and new technologies. During the last decades, many hospitals have seen their management changed and have put in place executives with specific attentions accorded to operating costs and margins. As a result, the frustration of many healthcare workers has been noticed and led to strikes and protests. On the other hand, we also need to reflect on what would have been the current situation of some hospitals without a clear focus on cost control.


When looking at our healthcare sector today, we quickly notice recurring HR issues: miscommunication or lack of communication, lack of performance, strong fears, long conflicts and disappointments. In the eye of the storm lies the Human Resources Manager. As a key element in such situations, the HRM is often the person in charge of improving communication processes, cooperation, coordination and well-being at work. In 2014, a study made in Japan showed that “effective Human Resources management has a string impact on healthcare quality and performance of hospital’s staff”. The authors, H. M. Elarabi and F. Johari, suggested to measure HR Managers’ performances before even starting performance development process and workforce training since they are “responsible for the attraction, selection, training, assessment and rewarding of employees” (P.14).


Indeed, Human Resources departments are most of the time the first point of contact with potential candidates. In a labor market that is always giving more power to candidates, their responsibility in employer branding and « candidate experience » is important. In a hospital, we should not forget the role of HR Managers in overseeing organizational management and ensuring compliance with laws and regulations. This wide scope of mission makes Human Resources in this sector even more complex, essential and challenging.


What is it like to be a Human Resources Manager in Healthcare ?


HR Managers have to face uncertainties, emergencies, high pressure, burnouts, staffing shortages, high flexibility and turnover rates. In a study published in 2015 by the professors Fried and Fottler, 62% of executives in Healthcare declared that their biggest challenge was to identify and hire people with the right skills to work in today’s complex healthcare organizations. In addition, another challenge lies in the resources allocation and dispatching of their workforce during crisis or periods of high workload. Indeed, in a context such as the coronavirus crisis, HR Managers also have the responsibility of quickly mobilizing many resources while having a duty of care towards them to provide a safe work environment.


How can the healthcare executives deal with their workforce ?


The Huselid Study in 1994 examined the HRM practices and productivity levels of 968 organisations across 35 industries. The effectiveness was evaluated and compared to the presence of benefits such as incentive plans, employee grievance systems and employee participation in decision making processes. In the study, results indicated that these practices have an economically and statistically significant impact on both intermediate outcomes (turnover and productivity) and short- and long-term measures of corporate financial performance.


Based on these results, we could argue that healthcare executives would need to focus their management effort on commitment and involvement of their employees to ensure high-level performance. With the help of their teams and feedbacks and ideas of employees, HR Managers can implement innovative solutions that will strengthen their hospitals, increase their performance and improve employees satisfaction.


In the last decade, another solution has been proposed by researchers: promoting the role of middle managers in the healthcare sector. These authors argued that middle managers are vital resources for healthcare organizations and reviewed the benefits for including them in leadership development and succession planning programs.


According to them, the combination of a greater executive span with less hierarchical depth creates a dual effect of devaluing and decreasing middle managers’ autonomy. Healthcare middle managers trigger perceptions of low expectations leading to low morale and high levels of stress. Others become hyper-effective or develop exit strategies. As a result, major problems are the rise of turnover costs and insufficient attention to succession planning, internal promotion and leadership development. By having a better understanding of the value of middle managers and their development needs as well as the factors and dynamics that can influence their motivation and affect retention, HR Managers would better benefit from the cooperation of knowledgeable and highly skilled professionals. This conclusion was also shared by an extensive research program ran by the iOpener Institute of Oxford in 2005, in which authors stated that « happiness at work » could decrease the turnover from 25% to 12,5% and drastically reduce recruitment costs.


Human Resources is obviously an essential and challenging topic in any organization. In the healthcare sector, the role of HR specialist covers recruitment, onboarding, training, evaluation, administrative HR but also project management, resources allocation, planning and crisis management. In a difficult context and more and more under pressure, HR Managers in healthcare have to innovate and constantly adapt themselves. Many of them are doing wonders every day in our hospitals, often with very few resources. During the last years, many studies have demonstrated the links between employees’ satisfaction and performance in difficult contexts. Given the current and recurring crises that our hospitals are going through, investments in new technologies and in reinforcements seem to be absolutely vital. It is at this price that our developed countries will be able to ensure strong and reliable health services.


Fanny Chollet

AION Consulting


Credits


  • The Pursuit of Happiness, Science, and Effective Staffing: The Leader’s Challenge, K. M. Kerfoot, Nursing Economic$, Vol. 30 N°5., September-October 2012.


  • HR Challenges Shaping the Healthcare Industry, R. O’Donnel, Workest, May 2019.


  • Planning Human Resources in Healthcare: Towards an economic approach, An international comparative review, K. Bloor & A. Maynard, CHSRF, March 2003.


  • Infirmières, hospitaliers, libéraux, internes… Qui fait grève et pourquoi ?, O. Gabriel, 20Minutes, December 2019.


  • Meeting Human Resources for Health Staffing Goals by 2018: a quantitative analysis of policy options in Zambia, A. Tjoa, M. Kapihya, M. Libetwa, K. Schroder, C. Scott, J. Lee & E. McCathy, Human Resources for Health, 15, June 2010.


  • Strengthening Human Resource Practices in Healthcare in India: The Road Ahead, A. Agarwal, S. Garg, U. Pareek, JIACM 2011.


  • The impact of Human Resources Management on Healthcare Quality, H.M Elarabi, F. Johari, Asian Journal of Management Sciences & Education, Vol. 3 N°1, January 2014.



  • Huselid Study, 1994.


  • What happiness at work is and how to use it, J. Pryce-Jones, Industrial and Commercial Training, April 2014.


  • Human Resources in Healthcare, managing for success, Fried and Fottler, Editors, 2015, 3rd edition, P.2.


  • Value in the middle: cultivating middle managers in healthcare organizations, A. Belasen, Journal of Management Development, Vol. 35 N°9, pp.1149-1162, 2016.


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