Name: MAMTA MARUSubject: STRATEGIC HUMAN RESOURCE MANAGEMENT & INERNATONAL HUMAN RESOURE MANAGEMENREPORT ON HR PRACTICES IN HEALTH SECTOR AT NATIONAL &INTERNATIONAL LEVELSUBMITTED TO: DR. CHETAN LAD
STRATEGIC HUMAN RESOURCE MANAGEMENTStrategic human resource management is designed to help companies best meet the needs oftheir employees while promoting company goals. Human resource management deals with anyaspects of a business that affects employees, such as hiring and firing, pay, benefits, training andadministration. Human resources may also provide work incentives, safety procedureinformation and sick or vacation days.Strategic human resource management is the proactive management of people. It requiresthinking ahead, and planning ways for a company to better meet the needs of its employees andfor the employees to better meet the needs of the company. This can affect the way things aredone at a business site, improving everything from hiring practices and employee trainingprograms to assessment techniques and discipline.Companies who work hard to meet the needs of their employees can cultivate a workatmosphere conducive to productivity. Human resource management is the best way to achievethis. Being able to plan for the needs of employees by thinking ahead can help to improve therate of skilled employees who chose to remain working for a company. Improving the employeeretention rate can reduce the money companies spend on finding and training new employees.When creating a human resources plan, it is important to consider employees may want or needand what the company can reasonably supply. A larger company can usually afford training andbenefit programs that smaller companies cannot afford to offer. This does not mean that asmaller company should not engage in strategic human resource management. Providingspecialized on-site training, even if provided by senior members of the company and offeringone-on-one assessment and coaching sessions can help employees reach peak performance rates.An important aspect of strategic human resource management is employee development. Thisprocess begins when a company is recruiting and interviewing prospective employees. Improvedinterviewing techniques can help to weed out applicants that may not be a good match for thecompany.After being hired on, a strong training and mentoring program can help a new member of thestaff get up to speed on company policies and any current or ongoing projects they will beworking on. To help employees perform at their best, a company can follow up with continual
training programs, coaching, and regular assessment. Investing in the development of itsemployees can allow a company to turn out more consistent products.Strategic human resource management is essential in both large and small companies. In smallcompanies, this may be as simple as the owner or manager taking a little time every day toobserve, assist, and assess employees, and provide regular reviews. Larger companies may havea whole department in charge of human resources and development. By meeting the needs of theemployees in a way that also benefits the company, it is possible to improve the quality of staffmembers. Taking the effort to provide employees with the tools they need to thrive is worth theinvestment.
WELCOME TO HUMAN RESOURCES FOR HEALTH IN INDIAThe responsibility of delivering health services falls primarily on health workers making themcentral to the health systems’ capacity to deliver health services. The health sector in India facesseveral challenges in human resources for health. At one level, information on the size,composition and distribution of the health workforce is limited and fragmented. The lack ofhealth workers, doctors, female doctors in underserved areas is a cause for concern. Though thepublic sector has made serious efforts to place qualified health workers in under-served areas,institutional constraints in the production and recruitment of health workers pose their ownchallenges.According to a research report by Job science, top talent in the healthcare industry is hard tocome by and even harder to retain in this competitive hiring market. Hospitals cannot afford tocontinue operating without giving more serious consideration to recruiting, hiring and retainingtop talent and then addressing it as a primary improvement initiative for the hospital as a whole.The other key findings include:• The top concern reported by hospital HR professionals is recruiting quality employees (80%)• More than 50 percent of HR professionals are dissatisfied with current recruiting processes• Best practices in recruiting and staffing are not consistently implemented (less than 50%)In order to deal with the concerns of hiring and retaining top employees, you must first start byaddressing the HR staff needs such as strategic investments in the technologies and bestpractices available. HR professionals must take a practical role in the strategic management oftheir institutions proving the value of HR to high-level administrators. Talent is thedifferentiator between industry-leading organizations and the rest, and the best practices forrecruiting, hiring and retaining that talent is constantly changing. Once HR professionalsproactively manage that talent and increase staffing effectiveness, they will become valuedmembers of their hospital.The hiring market is changing, not only on the availability of qualified staff, but also in howthose staff members apply for positions. Successful HR professionals must be continually awareof their location and the methods of their search to find the top talent. These methods areconstantly changing and it is up to the HR professionals to educate themselves with the new
processes available. Those who effectively leverage their HR procedures incorporate thefollowing into their course of action: partnering with an HR provider focused on service,implementing the latest technology to facilitate hiring and hospital recruiting process andproactively recruiting and talent pool building.• Leveraging technology and metrics to support the strategic value of HR• Positively affecting the economics of the institution by managing HR• Utilizing search agents and job boards to capture top talent• Creating an employment brand that attracts top talentNational Rural Health MissionThe National Rural Health Mission (NRHM), launched by the Honourable Prime Minister ofIndia on 12 April 2005, is an ambitious strategy of the government. It aims to restructure thedelivery mechanism for health towards providing universal access to equitable, affordable andquality health care that is accountable and responsive to the people’s needs, reducing child andmaternal deaths as well as stabilizing population, and ensuring gender and demographic balance.Formulation of transparent policies for deployment and career development of human resourcesfor health, strengthening capacity for data collection, assessment and review for evidence-basedplanning, monitoring and supervision and technical support to national, state and district healthmissions for public health management are part of the core strategy of the mission. Thesestrategies have several HRH dimensions and need to be examined as per the model given below: MANAGING FOR PERFORMANCE Work Health Health HUMAN system force Outcomes RESOURCE Performanc OBJECTI ACTION VES Coverage: e Equitable · Numeric adequacy Social & Access · Skill mix Physical · Social outreach Motivation: · Satisfactory Social & Efficiency Health of Remuneration & the Physical · Work environment Effectiven Population · Systems support ess Competence Quality & · Appropriate skills : Responsivene · Training and learning Training & ss · Leadership & Learning Entrepreneurship
Building HR Capacity for Health Reform• It is important to recognize the distinctive features & historical legacy of HR management in the health sector if reform is to be effective• HR issues need to be consider at an early stage in health care reform and not to be add on• Health care reforms have frequently been over optimistic about what can be achieved without the necessary resources: human or financial to make it happen. The commitment of senior policy makers to the Hr agenda is vital otherwise it won’t be taken seriously• The process of health sector reform- who is involved, the sequencing of developments & the institutional mechanisms to support reform as much consideration as the content of reform• Human resource for the health work is frequently focused narrowly on workforce planning & training , effective HR is characterized by much wider agenda• Developing an effective HR strategy requires ensuring that ownership, external fit & internal fit issues are addressed• The focus on reforming pay systems which has yielded limited results has diverted attention from the important issues of non-pay rewards, work reorganization & questions of performance managementThe HR Function• Developing HR capabilities requires investing in the training & development of both HR specialist & line managers with staff management responsibility• It is vital that any investment in specialist HR capacity evaluates the different ways to deliver the HR functions. Even if out-sourcing is rejected the in-house HR function should be properly audited & monitored
• To be effective HR function must develop both an operational & strategic HR capacity. The HR function should not try to run before it can walk- robust HR policies & practices should be developed before attempts at devolution or more radical changes in employment practices should be pursued.The Compensation Discipline deals with the various forms of direct compensation i.e.employees’ pay—that employers use to attract, recognize and retain workers. It includesdesigning and administering compensation systems including base pay, differential andincentive pay, and overtime. It also includes matters that focus on compensation-related careers,communications, legal and regulatory issues, technology, metrics and outsourcing, as well aseffective compensation practices and global compensation issues. It does not include the variousforms of indirect employee compensation—commonly referred to as “benefits,” which areencompassed in the Benefits Discipline.• Variable Pay: How to Manage it Effectively : Variable pay is a significant element of the direct compensation package of a growing number of organizations.• The Compensation Scorecard: What Gets Measured Gets Done : Employee compensation, one of the largest expenses in any organization, is also one of the least managed.• FAQs on Rewards Strategy• Implementing Total Rewards Strategies• CASE STUDY SERIES: Designing a Pay Structure: A Case Study and Integrated Exercises : Compensation is a critical area of HR that can greatly affect employee behavior. To be effective, compensation must be perceived by employees as fair, competitive in the market, accurately based, motivating and easy to understand.• Employers Assessing Salary Programs for Affordability, Competitiveness : Communication challenge: Just 51% inform employees of their positions full salary range• IT, ITES Sectors Lead The Pack In Salary Increments This Year: Although firms are expected to add more staff, most of the talent especially in the middle to senior management roles will remain in their current organizations, reveals Kelly Services Employment Outlook and Salary Guide 2010-11.
• Attrition woes spark salary increases; focus on pay for performance to intensify : Employees in India can expect an overall average salary increase of 11.6% in 2010, according to a recent Mercer India Monitor survey.• 10 Executive Comp Issues For Aligning Pay Strategy: Understanding these key executive compensation issues can help HR professionals to better integrate executive compensation with overall pay strategy throughout the organization.• Bonuses Are Back, With Emphasis On Hard Measures : More companies globally are awarding bonuses in 2010, but bonuses are more likely to be strongly tied to the bottom line with more challenging targets and greater focus on return on investment.•INCENTIVE PAY PLANS• Firms develop pay-for-performance culture in response to economic recovery in Asia : According to the Mercer Asia Executive Remuneration Snapshot Survey, approximately 30- 40% of an executive’s total pay package is linked to variable pay regardless of the type of organization.• Setting Goals for Executive Incentive Plans: With increased scrutiny of executive compensation and greater transparency attributable to enhanced disclosure requirements, having a pay-for-performance compensation philosophy is practically a must for U.S. companies.• Executive Comp: Rethink Incentive Plans for Difficult Times: The troubled economy is causing fundamental shifts in executive compensation bonus and equity-based incentives plans, according to a November 2008 report by pay consultancy DolmatConnell & Partners.• Avoid Bonus Blunders as Economy Slows: The end of the year brings bonus and performance review discussions for many employees.• Incentive Plans Hit Hard by Economy; Retention Efforts Increase : Decreased earnings and falling stock prices have shredded the value in some companies’ annual incentive and long- term incentive plans, according to a survey by Deloitte Consulting LLP.
• Keeping Comp on Track: Some Practical Tips: CHICAGO—It’s the economy, said Sharon K. Koss, SPHR, consultant and author of Solving the Compensation Puzzle (SHRM, 2007), during her June 21, 2008 workshop on “Compensation Basics,” held here.The Bombay Hospital has decided to only hire candidates with strong credentials, after a fakedoctor worked at the hospital for six years undetected until Wednesday, Currently, juniordoctors are hired on the basis of their documentation. “We plan to start getting at least twocross references for junior doctors as well. We also plan to cross check their SSC & HSCcertificates,” said Dr DP Vyas, medical director at the hospital. “It will help if the medicaldegree certificates display the candidates photograph.”This change in procedure came after Zuber Qureshi, a medical college drop out, assumed hisold classmate Meraj Shaikh’s identity and used his documents to secure a junior residentdoctor’s post at the hospital. This continued for six years until the police arrested him onWednesday after the real Dr Meraj Sheikh, lodged a complaint against him.The hospital said that at the time of appointment, the original certificates submitted by thedoctor seemed reliable. A statement released by the hospital on Thursday said: “Though weare very stringent about checking the authenticity of certificates submitted by candidates, thisis a clear case of impersonation and fraud.” The hospital currently has 200 resident doctors.Qureshi was working under Dr CA Somaya, a cardiothoracic surgeon. His seniors had nocause to complain about his work.“We did not receive a single complaint against him. As a junior resident doctor he was notdirectly involved with the treatment of the patients and was not authorized to take anydecisions regarding treatment on his own,” added Vyas. Qureshi is currently in police custodyunder charges of forgery and impersonation.RECRUITMENT, SELECTION AND INDUCTION PROCESS IN SAHARA HOSPITALCULTURE OF SAHARA HOSPITALThe organizational culture plays a significant role in making organization gets the best out ofthemselves. An optimum level of development climate is essential for facilitating H.R.D. Such a
climate can be observed in “SAHARA INDIA” consisting of following tendencies andattributes:-• There is a tendency at all levels and specially the top management to treat people as the mostimportant resources.• There is a perception that developing the competencies in the employees is the job of every manager/supervisor.• The employee has easy interaction with the seniors in respect to official work and personal problems.• There is a general climate of trust.• The psychological climate in the organization is very conductive to the employees.• Tendency on the part of the employees to be generally helpful to each other.• Team spirit and employees are encouraged to take the initiative.• There are tendency to discourage favoritism and Biases.• Supportive personnel policies.RECRUITMENT PROCESS IN SAHARA HOSPITALSPURPOSEHuman Resource is one of the key resources, which contributes to the success of the hospital. Itis imperative that human resource department will have to identify the right talent to achieveorganizational effectiveness. The success of identification of right talent depends upon findingthe applicants with the most appropriate level of skills, qualifications and experience, who willidentify themselves with the organizational objectives, values and culture and in turn contributetheir best to the organization.The objectives of the recruitment are,
• To lay down and follow an operating procedure for recruitment function of the HR Department.• To identify and select qualified manpower for the various roles as per the job specification lay down by the management.• To follow a systematic procedure to select a right person for the right job at the right time.• To recruit people who have a positive attitude towards customers, themselves and other employees and who are able to contribute towards quality service.• To follow a recruitment procedure this is applicable to all categories of employees.Recruitment PolicyThe recruitment process is carried out in alignment with objectives and major organizationalprinciples. The major policies include:Appointments in the hospital will adhere to the qualifications and the skill sets as mentioned inthe job description for various job titles.Wherever experience has been specified, effort will be made to recruit persons with suchnumber of years and nature of experience.The recruitment process shall be made transparent and should screen the best talents in theindustry.• Provide equal employment opportunities irrespective of gender or community.• Whenever vacancies arise, preferences will be given to applicants within the hospital.
• Recruitment of employee’s relatives will not be encouraged except in certain situations and categories.• Selection of unskilled workmen will be restricted for jobs that involve rigorous manual Labor keeping in mind their capacity to perform.• Age limit for unskilled / untrained personnel should preferably be below 30 years of age.• Selection will be strictly on merit taking into consideration the knowledge, skill sets, mindset of service, attitude and overall personality.ResponsibilityThe HR department is responsible for the observance and adherence of the approved recruitmentpolicy and procedures.Procedure for RecruitmentSahara Hospital is now ready to be operational. The requirement of Human Resource has beendetermined and the same is approved by Management. Staffing process is now beginning & TheManager – HR and his team is responsible for the recruitment process.Sources of RecruitmentInternal SourcesThe internal source of recruitment is to provide an avenue for the existing employees within theorganization to perform a new role. This will be based on the suitability of an employee for thatparticular vacancy. This may be termed as Promotion (if there is a change in salary / grade) orTransfer (with or without any effect on Salary / Grade) as stated by the management. Theprocess starts by sending a note to different departments stating the vacancy. The profiles arelater collected and stored in the data bank followed by the different steps involved in recruitingthe employee.
All internal recruitment will be done through:• Internal Circular• Intra – mailExternal SourcesThe various external sources used for Recruitment are as follows:• Advertisement• Recruitment through Job portals such as Jobsahead, Naukri, etc.• Head Hunters / recruitment consultants• Campus recruitment• Walk In interviewsAdvertisingWhen compiling an advertisement, the job profile should be made clear, concise and nondiscriminatory. Clear indication should be given regarding the level of competence the positionrequires.Advertisements for recruitment are done in such a manner that it provides the maximumrequired reach to the public. There is reliance in more than one source of advertisement.Advertisement in newspapers magazines / journals shall be considered when the vacancies arenot filled through other sources of recruitment. Identification of the right media for advertisingthe jobs has to be made to:• Attract suitable personnel.• Discourage unsuitable individuals from applying.• Project a good image of the hospital.The HR. Head is responsible for preparing an advertisement based on the current job descriptionand job specification. The respective Department shall provide all necessary details regardingthe job profile to the Human Resources Department.An effective advertisement will include:
• Job Title – should match that on the job description• Department & Location• Grade and Pay Scale or Range – where ever necessary• Type of Contract – where ever necessary• Key responsibilities – the essential elements of the job description• How to apply – All applications should be sent to the ‘Human Resources Department’ stating, the post asked for quoting the reference number.• Closing Date – normally a minimum of two weeks after publicationINTERVIEWSCampus InterviewThis source has to be used only for entry-level jobs. The directory of relevant educationalinstitutions may be referred for identifying institutors for conducting campus recruitment.Process for campus interview…• Obtain permission from the institutional authorities.• Communication of the same to the interview panel members.• Ad display at the college campus (10-15 days in advance stating position, date, time & venue).• Presentation of the Hospital.• Registration.• Tests (Written/Group discussion).• Short-listing of candidates.• Personal Interview.• Finalization of candidates.Campus interview kit requirements
• Booking of tickets• Boarding & Lodging / Vehicle arrangements• Impressed Cash• Presentation arrangements at the venue. Requirements include (Slide Projector/Slides, Laptop/Computer, OHP / Transparencies, OHP markers, Laser pointer, PampWets/Brochures)• Pay scales and details of other benefits are to be communicated.• Stationery: requirements include A4 sheets, ball point pens, pencils, erasers, sharpeners, stapler / pins, gem clips, ball pins, plastic folders, punching machine, flat files, box files, rubber bands, binder clips, paper weights, ruler, post-it, gum and calculator.)• Reports of the interviews conducted are to be submitted at the end of every such exercise and recorded by the concerned authority.Walk-in Interview• Confirmation of date, time and venue• Permission to be sought if necessary from local authorities• Communication of the same to the interview panel members• Preparation of advertisement• Release of ad (one week in advance & on the day of the interview)• Travel plan to be decided with the panel members.• Booking of tickets for interviewers• Boarding/lodging/vehicle arrangements• Venue arrangements (Interview & Seating arrangements for the candidates)• Report of the interviews conducted.
Walk-in interview kit requirements• Stationery (A4 Sheets, Ball point pens, pencils, erasers, sharpeners, stapler/pins, gem clips, ball pins, plastic folders, punching machine, flat files, box files, rubber bands, binder clips, paper weights, ruler, post-it, gum, calculator).• Application forms.• Pay scales and details of other benefits.• Interview rating forms.• Copy of Ads releasedSELECTION PROCEDURE IN SAHARA HOSPITALSSelection procedure is the most important part of the recruitment process. It should provideevidence of the required capabilities and should be a completely transparent. It should be atimely, cost efficient, effective and equitable process.Scrutiny of applicationsApplications received from the candidates are scrutinized and short listed as per the required jobspecification. Short listed applicants are called for an interview through an interview call letterby post or courier / phone call / e-mail /telegram/phonogram. A minimum time frame of 7 to 10days shall be given to the applicants to make necessary arrangements to appear for theinterview.Preliminary Screening I VerificationThis screening shall be done based on the job requirements and specifications. During the timeof interview, the candidate’s authenticity of the original certificates I testimonials of age,qualification and experience shall be verified, updated and recorded by the HR personnel. Oncompletion of verification, the candidates are asked to appear for the written test I groupdiscussion.
Written technical TestA standard questionnaire or a practical test shall be held for testing the skill of the candidates.Based on the marks awarded the candidate will be short-listed for a personal interview.Personal Interview I SelectionOn successful completion of the written I technical test, the short listed candidates will attendthe personal interview. The Interview panel will consist of Director (Medical Health), theconcerned departmental head, representative of Corporate HR and the representative / HR Headof Sahara Hospital. The panel members will look for the required criteria, based on which thecandidate will be selected or rejected.The following traits shall be looked upon during the Interview process:• Willingness to learn• Willingness to change• Self-starter• Ability to concentrate• Willingness to learn multiple skills• Team Player• Good family background• Personal grooming & etiquette• Loyalty to the organization• Dedication to the profession• Good communication skills• Positive attitude towards life
• Caring Nature and helping tendency Decision making ability• Active & quick to respond to situationsAntecedent checkDue diligence antecedent check shall be carried out for key positions before the offer letter issent.Medical ExaminationA pre-employment medical examination shall be done for all employees recruited from the levelof a probationer onwards. The medical fitness of candidate has to be certified by the StaffMedical Officer for appointment.Provisional SelectionProvisional selection letter shall be sent / issued to the final short listed candidates subject tobeing found medically fit.AppointmentOn receipt of the pre-employment medical fitness certificate and found fit for employment, anappointment letter will be issued / sent to the candidates enumerating the terms and conditionsdiscussed during the personal interview. On receipt of the appointment letter, the candidate hasto confirm their acceptance and date of joining by signing and returning the duplicate copy ofthe appointment order to the Hospital.Appointing Authority
The appointing authorities for various categories are as follows:SR. No. CATEGORY APPOINTING AUTHORITY Senior Management (Medical and Non1 – Medical) Hon’ble Dy. Managing Director Doctors (Consultants, Registrars,2 (C. & A.) Residents, Medical Officers)3 Managers / Executives4 Staff / WorkersPlacement and joining formalitiesA selected candidate has to report a day in advance with the following to complete the joiningformalities and creation of a personal record:• Proof of age, qualification & experience• Licenses / Registration Certificates, etc.• 3-passport size photographs.The Following forms are to be filled Employment form Communication form Nomination form Dependants declaration Form PF Form Gratuity FormThe Recruiting officer In – charge at Corporate HRD shall verify all the above documents on thedate of joining and complete the check -list formalities. The joining intimation report shall beprepared and sent to the following areas.
• Sahara Hospital HR• Time – office• Security office• Pay – roll SectionID cards and uniforms shall be provided on the date of joiningProcedure for New recruitment / filling vacanciesThe department in need of manpower will send in a properly completed personnel requisitionform to the HRD Development..The HRD Development will have to process the requisition and will have to place a personwithin 30 days of receipt of the requisition.The HRD Development may place a position on hold if it is not justifiable. In such case the userdepartment, which has made the requisition, will have a suitable alternative for ensuring servicedelivery.The HRD Development will do an internal search before starting the external recruitmentprocess. However if the position demands and need is urgent the HRD Development willembark on the external recruitment process.Recruitment Process for NursesThe deployments of nurses are being done in two stages depending on the occupancy projected.In the initial phase of operations, nurses are required in two cadres; staff and supervisory.Initially the number of supervisory nurses will be limited and allocated according to thefunctional areas of operation in the hospital.The Nursing Head would also have to simultaneously arrange for meetings with the Principal ofNursing colleges for Campus Recruitment.Recruitment Process for Paramedical PersonnelThe recruitment of paramedical staff has been conducted as per approved man power planningunder the direction of Director (Medical Health).
Recruitment Process for Administrative PersonnelThe staff requirement during the years will be constant since it is not dependent on the variationin the occupancy of the hospital. The following points have been considered while drawing upthe recruitment plan.1. The heads of most administrative departments have been recruited in advance owing to the fact that many of them will have to be deputed for orientation program.2. The HRD Development Team have been identified and recruited in the very beginning so that they can oversee the entire recruitment process of staff at various levels.3. The clerical level staff will be recruited just before the soft commissioning of the hospital. However adequate training period has to be accounted for while drawing up the recruitment plan.The recruitment process for all heads of departments will follow similar schedule. The onlyexception to the general rule is in the case of the HRD Development who has been to berecruited earlier than most administrative heads.The Executive and clerical level staff can be placed in the hospital just before operationscommence. The schedule however accounts for their training period before the date of softcommissioning.Recruitment Process for Support Service PersonnelThe following departments will constitute support services in the hospital:1. Engineering and Maintenance2. Biomedical Engineering3. Information Technology4. Medical Records5. Front Office6. Food and Beverages7. Security
8. House keepingThe recruitment of all the above departments has been be conducted in the following staffcategories:1. Heads of Departments2. Executive staff / Clerical staff3. Contract staffThe pattern of recruitment will be uniform in all cases with the exception of the following:1. HOD- Engineering and Maintenance2. HOD-Biomedical Engineering,3. HOD-Information technologyThe above departmental heads will have to be in place by the time the installation ofEngineering equipment, biomedical equipment and LT hardware and networking takes place.They would be placed in the hospital prior to the date of soft commissioning.INDUCTION & ORIENTATION IN SAHARA HOSPITALSAll new incumbents shall undergo a comprehensive induction program for familiarization of theorganization’s process, structure and people.The induction period sows the seeds for bringing out the best in the employee and enablesemployees to settle down quickly to perform their duties well.During this process the employee gets to know the mission and goals of the organization, itsvalues and norms and his expected behavior pattern.During this process, the new employee is provided with Induction Kit comprising the inductionmanual, service rulebook, all forms related to joining formalities of an employee.
It is mandatory that all the employees should attend the Induction program before they startreporting to their respective departments. After the successful completion of this program anOrientation form is filled up and attached in the personal file of that employee.INDUCTION PROGRAMInduction Program is a 3-4 days program, which is given to the newly employed staff (doctors,nurses, technicians, administrative staff etc.) and would include a series of lectures on varioustopics. The induction program introduces the employee to the Hospital about the generalfunctioning of the Hospital and would also include hospital rounds. Manager – HR isresponsible to organize this in the Hospital with timely integration with the commencement ofoperations and in relation to the joining dates of batches of employees.The Induction Program provided by the Hospital would include:• Introduction to the Hospital• Organization structure• Role of various departments• Importance of infection control• Communication and team work• Psychology of patient.• Human values etc.Need Based Training ProgramThe training is general to all departments and at all levels except for a few topics, which arespecific to executive and managerial cadre. These program are mainly aimed at developing thebehavioral aspects of individuals and will be more focused toward employees who interactdirectly with the patient.Technical Training Program
Technical training program consist of on-the-job training and would be given to the technicalemployees of the hospital. The technical training program is aimed at updating the technicalskills and knowledge of the employees according to the latest development in the fields.Technical training is generally given to the employees of the medical, nursing and paramedicaldepartments.What to avoid in Induction• Providing too much, too soon; the inductee must not be overwhelmed by a mass of information on the first day. Keep it simple and relevant.• HR rather than local personnel providing all the information – it should be a shared process.• Creating an induction program which generates unreasonable expectations by overselling the job.• Having to repeat the unproductive learning curve of the leaver damage to the company’s reputation.New HR Tactics for New ChallengesIncreasing rates of attrition are compelling HR departments in hospitals to rethink theirstrategies. Rita Dutta reportsIt was an entertaining and competitive evening with scintillating dancing and singingcompetitions and games at the Mumbai-based Dr LH Hiranandani Hospital. Winners weregifted with TVs, DVD players, microwave ovens and so on. Surprised?
It was a part of the well-crafted HR strategy to scale up the happiness and satisfaction quotientof employees. Whether it is cheering employees by celebrating their birthdays, weekend cricket,creating a sense of empowerment by making them stakeholders, weaving a cocoon of safety andsecurity, extending medical benefits after superannuation, or emphasizing training anddevelopment, the Human Resource Developments (HRD) in major hospitals are rolling outinnovative plans to woo employees. Having weekend cricket with employees is an HR strategy at Dr LH Hiranandani HospitalDynamics Are ChangingWhy this sudden awakening of hospital HRDs? The change is fuelled by an attrition rate of 15to 20 per cent in hospital administrators and managers in the last six months, a result of theburgeoning USD 23 billion Indian healthcare industry, growing at an annual rate of 13 per cent.New hospitals in Mumbai, Delhi and Bangalore are poaching employees from establishedhospitals by upping their salaries by 30 to 40 percent, say analysts. (See box for an estimate ofsalary hike in new hospitals)Gone are the days when an employee stuck to an organization for decades together working fora modest salary, while a few years back, a fresher with MHA received a salary of Rs 12,000 toRs 15,000, today he commands a salary of Rs 20,000 in corporate or upcoming hospitals. Amanager with three years experience, who used to earlier receive Rs 35,000 to Rs 40,000, todaypockets Rs 1lakh and above says unofficial estimates.
An opportunity for better career growth, stagnation and lack of job enrichment at the present organization are also driving employees to new hospitals" Ankush Gupta Senior Manager, HR and Administration, Hiranandani HospitalThe flip side of the boom is faced by the hospitals losing their top guns. In the last six months,Hiranandani Hospital lost eight key people, while Wockhardt Hospitals, Mumbai and PDHinduja Hospital, Mumbai lost eight and four people, respectively to the upcoming hospitals.Rockland Hospitals, Delhi has lost four key people. The sudden exits sometimes have HRDs attheir wit’s end scouting for immediate replacements within 24 to 48 hours. “I had to replace mymaterials manager within 24 hours. Sometimes, it becomes quite challenging,” says a harriedGupta. Coping with the crisis has made most hospitals realize that their HR policies needs to bebetter defined. Opines Gurushant Phatate, General Manager, HRD, Jaslok Hospital andMumbai, who worked in the steel industry earlier, “Hospital HR is definitely less well-definedwhen compared to other industries.”And why is it sketchy? S Patnaik, Senior General Manager, HR, Apollo Indraprastha Hospital,New Delhi explains, “Hospitals have always accorded more importance to doctors than theirinternal customers—administrators, nurses or ward boys. Hence, HR for other employees nevertook concrete shape, until recently.” Additionally, there is lack of trained HR personnel inhealthcare. “Most of the HR personnel in healthcare come from the FMCG and pharma sector,without any training in hospitals and thus fail to address the finer nuances,” avers Dr Alok Roy,Vice President, Operations, Fortis Hospital and Noida.Where the Problem LiesIt’s only a handful of hospitals which chart out a career graph for their employees whilerecruiting them, convey the group’s vision, train them or take steps to appreciate their work.Asian Heart Institute (AHI) learnt the importance of communicating with its employees the hardway. A host of people left the organization in its first year of operations. Dr Bhaskar Shah,Director, AHI reveals, “Employees were unsure of their growth and future in the organization as
we did not clearly define our group’s vision to them. But, now we have learnt from our mistake.We hold regular training sessions with employees.”According to Tufan Ghosh, CEO, Columbia Asia Hospital and Bangalore, “HR in hospitals ishierarchy-driven, which does not necessarily translate into career growth. There is no unifiedchain of command as the medical and the administration departments are mostly at loggerheads,preventing one from taking the right decision.” He feels that the recruitment process in hospitalsis heavily skewed towards people with the right technical knowledge than those with the rightbehavioral approach.Different hospitals are beset with different HR problems. Mumbai-based Jaslok Hospital, likemany other hospitals, has to cope with high degree of absenteeism and indebtedness in class IIIand class IV employees. Every year, around 30 people are suspended from Jaslok Hospitalbecause of absenteeism. This is after they are served innumerable warnings and show causenotices. “We also have a hard time trying to pay cheques of people with high debts,” says adistressed Phatate. To avoid such problems, most hospitals have started outsourcing Class IVstaff. "Hospital HR is definitely less well-defined when compared to other industries" - Gurushant Phatate, General Manager, HRD, Jaslok Hospital
Unions MatterThe dynamics of hospital HR are different in a unionized hospital, which often prevents theauthorities from taking immediate and stringent punitive measure against an errant employee.For instance, when an employee was found to be inebriated during duty in a major Mumbaihospital, the hospital authorities could not take any immediate action against him. Only after theenquiry committee filed its report after one and a half years, the employee was suspended forthree days. “Does such punishment hold any meaning?” asks an HR person.Lack of proper appraisal system can also lead to disgruntled employees and thus poorperformance. Most unionized hospitals do not have performance-based appraisal, except formanagers. The yearly hike is decided during the time of appointment, which is a demotivatingfactor.According to Dr SK Biswas, VP, Duncan Group, Kolkata, “Often employees grudge the hikesgiven to them, without knowing the dynamics behind that hike. A hospital needs to explain itsKey Result Areas (KRAs) to the employees, monitor their progress during the course of thefinancial year and then make them understand why a particular salary hike was given. This isthe KRA for the HR Department of a well-administered hospital.” The concept of ‘BalancedScore Card Approach’, a management tool introduced by Kaplan and Norton of HarvardUniversity thus assumes significance in HR. In this frame-work, the approach is to ensure betterfocus, accountability, alignment and communication at all levels, with the objective of fourinter-dependent perspectives of training and development, well-defined internal process,customer satisfaction, therefore more patients inflow and hence revenue viability.“The impact of behavior of employees on the revenue and the importance of balancedscore card needs to be explained to them,” says Dr Biswas, a firm believer in this innovativeconcept.Even as HR policies are taking shape, are all HR personnel given the power to execute policies?Dr Shreedhar V Sherigar, Chief Manager, Personnel & Human Resources, Breach CandyHospital, Mumbai fumes, “Most hospital managements twist HR for their own benefits. HRpersonnel end up being lackeys of the management.”
Ways to Curb Attrition RateTo curb the high attrition rate, the success mantra for a hospital is not just offering a fat paypacket, but chalking out long-term development and career growth for employees, along withgiving them a sense of empowerment. “A hospital should always innovate, keep theiremployees busy with various projects,” suggests Dr Roy.So that the functioning of a hospital is not plagued by somebody’s sudden exit, it is important tokeep a databank of apt substitutes ready. “I always chat with my employees trying tounderstand who is not happy and may leave the organization. I try to address theirproblems and grievances and always keep the replacements ready,” says Gupta. AnupamVerma, Director, Administration, PD Hinduja Hospital agrees, “We always keep a second lineof people ready so as to avert a sudden crisis.”Multi-tasking also comes handy in times of crisis. “It is the job of HR to identify the right talent,encourage and train them for multi-tasking,” says Dr Biswas.Winds of ChangeAccording to Dr Bidhan Das, Director, Administration, Rockland Hospital, “It is the role ofHR to analyze behavioral patterns whether it is a high-skilled surgeon or a low-skilledsecurity guard, chart their behavior for months together and then use targetedintervention, which is accomplished through behavioral and motivational training.”Manipal Hospital, Bangalore, like some of its counterparts, is consciously creating a workingenvironment that facilitates a performance-driven culture. “Performers are motivated with ampleopportunities to take up challenging assignments. We empower employees to take decisions andthus instill self-confidence and sense of pride in working for us,” says R Basil, CEO andManipal Hospital. The hospital also conducts sports and cultural activities for a span of threemonths in parallel with regular work every year, which culminates in the annual Manipalfestival called Manifest. “All these go a long way to instill a sense of loyalty not only among ouremployees but also among the consultants, who are not on our direct payroll,” says Basil. Theimportance of well-defined HR is slowly taking root. With a spate of new hospitals, there is
renewed emphasis on training and development. “From focusing on Industrial Rules (IR) orunion-related activity, hospital HR is now making a paradigm shift towards training &development and customer satisfaction (both internal and external),” says Patnaik.“Listen to the winds of Change.” Welcome to the employees’ world!!‘HR Should Never Cave In To Any Favoritism’The Chairperson for Mumbai Hospital HR Forum and Head of HRD with Reliance’s (ADAGGROUP) Kokilaben Dhirubhai Ambani Hospital (previously Mandke Heart Hospital), SunilKaranjikar, is a busy man these days crafting HR strategies for the upcoming hospital. In acareer spanning 12 years, Karanjikar has worked with Tata SSL (Wire Division), a subsidiarycompany of Tata Iron & Steel Company, Voltas, Norwegian conglomerate Norsk Hydro andSaint Gobain Sekurit India. Dabbling in the healthcare industry for the last two years, he isrespected in the industry for setting the HRD standards in PD Hinduja National Hospital andMedical Research Centre, when he was the Deputy Director, Personnel & HR. An ExecutiveCommittee member and treasurer of National Institute of Personal Management, MumbaiChapter and HR Committee member of Bombay Management Association, he discusses theparadigm shift needed in HR related to healthcare, in an interview with Rita DuttaHR in healthcare is sketchy. Do we need to overhaul the present HR systems in hospitals?A doctor’s role in treating patients is important, but the time he spends with patients is very lesscompared to others. Yet, it is always the doctor who is treated as demi-god both by patients andmanagement, forgetting others who are also serving the patient. We need a 360-degree changein HR approach, so that the support staff is also given the equal importance they deserve. Ahospital needs to have such HR standards, which act as a magnet to attract talent.What changes did you bring in at Hinduja Hospital’s HR?During the two years of my tenure, I have helped the hospital not only to attract the right talentbut also successfully implemented various HR initiatives to make the workplace people-centric.‘Team HR’, which we used to call ourselves, started by designing an HR mission, based onwhich various initiatives were taken.
In one year, almost 20 innovative HR practices were successfully implemented, includingcelebration of birthdays of all employees by the department heads, presentations by employeesafter attending external training programs for knowledge of other employees and union leader-employee discussions. We also introduced dance classes for doctors and administrative staff,training programs and HR survey to understand the needs of employees.What are the main challenges faced by HR personnel?To begin with, we have to maintain quality of service, which we attain by inculcating the rightphilosophy and principles in our staff. Training programs are thus very important. It is achallenge to create passion for work in people and that applies for HR people too. Secondly, wehave to battle with attrition, which is highest in nurses. Besides a good salary, we need to givepeople fancy designations, career paths, and empower them, which will lead to betterproductivity. We should also have a succession plan for at least the top two levels.We have to attract the right talent, because there is a dearth of trained personnel. The parametersof judging talent are different for various roles; soft skills have assumed immense significancetoday. People are in a sensitive state of mind when they visit a hospital and one small mistake orslip in service can be blown out of proportion. Even doctors cannot afford to be rude withpatients. Additionally, we have to increase the level of transparency and trust in employees andmake the hospital people-centric.However, the most important challenge lies in not caving in to the demands made by doctorsand management to hike salaries or promote certain people, whom they think are goodperformers.We must put our foot down, because if we agree to their demands every time, we end up notonly upsetting the salary level of everybody else in the same category, but also the financialgoals at the end of the year. Rules and regulations apply to all and favoritism cannot be allowedunder any circumstances. Such situations mostly arise when the organization is dictated by oneperson.A renowned CEO of a prominent Mumbai-based hospital left the organization some years backas the management were not ready to listen to his suggestions for improvement. What is the roleof HR in such situations?
It is very sad that sometime people at the helm don’t understand professionalism. It is the topmanagement which should support all strategic plans of its CEO. Nobody appoints a CEOwithout understanding his professional status, credentials and the work he has done in the past.What we need is more transparency while recruiting top people. There is a need to decentralizepower.There is a sudden hike in salaries in healthcare. What impact will it have on employees’mindsets?The hike is well-deserved and expected considering the boom in the healthcare industry. Mosthospitals don’t pay heed to rewarding their own employees. They fail to understand that theranking they have is not only because of their technology or medical practitioners, but also dueto hard work put in by the employees working in Para-medical, nursing and administrativeareas.Salary in healthcare has never been competitive, be it for marketing, finance, HR, administrationor technicians. I want people to feel cheerful while coming for work and not have Mondaymorning blues. Rectifying salary is the one of the steps towards achieving that goal.is lack of skilled HR professional in healthcare. Please comment.Yes, that is true. HR is not seen as a lucrative career option in hospitals as students opting forprofessional healthcare courses believe that they only go for administration in a hospital. Thereare only a few institutes, like TISS, Mumbai, ASCI and IIHMR which have HR courses relatedto healthcare. While we need more such institutes, keeping in synch with times, most of theseinstitutes need to modify their syllabus.INTERNAIONAL HUMAN RESOURCE MANAGEMENTThe shortage of health human resources (HHR) has been identified as one of the majorchallenges facing Trinidad and Tobago and the region of the Caribbean and the Americas for anumber of years. WHO estimates that a total of 4 250 000 health workers, are needed to fill thehuman resources gap that exists in fifty-seven countries, and that without prompt action, theshortage will worsen.
The health human resource shortage in Trinidad and Tobago has been exacerbated by themigration of health care professionals from the country. This migration is not unidirectional,however; statistics for 2008 show that there was a net inflow of medical doctors to Trinidad andTobago. There were 501 Trinbagonian doctors resident abroad, and 1180 foreign doctorsregistered with the Medical Board of Trinidad and Tobago.International FactorsThe ability of the health system to effectively respond to the changing needs and health profileof the population has been constrained by the shortage of health personnel and the absence of acomprehensive approach to HR planning for health that adequately incorporates theinternational factors. Some of these international factors include:• the international composition of the health workforce in Trinidad and Tobago;• the impact of the international labor market for health on the domestic health labor market;• the migration of health professionals into and out of Trinidad and Tobago;• national and regional codes of practice on recruiting of health care workers;• existing bi-lateral arrangements between Trinidad and other countries for the supply of health workers;• the opportunities that exist to strategically pursue internal cooperation arrangements with other countries;• the impact of international training institutions on the supply of health care workers to Trinidad and Tobago;• the capability and capacity of local training institutions
Health System Labour PoolNational Health Labor Market Inflows: National Health Labor Market Outflows local and regional and international training institutions MigrationEffective recruitment and retention strategies International health labor marketMigration Ineffective national retention strategiesInternational health labor market International recruitment agenciesGovernment’s policies and plans Foreign policy and international cooperationForeign policy and international cooperation Internationally relative social and economic conditionsSocial and economic conditions International and bilateral treatiesBilateral treaties and arrangements on Recruitment Absence of an international Code of Practice on Recruitment of health personnel of health personnelFactors impacting on the national labor market determine the size and composition of the poolof health care workers for the country. This pool comprises all persons that are willing to workin the health sector in Trinidad and Tobago and possess the necessary qualifications and meansto do so. It is important to note that the labor pool is not limited to a geographic area or aspecific nationality. The health labor pool will comprise mainly nationals and residents,however, eligible non-residents and non-nationals would also be a part of that pool.The size of the health labor pool is determined by the national health labor market inflows andoutflows, which are themselves influenced by both national and international factors. Where thelabor market inflows exceeds the outflows an increase in the size of the labor pool results, andwhen the labor outflows exceed the inflows, the labor pool decreases in size.The health labor market inflows are in turn influenced by: inward migration; training programavailable at local, regional and international training institutions and the throughput of healthgraduates; the employment of effective recruitment and retention strategies; bilateral treaties andarrangements on the recruitment of health workers; government’s policies and plans; and thecountry’s foreign policy and international cooperation.
Labor market outflows are influenced by: the level of migration of health workers from thecountry; demand and supply conditions in the international labor market; ineffective and poorlyinstituted retention strategies; recruitment practices of international recruitment agencies;superior living standards in countries that are competing for health workers; and foreign policyand international cooperation; and the absence of an international code of practice on therecruitment of health workers.The challenge that nation states face is how to increase its health labor pool given the globalizednature of human resources for health and the fact that there is an international shortage of healthhuman resources. Any manpower plan and strategy to increase the size of a country’s healthlabor pool must therefore be international in scopeAt the national level, these include:1. The health needs of the population;2. The health profile of the population;3. The social determinants of health; and4. Government’s policies and plans.At the international level, these include:1. The country’s commitment to regional and international health goals;2. The growing numbers of multinational fast food establishments;3. The multinational tobacco companies;4. International marketing that induces health impacting behavior;5. International trade; and6. US deportation policies with respect to Trinidad and Tobago and the CARICOM region.