166 Economics, Management, and Financial Markets Volume 8(4), 2013, pp. 166–171, ISSN 1842-3191 THE IMPORTANCE OF HUMAN RESOURCES MANAGEMENT TO THE HEALTH CARE SYSTEM ELVIRA NICA [email protected] Academy of Economic Studies, Bucharest ABSTRACT. This paper discusses the major trends in scholarship about the role of HRM in strategic management, the migration of health workers, human resource professionals’ attempt to deliver high-quality health care to citizens, and the im- portance of human resources in the health care industry. The purpose of this article is to gain a deeper understanding of the impact of human resources on health sector reform, the importance of HRM in all aspects of healthcare organizations, the positive impact of increased job autonomy on employee outcomes, and the dynamics of employee engagement in healthcare. The literature on the link between HR system perceptions and civility towards patients, specific roles for HRM in building shared values that can service both the care needs of patients and the business needs of health organizations, the complex linkages between employees’ perceptions of human resources systems and hospital performance, and the mechanisms through which HRM can enhance patient satisfaction in health care organizations is relevant to this discussion. JEL Codes: E24, J24, O15 Keywords: HRM; health care system; hospital; employee; patient 1. Introduction I am specifically interested in how previous research investigated the im- portant roles that HRM can play in orchestrating organizational change, the relationship between human resources and health care, the job satisfaction of healthcare employees, and the impact of HRM in the health sector. This paper aims to analyze and discuss the impact of human resources on the health care system, information that human resource managers can apply to the healthcare industry, the education and in-service training of health care workers, and the impact of HRM practices on health sector outcomes. The theory that I shall seek to elaborate here puts considerable emphasis on the 167 different types of employees in the healthcare industry, HRM’s significant role in the distribution of health care workers, the importance of safety climate in determining patient safety outcomes, and the use of HRM in the health sector. The mainstay of the paper is formed by an analysis of the impact of changes in HRM practice on employee and patient outcomes, the role that HRM activities play in the operations of a healthcare organization, the labor shortage in the healthcare industry, and the ability of public health organizations to afford full-time human resources employees. 2. The Impact of HRM in the Health Sector Human resources management (HRM) plays an essential role in the health care system. The relationship between HRM and health care is complex. Both the number and cost of health care consumables can ...

1. 166
Economics, Management, and Financial Markets
Volume 8(4), 2013, pp. 166–171, ISSN 1842-3191
THE IMPORTANCE OF HUMAN RESOURCES
MANAGEMENT
TO THE HEALTH CARE SYSTEM
ELVIRA NICA
[email protected]
Academy of Economic Studies, Bucharest
ABSTRACT. This paper discusses the major trends in
scholarship about the role of
HRM in strategic management, the migration of health workers,
human resource
professionals’ attempt to deliver high-quality health care to
citizens, and the im-
portance of human resources in the health care industry. The
purpose of this article
is to gain a deeper understanding of the impact of human
resources on health sector
reform, the importance of HRM in all aspects of healthcare
organizations, the positive
impact of increased job autonomy on employee outcomes, and
the dynamics of

2. employee engagement in healthcare. The literature on the link
between HR system
perceptions and civility towards patients, specific roles for
HRM in building shared
values that can service both the care needs of patients and the
business needs of
health organizations, the complex linkages between employees’
perceptions of human
resources systems and hospital performance, and the
mechanisms through which
HRM can enhance patient satisfaction in health care
organizations is relevant to this
discussion.
JEL Codes: E24, J24, O15
Keywords: HRM; health care system; hospital; employee;
patient
1. Introduction
I am specifically interested in how previous research
investigated the im-
portant roles that HRM can play in orchestrating organizational
change, the
relationship between human resources and health care, the job
satisfaction
of healthcare employees, and the impact of HRM in the health
sector. This
paper aims to analyze and discuss the impact of human
resources on the
health care system, information that human resource managers
can apply to
the healthcare industry, the education and in-service training of
health care
workers, and the impact of HRM practices on health sector

3. outcomes. The
theory that I shall seek to elaborate here puts considerable
emphasis on the
167
different types of employees in the healthcare industry, HRM’s
significant
role in the distribution of health care workers, the importance of
safety
climate in determining patient safety outcomes, and the use of
HRM in the
health sector. The mainstay of the paper is formed by an
analysis of the
impact of changes in HRM practice on employee and patient
outcomes, the
role that HRM activities play in the operations of a healthcare
organization,
the labor shortage in the healthcare industry, and the ability of
public health
organizations to afford full-time human resources employees.
2. The Impact of HRM in the Health Sector
Human resources management (HRM) plays an essential role in
the health
care system. The relationship between HRM and health care is
complex. Both
the number and cost of health care consumables can drastically
increase the
costs of health care. In both government-funded and employer-
paid systems
(Hunter, 2013a), HRM practices should help in finding the

4. appropriate
balance of workforce supply (Kunnanatt, 2013) and the ability
of those prac-
titioners to practice effectively and efficiently. Human
resources in health
sector reform aim to improve the quality of services and
patients’ satisfac-
tion. Effective HRM is crucial to health care in a practical
setting, playing a
vital role in the success of health sector reform. HRM plays an
important
role in investing in employee development. The migration of
health care
workers arises when examining global health care systems. The
specific
health care reform process varies by country. Accessing good-
quality health
care services can be arduous for those living in developing
countries (med-
ical personnel and resources may not be available or accessible
for such
residents), and the issue of migrant health care workers is
critical. The mig-
ration of health workers to more affluent regions and/or
countries results in
citizens in rural areas of developing countries experiencing
difficulties re-
ceiving adequate medical care. (Kabene et al., 2006)
Human resources can be applied to any activity of the
operations of an
organization (HRM is an administrative function of an
organization). It is
the responsibility of HRM personnel to ensure that legally
mandated em-
ployee benefits are implemented correctly. Terminating an

5. employee influ-
ences the individual’s life and livelihood. Healthcare
organizations aim to
provide quality of care to their patients. Underperforming
employees could
risk the lives of their patients. Employees are motivated to
perform well by
the quality of work environment. The increasing diversity of the
workforce,
the globalization of health care, technology’s impact on the
healthcare sys-
tem, and the focus on teamwork and quality patient care
influence HRM. The
increased diversity of employees and patients can be linked to
the increased
globalization of health care. (Niles, 2013)
168
3. The Relationship between Human Resources and Health Care
Human resources have been a neglected component of health-
system devel-
opment in low income countries. Investment in human resources
for health
has been insufficient in absolute terms and has been inefficient
in its dis-
tribution. The pool of health workers in low and middle income
countries has
been depleted. HIV/AIDS increases the numbers of health
workers willing
to work overseas. Training strategies tend to emphasize initial
training over
continued professional development. Poor working conditions

6. and remuner-
ation push health workers out of the public sector, the health
sector, or the
country. Training strategies that fail to emphasize continued
professional
development and poor working conditions and remuneration
affect the num-
bers of health workers and their quality and performance. Nurse
training is
a highly saleable asset in the international market. In Africa,
nurse aids,
medical assistants, and clinical officers are doing essential
medical tasks
despite the existence of professional restrictions and
regulations. Use of
non-medically qualified health staff may affect quality and
safety, whereas
use of provider incentives and enablers (Pera, 2013) can
improve performance
under specific circumstances. Human resources have been a
neglected com-
ponent of health-system development. The grounds of public
and health
sector reform are strongly contested, whereas reforms have
undermined
human resources in health sectors. The HRM (strategic)
function should be
substantially upgraded in the health sector. (Hongoro and
McPake, 2004)
Governance encompasses the role of the government in health
care and
its relation to other actors whose activities impact on health,
involving dif-
ferent components, from policy and legislation formation to
financing and

7. monitoring. There are glaring inequalities between countries in
terms of their
public financing (Nicolăescu, 2013a) of mental health. Level of
human re-
sources and presence of advocacy groups are liable to influence
the invest-
ment made in mental health. Primary care and mental health
services are
linked by the establishment of formalized referral procedures.
Training on
mental health issues is weak in primary care settings. Outpatient
facilities
provide a primary point of care in community settings. The
continued expan-
sion of outpatient facilities is vital to reduce the treatment gaps
for mental
disorders. Mental hospitals represent the primary mode of
inpatient service.
A mental hospital provides inpatient care and long-stay
residential services
for people with mental disorders. A decrease of resources spent
on mental
hospitals represents a positive change, whereas a paucity of
general hospital
psychiatric beds does not replace mental hospitals in caring for
acute mental
disorders. Family and user associations are important allies in
fighting for
the health care and rights of people with mental disorders.
(Morris et al., 2012)
169

8. 4. The Various Functions of HRM in Health Care Systems
In the health context, high-involvement management adds to the
human
capital of the workforce. HRM practices affect intermediate
outcomes in
the health sector. (Patterson et al., 2010) Some elements of
health-related
activity have not received the full benefit of modern human
resources capa-
bilities. (Fleming Fallon, Jr., and McConnell, 2007) The
relationship between
employees’ human resources system perceptions and patient
satisfaction is
mediated by employees’ civility towards patients (i.e., by the
extent to which
employees treat patients with courtesy, dignity and respect), a
behavioral
human resources outcome negatively affected by employees’
intention to
leave. (Baluch, Salge, and Piening, 2013) Hospitals aim to
achieve high
levels of clinical performance. HRM processes positively
influence organi-
zational-level performance. In the context of management,
information
management, and health and safety processes, the effective
functioning of
HRM processes (Hunter, 2013b) influence the continuity of
quality patient
care. The effectiveness of HRM processes (Yuan, 2013)
moderates the re-
lationships between: (1) strategic and operations management
processes,
and (2) health and safety processes and the continuity of quality
patient

9. care. When examining the influence of the effective functioning
of HRM
processes on organizational-level performance (Bacalu, 2013) in
hospitals,
one should consider the simultaneous and interdependent
influence of mul-
tiple processes. (Townsend, Lawrence, and Wilkinson, 2013)
Pro-social
organizational behavior (PSOB) is important in health
organizations where
service provision involves high levels of task interdependence
(Sánchez de
Madariaga, 2013), task complexity and uncertainty: value-
driven human re-
sources may offer one means of maintaining and encouraging
both altruistic
and conscientious act of PSOB on which health care depends.
(Hyde, Har-
ris, and Boaden, 2013)
Managers can improve patient care experiences by improving
employee
satisfaction and retention. Health system performance depends
on a capable
workforce in healthy and productive workplaces. The quality of
the work
environment (Fost, 2013) for staff and physicians is a key
determinant of a
high-performing healthcare organization. More-engaged
employees are better
able than their less-engaged colleagues (Cremers, 2013) to
achieve organi-
zational goals. Using a variety of tools, healthcare organizations
assess the
quality of patient care and of the non-clinical services provided.
Achieving

10. higher levels of employee engagement is part of the solution to
quality im-
provement. Engaged employees benefit patients and reduce the
workforce
costs associated with turnover. Higher levels of employee
engagement must
become a strategic goal for all healthcare organizations. The
key to unlock-
ing higher levels of engagement is for managers at all levels to
build trust
170
with employees. Trust building happens in every interaction
(Nicolăescu,
2013b) and becomes engrained in an organization’s culture
(Prager, 2013),
whereas culture becomes the vital link between positive staff
experiences and
performance. Highly engaged employees are able to perform
effectively in
their job (they have a supportive supervisor and adequate
resources and
equipment). (Lowe, 2012)
5. Conclusions
Over the past decade, there has been increasing evidence
describing effec-
tive HRM practices and their effects on employees within the
health sector,
the roles human resources play in improving performance
outcomes, human

11. resources initiatives for health sector reform, and the quality
and produc-
tivity of the health workforce in low income countries. My
paper contributes
to the literature by providing evidence on initiatives made by
human re-
sources professionals in an attempt to improve the overall
standard of care
in the hospital, the contribution of HRM to successful strategic
planning,
strong relationships between employee engagement and
organizational per-
formance, and the various functions of HRM in health care
systems. The
paper generates insights about HRM’s integral role in strategic
planning to
address workforce needs and projected shortages, training as a
solution to
human resource difficulties, the impact of HRM interventions or
practices on
job satisfaction among health professionals, and the trends in
health sector
reform.
REFERENCES
Bacalu, Filip (2013), “The Role Language Plays in Social
Behavior,” Analysis and
Metaphysics 12: 154–159.
Baluch, Alina M., Torsten Oliver Salge, and Erk P. Piening
(2013), “Untangling the
Relationship between HRM and Hospital Performance: The

12. Mediating Role of
Attitudinal and Behavioral HR Outcomes,” The International
Journal of Human
Resource Management (Special Issue: HRM in the Healthcare
Sector) 24(16):
3038–3061.
Cremers, Jan (2013), “Non-financial Reporting and Reference to
Workers’ Repre-
sentatives,” Contemporary Readings in Law and Social Justice
5(2): 50–89.
Fleming Fallon, Jr., L., and Charles R. McConnell (2007),
Human Resource
Management in Health Care Principles and Practice. Sudbury,
MA: Jones and
Bartlett Publishers.
Fost, Joshua (2013), “The Extended Self, Functional Constancy,
and Personal Iden-
tity,” Linguistic and Philosophical Investigations 12: 47–66.
Hongoro, Charles, and Barbara McPake (2004), “How to Bridge
the Gap in Human
Resources for Health,” Lancet 364: 1451–1456.
171
Hunter, Murray (2013a), “Capabilities throughout the
Organization Lifecycle,” Psy-
chosociological Issues in Human Resource Management 1(1):
37–107.
Hunter, Murray (2013b), “Imagination May Be More Important

13. than Knowledge:
The Eight Types of Imagination We Use,” Review of
Contemporary Philosophy
12: 113–120.
Hyde, Paula, and Claire Harris, and Ruth Boaden (2013), “Pro-
social Organizational
Behavior of Health Care Workers,” The International Journal of
Human Re-
source Management (Special Issue: HRM in the Healthcare
Sector) 24(16):
3115–3130.
Kabene, Stefane M., Carole Orchard, John M. Howard, Mark A.
Soriano, and
Raymond Leduc (2006), “The Importance of Human Resources
Management in
Health Care: A Global Context,” Human Resources for Health
4: 20.
Kunnanatt, James Thomas (2013), “Globalization and
Developing Countries: A Global
Participation Model,” Economics, Management, and Financial
Markets 8(4):
42–58.
Lowe, Graham (2012), “How Employee Engagement Matters for
Hospital Perfor-
mance,” Healthcare Quarterly 15(2): 29–39.
Morris, Jodi, Antonio Lora, Ryan McBain, and Shekhar Saxena
(2012), “Global
Mental Health Resources and Services: A WHO Survey of 184
Countries,”
Public Health Reviews 34(2): 1–19.

14. Nicolăescu, Eugen (2013a), “Developments in Corporate
Governance and Regulatory
Interest in Protecting Audit Quality,” Economics, Management,
and Financial
Markets 8(2): 198–203.
Nicolăescu, Eugen (2013b), “Understanding Risk Factors for
Weaknesses in Internal
Controls over Financial Reporting,” Journal of Self-Governance
and Manage-
ment Economics 1(3): 38–43.
Niles, Nancy J. (2013), Basic Concepts of Health Care Human
Resource Manage-
ment. Burlington, MA: Jones & Bartlett Learning.
Patterson, M., J. Rick, S. Wood, C. Carroll, S. Balain, and A.
Booth (2010), “Sys-
tematic Review of the Links between Human Resource
Management Practices
and Performance,” Health Technology Assessment 14: 51.
Pera, Aurel (2013), “The Social Aspects of Technology-
enhanced Learning Situations,”
Geopolitics, History, and International Relations 5(2): 118–123.
Prager, Jonas (2013), “The Financial Crisis of 2007/8:
Misaligned Incentives, Bank
Mismanagement, and Troubling Policy Implications,”
Economics, Management,
and Financial Markets 8(3): 11–56.
Sánchez de Madariaga, Inés (2013), “Advancing Gender
Equality in Research and
Innovation in Europe and Beyond: COST Network and
GenderSTE,” Journal

15. of Research in Gender Studies 3(1): 131–143.
Townsend, Keith, Sandra A. Lawrence, and Adrian Wilkinson
(2013), “The Role of
Hospitals’ HRM in Shaping Clinical Performance: A Holistic
Approach,” The
International Journal of Human Resource Management (Special
Issue: HRM in
the Healthcare Sector) 24(16): 3062–3085.
Yuan, Shengjun (2013), “Educational Policies and Economic
Growth in BRICS:
Comparative Perspectives,” Knowledge Cultures 1(3): 32–44.
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