Hospital industry is manpower intensive industry. Manpower management is critical for its performance.

2. Dr. A. K. KHANDELWAL
ASSESOR OF NATIONAL ACCREDITATION
BOARD FOR HOSPITAL AND HEALTH SERVICE
PROVIDER
Medical Director
Anandaloke Hospital & Neuro Sciences
Centre

3. Introduction
The importance of the human resources management
(HRM) to the success or failure of health system
performance has, until recently, been generally
overlooked. Health sector reform in many countries in
the 1990s focused on structural change, cost
containment, the introduction of market mechanisms
and consumer choice but with little direct attempt to
address HR aspects.
In recent years it has been increasingly recognized
that getting HR policy and management "right" has to
be at the core of any sustainable solution to health
system performance

4. The hospital utilises widely divergent groups of
professionals, semi-professionals and nonprofessionals.
It represents high interdependence among services.
A hospital’s success is largely dependent on the quality
of work of its employees. The HR role is the most crucial
in a hospital as it is more people oriented and intensive
rather than equipment oriented.

5. HRM Characteristics in the health sector
HRM in health has to function in a sector with some
unique characteristics.
The workforce is large, diverse, and comprises separate
occupations. Some have sector-specific skills; other can
readily move from the health sector to employment in
other sectors.
The avowed first loyalty of those with sector-specific skills
and qualifications (physicians, nurses, etc.) tends to be to
their profession and their patients rather than to their
employer.
Health is also very labour-intensive – the proportion of the
total spent on staff is much higher in health than in most
manufacturing industries and in many service industries.

6. WHY HRD becomes imperative in health organizations ?
1. Manpower is the most important factor of production of
services.
2. Human resource costs are usually 60 to 70 per cent of the
total cost of the hospital.
3. There is a shortage of quality and quantity of human resource
in our hospitals.

7. 4.There is high turnover among professionals and
para-professionals due to brain drain. Therefore, how
to retain employees has been a challenging task in
hospitals.
5. There is underutilisation and wastage of human
resources in health care organisations due to lack of
professional HRD functions.
6. There is low motivation due to the poor working
conditions, top management being out of touch with
the people, inadequate growth opportunities and lack
of cordial relationships among the staff.

8. How an organised HRD programmes will help?
To achieve and maintain good human relations within
the hospital.
To enable each employee to make his/her maximum
contribution to the recovery of patients.
To ensure respect and well-being of other employees
To ensure maximum development of an individual
who provides quality care to the patient.
To ensure participation in decision making.
To ensure satisfaction of various needs of the patient
in order to help realize the hospital’s goals.

9. Constituents of Health Care Organisations
Doctors who provide the medical treatment.
Nurses who take care of peripheral treatment.
Patients who are the ultimate customers.
Paramedical staff, which provide support services to
the medical staff.
Non-medical staff, which provide maintenance,
ancillary, supportive,administrative and other
services.

10. HRD Model for Hospitals
There is a need for a conducive HR climate, which
is reflected by values of openness, confrontation,
trust, authenticity, proactivity, autonomy,
collaboration and experimentation (also called the
OCTAPACE culture).
In the presence of these values, there exists
harmony in HRD practices, which will result in
concrete results.

11. OPENNESS
It is the spontaneous expression of feelings and thoughts and
the sharing of these without defensiveness.
Both upward and downward communication should be
encouraged.
CONFRONTATION
Facing rather than shying away from the problem.

12. TRUST
Trust should be developed between team member.
It means accepting what other says at face value rather than
looking for ulterior motives.
AUTHENTICITY
It is the congruence between what one feels , says and does.
It reduces distortion in communication.

13. PROACTIVITY:
It means taking initiative, preplanning,and taking preventive action.
Both employer and employees should be proactive to slve the
problem in early stage.
AUTONOMY:
It means using and giving freedom to planand act in one’s own
sphere.
This is effective delegation.

14. ACHEIVEMENT- 42%
RECOGNITIONS-31%
WORK ITSELF-22%
RESPONSIBILITY-21%
ADVANCEMENT-12%
GROWTH-7%
SALARY-6%
CAUSES OF EMPLOYEES SATISFACTIONS

15. COMPANY POLICY AND ADMIN.-36%
SUPERVISION- 18%
RELTIONSHIP WITH SUPERVISOR-10%
WORK CONDITIONS-10%
SALARY-7%
RELATIONSHIP WITH PEERS-6%
PERSONAL LIFE-4%
CAUSES OF EMPLOYEES DISATISFACTION

16. COLLABORATION
It means working together to solve the problem and with team
spirit.
EXPERIMENTATION
It means using and encouraging innovative approaches to
solve problems.

17. Motivation can be defined as the willingness to exert
and maintain an effort towards organizational goals.
Motivation develops in each individual as a result of the
interaction between individual, organizational and
cultural determinants.

18. FEATURES OF SOUND MOTIVATION SYSTEM
To motivate employees positive and reward based
approach should be followed. stick policy should be
used for reforming erring employees.
This carrot and stick policy should be followed in
balanced manner.
A objective appraisal system should there with aim
of improve employees efficieny.
Participative and consultative style of management
and supportive supervision should be adopted..
Career and personal development training programs
Good grievances handling system should be there
There should be good intra-organizational
communication processes.

19. INNER MOTIVATORS
A person's inner drives push and propel him/her towards an
employer, a particular job, career, line of study, or other activity (such
as travel or recreation). It is these drives that Maslow delineates in his
hierarchy of needs, and which we must understand and internalize,
use as guidelines in our efforts to help employees feel motivated.

20. Self-Actualization
Ego
Social Needs
Safety Needs
Physiological Needs
MASLOW'S HIERARCHY OF NEEDS

21. MASLOW'S HIERARCHY OF NEEDS
Applied to workers, it translates as follows:
Physiological Needs
Basic physical needs: the ability to acquire food, shelter, clothing and
other basics to survive
Safety Needs
A safe and non-threatening work environment, job security, safe equipment
and installations
Social Needs
Contact and friendship with fellow-workers, social activities and
opportunities
Ego
Recognition, acknowledgment, rewards
Self-Actualization
Realizing one's dreams, using one's gifts, talents and potential.

22. EXTERNAL MOTIVATORS
The outer (external) motivators are the mirror image
the employer or outside world offers in response to
the inner drives.
These are:
 Good salary
 Old age security benefits
 Medical and other insurance coverage
 An atmosphere of teamwork and cooperation
 Social activities
 Reward and recognition programs
 Incentive programs

23. ACHEIVEMENT- 42%
RECOGNITIONS-31%
WORK ITSELF-22%
RESPONSIBILITY-21%
ADVANCEMENT-12%
GROWTH-7%
SALARY-6%
CAUSES OF EMPLOYEES SATISFACTIONS

24. COMPANY POLICY AND ADMIN.-36%
SUPERVISION- 18%
RELTIONSHIP WITH SUPERVISOR-10%
WORK CONDITIONS-10%
SALARY-7%
RELATIONSHIP WITH PEERS-6%
PERSONAL LIFE-4%
CAUSES OF EMPLOYEES DISATISFACTION

25. PRESENT CONDITIONS and HR Suggestions
The uniqueness of a hospital is that the working
environment is unpleasant and the client system that
one deals with is sick (unhealthy). This makes the
environment difficult and demanding for an individual.
The following suggestion are useful.

26. Doctors
The doctor’s role in the hospital is becoming complex
day by day. With the advancement in diagnosis and
treatment for various diseases becoming multifaceted
and intricate, stress levels for doctors remain high. In
such a scenario, the following is recommended:
1. Clearly define and distinguish the roles for doctors so
they do not have conflicting expectations from others.
2. The doctors are highly burdened with their work
because they keep on hopping to various hospitals as
well as their private clinics. In such cases, their work
schedule should be managed properly or some policies
should be framed.

27. They should be given training in soft skills so as to treat
their patients better.
4. They should be encouraged to attend medical
seminars to update their knowledge about various
diseases and their treatment.

28. Nurses
Nurses are the main support staff for doctors. They spend
the maximum time with patients and are intensively
involved with them. Their work causes maximum stress
and burnout experiences as they are expected to handle
and treat patients with high degree of efficiency,
effectiveness and involvement.
At times they hold negative perceptions of achievement,
recognition, advancement or even the work itself, with its
lack of autonomy or advanced technology.

29. Recommendations are as follows:
1. Their career paths should be broadened so that they may
experience meaningfulness, achievement and recognition in
their work.
2. Self-role integration among nurses should be increased so
that they can make use of their other skills like interpersonal
and communication skills.
3. They should be trained in soft skills as they deal with a sick
client system.
4. They must be imparted training which result in win–win
situations.
5. Teamwork should be encouraged and training should be
provided for this.
6. Periodic meetings with doctors and other staff members
and proper feedback system for nurses should be
implemented.

30. 7. Nurses should be given the opportunity to be more
creative in treating patients through yoga and other
modern physical and mental exercises.
8. They should be given training in developing
confrontation abilities and approaches for creative
problem solving.
9. Participation in various seminars for continuous
medical education should be encouraged.
10. They should express feelings, share ideas, meet and
interact with people to avoid stressful situations.
11. Forums and counselling desks should be formed
where important personal as well as work-related
problems may be solved.
12. Besides, special attention should be given to areas of
patient orientation, social values with focus on patients’
well-being, attitudes towards patients, service skills,
making patients happy and providing emotional support
to them.