A brief idea and concept on Human Resource Management in Hospitals

1. Human Resource Management (HRM)
Brig Gen Dr Zulfiquer Ahmed Amin
M Phil, MPH, PGD (Health Economics), MBBS
North South University (NSU) , Bangladesh

2. Which Personality we belong to:
‘Personality is the persistent characteristic patterns of thoughts,
feelings, and behaviors that make a person unique’.

4. What is Human Resource?
HR has at least two related interpretations depending on context.
The original usage derives from economics, where it was traditionally
called labor, one of four factors of production (Land, labor, capital,
and entrepreneur).
The more common usage within corporations and businesses refers
to the individuals within the firm.

6. Key Assumptions
• The quality and effectiveness of the organization is determined by
the quality of the people that are employed.
• Success for most organizations depends on finding the employees
with the skills to successfully perform the tasks required to attain
the company’s strategic goals.

7. HR is multidisciplinary:
• It applies the disciplines of Economics (wages,
markets, resources), Psychology (motivation,
satisfaction), Sociology (organization structure,
culture) and Law (Maternity Benefit Act, Minimum
Wage Act, Factories Act, etc).
• HR is embedded within the work of all managers, to
get things done.
What is unique about HRM

8. • Authority: The right to make decisions, direct other’s work, and
give orders.
• Line manager: A manager who is authorized to direct the work of
subordinates and responsible for accomplishing the organization’s
goals.
• Staff manager: A manager who assists and advises line managers.
HR managers are generally staff managers.
Terminologies in HRM

10. HR Manager- Line or Staff
HRM For Small Organization
HRM For Large Organization

11. Legacy of HRM

12. The origin of HRM dates back to ancient times. Earliest reference
of HR policy as early as 400 B.C. is found, when the Babylonians
had a sound incentive wage plan.
The status of labor prior to industrial revolution (1760 to 1840)
was extremely low and the relationships were characterized by
slavery, seldom and guild system.

13. Slavery is the system in which property-law are applied to people,
allowing individuals to own, buy and sell other individuals.
The slavery structure was replaced by seldom, which is between
slaves and hired laborers. The structure was related to rural and
agrarian pursuits. Workers belonged to the owners, but were
offered positive incentives.

14. With growth in manufacturing and commercial enterprises, the guild
developed as an extremely hierarchical body with structure of
masters, journeymen, and apprentices.

15. With the advent of Industrial Revolution, the guild system
disappeared. Factory system was developed basing on cottage
industry, leading to enhanced specialization. But this period was
characterized by unhealthy work environment, and poor work
relationship.
A major change was noticed in personnel practices after the World
War I (2014-18). The modern HRM started in 1920 with the
adoption of psychology in management.

16. Industrial growth diminished during the great depression (1929-
1939). Then-on, organizations started offering fringe benefits to
workers to induce them to work. Theories of behavioral science were
used to enhance productivity.
Elton Mayo (Hawthorne Effects), Abrham Maslow (Maslow’s Need of
Hierarchy), Kurt Lewin (Force Field Theory) , Max Weber (Division of
Labor), Frederic Herzberg (Two factor theory of motivation), David
McClelland (*Three needs theory), etc formed the basis of industrial
psychology.
*A need for achievement, a need for affiliation, and a need for power.

17. Hawthorne Effect
Hawthorne Effect:
Employees may work harder and more diligently knowing their
manager is closely watching.

18. Force Field Theory
The idea behind Force Field Analysis (Kurt Lewin} is that situations
are maintained by an equilibrium between forces that drive change
and others that resist change. For change to happen, the driving
forces must be strengthened or the resisting forces weakened.

19. Division of Labor
Max Weber's theory suggests a maximum possible level of
specialization, so that each position can be filled by individuals who
are experts in a narrow area of activity.

20. Two Factor Theory
The two-factor theory (Frederick Herzberg) states that there are
certain factors in the workplace that cause job satisfaction while a
separate set of factors cause dissatisfaction, all of which act
independently of each other.

21. Three Needs Theory
Three Needs Theory (David McClelland) attempts to explain how
the needs for achievement, affiliation, and power affect the actions
of people from a managerial context.

23. Evolution of HRM

25. Period Functions Development
Status
Outlook
1930s Employment
Beginning
Paternalism
1940s Welfare Activities
Struggling for
Recognition
Well-being
1950s Compensation & Benefits •Legalistic
•Operational
1960s Industrial Relations
1970s-
1980s
• Human resource Planning
• Training & Development
• Performance Management
Achieving
Sophistication
•Professional
•Impersonal
1990s-
2000s Strategy implementation Promising
Philosophical
Labor
Officer
Welfare
Officer
Personnel
Manager
HR
Manager
Designation
Clerical Administrative Managerial Executive
Role Strategic Partner
Director/VP
HR
Evolution of HRM in Bangladesh

26. Importance of HRM in Healthcare
• HR management links between employees' performance and the
organization's strategic objectives
• Concerned with manpower planning, with appropriate specialty.
• HR professionals manage the human capital of an organization
•Hire right person with required qualifications and human qualities
•Retention of core personnel
• Deal with problem personnel

27. • Ensure equitable distribution of health work force in the
organization
•Handling grievances
• Creating a conducive working environment
• Ensuring regulatory and legal compliance
•Providing maximum opportunities for personal development of each
employee
•Providing environment and incentives for developing and utilizing
creativity
• Maintaining healthy relationships between individuals and work
groups.
•Employee protection
•Continuous supply of manpower to handle challenging jobs
• Cut cost by Human Resource Budget

30. HRM Planning
In this function of HRM, the number and type of employees needed
to accomplish organizational goals is determined. Information is
collected and analyzed to identify current and future human
resource needs and to forecast changing values, attitude, and
behavior of employees and their impact on organization.
Management Functions

31. HR Planning
Human Resource Planning (HRP) is the process of forecasting the
future human resource requirements of the organization.

32. A. Environmental Scanning:
It involves analysis of external and internal environment of business
to identify issues and opportunities that will influence organization’s
strategic plan.

33. B. Analysis of Organizational Objectives :
Plans concerning technology, production, marketing, finance,
expansion and diversification give an idea about the volume of
future work activity. It is also necessary to decide the time horizon
for which human resource plans are to be prepared.
C. Forecasting Demand for Human Resources :
Human resource planning starts with the estimation of the quantity
and type of personnel required at different levels and in different
departments.

34. D. Forecasting Supply of Human Resources :
It involves evaluation of various sources of supply of human
resources. Organization can acquire workforce from within or
outside the organization. Human resources planning is to deal with
allocation of persons to different departments depending upon the
work-load.

35. E. Estimating Manpower Gaps :
Net human resource requirements or manpower gaps can be
identified by comparing demand and supply forecasts. Such
comparison will reveal either deficit or surplus of human resources
in future. Deficits suggest the number of persons to be recruited
from outside, whereas surplus implies redundant to be redeployed
or terminated. Similarly, gaps may occur in terms of knowledge,
skills and aptitudes.

36. F. Matching Demand and Supply (Gap) :
Once the manpower gaps are identified, plans are prepared to
bridge these gaps. Plans to meet the surplus manpower may be
redeployment in other departments and retrenchment in
consultation with the trade unions. People may be persuaded to
quit through voluntarily retirement. Deficit can be met through
recruitment, selection, transfer, promotion, and training plans.
F. Evaluate and Revise the strategy.

37. These functions are confined to only HRM Division for their own
activities.
2. Organizing – In an organization tasks are allocated among its
members, relationships are identified, and activities are integrated
towards a common objective. Relationships are established among
the employees so that they can collectively contribute to the
attainment of organization goal.
3. Directing – Activating employees at different level and making
them contribute maximum to the organization is possible through
proper direction and motivation. Taping the maximum
potentialities of the employees is possible through motivation
and command.
4. Controlling – After planning, organizing, and directing, the
actual performance of employees is checked, verified, and
compared with the plans. If the actual performance is found
deviated from the plan, control measures are required to be taken.

38. Recruitment and Selection: Recruitment is the process of actively
seeking out, finding and hiring candidates for a specific position or
job.
Sources of Recruitment:
• External recruiting
• Internal Recruiting
• Outsourcing
Operative Functions

39. Job Analysis:
The job Analysis process in HRM helps to identify the requirement
of a job and describe the suitability of a person who is supposed to
perform the job. It has 2 components:
-Job Description: A statement of work to be done.
-Job Specifications: Skills and knowledge required to perform the
job.

41. Human Resource Development
Human resource development is a process to provide its members
with the opportunities and facilities to learn necessary skills and
develop competencies to perform the current jobs and prepare
them for further jobs also.

42. Training and Development:
Training helps employees for operative functions and development
activities help to prepare for higher level responsibilities.

43. A performance appraisal evaluates an employee's skills, achievements,
growth, job performance and overall contribution to a company. It
evaluates:
– Job related strengths
– Development needs
– Progress toward goals
– Determine ways to improve performance
– Promotion decisions
– Retention or termination
– Salary administration
– Performance feedback
– Recognizing individual’s performance

44. Performance Appraisal Methods

45. Performance Appraisal By MBO
MBO approach is the monitoring and evaluation of the performance
and progress of each employee against the established objectives.

46. Behavioral Anchored Rating Scale
A performance management scale that use behavior “statements” as
a reference point instead of generic descriptors commonly found on
traditional rating scales.

47. Assessment Center Method
The assessment center method of performance appraisal combines
role plays, situational judgment tests, presentations, group activities,
interviews, simulations, psychometric tests and other techniques to
make critical talent decisions by the expert observer.

48. A 360-degree feedback is a process through which feedback from an
employee's subordinates, colleagues, and supervisor, as well as a
self-evaluation by the employee themselves is combined to generate
performance report.

49. Cost Accounting Method of Performance Appraisal
Cost accounting method of performance appraisal is the process of
evaluating monetary benefits yield to the organization from the job
performance of an employee. In other words, this method is used to
analyze the cost of keeping the employee and the benefits the
company derives from his/her presence and / or absence.

50. ‘Raters errors’ in Performance Appraisal:
These errors are reflective of our unconscious biases toward the
employee.
1. Halo and Horn Effect
This is when a manager really likes or dislikes an employee and
allows their personal feelings about this employee to influence their
performance ratings of them.

51. 2. Leniency Error
Leniency error is when a raters’ tendency is to rate all employees at
the positive end of the scale (positive leniency) or at the low end of
the scale (negative leniency).
This can happen when a manager over-emphasizes either positive or
negative behaviors.

52. 3. Central Tendency Error
Central tendency error is the raters’ tendency to avoid making
“extreme” judgments of employee performance resulting in rating
all employees in the middle part of a scale.
This can happen either when a manager is not comfortable with
conflict and avoids low marks to avoid dealing with behavioral
issues or when a manager avoids to be questioned by higher boss
for higher grading.
4. Recency Error
Recency error is the rater’s tendency to allow more recent
incidents of employee behavior to carry too much weight in
evaluation of performance over an entire rating period.

53. Compensation
Typically, compensation refers to monetary payment given to an
individual in exchange for their services. Compensation is three type:
- Direct compensation involves monetary payments to employees for time worked or results
obtained.
- Indirect compensation involves expenditures made by an employer on behalf of all
employees (Canteen, Creches etc) and "fringe benefits.“ (Car, house etc).
- Intangible compensation involves non-monetary rewards such as verbal or written
recognition, medal etc.

54. • Wage:
Paid to blue-collar workers; paid daily, weekly or monthly for jobs which can,
to some extent, be measured in terms of money’s term.
• Salary:
Paid to white-collar workers; paid monthly to employees whose
contributions can not be easily measured.
• Fringe Benefit: Compensation in addition to direct wages or salaries, such
as company car, house allowance, medical insurance, paid holidays, pension
schemes, subsidized meals.
•Incentives:
It's generally tied to meeting established objectives, and it can come in the
form of monetary and non-monetary rewards.
• Bonus:
A bonus is a financial compensation that is above and beyond the normal
payment expectations of its recipient.

55. Integration
Integration means extent to which interdependent organizational
components rapidly and adequately adapt to each other for pursuing
common organizational goals. Employee integration comprises:
• Motivation
• Job Satisfaction
• Grievance Redressal
• Collective Bargaining
• Conflict Management
• Participatory role
• Discipline

56. Motivation
Motivation is the process that initiates, guides, and maintains goal-
oriented behaviors. Fulfillment of a physiological or psychological
deficiency (Need), drives us to action.

57. Grievance Redressal
While the term “Grievance Redressal” primarily covers the receipt
and processing of complaints from employees and remedial actions
taken on the issue.

58. Collective Bargaining
Collective bargaining is the process in which working people, through
their unions, negotiate contracts with their employers to determine
their terms of employment (Including pay, benefits, hours, leave, job
health and safety policies, ways to balance work and family, and
more).

59. Distributive Bargaining: In this type of negotiation process, one
party benefits at the expense of others. eg, higher wages or better
healthcare for employees means smaller salaries for management or
fewer profits for shareholders.

60. Integrative Bargaining: In this type of bargaining, the agreement is
reached in such a way that both the participating sides tend to
benefit a ‘win-win’ situation.
Productivity Bargaining: Two parties agree to certain changes that
promise to boost productivity in exchange for higher wages.
Composite Bargaining: Negotiation emphasizes on factors, not
directly related to pay, but rather focused on employee welfare and
job security.
Concessionary Bargaining: In this type of bargaining, the union
sacrifice some benefits to the employer during the stressed economic
situation, which in turn benefits the employees in the long run. eg, in
recession.

61. Mode of Collective Bargaining
Negotiation: Two conflicting parties discuss among themselves, without
the involvement of a third party, to settle themselves.
Mediation: A neutral third party acts as the mediator between the
conflicting parties to settle. The mediator ensures that it occurs fairly,
honestly, and impartial. Together they resolve the dispute.
Arbitration: Third party, the arbitrator listens to the arguments of the
conflicting parties and then makes an informed decision, similar to what a
Judge does in the court.

62. Conflict Management
Conflict management is the practice of being able to identify and
handle conflicts sensibly, fairly, and efficiently.

63. Conflict happens when two or more people have seemingly
incompatible opinions, values or needs. A series of minor incidents
can build up over time and escalate into something major.
1. Discomfort: A little annoyance without any hard fact may indicate
that a conflict might be brewing.

64. 2. Incident: A minor event fuels the conflict. It could be a short,
sharp exchange, or a visible expression of the conflict.
3. Misunderstanding: The situation has escalated to a degree that
one or both parties have developed false assumptions about the
other.
4. Tension: At this point there is communication breakdown and
emotions are running high. It builds-up through the silence.
5. Crisis: This is the breaking point for the relationship. The situation
may get violent.

65. Conflict Handling
*Zero Sum Orientation: One person's gain would be another's loss

66. Maintenance
Maintenance in HRM Involves looking after staffs wellbeing, health
and safety, effectively managing communications and complying
with industrial agreements and legal responsibilities to keep
employees loyal and committed towards organization.

67. Employee Welfare:
This function refers to various services, benefits, and facilities that
are provided to employees for their convenience and well being.

68. Labor Relations:
This function refers to the interaction of human resource
management with employees who are represented by a trade
union. Employees comes together and forms an union to obtain
more voice in decisions affecting wage, benefits, working condition,
etc,.

70. HRM Challenges
a. Increasing Size of Workforce : The size of organizations is
increasing. The management of increased workforce with large labor
union might create new problems and challenges as the workers are
becoming more conscious of their rights.
b. Technological Advances : With the changes coming in the
wake of advanced technology, new jobs are created and many old
jobs become redundant. It is causing unemployment of some, and
additional training to adapt to technology. Sometimes, old industry
is becoming redundant.

71. c. Changes in Political Environment : There may be greater
Government‘s interference in business to safeguard the interests of
workers, consumers and the public at large. Government‘s
participation in trade, commerce and industry will also pose many
challenges before management.
d. Increasing Aspirations of Employees : Considerable changes have
been noted in the worker of today in comparison to his counterpart
of 1950s. The workers are better educated, becoming more aware of
their higher level needs and this awareness would intensify further.

72. e. Changing Psychosocial System : In the traditional bureaucratic
model, the organizations were designed to achieve technical
functions with a little consideration given to the psychosocial
system. In future, along with advance technology, satisfying
psychosocial needs (dignity, self-esteem) will be a challenge.
f. Digitalized Information System : In the past, the automation of
manufacturing processes had a major effect upon the systems of
production, storage, handling and packaging, etc. More recently,
digitalized Management Information System (MIS) will further
impact the process.

73. g. Mobility of Professional Personnel : As individuals develop
greater technical and professional expertise, their services will be in
greater demand by other organizations. It increases mobility of
various managerial and professional personnel between
organizations.
h. Changes in Legal Environment : Many changes are taking
place in the legal framework of industrial relations systems in a
country. It is the duty of the human resource or personnel executive
to be aware of these changes and to bring about necessary
adjustments within the organizations.

74. i. Management of Human Relations : Growth of multi-unions in
industrial complexes having different political affiliations, causing
industrial unrest.
j. Changing composition of workforce: Increased number of women
are participating in workforce, with demand for gender equality.
k. Employees Expectations: Employees are now better educated,
more demanding and voice for better return.
l. Workforce availability and quality: Inadequate supply of skilled
workforce causing hiring from abroad.
m. Balancing work and family: Dual-career couple, single-parent
household.

76. Conclusion
Human resources management is a very important function in every
organization. Without human resources management, companies
would not be able to effectively recruit and retain employees,
improve and enhance the organization, and they wouldn't be able to
maintain a healthy, accepting workplace culture and environment.