Human Resource Management in Health Sector

Human Resource Management in Health Sector

1. Human Resource Management in Health Sector Dr. Ankit Chaudhary Resident Community Medicine IGMC Shimla

2. Defining Human Resource Management Human resource management is the integrated use of system policies management practices To support organization to meet its desired goal through recruitment, maintaining and development of employees *Attempts maximum utilization of pooled skills & experience Management Sciences for Health 2

3. Need in Health sector Requirement of varied manpower (non skilled to highly skilled) Outcome of any programme depends on competencies & skills of implementing personnel Mismatch between requirement & production of manpower Continuous updating of skills and knowledge has not been mandatory Regional disparities both in quality & quantity 3

4. Health sector Vs Other Sectors Long lead time b/w: Need & Supply of manpower High cost of training & Retraining of health personnel Continuously evolving medical sciences, changing patterns & approaches High migration of personnel Need of co-ordination among public, private & voluntary health agencies Lack of an effective feedback system 4

5. Components 5 Human Resource Management Planning Retention & Attrition Recruitment & Selection Career Management Training & Development Salary & Reward Performance Management

6. A. Human Resource Planning HR Planning includes all activities required do to forecast current & future HR needs Needed when a new programme is envisaged Must be done prior to recruitment & selection Demand forecasts estimate number & qualifications needed Supply forecasts estimate availability & qualifications of current workers 6 Job Analysis Determines Requirement for job: Skills Duties Knowledge Training Job Specification Minimum acceptable standards: Educational Qualification Training Experience Forecasting Manpower Projected turnover Suitability of existing employees Budget availability

7. Human Resource Planning contd...Job description 7 Job Job Title: Health worker (F) Work Location : Sub Centre ‘X’ Grade: 7200-8400 + 4200 Accountable to: MO (PHC) Monitored by: Health Supervisor (F) Objective: To provide MCH care & Family welfare services Performance Standards Coverage: 5000 population Estimate: Eligible couples, births Prepare work plan & estimate req. Register: 100% pregnant mothers, ensure 90% institutional deliveries Provide ANC care Promotes: Family planning methods Immunize 100% PW & infants Maintains records & prepare reports Working Relations Coordinates with : HW (M), AWW Responsible for: Trained Dais & ASHA Liaison with Village Leaders Mahila Mandals School teachers NGOs

8. B. Recruitment & Selection Recruitment: Defining jobs & Inviting applications Selection: Specific filtering process for choosing the most suitable personnel External Internal Outsourced Medical fitness/Police verification Probation 8

9. Recruitment & Selection Contd.... Cognitive Ability Test Performance tests Personality test Group Discussion Interviews Selection Tools 9

10. Recruitment & Selection Contd.... 10 Recruitment Pyramid

11. C. Training & Development An act of increasing knowledge & skills of employee to do a particular job Health personnel are adults: Principles of adult learning Participatory approach, Experiences are to be shared Initial period best for training Introduction to goals/vision/mission; Work culture/Hierarchy explained Job description chart Induction/pre-placement training Reorientation/Refresher training 11

12. D. Training & Development contd... 12 Training & Development Training Need Assessment Training Objectives Training Delivery Training Evaluation Training needs Task Analysis Competency analysis Seeking expectations Measurable/Observable Relevant skills/knowledge Updating Motivation Cognitive/Practical Behavioural approach e-learning Pre/Post test Feedback

13. E. Performance Management 13 Defining performance Corrective action Training & Developmental plan, Salary, Career Development Performance appraisal & Evaluation Regular review & monitoring Feedback Setting standards/targets Mutual agreement Immediate Superior Monthly meetings Verbal/written Reprimand/Appreciation Employer/Employee Needed support Actions for misconduct Quantity/Quality Expectations Achievement Feedback Competency vs Reality Linked to performance

14. Performance Management contd... Organization: Standing orders about code of conduct/procedure for disciplinary actions All employees treated at par Initially verbal warnings (immediate supervisor) →Written warning Charges communicated → Opportunity to defend → Penalty Appeals 14 Major Penalties (Enquiry) Compulsory retirement Removal from service (with/without future disqualification) Minor Penalties (Head of office) Censure Withholding of promotion Withholding of increment Reduction to lower scale

15. Performance Management contd... Performance appraisal system Current practice: Annual Confidential Report Graded response Usual way: Expenditure of grants (Financial yardstick) Record observations on certain aspects of work Excellent appraisal → potential for promotion 15

16. Performance Management contd... A FHW is assessed for her Quantitative performance, mostly in terms of No. of antenatal mothers registered Family planning services Targets related to National Health programmes No. of immunizations conducted No attention to quality of services 16

17. Performance Management contd... Common problems/Shortcomings Lack of standards Poor system of feedback to employees Standards not reflecting real performance Irrelevant standards Only negative communication Lack of proper system to utilize evaluation data Only control mechanism rather than improvement Treats every employee in same manner Subjective: Favouritism/Dislike 17 Halo effect: Better report>Deserved Good past/recent Pleasant disposition/personality Paper qualifications Yes man Horn effect: Worse report>Deserved Recent poor performance Self comparison

18. Performance Management contd... Alternatives Self Appraisal: Everyone claims to be outstanding performer Example: Management asked workers to report their - ve aspects rather than + ve “I am guilty of ignoring my family because of my dedication to work. I keep late ours at office and don’t spend time with my family” Peer Group appraisal: Criticism out of jealousy Sub-ordinate appraisal Patient/customer appraisal 18

19. F. Salary & Reward Management Generally Govt wages are quite fair Each designated post carries a pay scale Salary doesn’t commensurate with performance Based on qualifications + years needed for qualifications Difference b/w regular & contractual employee Enthusiastic and best performer may lose interest Salary also linked to inflation rate Incentives/additional increments/out of turn promotions 19 Hard area incentive Kayakalp incentive ASHA incentives Family Planning incentives

20. G. Career Management Management should assist employees to achieve realistic career goals Timely promotions Opportunity to acquire additional qualifications Clearly defined promotion policy Seniority & Merit based 20

21. H. Retention & Attrition Retention: Worker remaining with organization for a long period Attrition: Departure of employee If premature departure: cycle repeated, Resource consuming 21

22. Retention & Attrition contd... Help Retention Remuneration/fair incentives Organization’s reputation Good seniors Cohesive/friendly staff Job satisfaction/meaningful Safe/healthy environment Respect & Affection Reasons for attrition Retrenchment/Unsatisfactory Better payment/working conditions Health/family related Retirement 22

23. Morale & Motivation Welcome new ideas Recognize & Reward Help in succeeding ‘Thank you’ notes Huddle Open up Have fun Add perks Let resisters go Measure morale 23 Motivation: Set of processes driving a person towards a goal Maslow’s hierarchy of needs

24. Stress Not a personality trait /psychological problem Physical/psychological condition of body/mind Situations, people & events don’t cause; Perceptions, attitudes, values, belief & rexns 24 Stressor Perception of threat Emotional Reaction Activating event Subjective appraisal of a situation as dangerous Stress response

25. Stress...Management Realize that stress is a fact of life Modify your – ve self talk to + ve Dispute irrational beliefs Accept responsibility for yourself Accept that you are not in control of world Stop perfectionistic attitude Cultivate spiritual intelligence Manage time/habits/hobbies Engage in leisure/exercise Learn to say no 25

26. Conflict Issue of perception: different feelings about what is logical/natural, desirable, good/bad Contradiction in perception of needs within a person in interest & thinking from others Intrapersonal Interpersonal 26 Antecedent conditions Communication Structure Personal variables Perceived conflict Felt conflict Conflict handling Competing Collaborating Compromising Confronting Avoiding Accommodating Overt conflict Party’s behaviour Other’s reaction Increased performance Decreased performance Stage I Potential opposition Stage II Cognition & Personalization Stage III Intentions Stage IV Behaviour Stage V Outcome

27. Conflict Management...Resolving conflict Working through differences Authentic communications between & among members: trust & support Genuine respect for differences in idea, knowledge, attitude, emotional status Role Clarification/ Job description Personnel problem: Counselling lack of motivation: On going in-service program Grievance: Fairly/quickly 27

28. Employee welfare Anything done for intellectual, physical, moral & economic betterment of worker by employer/Govt over and above what is laid down by law or what is normally expected of the contractual benefits for which the worker may have been bargained (LIC 1946) Adequate canteens, Rest & recreational facilities, Sanitary, Medical facilities, Travel arrangements from/to, Accommodation, Social security Provided with in/outside establishment 28

29. Employee welfare contd...Measures 29 Medical & health care Regular health checks In/out patient coverage Referral services Benefits to dependents MCH/FP services Maternity/paternity leaves Health education Occupational safety Periodic Medical Exam: Early Dx of occu dis Prompt Rx Job rotation Working Environment Safe Work area Equipment operation Clothing/PPE First aid kits Installation Personnel Policy Financial measures: Pay/Bonus/Loans/cash/incentives/promotion Ret/Medical/Disability/Death benefits GIS/staff benefits Recognition: LOP/certificate/badges Administrative measures Work hours, Leave/absence, Couple employees Communication: Intercom/allowances Housing/Rest room/canteen/ creche facility/Transport Water/Noise/Lighting/Cleanliness/Recreation rooms

30. Personnel Records Need: Enables manager to identify/classify the available HR Methods: Manually/Computer-Incomplete/Infrequently updated Contents Application of recruitment Record of selection Bio data of applicant Copies of certificates/testimonial (DOB, Caste status, qualifications, character) Identification mark, signature/thumb impression, photograph Copy of appointment letter Job description Leave records Letter of confirmation, increments, promotions, transfers, punishments Record from previous employer, if any Exit form including retirement benefits Any other relevant record 30

31. Grievance s Grievance handling: Heads/Superior perform technical professional duties Without proper skills, head can interpret conflict as personal attack Grievance procedure Mechanism by which employee’s disputes/problems can be resolved Ensure fair treatment/environment where conflicts are settles amicably Why Grievance Committee? Enables employee with a means of airing dispute without fear Renders decision making authority as neutral Supervisor may lack necessary skill/authority Allows employee to bypass immediate superior for a just cause Can avoid union activities/strikes 31

32. Grievance s contd...Grievance Procedure 32 If employee faces grievance: must discuss with immediate supervisor If can’t be resolved: head level If not resolved at head level: Grievance committee Committee: Democratic principles to solve Committee: Guilty/not If guilty: penalty/administration Committee: evaluates its own actions if protested Step I Step II Step III Step IV Step V

33. Role of Employee 33 Ambitious Confident Humble Committed Reliable Positive/Enthusiastic Culturally fit Self motivated Hard working Team spirit Punctual Proactive Creative Honest Communicator Leadership qualities

34. Role of employer/Boss 34 Clear Vision Must know how to execute Supportive Decisive Available to employees Leads by examples Sets standards/Demands results Shares relevant information Shares credit Cares about well being Respect employees Delegates appropriately Empowers Mentors Appreciates Listens Neutral

35. References Epidemiology & Management for Health care: P V Sathe and P P Doke 5 th edition Introduction to Management Module: National Institute of Health & Family Welfare Health Management Module: Indira Gandhi National Open University 35

36. Thank you...!! 36