The Role of Human Resources in the Provision of Health and Social Care

The system tasked with the provision of health and social care (H&SC) depends on available human resources. Globally, estimates indicate that HSC attracts more than 59 million employees.  However, projections indicate that 21million professionals will be required in the industry by 2030 to cater for various needs that might be prevalent among different populations. The budget developed for HSC mostly caters for the salaries which accrue to human resources. For example, the Czech Republic directed 17% of its expenditure to settle the wages accruing to its H&SC workers in 2000 (Snell, Morris and Bohlander 2015). In 2017, an increment of 10% was implemented to curb the loss of professionals to countries with better remuneration such as Germany as well as Austria. The challenges emanating from the loss of workers to better-paying nations or even facilities require refined strategies to manage available human resources.

Remuneration packages are among the factors that mandate consideration for the management of HSC workers. The study conducted by The Resolution Foundation indicated that 16000 individuals who are required to provide care are paid less than the minimum amount stipulated for wages. Annually, their losses amount to £130m (Nelson and Staggers 2016). Regardless of the 80,000 positions available in England for H&SC workers, the employees estimated to exit the profession daily are about 900 individuals. Poor salaries create acute shortages for operational facilities. The outcome is that agency staff must be relied on for core services to be adequately delivered. Hence, medical facilities have to deal with the challenges that result from dealing with additional workers who might not be conversant with the routines applicable to the facility.

The strategies used to manage employees available for operational facilities must ensure that retention levels are adequately improved.  For example, a survey conducted in 2016 indicated that 29% of the professionals offering H&SC services in America anticipated changing employers in 2017. The workers cited the availability of positions which were more challenging. Moreover, other employers offered the promise of improved rewards prompting the decision made by the workers. The quest to ensure that professionals were retained in the provision of care for Americans paved the way for a shift in the scale applicable to the salaries of healthcare professionals. The increment implemented for physicians as well as surgeons was valued at 2.5%.

On the other hand, a 4.3% salary addition was implemented for physician assistants. However, nurses were subjected to a 3.1% decrease while healthcare executives were forced to contend with a 12.9% pay cut (Mintzberg 2018). The efficient retention of H&SC employees reduced the expenses accruing to the human resources department where workers are to be trained for available positions.

Currently, the success that hospitals and H&SC workers aim to attain relies on an employee’s interpersonal skills. For example, Pastore’s hospital -which is located in the U.S – implemented a new methodology to hire its workers. The strategy adopted was also intended to ensure that the success which could be attained from an employee could be effectively predicted. The adoption of systems such as Central Maine Medical Family led to a 7% reduction of the turnover of the facility’s employees owing to the utilisation of the assessment solution (Drummond et al. 2015).

The culture practised in facilities offering medical services is an important determinant concerning whether H&SC workers continue to cater to the needs prevalent among patients. In the UK, numerous appeals have been made to foster policy reviews relating to the culture which accrues to hospitals or other facilities under the jurisdiction of the NHS. Sir Roy Griffiths spearheaded various developments relating to general management in the 1980s (Busse, Aboneh and Tefera 2014). The outcome was that clinicians would be involved in formulating budgets for initiatives on the management of resources. Progressive management of the human resources in a hospital considers the culture applicable as being essential in determining the perspectives of H&SC workers where quality is involved with regards to the provision of patient care. The employees working in American facilities have varying perceptions with regards to the organisational safety climate that is appropriate for patients. Senior managers are often considered to harbour positive perceptive as opposed to frontline workers. Hence, parties responsible for managing hospital workers are mandated to foster cooperation for different categories of H&SC workers. The outcome is that regardless of the roles that practitioners and caregivers are required to perform; their satisfaction levels can be adequately improved. Moreover, the culture should adapt to the adjustments made with regards to the strategic objectives of a facility.

Talent management is among the requirements for effective management of a facility’s human resources. In most cases, consideration is often made in respect to sourcing for H&SC workers in the course of recruitment processes. The pool from which talent can be obtained must be improved through the resumes obtained from prospective candidates and the records obtained from the interviews conducted. iCIMS is among the platforms which can be relied on for talent recruitment. The platform which is primarily online-based enables its users to access a dashboard from which a review can be conducted of the talent access to the respective facilities. IT is considered one of the areas where available talent is subject to an acute shortage. Moreover, great challenges are primarily anticipated where Electronic Health Records are to be implemented. Technologies which facilitate talent management ensure that compliance is adequately improved and any gaps evident where skills are involved can be adequately addressed. The report prepared by the Care Quality Commission which was entitled the State of Care indicated that only 71% of the providers of social care out of the 16000 individuals could be considered to be “good” in the provision of their designated services. Moreover, only 1% of the professionals were ”outstanding” in the performance of their duties whereas 2% were rated as being inadequate (Macinko and Harris 2015). Talent management of workers can help to ensure that professionals with impeccable skills are retained while areas indicating inadequate expertise can be improved upon.

Effective communication is crucial in determining the efficiency with which a facility’s human resources can be managed.  The outcome is often the development of working relationships with colleagues. Messages can be communicated through email, over the telephone or even by making use of one-on-one conversation. Communication creates a channel through which a facility’s employees can not only request, but also obtain the information required. For example, details regarding patients must be exchanged by physicians who offer primary care and respective hospitals upon admission or even the discharge of the clients involved. Mechanisms relating to electronic data transfer are beneficial, especially where general practitioners are concerned. However, communication breakdown provides the impetus that facilitates the occurrence of medical errors. In the U.S, over 25000 patients die annually owing to the mistakes committed by the teams in charge of their medical wellbeing (Lecca et al. 2014). John Hopkin’s report also served to indicate that the fatalities arising from communication breakdown among H&SC workers are higher when compared to individuals who succumb to heart diseases or even cancer. The management of medical staff mandates the provision of adequate information concerning the cyclical processes which might be ongoing. Moreover, interpersonal conflicts evident among staff members can be adequately addressed to foster improvements in the care offered to patients.

H&SC workers are an integral component of the systems in which they operate. In the U.K, the NHS acknowledges that the adequate engagement of its workers paves the way for the desired improvements where caring for patients is concerned. Employee involvement determines the likelihood that they will direct some discretionary efforts towards their designated duties.

Source: Hall (2016)

The diagram indicates different levels concerning the engagement of a hospital facility’s staff members. Reduced employee engagement results in lower satisfaction among patients at a rate of 76.78%. However, extensive employee involvement paves the way for increased satisfaction among H&SC workers at 80.86%.

Source: Hall (2016)

The figure indicates the anticipated mortality rates among patients where H&SC workers are engaged. The mortality of patients is reported to be higher at a figure of 103.2% where staff engagement is low. However, high engagement of the individuals who formulate medical teams results in a reduction of the overall mortality rates which are evident among patients.

The system that provides health care in the U.K strives to foster a positive environment in which H&SC workers are required to offer their services. Hence, staff members are allowed to participate in processes through which decisions can be made affecting them or even the services which they are mandated to provide. Through the engagement of its workers, the NHS anticipates that the savings which are bound to accrue from its initiatives will total GBP22billion by 2021 (Sandifer, Sutton-Grier and Ward 2015). In 2014, the Five Year Forward View was published in England as a result of NHS efforts. The strategy highlighted the well-being as well as the health of staff to be among the factors essential in fostering the improvements necessary in healthcare provision. The individuals responsible for managing the workers designated to a specific medical facility are responsible for facilitating their positive engagement. Hence, HR managers are expected to mediate where workers are involved and other parties such as a hospital’s executive leadership or even departmental heads. In addition, strategies can be adapted to evaluate the engagement of H&SC workers. For example, the NHS conducts its staff survey annually to assess different dimensions relating to its employee’s involvement. The survey examines the psychology of NHS’s employees, their propensity to advocate for their respective organisations to other professionals and their involvement in highlighting the factors which can foster the required improvements.

Managers dealing with the personnel working at a hospital are mandated to perform some job analysis of the duties that must be performed in their respective premises. Through the process, the skills necessary for specific jobs can be underscored and the environment that would be deemed as appropriate. The outcomes to be anticipated while caring for patients should be highlighted. Increased engagement of employees can also result where HR managers resort to shifting their respective roles. For example, the Department of Veterans affairs, operational in the U.S, resolved to extend the authority of full practice to some advance practice registered practitioners in 2016 (Freund et al. 2015). Telehealth is also being relied on to ascertain that care delivery and the roles which are attributed to caregivers are effectively shifted. Moreover, leaders mandated to perform HR functions are changing the orientation of their departments to facilitate their roles as the strategic providers of mandatory services. The modification of the roles H&SC workers are mandated to perform requires the provision of necessary information by HR practitioners.

The efficient management of health, as well as social care providers, mandates the stipulation of metrics which can be used to evaluate performance. In America, The Centers for Medicare & Medicaid Services rely on seven outcomes to determine the quality which can be attributed to a specific hospital. Hence, H&SC workers should be conversant with such guidelines in the course of the provision of the care necessary for their facility’s clients. Mortality among patients is among the factors that should be accorded some consideration. For example, the deaths of patients suffering from pneumonia were subjected to a 28% reduction as a result of the initiatives implemented by Multicare Health System. The readmission of clients after hospitalisation can be used as an indicator of outcomes anticipated from the interaction of patients with H&SC workers. Order sets which were evidence-based were used by MultiCare Health System to foster a 23% reduction of pneumonia readmissions (De Raeve et al. 2017). Moreover, social workers were expected to ensure that patient follow-up was adequately improved. The deployment of analytics applications paved the way for the provision of necessary feedback in real-time where compliance, as well as performance, was involved. MultiCare’s initiative also ascertained that patient-specific data could easily be offered regardless of the settings used to provide care or even the number of visits.

The safety accorded to patients in the course of receiving care should also be considered among the metrics relating practitioner performance. The result is that medical mistakes can easily be evaluated to determine the efficiency with which an employee can operate. Skin infections, as well as hospital-acquired infections, are determines considered where patient safety is concerned. HAI’s are prevalent where fungal pathogens, bacteria or even viruses are involved. Enterprise Data Warehouse utilisation in addition to analytics applications by Texas Children’s hospital ensured that patients who were vulnerable could be identified (Papanicolas, Woskie and Jha 2018). Moreover, the initiative ascertained that the compliance of clinicians could be adequately monitored during the implementation of practice bundles. The experience which accrues to patients, as well as the effectiveness which can be attributed to care, is among the factors which can be relied on in the evaluation of the performance of H&SC workers. Clients should also have access to care in a manner which is timely.

Medical imaging is also an essential determinant concerning the performance which accrues to practitioners in their respective facilities. It is essential in ascertaining that healthcare is cost-efficient regardless of the disease entities which might be involved. For example, Texas Children’s Hospital embarked on efforts which were intended to foster some improvements in the provision of asthma care. However, chest X-rays were being extensively administered to patients who were victims of asthma attacks. X-rays were performed for 65% of the facility’s patients whereas practice which is evidence-based only recommends 5% of the tests to be performed (Moran, Nancarrow and Enderby 2015). However, some improvements were made to ensure that order sets aligned with best practices which were evidence-based. Therefore, the parties responsible for managing a hospital facility’s workers must develop clear procedures which can be used for the achievement of the desired outcomes.

HR managers are integral in facilitating conditions which enable data interoperability. Information must be seamlessly shared among the departments operational in a facility offering medical services. Improvements in the outcomes which accrue to patients and the efficiency with which H&SC workers can operate depends on data sharing among clinicians, pharmacies, laboratories, settings, hospitals or even facility departments. Data interoperability is essential in ascertaining care transitions for critical patients are subjected to increased efficiency (Supper et al. 2015). Moreover, the provision of care which is integrated can be greatly simplified. For example, patients can be moved from emergency rooms to a normal state or even to operation rooms according to their respective needs. Seamless data provision facilitates the provision of care characterised by efficiency for the benefit of the patients involved. Moreover, the rates attributed to H&SC workers’ success during their interaction with a facility’s clients can be adequately improved.

However, the outcomes anticipated from H&SC staff often rely on a hospital’s facility workload and the employees available. The survey conducted by the CareerBuilder indicated an acute shortage where nurses are required. As a result, the performance of the roles designated to H&SC workers has become a task which is quite challenging. The survey indicated that 48% of nurses were overwhelmed by the duties which they are required to perform whereas health workers shared similar sentiments at 40%. Furthermore, workers are forced to deal with reduced satisfaction where the performance of their duties is involved. Moreover, increased accidents are common where workers are distressed emotionally as well as psychologically. Currently, the positions to be filed by professionals extensively exceed the individuals who wield the necessary qualifications. Forecasts indicate that the growth to be expected concerning vacant health care positions is bound to grow substantially. The increment in the positions for registered nurses is projected at 22% while 39% applies to physician assistants (Scambler, Scambler and Speed 2014). However, HR managers are responsible for implementing various strategies aimed at fostering the necessary improvements for workers. For example, redundant activities can be automated to pave the way for H&SC workers to focus on their key duties. Moreover, efforts to obtain additional workers can be made to ease the burden on a facility’s employees.

Employees must be offered opportunities for development which can be formal or even informal.  Before joining respective facilities, nurses indicate their concern for available sessions through which they can be trained. The flexibility provided concerning facility schedules also dictates the propensity of professionals to acquire additional education. Where H&SC is involved, professional learning is essential in addition to development. However, 57% of H&SC staff has to contend with the limitation of opportunities for the acquisition of additional training (O’Donnell et al. 2016). Hence, HR managers are expected to formulate strong programmes to facilitate employee orientation as well as development professionally. Workers must be informed of the opportunities available for advancement and the requirements necessary for enterprise promotion. Partnerships can also be relied on to cater for the training needs evident among H&SC staff. For example, Ixion provides different training courses for workers in facilities offering medical services. The organisation ensures that organisational objectives are met by impacting the relevant information necessary for improving the care offered by practitioners.

The management of H&SC staff necessitates the development of programmes to foster employee mentorship. The assessment conducted by the CareerBuilder, which is based in Chicago, indicated that 25% of healthcare practitioners had limited access to opportunities for mentorship. On the other hand, 59% of the establishments examined highlighted the availability of such opportunities for their workers. As a result, HR managers are required to ensure that the availability of such provisions is underscored for the benefit of interested employees. Such initiatives can be used to ensure that the shortages evident where skilled H&SC workers are involved are addressed. For example, WellSpan Medical Group, which is located in Pennsylvania, launched its mentorship programme intended to operate formally. The concept generally relates to ensuring that physicians who are newly hired are matched with providers specialising in the same area but with extensive experience.

Caregiving often requires teams whose operations are characterised by effectiveness. Labour is often divided among nurses and medical practitioners.  Care episodes require the collaboration of professionals with varying specialities. Breakdowns relating to team efficiency pave the way for the errors which are medically evident which are often rated from 70% to 80%. The implication is an increase in the prevalence of deaths among patients. The management of teams mandates that individuals whose skills serve to complement one another must be grouped. Collective intelligence ensures that the performance which can be attributed to respective teams is adequately enhanced. Moreover, patients can also anticipate an increase in the levels associated with the services they are offered.  Team leadership determines the rate at which useful information can be incorporated into respective processes to facilitate outcomes which can be deemed as positive. They also determine the goals to be achieved which must align with the overall goals developed by a particular hospital facility.

Conclusion

Human resources must be properly managed for the health care provided to be of high quality. However, complex relations exist where human resources and the provision of the care required by patients is concerned. Hence, managers responsible for a facility’s personnel are required to use an approach that is progressive to counter the challenges encountered regardless of the hurdles which might be evident. The commitment of H&SC workers is essential in determining the success attributable to facilities responsible for offering different medical services. Moreover, efficient employee engagement ensures their overall satisfaction paving the way for positive outcomes for patients. As a result, medical facilities can also expect an improvement concerning how they can perform financially.

References

Busse, H., Aboneh, E. A., and Tefera, G. (2014). Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University’s Tikur Anbessa Specialized Hospital (Ethiopia). Globalisation and health, 10(1), 64.

De Raeve, P., Gomez, S., Hughes, P., Lyngholm, T., Sipilä, M., Kilanska, D., ... and  ENS4Care project. (2017). Enhancing the provision of health and social care in Europe through eH ealth. International nursing review, 64(1), 33-41.

Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., and Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford university press.

Freund, T., Everett, C., Griffiths, P., Hudon, C., Naccarella, L., and Laurant, M. (2015). Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?. International journal of nursing studies, 52(3), 727-743.

Hall, B. (2016, December 2). Employee Engagement in NHS Healthcare | Interact software. Retrieved from https://www.interact-intranet.com/blog/employee-engagement-in-nhs-healthcare/

Lecca, P. J., Quervalu, I., Nunes, J. V., and Gonzales, H. F. (2014). Cultural competency in health, social & human services: Directions for the 21st century. Routledge.

Macinko, J., and Harris, M. J. (2015). Brazil’s family health strategy—delivering community-based primary care in a universal health system. New England Journal of Medicine, 372(23), 2177-2181.

Mintzberg, H. (2018). Managing the Myths of Healthcare. In The Myths of Health Care

(pp. 3-11). Springer, Cham.

Moran, A., Nancarrow, S. A., and  Enderby, P. (2015). Mechanisms to enhance the effectiveness of allied health and social care assistants in community‐based rehabilitation services: a qualitative study. Health & social care in the community, 23(4), 389-398.

Nelson, R., and Staggers, N. (2016). Health Informatics-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

O’Donnell, C. A., Burns, N., Mair, F. S., Dowrick, C., Clissmann, C., van den Muijsenbergh, M., ... and de Brun, T. (2016). Reducing the healthcare burden for marginalised migrants: the potential role for primary care in Europe. Health Policy, 120(5), 495-508.

Papanicolas, I., Woskie, L. R., and Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.

Sandifer, P. A., Sutton-Grier, A. E., and Ward, B. P. (2015). Exploring connections among nature, biodiversity, ecosystem services, and human health and well-being: Opportunities to enhance health and biodiversity conservation. Ecosystem Services, 12, 1-15.

Scambler, G., Scambler, S., and Speed, E. (2014). Civil society and the health and social care act in England and Wales: Theory and praxis for the twenty-first century. Social Science & Medicine, 123, 210-216.

Snell, S., Morris, S., and Bohlander, G. W. (2015). Managing human resources. Nelson Education.

Supper, I., Catala, O., Lustman, M., Chemla, C., Bourgueil, Y., and Letrilliart, L. (2015). Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors. Journal of Public Health, 37(4), 716-727.