Article: Driving Factors towards a Career in Healthcare Management in context of HR in India

Author: Dr. Rakesh Verma, MBBS, PGDM (UK),   
              Faculty Member PGDM Healthcare Management Program– IFIM B School
              Managing Director, Falcon Skills  
              Formerly Group Head Learning & Development, Narayana Health


Dr. Rakesh Verma
The Indian healthcare industry is facing significant challenges in all areas of human resource management (HRM), from recruitment and selection to retention, to staff welfare, and in creating meaningful career pathways for staff. It is not just a matter of more health resources for the industry since finite resources must be managed efficiently and effectively.
This is a significant issue for India where the resources for even the most basic health care needs may be difficult to obtain and therefore, we need qualified and experienced Healthcare Management Professionals (HMP`s – who have undertaken either an MBA or a PGDM in Healthcare Administration to help the health system to become more efficient and effective using the limited resources available to them.

Healthcare Resource Management (HRM)being a global perspective is well established in non-healthcare industries. Unfortunately, the importance of HRM in improving overall patient health outcomes and delivery of health care servicesis under rated and undervalued.
Therefore, human resource professionals face many obstacles in their attempt to support the delivery of high-quality health care to patients. Some of these constraints include budgets, lack of congruence between different stakeholders’ values, absenteeism rates, high rates of turnover and low morale of health personnel and since all health care is ultimately delivered by people and effective HRM will play a vital role in the success of health sector services.
However, sofarthe focus of Healthcare H.R. is currently confined to maintaining regulatory compliance and recruitment and selection rather than a holistic extension of their roles to staff appraisals lined to performance; training and skill development; and creating structured career pathways post-qualification; skill-mix and extended roles (for e.g. developing nurse leaders, nurse practitioners). Therefore, quality of services is variable and questionable due to severe shortage of doctors, nurses, and paramedics.


Since one of the largest and most complex health care input are the human resources, it is clear that as  we increase the number of staff, HRM will have an active and important role to play. With limited resources available, workforce training issues can become challenging and HR will have to help develop strategies that are appropriate and sustainable.

These approaches could include, embracing technology or even broadening the role for different health workers such as nurses in management/ develop healthcare support workers to support nurses in their routine duties and free the qualified nurses for pure clinical nursing care only. HR will have to work with existing health workers to help integrate these and other new approaches to how workers are trained.

This is especially challenging, not only because of the extreme rural and urban divide, but also because of the increasing pressure from foreign countries to "poach" health care workers. By helping to develop policies and strategies HMP`s can help reduce the migration of health workers from where they are needed.

Therefore, proper management of human resources is critical in providing a high quality of health care. A refocus on HRM in health care and more research are needed to develop new policies and effective HRMstrategies are greatly needed to achieve better outcomes from and access to health care.

Unlike other industries, investment decisions in health are critical and can prove costly because they are generally irreversible as they commit large amounts of money to places and activities that are difficult, even impossible, to cancel, close or scale down.

Human resources, when pertaining to health care, can be defined as the different kinds of clinical and non-clinical staff responsible for public and individual health intervention. As arguably the most important of the health system inputs, the performance and the benefits the system can deliver depend largely upon the knowledge, skills and motivation of front line clinicians and non-clinicians responsible for delivering health services.
Key questions and issues pertaining to human resources in health care
Some of the issues of greatest relevance include the size, composition and distribution of the health care workforce, training issues, migration of health workers, sociodemographic, and geographical factors.

The variation of size, distribution and compositionwithin the health care workforce is of great concern. For example, the number of health workers available in a hospital is a key indicator of that hospitals capacity to provide delivery and interventions. Factors to consider when determining the capacity needs to also consider the competencies and experience of the hospital staff in delivering services.
Reconfiguration of services: point of contact for patients is changing and bucking the traditional trend of approaching local hospital for all ailments. This is changing in favor of healthcare services being offered (a range of services including diagnostics, care of elderly, chronically ill, post-partum etc. at home) closer to patient’s home and needs specialist understanding of skill mix.
Workforce training is another important issue. It is essential that HMP`s consider the composition of the health workforce in terms of both skill categories and training levels. New options for the education and in-service training of health care workers are required to ensure that the workforce is aware of and prepared to meet the present and future business needs because a properly trained and competent workforce is essential to any successful health care system.
The migration of health care workers: Workforce mobility can create additional imbalances that require better workforce planning, attention to issues of pay and other rewards and improved overall management of the workforce. In addition to salary incentives, we need to use other strategies such as housing, infrastructure and opportunities for job rotation to recruit and retain health professionally, since health workers across many hospitals are also underpaid, poorly motivated and very dissatisfied. The migration of health workers is an important human resources issue that must be carefully measured and monitored.
An ageing population leads to an increase in demand for health services and health personnel. An ageing population within the health care system itself also has important implications: additional training of younger workers will be required to fill the positions of the large number of health care establishments. 

1 comment:

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