Controlling healthcare professionals: how human resource management influences job attitudes and operational efficiency

Abstract

BackgroundWe assess how human resource management (HRM) is implemented in Australian hospitals. Drawing on role theory, we consider the influence HRM has on job attitudes of healthcare staff and hospital operational efficiency.MethodsWe adopt a qualitative research design across professional groups (physicians, nurses, and allied health staff) at multiple levels (executive, healthcare managers, and employee). A total of 34 interviews were carried out and analyzed using NVivo.ResultsFindings revealed a predominance of a control-based approach to people management. Using Snell’s control framework (AMJ 35:292–327, 1992), we found that behavioral control was the principal form of control used to manage nurses, allied health workers, and junior doctors. We found a mix between behavior, output, and input controls as well as elements of commitment-based HRM to manage senior physicians. We observed low levels of investment in people and a concentration on transactional human resource (HR) activities which led to negative job attitudes such as low morale and frustration among healthcare professionals. While hospitals used rules to promote conformity with established procedures, the overuse and at times inappropriate use of behavior controls restricted healthcare managers’ ability to motivate and engage their staff.ConclusionsExcessive use of behavior control helped to realize short-term cost-cutting goals; however, this often led to operational inefficiencies. We suggest that hospitals reduce the profusion of behavior control and increase levels of input and output controls in the management of people. Poor perceptions of HR specialists and HR activities have resulted in HR being overlooked as a vehicle to address the strategic challenges required of health reform and to build an engaged workforce.

Efficiency of health resource utilisation in primary-level maternal and child health hospitals in Shanxi Province, China: a bootstrapping data envelopment analysis and truncated regression approach

“…These results were consistent with those of other studies. Indeed, health workers, as the core health resource in hospitals, have a direct effect on the quantity and quality of health services and substantially contribute to outputs [11,34]. However, most skilled health technicians are unwilling to work in primary healthcare sectors due to low income and high-pressure working conditions [6,7,10].…”

Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria

“…Keywords: Organizational justice, Health professionals, teaching hospitals, Nigeria Background Skilled and motivated health workforce is an essential input to strengthen hospitals in low and middle-income countries (LMICs) [1]. Nonetheless, perception of unfair treatment of health workers reduce health workforce performance and hospital operational efficiency [1,2]. Health workers have views about and expect fairness in the distribution of organizational resources and opportunities, wages, decision-making processes, interpersonal behaviors and provision of information within their work environment [3].…”

“…Organizations should tolerate opinion of employees; make decisions based on consistent approach and correct information; exhibit impartiality, avoid favoritism and remain ethical; provide effective feedback; and explain decisions to employees [5]. When decision-making is perceived as fair, performance improves due to increased job involvement, organizational commitment, trust and cooperation among employees [2].…”

“…Doctors lacked respect for other health professional [16]. Health managers tend to be authoritarian, unsupportive, overuse behavioral control, lack respect for junior staff and provide negative feedbacks during supervision [2,4,[18][19][20][21][23][24][25][26][27].…”

Selected Current Trends in Human Resource Management in Health Service Providers in the Czech Republic

“…According to Cogin, Ng and Lee (2016), there is increasing evidence that human resource management practices adopted by corporations/ organizations can have a significant impact on firm performance and effective human resource practices can positively contribute to corporations, organizations, hospitals, clinics etc.…”