Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

Abstract

BackgroundImproved management of clinicians’ time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models.MethodsThe current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken.ResultsSix themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM.ConclusionsThere is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and performance management of individual clinicians may be possible but requires an alternative approach for the NHS.

Motivation factors affecting the job attitude of medical doctors and the organizational performance of public hospitals in Warsaw, Poland

“…This method helps to meet professional requirements in terms of goal-setting or employee development review, even among high achievers. David Wigley argues that the IPR system should cover both individual motivation [32] and external motivation [33], and then combine it with organizational development programs to create an appropriate organizational culture [32]. IPR is a tool that enables achievement of high productivity, improved performance, and overall commitment [33] as well as improved behavior and professional autonomy of medical doctors and their involvement in the ongoing changes [34].…”

“…NHS also reviews clinical outcomes at the individual level through "rigid systems" by measuring and publicly disclosing data on the obtained treatment outcomes [37,38,39,40]. Clinicians are awarded bonuses for their positive performance [33].…”

Human Resource Policies and Practices: Evaluating and Reviewing the Contemporary Recruiting Process

“…Today's platforms however, tend to yield an exponential number of job applicants. Some companies are even pioneering a unique methodology such as online programming contests, which parade as games, in order to identify and engage potential employees with the best skill sets that might be convinced to apply for their vacant positions [7,8,10,12].…”

Clinically led performance management in secondary healthcare: evaluating the attitudes of medical and non-clinical managers

“…Therefore, Trebble et al 32 undertook an in-depth study of good practice in performance-related HRM among successful non-healthcare organisations within commercial, public sector and voluntary sectors. This was used to develop a performance-related HRM framework that was implemented into a large secondary healthcare centre.…”

“…The performance-related HRM framework (figures 1 and 2) was developed based on the observation of successful practice in non-healthcare organisations32 and with reference to published approaches to performance measurement and management33–36 (see online supplementary appendix 1 for full description).…”