MHSA 7650 Human Resources Management in Health Care Human Resources Management Processes I. Overview of HRM Process Model ** The formal management of human resources within health services organizations involves several interdependent processes including: ** HR Planning: internal planning process involving a determination of staffing needs for the organization throughout the planning period - often a function of projected organizational growth, expected turnover, and anticipated changes in organizational technology (as it affects the demand for new types of workers/worker categories). >> Two inter-related sets of functions that are commonly conducted as part of the HR planning/acquisition process are the job analysis and studies of job design. ** HR Acquisition: organizational processes and activities that lead to the successful identification and selection of qualified candidates for specific job opportunities. Two inter-related sets of functions involved in HR acquisition are job recruitment and candidate selection efforts. ** HR Retention: activities that occur throughout the employee s term of employment; designed to optimize the organization s ability to retain vital human resources. A number of organizational HRM activities associated with the goal of HR retention include performance evaluation, training and development, employee discipline, and compensation/benefits administration. ** HR Separation: organizational HRM activities directed towards facilitation of employee exit from the organization (retirement, resignation, termination, etc.) Tasks include pre-retirement planning, exit interviews, out-placement services (separation due to involuntary termination). ** Though the aforementioned HRM activities are listed in a rough chronological ordering of HR flows through the organization, it should also be noticed that these steps are highly interrelated and inter-dependent on the other HRM processes in the model. It is also the case that the external environment has a profound impact on all HRM activities and functions as well. A thorough understanding of internal HR activities as well as the external environment is critical to successful management of human resources within health services organizations.
II. Human Resources Planning Activities ** As stated in the initial lecture on strategic human resources management, contemporary HR planning efforts are conducted in a manner and context that is (or should be) fully consistent with the organization s strategic mission, vision, and goals as identified within the strategic plan. ** A number of inter-related activities are typically conducted as part of the initial stages of long-range HR planning: ** HSO Profile Development: long-term projections of personnel needs consistent with organizational mission and strategies. ** Personnel Estimation: based on industry-specific staffing ratios, used to estimate approximate # s of employees needed by functional area, given the proposed HSO profile. ** Internal Inventory: assessment of present personnel (# s and skills), comparison to projected needs based on profile and estimation process. ** Forecasting: internal forecasting of future patterns of organizational changes in personnel due to new entries, exits, and transfers, based on historical data. ** The assimilation of data from the above processes assists HRM staff in the development of an HRM plan for the organization which supports the overall strategic mission, vision, and goals of the organization as well. III. Job Analysis and Job Design ** HRM Terminology ** Job grouping of similar activities and duties in the workplace. ** Position duties/responsibilities performed by a single worker. ** Job Analysis structural process for obtaining information about a job by determining the job s duties, tasks, and/or activities. ** Job Description formally enunciates the duties associated with a given job. Most typically includes formal job title, job identification, and job duties. ** Job Specification describes the skills necessary to adequately perform a given job and the physical demands on the employee associated with the job. Most typically includes requirements in terms of experience, education, knowledge, training, licensure, etc.
** The most important outcomes of a formal job analysis are the development of the formal job description and the delineation of the specifications/qualification for a given job. ** In addition, the formal job analysis also provides critical inputs into virtually all other HRM functions and activities including recruiting, candidate selection, training and development, performance evaluation, compensation, etc. ** Job Analysis Process Steps ** Establish purpose of job analysis What is the primary goal of the job analysis (e.g. compensation evaluation, occupational safety, training/development issues, recruiting issues, etc.) ** Identify job(s) to be analyzed. All newly developed jobs should be formally analyzed prior to HR acquisition. Significant changes to existing positions (e.g. re-structuring, mergers, acquisitions, etc.) also should require job analysis in most cases. ** Determine employee involvement. Communicate need for analysis to affected workers, describe the process, involve affected workers wherever feasible so as to facilitate the process. ** Collect job data. Collection of data/information about job from a variety of sources including: >> Direct observation of employees performing job-related tasks. Most useful as a data collection method where job tasks are primarily physical/observable. >> Interview worker(s) as a useful method of data collection for job-related information that cannot be obtained by other means. Structured interview questionnaires provide information that is most reliable/valid. >> Administration of job surveys/questionnaires to selected workers who perform the job being analyzed. Regarded as most efficient/least resource intensive method of data collection for job analysis, and most often utilized as the initial method of data collection by most HRM personnel. A number of pre-formatted and validated survey instruments are commonly used for this purpose including the Position Analysis Questionnaire (PAQ). A number of discipline specific survey tools have also been developed and utilized with respect to specific jobs. (e.g. nursing).
** Direct experience method of data collection for job analysis involves the job analyst actually performing the tasks of the job, mostly with respect to the less technical types of jobs. Not often utilized as a method of data collection by HSO s due to the highly specialized nature of the professional workforce. ** Impact of Job Analysis on HRM Functions ** With regard to HRM planning activities, the job analysis provides necessary inputs with respect to job planning and workforce forecasting, described previously. Also provides useful inputs to facilitate the flow of human resources within the system (transfers, promotions, etc.) ** With regard to recruitment and candidate selection activities, there is an obvious need for an accurate job description and specifications when doing job recruitment. In terms of candidate selection, legal precedent requires that all job requirements and specifications in terms of qualifications must be job-related to avoid possible discrimination liability. ** With regard to development and training activities, the outcomes of the job analysis provide useful information that can be utilized for the purpose of implementing career development and employment/job training programs to facilitate professional competence on the job. ** With regard to worker performance appraisal, it stands to reason that the job duties and responsibilities identified as part of the job analysis should form the basis for the development of job performance evaluation criteria. Such criteria, again, should be explicitly job-related to avoid discrimination liability. ** With regard to compensation, the delineation of job duties and job specifications serves as the internal basis for determining wages/salaries and benefits. ** With regard to safety/health issues, the job description should describe any job-related safety/health issues that a prospective job candidate may have to contend with on the job.
** Legal Issues with Job Analysis ** Equal Employment Opportunity Law as enumerated under Title VII, with amendments. Requires that all job requirements and specifications be clearly stated and directly related to job-related performance issues. Job descriptions that are vaguely written are more likely to be challenged as discriminatory. ** Americans with Disabilities Law Requires that all job descriptions include a listing of essential physical and mental requirements (essential job functions) so as to more closely match employee capabilities with job requirements. Under ADA, such functions are deemed essential (and thus non-discriminatory to the disabled) if (1) the position exists to perform a specific function; (2) there are only a limited number of employees who can perform that specific function; (3) the function in question requires specific expertise in order to accomplish. ** Future Issues with Job Analysis ** The rapidity of technological change is having a dramatic impact on the structure and function of a number of jobs in the HSO environment. New jobs are being created literally overnight, existing jobs are being significantly re-defined within short periods of time, etc. ** Given the degree of environmental change, traditional approaches to job analysis have been considered to be obsolete by some HRM professionals. ** Alternative approaches to job analysis such as future-oriented, competency-based, and generic approaches have been utilized by some HRM professionals for the purpose of attempting to develop job descriptions and specifications that are more flexible and less in need of frequent substantial revision given the current environment. ** Job Design Issues ** Adjunctive function to job analysis as it relates to HR planning and acquisition that involves structuring a job to simultaneously improve organizational efficiency, employee work performance, and employee satisfaction.
** Job design processes take into formal consideration a number of aspects related to a specific job how the job is defined, how job tasks/duties are completed, where/how the job relates to other jobs within the organizational structure, how/to what extent the job contributes to organizational mission, goals, objectives, etc. ** Such job design/re-design efforts must also take into formal consideration individual worker class and skills, expertise, as well as licensure, training, and legal requirements as they apply to a particular class of job. ** Traditional approaches to job design within HSO s centered around the organization of work processes and jobs based on individual professional specialty area (nursing, pharmacy), which invariably led to the highly fragmented, strictly departmentalized organizational structure that one typically encounters within health services organizations. ** Such an approach was predicated largely on the basis of efficiency and legal issues related to a specific job category. The major disadvantages, from an HR perspective, of utilizing such an approach to work design include increased worker burnout, reduced employee satisfaction, and increased worker turnover/attrition due to the repetitive, routinized nature of work within such structures. ** More contemporary approaches to job design that attempt to address some of the issues associated with increased specialization as the basis for work organization include: ** Job re-design: changing the structural/functional organization of work via (1) job enlargement, which involves an expansion of scope of work for a given job; (2) job enrichment, which involves the granting of increased autonomy/responsibility within existing scope of work. A fairly common example of job re-design efforts in HSO s involved the creation of the multi-skilled health care practitioner and the implementation of cross training programs to facilitate such job designs. ** Employee empowerment: organizational initiatives to allow for increased employee involvement/input into certain organizational decision-making processes within the existing scope of work. Less formal job design approach than job re-design efforts, may allow for increased employee input into job content and context.
** Work group design: organizational initiatives to establish the working group or team as the fundamental unit of work (as opposed to the individual employee) in the organization. >> Groups can be developed along several different dimensions cross-functional, project-specific, selfdirected, task forces, performance improvement groups, and/or virtual groups or teams. >> The presumed rationale for the working group or team approach to work/job design is predicated on the two heads are better than one euphemism. In an increasingly turbulent and complex work environment that characterizes the HSO workplace, the team approach is theoretically advantageous is terms of work effectiveness. >> Not all working group/team approaches to work design in HSO s have been successful to date. Research suggests those that have been shown to be most successful share a number of characteristics: shared group goals, consensus-based decision making, shared group leadership, conflict resolution success, excellent group member interpersonal skills, formal training in team-based methods or work, and effective managerial leadership supporting the team concept. ** Work schedule re-design: adaptations/changes to the traditional eight hour a day, five day a week work schedule, for the purpose of incorporating more flexible scheduling approaches. As many HSO s are classical 24/7 operations, the need for flexible scheduling is becoming increasingly necessary, especially to ensure work coverage afterhours. ** Other more contemporary approaches to job design that have been utilized by some HSO s include job sharing and telecommuting applications.
IV. Recruitment and Selection of Human Resources ** HR Recruitment Issues ** Recruitment is defined as the process by which the organization attempts to attract a sufficient number of qualified persons on a timely basis for the purpose of encouraging them to apply for a specific job within the organization. ** Organizations have to address a number of questions with regard to the planning of recruitment initiatives: >> Internal vs. external recruitment -- there are advantages and disadvantages associated with either recruiting source (Table 6-3) that organizations weigh when deciding on a recruitment strategy. Most organizations will use a combination of both sources for most recruitment efforts. ## Internal recruitment sources include current employees (job postings and internal inventory of employee skills), employee referrals, former employees of the organization, and former job applicants. ## External recruitment sources include professional and trade associations, employment agencies, executive/professional search firms, media advertisement, training/educational schools, and competitor organizations. >> Job design issues with recruitment -- will jobs be recruited as full-time or part-time/flex-time positions? Should outsourcing be considered? Job sharing? >> Recruitment criteria -- how should the recruitment "message" be targeted via whatever medium chosen? Should emphasis be placed on technical skill or identifying candidates who are the best "fit" with the organization? ** In terms of recruitment targets and the issues that they most likely consider as part of the job recruitment process: >> Job vacancy factors: characteristics of the job opportunity that make a candidate more/less likely to apply for said opportunity (compensation, benefits, opportunities for advancement, geography, job security, etc.).
>> Individual candidate factors -- personal preferences and circumstances that make a candidate more/less likely to apply for a given job opportunity (family status, career status, age, etc.). ** Different candidates will place different weights (priorities) on each of these individual recruitment factors in terms of their personal importance to the candidate. ** Having an understanding of those vacancy-related factors that are most important to candidates and taking into account individual candidate factors that may also be important assists HR personnel with effectively "targeting" the recruitment effort(s) of the organization to increase the efficiency and effectiveness of the recruitment process. ** At a minimum, any recruitment message/solicitation should include information regarding the title of the position, a job description, job specifications, the application process to be followed, and the name of the organization/department doing the solicitation. ** In terms of evaluation of recruitment efforts, measures of recruitment process efficiency (cost per applicant) and effectiveness (quantity/quality of applicant pool, EEO/diversity issues, average time to fill jobs) are most commonly utilized. ** Candidate Selection Issues ** Employee selection involves a number of activities and processes aimed at collecting and evaluating information about job applicants to find the right individual(s) to whom to extend an offer of employment. ** Differentiated from the simpler hiring process, which entails offering employment to an individual based on availability, the selection process is a planned, structured, and formally detailed procedure for the identification of those candidates who are most qualified and/or represent the best "fit" within the organization based on pre-defined job criteria. ** The most commonly utilized tools utilized by HR management for the purpose of candidate selection are job application forms, standardized tests, personal interviews, job simulations, and personal reference letters.
** Any selection instrument utilized as part of this process should have a number of characteristics that make it useful for the purpose of predicting job-related performance: >> Instrument reliability -- how dependable/consistent the results of a given instrument are. Selection tools/instruments that provide more reliable/consistent results are preferred insofar as they provide highly similar results regardless of the person(s) using the tool and/or the context within which it is used. >> Instrument validity -- measures the extent to which the results of a given selection tool/instrument actually corresponds to successful work performance. Three different types of validity that will be relevant to discussion of different selection tools are as follows: ## Criterion-based validity -- includes both concurrent as well as predictive validity, measures how well the results of a selection tools correlate with current/future job performance, respectively. ## Content validity -- measures how well a selection tool representatively samples the content of the job for which it is used. (face validity) ## Construct validity -- measures how well a selection tool actually estimates the construct it is intended to measure. (job-related success) ** Among selection instruments/tools commonly utilized, what follows are summary descriptions of the validity and reliability for each tool/instrument: >> Reference letters -- tend to have low reliability on a variety of measures and low to moderate predictive validity due to the highly subjective, biased, and often non-uniform approach to candidate evaluation used by different references. Approaches to improve the validity of such instruments include relying on most recent employer references for input and requiring that each reference have known the applicant for an extended period of time. Typically of most use with respect to verifying employee information derived as part of the application process.
>> Personal interviews -- most commonly utilized selection tool outside of the application form. Tend to be characterized as having both low reliability as well as low validity. Sources of bias include interviewer bias and Hawthorne effect, whereas sources of error include nonstructured question formats and scoring/interpretation errors on behalf of interviewers. Among different approaches to personal interviewing, the structured interview (conducted by trained interviewers) is preferred on reliability, validity, and legal grounds (to verify that interview questions are explicitly job-related and not likely to be construed as discriminatory). >> Application forms and resumes -- universally employed selection screening tool. Most useful on validity, reliability, and legal grounds if accompanied by a legal veracity statement (i.e. "By signing below, the applicant certifies that all the information contained herein is accurate to the best of his/her knowledge.") and structured according to different job information requirements for different jobs. Non-job-related information solicitation requests should be avoided (questions related to marital status, # of kids, age, height, weight, disabilities, etc.) unless such information is related to an essential job function as defined in the law. >> Standardized tests -- tests of personality, honesty, integrity, cognitive abilities, motor functionality. Typically standardized so as to ensure sufficient validity and reliability. Primary concern(s) related to the legality of such tests under anti-discrimination law.