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THE SEARCHLIGHT MESSENGER

CURRENT STRATEGIC PLANNING IN HEALTH CARE HUMAN RESOURCES

Between now and the end of 2014, the US Department of Labor is predicting a thirty percent increase in the number of health care jobs. This will amount to approximately five million new employees in the field of health care and one out of every five of these jobs will be in the field of health services. The challenges facing health care organizations will be immense as they try to develop and implement strategic plans to recruit and train a quality workforce. Retention of these employees will be a key factor in minimizing operating budgets due to the high cost of employee turnover, which in a study conducted by the American Association of Retired Persons (AARP), can amount to up to fifty percent of payroll dollars. The role of the human resource department will be critical to the success of these health care organizations in their ability to hire, reward, and retain the employees they need to operate and thrive in a constantly changing industry.

In this article we will discuss the human resource processes of recruitment and retention; selection and onboarding; training and development; and performance appraisal and compensation as they relate to four different types of corporate strategies: a low cost strategy, a quality differentiation strategy, a growth through acquisition strategy, and a focus differentiation strategy.

The difficulties facing the human resources department of a health care organization with a low cost corporate strategy, such as a community health center, will more than likely be financially related. These facilities often have a high employee turnover rate due to low pay, and must operate and succeed on a limited budget. Therefore, recruitment of employees will have to be done through services who do not require remuneration, such as Craigslist; industry journals; and internet job sites such as, Career Builder. Selection of candidates will normally consist of just a single interview where their skills can be demonstrated. Once hired, training for the workers such as medical assistants and administrative staff will be done on the job with other employees assisting to develop the new “hires” to perform their duties efficiently and at a minimal cost. Doctors and nurses working or volunteering at the community center should already possess the skills necessary and as determined through the credentialing process, need very little training. However, they too will have to learn how to operate on a limited budget while still providing the highest possible quality of care to their patients. Performance appraisals will normally be done once a year but annual pay raises will be small. Most employees of a health care facility operating on a low cost strategy will be paid an hourly rate that is on the lower end of the pay scale for the health care industry and benefits will be minimal, if they are even offered at all.

Another source of potential employees for a low cost-strategic approach is to allow and incorporate the use of interns from various medical training programs in the medical office while they work toward meeting their course requirements. This would be a free source of labor and can help keep costs down. These students could be trained on the job and would be a continuous source of free labor since most of the educational institutions pay for their insurance while they work at their intern sites. Training hospitals affiliated with U.S. medical colleges have been utilizing this technique for nearly one hundred years, as they place upper class-men in these institutions for clinical experience.

A quality-differentiation corporate strategy approach, such as adding a birthing center to a family practice clinic, would allow the HR department more resources in their search for skilled employees. Recruitment would still be done via online sites as well as local newspapers and local workforce centers but it can also be done from within. Employees already working for the facility may wish to transfer to the new clinic, which would help minimize the training and onboarding processes since these individuals will already be employees of the company and in their system. This type of health care organization would want to focus a little more on quality employees who would provide outstanding care since competition for patients would be more of a factor. Performance appraisals could still be conducted annually and good employees should be compensated for successful execution of their job duties. Compensation would be based on a scale for similar jobs in the area and basic benefits should be offered.  

A situation in which the human resources department would have unique challenges would be a growth-through-acquisition strategy, such as two hospitals merging. In a setting such as this, most employees already working for the facilities would probably be retained and some may even need to be laid off initially until the merger is complete and new growth in the businesses is achieved. The first step would be to offer severance packages to any employees who are interested. The HR department would then begin to assess the performance reviews of other employees and attempt to determine which ones are the best to keep on staff. Once the merger is complete and the facilities can begin to expand their operations, new hiring can be achieved in much the same way as other corporate strategies. Advertising for available positions could be done via job search sites, local media and job force centers and even national sites and agencies if the organization is trying to attract highly skilled professionals from a vast pool of individuals. Interested applicants would be pre-screened to determine qualifications and go through an initial interview process. The qualified candidates would then be chosen and offered employment. Quality employees would be a top priority in order to maintain a high standard of patient care and satisfaction. Medical and dental benefits should be offered to employees as well as at least one week per year of paid vacation for senior employees. Performance appraisals would be conducted at least once per year and pay raises offered to deserving individuals. For employees who are salaried, annual pay raises should be offered.

The most challenging scenario for human resources would be a focus-differentiation strategy, such as a surgical burn center. According to a study done by the Department of Health and Human Services, the demand for physician services will increase by 22% between 2005 and 2020 and the supply of physicians to fill that demand will not be sufficient. Therefore, competition to hire the type of highly skilled and desirable health care workers will be tough and HR departments may even recruit from overseas to meet their staffing needs. “Headhunting” firms may be utilized to help find potential employees and due to the large fee awarded to these agencies, retention of the hired individuals will be key. Candidates from across the country would be prescreened to determine qualifications and applicants would then be flown at company expense for an interview with senior administration of the specialized facility where they will work. Once hired, the new employees would be paid a moving stipend and offered the assistance of a relocation specialist to make their move a hassle free one. Upon starting their new job, they would be provided with a sponsor or mentor within the organization who will help them learn the ropes of the institution and assist with onboarding until they are comfortable in their new role. 

Since the health care industry is constantly changing, continued training and skills enhancing workshops would be offered to employees as needed in order to keep them up to date with current trends and technology. If these training seminars are in other locations, the trips will be paid at the expense of the employer. Performance appraisals will be conducted by senior staff and peers at least twice a year and bonuses awarded based on satisfactory results and achievements. Compensation would usually be salaried pay and would need to be at the high-end of the pay scale for similar jobs in the field with a severance and retirement package to be determined prior to employment.

Due to the high costs involved in hiring of employees of this caliber, retention becomes a critical issue. A comprehensive options and benefits package would have to be offered to include such things as paid time off, income protection, regular salary increases, performance bonuses, 401K and retirement packages, assistance with paying malpractice insurance, and “work and life balance” programs.

The demands on the healthcare industry are increasing at a time when the cost of providing healthcare is also increasing and a quality workforce will be the key to success for companies wishing to operate and survive in the business of health care. The need to implement successful human resource policies for employee recruitment, selection, training, development, compensation, and benefits, in addition to performance management, will be an important part of an employer's strategic plan.

Stacie Fisher



ABOUT THE AUTHOR:

Stacie Fisher is a senior business student of Dr. Counce, and is in the Health Information Management degree program at Intellitec Medical Institute in Colorado Springs, Colorado. A Magna Cum Laude student, Ms. Fisher is finishing her internship this Spring and will graduate this Summer with The Class of 2013. All professors and instructors at IMI are convinced that Stacie will eventually move into the ranks of instructor and beyond.


108 Comments to CURRENT STRATEGIC PLANNING IN HEALTH CARE HUMAN RESOURCES:

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I totally agree with you. More article please!
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Dr. Counce on Sunday, February 03, 2013 1:44 PM
Thank you. More coming.


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