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| Dr J Sivakumaran |
In spite of technological advancements, one cannot rule out the importance of manpower in hospitals. Latest and modern technologies cannot substitute the contribution made by specialised manpower in the healthcare industry. Human resource (HR) is a very vital resource, a veritable sine qua non in the healthcare industry. To err is human, goes the old adage, probably suggesting that one need not make a big deal of mistakes committed. However, in healthcare mistakes can prove quite grave, with fatal consequences for the patient. Hence, healthcare staff should have the ability to follow and implement safe and ethical practices with highest level of technical competency. There are many challenges before the human resource department of a hospital. Few of the important challenges are discussed here.
Shortage of workforce
The first and foremost challenge is the identification, recruitment and retention of the required workforce. In healthcare, there is a dearth of talent and trained manpower. India faces a huge gap between demand and supply of healthcare workforce. This is due to the heavy shortage of beds and human resource, and to compound the situation further, a highly skewed infrastructural growth. As per a survey conducted by Tecknopak, by the year 2020, we need 2.5 million hospitals, one million doctors, two million nurses and 10 million paramedics, with the growth opportunity to do a healthcare business of $280 billion. It is a fact that we are struggling to meet the demand even for the current level of operations. The shortage of workforce is due to various reasons. Many of the quality manpower are being hired by hospitals abroad, causing shortage and brain-drain in India. Skilled workforce from India is much sought after in the international market. Indian healthcare employees seek overseas opportunities due to prevalence of poor pay scales, lack of professional growth, skill development and poor working conditions in India. These factors contribute to the flight of local talent seeking greener pastures abroad. It is to be noted that it takes at least five years to train a doctor and minimum three years to train a nurse before they attain the expected level of service delivery after their professional degree. There are no shortcuts here. Any attempt at trying to shorten the gestation period would be highly detrimental. When there is a shortage, it becomes necessary to have effective HR strategies in place to achieve better outcomes. Therefore, the HR personnel need to act as coaches, mentors, counsellors, identifiers of successors by promoting organisational ethics, values, culture and beliefs.
Training and retention of employees
Apart from the challenge of having the right people for the right task, technological advancement warrants consistent training for maintaining the highest standards of medical excellence. Whether it is for accreditation, technology upgradation, service customisation, quality service delivery or developing medical tourism, constant training and retraining of the employees is essential for aligning their skill sets in line with the objectives of the organisation. A professionally trained and skilled workforce is essential for running any hospital successfully. Once trained properly, retaining the workforce is also a huge challenge confronting hospitals. Retaining talent is less expensive than hiring a new employee and training him/her to suit the organisational needs. Developing a workforce is, in a way, upgrading the skill set of the existing workforce as well as helping the staff in acquiring competencies and skills for their current and future roles. Mentoring employees to take up bigger roles within the company often helps unearth latent talents and skills, benefitting individuals and the hospitals. This will improve the motivational and confidence level of staff to perform efficiently and effectively.
Developing multi-tasking workforce
Employee cost is a major expenditure in hospitals and it keeps increasing consistently. Sometimes it goes beyond the budgeted level due to repeated revision of wage norms by state governments. With the healthcare sector witnessing an unprecedented boom, there is an abundance of employment opportunities for healthcare professionals, further pushing up the costs of retaining them. Due to this, hospitals are working on methods to keep the cost under control, without compromising on the quality of service. One such method is to have a multi-tasking manpower pool which can be made to perform multiple functions based on business exigencies. Identifying, orienting, training, inducting and retaining a multi-tasking manpower is an onerous task which many hospitals have taken upon themselves. Talents are being identified and trained to do multi-tasking and this task force is often called upon to make up for manpower deficiencies in specific areas. This strategy helps hospitals retain the manpower cost at a reasonable level and ensure better utilisation of the manpower employed.
Developing second line staff
Migration of healthcare workers is comparatively high, as compared to other industries. In case of nurses, the hospitals are not only facing threat from competitors within the city hospitals, but also from government hospitals, teaching institutions and from healthcare institutions abroad. Retaining this vital workforce despite the ‘pull-factor’ from competitors is a challenge. In spite of the best efforts being put in by hospitals to retain talent, the employee turnover ratio in the Indian healthcare space is a whopping 30 per cent. In such a scenario, hospitals need to constantly work on developing a second rung workforce to fill in the shoes of the employees leaving them. Identification of such talent and grooming them to take up bigger roles is a real challenge before hospitals. This exercise needs to be done in all areas and at all levels. Replacing a talent from the existing work force often proves to be cheaper than hiring from outside, as long as the competency level is sufficient to meet the challenge.
Managing younger workforce
The population demography of the country is heavily skewed with the youth making up for a substantial percentage of our population. Many of the fresh recruits are barely into their twenties when they are inducted into the workforce. Their attitude is different from the more seasoned seniors. The younger generation needs to be handled with care, largely owing to their outlook, upbringing and attitude. The youth of today are ready to take on any challenge, assume ownership of work and run the extra mile in pursuit of their ambitions. However, the flip side is that they are fiercely independent and are generally unappreciative of a senior constantly watching over their shoulders. They are generally go getters, flexible, non-conservative and liberal in culture. Training and aligning them to the organisational culture, maintaining high decorum, sustaining a safe workplace that keeps up with their self-actualisation objectives is a challenge in itself. Therefore, it is essential that hospitals try and maintain a workplace which would cater to the dynamic needs of the workforce. The deserving employees need to be recognised, encouraged and rewarded for getting the best out of them.
Accountability of workforce
Patient care, in general, is a team work and not an individual task. The team mix is hybrid, consisting of uneducated, unskilled workers to highly qualified doctor(s). In such a scenario, it is important to fix the accountability for each job performed by each individual, so as to ensure seamless delivery of quality healthcare. Documentation of responsibilities given to each individual in the healthcare delivery system is very important for achieving desired results. This is again a challenge before us.
In spite of all these challenges, hospitals find their own ways and means to overcome these problems. Undoubtedly, the sector is growing year after year and these challenges are expected to settle down over a period of time if the stakeholders come together and take suitable initiatives.
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