Human Resource Planning for Health Care
The WHO defines human resources for health (HRH) planning as “the process of estimating the number of people and the types of knowledge, skills and attitudes they need to achieve predetermined health objectives and, in ultimately, health status goals.
HR planning is a dynamic process, it involves 3 stages; temporary labor inventory, forecasting and design. In the first stage of inventory, the recruitment and selection of key types of employees are aligned with the strategic business plan to achieve specific goals. The second stage of the forecast is subdivided into two phases, the forecast of people’s future needs (demand forecast) and the forecast of people’s availability (supply forecast). The third and final phase involves a flexible strategy to hire temporary employees based on needs assessment and profitable benefits.
1. Inventory: – The principle is to identify how many people are needed at each level of the organization to achieve business goals, in line with overall strategic plans, and what kind of knowledge, skills, abilities, and other characteristics these people need. .
Optimal staffing of modern health services requires many different types of personnel. These include; –
1. Clinical workers: doctors and nurses.
2. Technical personnel for diagnostic services, such as laboratory and radiology, pharmacy personnel.
3. Environmental health workers, such as health inspectors.
4. Preventive and promotional staff, such as community health workers, administrative staff, etc.
In a health care organization, the traditional quantitative approach is used to make enumerative judgments based on the subjective prediction of managers to allocate certain budgets for employee payroll expenses and the potentialization needs assessment of key employees that respond to system and organizational design. Resource allocations are better executed with the help of activity-based cost management, which controls the cost and labor required for a specific job/event and reduces waste.
For example: Comparative rates of care activity: –
Hospital bed days per capita
Acute care bed days per capita
Ratio of intensive care staff – staff per bed
Ratio of critical care nurses – staff per bed
Inpatient admissions per 1,000 population
Acute care admissions per 1000 population
Medical consultation per capita.
The types of health personnel in a particular country are dictated by the types of health services provided and the level of technology available.
For example:-
Nature of the health organization: primary, secondary and tertiary.
Sector Types: Public, Private, Funded Non-Profit Organization.
Infrastructure: hospital size (200 beds, 400 beds, 1000 beds).
Providers of general care (multispecialty) or specific care (cardiovascular, oncology).
2. Forecast:-
Demand forecasting: – Medical workforce planning is complex and driven by relatively mechanistic estimates of health care demand. Dr. Thomas L. Hall (1991) proposed 5 generic methods to estimate the demand for medical care, such as
1. Staff-to-population ratio method: – This method calculates the ratio between the number of
Staff compared to population count. However, with inadequate data available, it has serious limitations, such as only being applicable with acceptable health conditions, a stable health sector, and limited planning capacity.
2. The health needs method: -This method requires and translates the opinion of experts on the health needs of people to the requirements of the staff. Health needs are derived from the determination of disease-specific mortality and morbidity rates. Staffing requirements are assessed from norms for the number, type, frequency, and quality of services, and staffing standards that translate services into time requirements for a given category of health care workers to perform services. This approach initiates the need for sophisticated data system and survey capabilities, and a high level of planning expertise that are not readily available.
3. The service demands method: This method accounts for the number and type of health services that people will use at an anticipated cost to obtain them, rather than their professionally determined need for those services. This specifically provides data on the economic regression related to the use of the private health sector compared to the government-funded health sector.
4. The managed health care system method: – The managed health care system implies a known client population that would have reasonably good access to health services. But flexible sociopolitical trends and economic recession influence health care reform policies.
Supply forecast: –
Forecasting the supply of human resources involves the use of information from the internal and external labor market. The calculation of the rates of rotation and stability of the workforce measures the internal offer of HR Planning. The external labor market provides a detailed spectrum of supply shortages, demographic factors, and social/geographical aspects.
Internal supply: – The evaluation of the gross number of people needed for a specific job and the organization of other provisions of the human resources processes, such as training and development programs, transfer and promotion policies, retirement, career planning and others, They are of crucial importance in maintenance. constant supply of human resources in an organization.
1. Stock and Flow Model: This model follows the employee’s path through the organization over time and attempts to predict how many employees are needed and where in the organization.
a) residue analysis; – This analysis refers to the rate of departure of people from the organization, or represents the turnover rate.
The number of people leaving in a specific period
Residual analysis= x 100
The average number of employees in the same period
b) Stability analysis (Bovey, 1974): – This method is useful to analyze the magnitude of waste in terms of service time.
Total service time of the workforce employed at the time of analysis
Stability analysis=x 100
Total possible duration of service if there were no waste of labor
2. Replacement cadres: – The replacement cadres is a list of employees for promotion, selected based on the opinions and recommendations of higher ranking people (Mello, 2005). Some replacement charts are more systematic, showing an employee’s skills, abilities, competencies, and experience levels.
3. Succession Planning: – An aging workforce and emerging waves of baby boom retirement are driving the need for a new management process known as succession planning that involves analyzing and forecasting talent potentials to execute the business strategy.
Will Powley, senior consulting manager for GE Healthcare’s performance solutions group, says the first step in effective succession planning is a quarterly talent review that begins with an examination of the hospital or health system organization chart.
In a 2008 white paper on succession planning, GE Healthcare identified some health care best practices for succession planning:
1. Identify and develop talent at all levels
2. Assess top talent rigorously and repeatedly
3. Closely link talent management with outsourcing
4. Keep top management actively involved
5. Emphasize workplace leadership and personalized employee development
6. Create systematic talent reviews and tracking plans
7. Maintain dialogue with potential future leaders.
External supply:- HR managers use external information such as statistics about the organization’s labor market and the external labor market, in other words, external and internal statistics.
External statistics: – Graduate profile
unemployment rates
skill levels
age profile
Graduate Profile: – There is substantial public sector regulation of all healthcare markets, and entry into the labor market is highly restricted by licensing and professional regulations.
Unemployment rates: – There is a lack of economic principles, the role of incentives is largely ignored, and the elasticity of supply in the labor market is largely unknown and under-researched.
Ability levels: – Higher education (major and super major) is proportionally restricted to an admission limit governed by medical regulatory bodies.
Age Profile: – Hiring charts provide details of employee hire, retention, return and early retirement rates, helping to list future vacancy rates, shortages and replacement needs.
Internal statistics: – Demographic profile
Geographical distribution
Demographic profile: – Demographic changes (for example, the number of young people entering the labor force) affect the external supply of labor. The age composition of the workforce will force a review of hiring policies. The trend of increasing the proportion of women in employment has led to the progressive development of both the organization and the country.
Geographic distribution: – The attraction of labor to urban areas is influenced by the following reasons; employment opportunity, access to facilities – transportation and technology, and others.
3. Temporary Manpower Planning:-
Herer and Harel (1998) classify temporary workers as: temporary employees, contract employees, consultants, leased and subcontracted employees.
The high social costs have started a shared work strategy that is flexible and provides more benefits, such as
1. The number and hours of temporary part-time workers can be easily adapted with low maintenance cost to meet the needs of the organization.
2. Employees who possess appropriate/specialized skills benefit functional areas inside and outside the organization.
3. No responsibility for enrollments of exclusive benefits, such as job security, pension plan, insurance coverage, etc.
In today’s work environment, outsourcing can be added as a temporary worker planning technique. The outsourcing requirement is assessed and evaluated in the cost benefit decision. Outpatient services, diagnostic or pathological testing services, laundry, catering, billing, medical transcription, and others are the most commonly promoted outsourcing services in the healthcare organization.