Human Resources In US Healthcare
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The healthcare industry is the largest employer in the United States, in 2002; this industry consisted of 518,000 organizations that employed 12.9 million individuals (Fallon & McConnell, 2007). The healthcare sector employs 10.9% of all employment in the United States and has a 16% new job growth. The reason behind this growth is primarily due to two factors: increased in the use of technology and the continued aging of the population (McConnell, 2006). Large numbers of individuals are needed to provide, record, and bill for the services provided to the patients. Human resources are the backbone of the health organization because they address the need to ensure that each department is staffed with qualified and motivated personnel (Hernandez, 2009). In strategic human resources planning, the human resources department is an important member of the healthcare industry. The HR department is involved in a number of activates that together comprise of four major activity groupings: hiring of employees, maintaining employees, retaining employees, and separating employees.
To most people the human resources department is viewed as more administrative than advisory and as an enforcer of policies than the actual policy makers. Basically, people consider this department as where you go to get hired or to file your personal papers. There are times when other departments may look upon the human resources department negatively and this is due to the fact that other departments may not know the rules and regulations that HR must follow for example: a department manager may have a key position that has been vacant for a few weeks and because of the vacancy the other employees in the department has to work mandatory overtime (Bohlander, Snell, & Reviews, 2009) An ideal candidate has been interviewed by the HR department and is then referred to the manager for another interview, the manager then tell HR that this is the exact person they are looking for and they would like this person to start in their department as soon as tomorrow, however, because of the protocols that HR must follow they are not able to hire this person before a background check, references and a drug test has been done. The manager of the department may then complain to their senior manger that HR is taking their time or is unwilling to cooperate (Bohlander, Snell, & Reviews, 2009).
There are many departments within the healthcare field, from different types of physicians, nurses, administration and technicians. In hospitals the human resources has a part in hiring all of these people, in private facilities that is owned by one or two physicians the HR department will in most cases hirer everyone except the physicians. Physicians are some of the most important people that work in a hospital; they are traditionally the focus of the health care industry. The reason is because they are the people who primarily evaluate and diagnose patients' conditions and prescribe treatment. When it comes to the hiring of a physician, it must be determine that their services will be an asset to the hospital because of their salary related costs. When there is a need for the hiring of a physician, the HR department must make sure he/she is competent, a background check must be preformed and they must make sure they are licensed to practice in the state where they are practicing. Physicians must complete internship/residency which is a form of paid on the job training and this is usually done at a hospital. Nurses work closing with physicians because they provide the primary care to the patients in both hospital and clinic settings. The duties of nurses differ depending on the type of setting in which they are working. The different settings that nurses work in are:
- Nursing homes
- Private practice
- Ambulatory center centers
- Managed care organization
- Government and private agencies
- Retirement communities
- Rehabilitation centers
Nurses are increasingly being employed by outpatient centers and home healthcare organizations because of the trends toward discharging patients from hospitals faster and performing many procedures in outpatient settings (Wolper, 2004). When a nurse is hired the human resources department must make sure that the nurse is licensed to practice. A nurse's licensure is achieved by graduating from an accredited nursing school and completing a national exam. A physician that does not have a MD or a DO degree are non-physician practitioners, they provide health services in areas similar to those of a physicians. In 47 states and the District of Columbia, they can prescribe medication (Wolper, 2004).
Human resources may be recognizable as 5 different models, these are: clerical, counseling, industrial relations, control and consulting model. Under clerical model, human resources perform the following duties: processor, file paper, keep records, and track various statistics and key dates and administrator of employee benefits plans. Under this model, the top manager of this department is most likely to be experiences as a benefits administrator or have a similar practitioner orientation. The counseling model is relatively common in hospitals because the total cost of employees represents a large portion of the budge and there is an emphasis on maintaining employees as effective productions. Under this model HR is likely to: function as an advocate for employees, place high priority on preserving privacy and confidentiality, actively stress training and development and function as a resource to managers for people problems, disputes, and disciplinary issues. The industrial relations model develops in organizations in which the work force is unionized, and there are periodic contract negotiations and considerable activity having to do with grievances and arbitrations. HR functions specified by contract are performed automatically and as expected, with little room for flexibility or judgment in their performance. The control model observed in very few organizations offers the HR department substantial power, under this model little management action is taken without the clearance of HR; the HR department is current and knowledgeable concerning all legal requirements and the HR executive will be a key member of the organization's administrative team. The consulting model is usually found in larger organizations, under this model the HR practitioners are usually expert resources, relied upon by employees, department managers, and executive management according to need. There are alternative models such as managerial model and financial model, under the managerial model the HR has no particular strategic outlook or long range planning involvement. A HR function operating under the financial model displays maximum attention to HR costs, in particular, indirect compensation costs such as health and dental insurance, life insurance, retirement plans, paid time off, and other benefits.
The human resources department of any healthcare entity must protect and encourage the quality of the patient's relationship with the healthcare entity, but it also must protect and encourage the quality of the employee's relationship with the healthcare entity. The employees of the healthcare industry must provide compassion and they should consider care but their job satisfaction is important. The major managerial function surrounding human resources are:
- Strategic Planning
- Recruitment and Selection
- Compensation and Benefits
- Performance Evaluation
- Training and Education
- Legal and Regulatory Issues
Strategic planning is the process of matching the human resources of an business with its goals and objectives. In strategic HR planning, the human resources department is an important member of the executive committee. Recruitment and selection allow hiring of the best candidate with the needed skills. When recruiting people for a new position, it is important to recruit internally as well as externally, because a member of the current staff may be appropriate for the position. It is important that new recruits fit into the organizational culture but it is also critical to assess the organizational culture to ensure that it is not a source of retention problems. For example: doctors' lack of respect for nurses in some organizations has created a retention problem for nurses. The process of recruitment, selection, and training is intensive and expensive, in both actual cost and opportunity costs. High compensation is a factor that will enhance retention of workers, benefits is also important in retention. Performance evaluation is a way to define the level of competence of an employee as measured against a certain standard level of skills and knowledge. To encourage the practice of performance evaluation, many health care organizations, especially integrated health care systems are implementing, pay for performance, compensation plans. Pay for performance can be based on individual, tem, organization goals.
Human Resources not only have to deal with many challenges such as training and education mandates, health care organizations must be knowledgeable of the legal and regulatory issues related to the HR department in general. This is especially when it deals with safety in the workplace and union regulations, because of the potential for exposure to blood borne pathogens and radiological substance. Health care organization must have appropriate safety measures in place to protect their employee against injury, as well as appropriate training to facilitate the use of these safety measures. Another challenge in HR is planning is very important in the HR department; by planning correctly (McConnell, 2006). HR can avoid having a surplus or a shortage. If HR has hired too many employees for the health care faculty then there would be a surplus but it do not hire enough then there would be a shortage. The health care organization is very diverse, diversity means a wider range of people bringing a greater variety of approaches to work, ideas, lifestyles issues and many other things. Human resource policies must address these differences in order to attract, retain, and maximize the contributions of all members of the changing workforce.
Human resource planning in the 21st century is a much more comprehensive set of analyses and examinations to ensure that the HR department function optimally contributes to the organization's overall business success. Human resources function is striving toward creating stronger business partnerships within the organization, the need for thorough and accurate HR planning is likely to be unique to each organization. There are laws that affect different aspects of employment relationship, the human resources department must be aware of these pieces of legislation. A significant legislation was the Civil Rights Act of 1964; this legislation marked the beginning of significant changes in relations between the government and business in the United States (McConnell, 2006). Before the Civil Rights Act, businesses were free to treat their employees essentially as they chose, there were only two exceptions: wage and hour laws and labor relations laws. Prior to 1964, the only laws that had noticeable impact on the employment relationship were the Fair Labor Standards Act and related state laws, and the National Labor Relations Act. Employees' payment of wages and other related conditions of employment were governed under the Fair Labor Standards Act (McConnell, 2006). The relationship between work organizations and labor unions were governed under the National Labor Relations Act. The Social Security Act provided low income elderly people with social insurance. In 1937 this act was expanded to provide benefits to survivors of covered workers who became permanently disabled. The Health Insurance Portability and Accountability Act (HIPAA) went into effect on July 1st, 1997; this law ensures that most persons who change jobs will receive continuous health insurance without regard to many preexisting health conditions (McConnell, 2006).
Organization need to consider a variety of issues when analyzing the impact of HIPAA on their organization. Some issues that may impact their organization are:
HIPAA is about improving the efficiency and cost effectiveness of the healthcare system.
Limited resources, both in terms of dollars, staffing, and time
Convergence of e-health strategies and HIPAA objectives, which are clearly connect in the areas of standardization and technical security measures.
Constraining effects of legacy systems within industry, which add to cost of compliance as well as ongoing dependency on vendors.
There will be a profound impact on overall healthcare industry electronic communications and transactions HIPAA have pave the way for increasingly sophisticated e-health and other healthcare e-commerce and communications applications as well as for new uses of evolving technologies, such as hand held devices and wireless access (Fallon, & McConnell, 2007).
There are a few healthcare industry forecasts that will directly impact job analysis. In healthcare technology is ever and quickly changing and such technology makes new procedures and treatment possible. These new treatments and procedures provide a solution that meets medical needs for a number of patients, which leads to an increasing survival rate and the rising life expectancy of the nation as a whole. It is believed that over the next 15 years, there will be a shortage of physicians in the United States. We may also see a similar trend in the supply of nurses. With the demand for quality healthcare increasing by an aging population demanding more health care service, the nursing shortage will be an important strategic human resource issue in the health care industry (Shi, 2007). Job analysis will play an important role. Since the healthcare industry is forever changing, the idea of strategic job analysis surely will become a major focus on healthcare organizations. Strategic job analysis is the identification and specification of future jobs takes and responsibilities and the knowledge, skills, and abilities needed to perform those jobs that currently do not currently exist but are anticipated to be needed in the future. There should be also be anticipation of the future changes in terms of laws and regulations, employee demographics, profession shortages, technology, information, technology, and other possible changes (Shi, 2007). It is important for human resources to know which jobs and associated tasks will be needed in the future, along with identifying the knowledge, skills, abilities, and other requirements needed to perform such jobs, will be a potential advantage for health care organization desiring to effectively compete in the future.