Jack: Hi, everyone,
and welcome back to Module 4.
In today's lecture, I'll be presenting the intricacies
of human resource management in a global context.
Key aspects of this module
include the healthcare sector as a human enterprise.
The core principles impact
and challenges that human resource management,
best practice human resource management,
and diverse socioeconomic perspectives.
The healthcare sector is an enterprise
of people engaging and serving other people.
The connections between people
who engage in health work have long been recognized
as integral to the professionally dominant roles
within the sector.
Traditionally, healthcare has been delivered
by relatively large organizations
with large bureaucratic structures,
but now the field is becoming increasingly systematized.
Boundaries are being redefined
to respond to changing populations and workforces,
the increasing burden of chronic disease,
the impact of technology,
social movements, and socioeconomic determinants.
The struggle to redefine and reform health systems
and professional organizations has been evident
since at least the beginning of the 21st century.
There are nine primary competencies
for the global health human resources manager.
These are human resources,
a human resources expertise rather,
relationship management, consultation,
leadership and navigation, communication,
global and cultural effectiveness, ethical practice,
critical evaluation, and business acumen.
These competencies provide a starting point
for considering strategic HR issues for the health sector.
Another way to think about HR issues in global health
are by looking at key issues.
We see some issues listed on the slide,
and we'll add some to summarize some additional issues.
These are as follows.
The size, distribution, and composition
of a country's healthcare workforce
are key indicators of the country's capacity
to deliver services and interventions.
Human resources personnel must consider the composition
of the health workforce
in terms of all skill categories and training levels.
A properly trained and competent workforce
is essential to any successful healthcare system.
The migration of healthcare workers
is a critical issue for global healthcare systems,
as is the movement of healthcare professionals
internationally, nationally, and regionally.
Oftentimes, we see internal movement
of a workforce from rural areas to urban areas
and countries for economic opportunity.
This workforce mobility can create imbalances
that require better workforce planning.
Evidence suggests that a significant positive correlation
exists between a country's level of economic development
and its supply of human resources for health.
Aging populations and the aging health workforce
have a significant impact
on health workforce capacity and sustainability.
Cultural and geographic factors
affect the supply and demand of human resources for health,
and therefore must be considered
when examining global healthcare systems.
Human resources have a significant impact
on attempts at health reform,
and this impact should not be underestimated.
And health resources or human resources
are one of three main health system inputs
along with physical capital and consumables.
They are the hardest of the three inputs
to develop, manage, and maintain.
Fortunately, while there are challenges
in HR and global health,
there are also many best practices
that have been developed
for effective human resource management.
One comprehensive review, for example,
of large system transformation in healthcare
found five simple rules
that blend designated leadership with distributed leadership
to establish feedback loops
to engage physicians and other clinicians
in all aspects of patient care
and to include patients and families in decision making.
Optimum patient care cannot be delivered
without effective human resource management.
There are other studies that have also theorized
and found evidence for best practices,
and some of them are as follows.
Related to HR planning and job analysis,
it's important to encourage employee involvement
to ensure strong buy-in of HR practices
and managerial initiatives.
It's also important to provide employment security
and encourage teamwork
so employees are more willing to collaborate.
Regarding staffing,
it's important to be proactive
in identifying and attracting talent.
In selecting new employees,
use additional criteria
like attributes outside the scope of one's resume
beyond their basic skills.
Regarding training and organizational development,
it's important to invest in training
and organizational opportunities
to enhance employees skills
related to the goals of an organization.
It's also important to recognize employees
through both monetary and non-monetary rewards
and to offer high compensation
contingent on organizational performance.
Finally, in relationship to employee rights,
it's important to communicate effectively with employees
and to keep them informed
about major issues and initiatives.
To share financial, salary, and performance information
to develop a high trust organization
and to give higher priority
to internal candidates for promotion,
therefore, enhancing employee motivation.
Now, we turn to look at social cultural perspectives
and the impact of culture on healthcare in human resources.
The diverse multicultural nature
of today's global health workforce
and the mobility of from one part of the world to another
carries significant implications,
which have been examined in depth by numerous studies.
For example,
the United Nations Human Development Report 2015
makes several key points relevant to the health workforce.
It emphasizes that work,
including volunteering and creative work, not just jobs,
contributes to human progress
and enhances the wealth and wellness of populations.
This report also cautions that globalization
and the technical revolution
are rapidly changing how we work and what we do.
HR strategies and practices
need to recognize the impact of the cultural differences
that exist among nations
and among communities within the same nation,
as well as the differences that exist
among various professional groups in the health setting.
While these differences can be challenging,
they can also help us to improve the ways
that we learn, manage, and lead.
In any setting, distinct cultural,
values, legal framework, and political systems
vary in different countries
and regions shape the way that individual systems operate.
The central functions of human resources
are similar around the globe,
but the prevalence of particular HR practices
and their impact and outcomes vary widely.
For example, while the US healthcare system
has a large emphasis on private for-profit organizations,
many countries of Latin America and Asia
are largely based on socialized systems
like universal healthcare.
Furthermore, in a comparison of management priorities
in the US and mainland China,
it's been found that US managers
are more concerned about getting the job done
while Chinese managers were concerned
with maintaining harmony among employees and managers.
Next, we turn to the effective development
of human resources management.
There are several strategies that can be used here.
Namely, it's important to use learning and research
based on a global perspective
and collaborate extensively with international partners
in both learning and research,
incorporating collaborative management
and leadership practices, for example.
Having higher level executives
from different cultures in different countries
can help to facilitate the development
of effective human resource management across cultures.
In your textbook this week,
the case study has a great example
of the development of human resource management
in different cultures.
It also provides some methods for surveying
and/or quantitatively assessing the differences
in cultural dimensions between countries.
One of the challenges in the field
is that there's less research concerning the effect
of different HR methods and policies upon people
and different cultural or ethnic groups.
Additionally, other factors that might impact the success
or effectiveness of different HR practices
include whether companies are publicly or privately owned,
whether structures are multinational or national,
and whether they're located in urban or rural areas.
I encourage you to look at Chart 4.3
on page 104 of your textbook
has a great example of some of the ways
that the values of a country
or a community might impact the effectiveness
or the utilization of common HR practices in organizations.
Now, let's talk a little bit about ways to manage others
in a healthcare environment.
When we talk about competency, capability, and capacity,
what we're essentially stating
is that it's important that healthcare managers
are competent, capable, and have the capacity
to manage the organizations
or the human resources of a certain organization.
Competence refers to the knowledge,
skills, and attitudes that people possess
when people know how to do something.
Capability refers to the abilities
reflected in the breadth of a role,
usually expressed as strategic, technical, operational,
and transactional terminologies.
And finally, capacity refers to the amount
and variety of work that the workforce can accomplish.
The most important of these perhaps
is the skill or the qualifications of the health manager
or their capability.
A lot of this chapter
focuses on the competencies and capabilities
necessary to be an effective global health manager.
Now we turn to some principles for managing health systems.
These five principles were identified
in a report from 2009
in the first International Conference
of Health Service Delivery Management in Thailand.
They are as follows:
priority and resources and policy implementation
should be given to developing
leadership, management, and governance
as the means to strengthen health systems development.
The successful management of health services
requires leadership and teamwork from managers
who have positive personal and professional
values and self-perceptions
and who are empowered to engage
with individuals and communities
and to respond to the needs of the poor
and to marginalized groups.
Leadership for health systems,
public health, and primary healthcare
requires that managers have access
to high quality education,
training, and experiential health context
and knowledge that equips them
to operate effectively in health systems.
Our research culture is required that networks
and engages in collaborative research
to develop health management capacity
and evidence as a base for decisions
to guide policy development
and that both challenges and alliance researchers
and operational health systems
professionals, citizens, and communities,
and outcomes identified from this research
on leadership and health management
should be conveyed to health organizations,
professional bodies, local governments,
and ministries of health and education.
This graphic I like a lot
because it presents the relationship
between the need to invest in managerial competence,
the assessment of need,
and the key outcomes
of competence, capability, and capacity.
A lot of this week
and a lot of this goal and health systems
focuses on self tests or self-assessments,
looking at what competencies you have
and what you still need to achieve
and the different strategies you use
in order to achieve those competencies.
Next, this list of competencies
comes from the International Hospital
Federation Global Consortium.
They published a report called the Leadership Competencies
for Healthcare Services Managers in 2015
and identified these critical areas
for professional healthcare management.
Here we see this health management competency framework.
It lays out the key competencies
with leadership in the center
related to all of these competencies.
And in order to be a successful leader,
one must have a comprehensive grasp
of these different competencies.
Next, we'll turn to different strategies
and different key concepts
in self-management or managing the self.
This is an important aspect of leadership
and it cannot be overlooked.
Leadership often requires high levels of performance
in different circumstances,
and people in these positions typically find themselves
as role models, mentors, and leaders
in the education of others.
There are three key concepts related to managing the self.
The first is emotional intelligence
or the capacity for recognizing,
understanding, and managing emotions in oneself
and in one's relationships.
There is a need for individuals and leaders especially
to be highly emotionally intelligent
as this is key for understanding
and managing emotions in oneself
and relationship aspects of relationships with others.
Critical reflection is the practice of identifying
and assessing the underlying assumptions and values
that influence one's performance.
And self-awareness is another key skill
that goes hand in hand with critical reflection
in order to understand how one's actions
impact others and themselves.
Next, we'll turn to two key practices or two key principles
in human resource management,
hire slow and fire fast.
Hiring slow refers to fighting the instinct
to quickly fill an open position
with someone who meets the the lowest standards
required for the role.
It's a good idea to wait until you find a candidate
who brings something special to the role.
Similarly, fire fast.
Oftentimes, especially in healthcare organizations,
it's unacceptable to keep
employing an underperforming clinician,
someone who might be putting
someone's else's lives in danger.
Therefore, it suggested
that after making sure that the employee understands
what they're doing is wrong,
and if they continue doing it, to fire them.
Next, it's important to distinguish
between high, middle, and low performers,
and your textbook has a great graphic
on the different descriptions of each.
And finally, it's essential to be considerate of
and aware of different genders
and generations in your workplace.
This awareness is essential
for maximizing the health workforce.
Finally, here's some conclusions for this module.
We talked about the importance of human resources
and human resource management in healthcare organizations
in the United States and internationally.
We discussed the competencies
and the goals of healthcare staff
and human resource managers in different settings,
and we looked at the role
of human resource managers in developing the competencies
and capability of the workforce
to ensure its success and longevity.
Thank you. I hope you enjoyed this lecture.