Human Resource Management System in a Medical Institution
A modern HR management system in a medical institution should rationally use all available resources: financial, technical, and, of course, human. The primary mechanism for optimizing the work of personnel is job training (Radeva, 2019). Creating a professional development system for employees is designed to increase the efficiency of a medical institution by improving the quality of services provided (Vuong et al., 2021).
Professional development of personnel is a system of interrelated measures aimed at improving the professional competencies of employees in order to perform not only the duties necessary for work but also new functions to solve the urgent and future tasks of the organization (Price & Reichert, 2017). The success of a medical clinic directly depends on the competitiveness of doctors, who are the main driving force of the industry. This factor becomes the main reason for the implementation of the system of job training in medical clinics.
The World Medical Association (WMA), realizing the need to establish medical professional autonomy around the world, has created a set of rules and requirements for self-regulation of the activities of medical workers. The central element of professional autonomy is the belief that the activity of doctors contributes to free decision-making on the prescription of diagnostic and treatment services to patients in need of medical care and attention (Bowman & Callender, 2019).
At the same time, particular emphasis is made not only on the unification of the professional rights of physicians around the world, but also on their responsibility for the choice of therapeutic (surgical) methods in treatment, for the use of medicines and medical devices, and medical ethics and deontology. In addition, the desire of doctors in each country for their professional uniqueness is combined with the ability to adhere to their corporate ethical norms and rules, which, in the end, can ensure professional autonomy of medical decisions (Lases et al., 2018). The quality of medical care provided to patients and the competence of each doctor becomes the main task of any self-regulation system. Physicians are knowledgeable enough to make decisions that can benefit patients by providing quality care.
Currently, the idea of introducing new approaches to management is gaining popularity, which would make it possible to increase the efficiency of the activities of medical organizations with an optimal ratio of costs and quality of the service provided. The highest priority is given to the process approach in management (Lerman & Jameson, 2018). The essence of the changes in the management apparatus of the clinic is to optimize the organizational structure and reduce the decision-making time by delegating a number of powers to line managers – this is one of the fundamental principles of the process approach.
In the context of the growing competition of medical institutions, accessibility, speed of response, individual approach, accuracy, and, of course, the price of services are of paramount importance. The introduction of a process-oriented management system presupposes a vast delegation of authority and responsibility to performers, a decrease in the number of decision-making levels, and a combination of the principle of target management with a group organization of labor.
Specialization and division of labor plays a crucial role in an organization’s productivity. However, unless the relationships between people and organizational units are clearly defined and coordinated, the effectiveness of specialization will be lost (Edwards et al., 2018). Delegation of authority is the primary process by which managers establish formal relationships between people in an organization. Motivation and control also play an essential role in ensuring the effectiveness of tasks (Edwards et al., 2018).
However, the organization as a process is a function most obviously and directly related to the systematic coordination of many tasks and, accordingly, the formal relationships of people who perform them. For example, a surgical team leader delegates many essential responsibilities to nurses. However, if the patient dies because the sister chose the wrong blood type for the transfusion, the operating surgeon will be in charge and prosecuted for gross negligence. If a person is expected to take responsibility for the satisfactory accomplishment of a task, the organization must provide him with the required resources. Management accomplishes this by delegating authority along with tasks. Authority is a limited right to use the resources of the organization and direct the efforts of some of its employees to perform specific tasks.
The Healthcare Industry in Saudi Arabia
In addition to the aging of the population and increased focus on healthcare by the government, the major driver of the changes to the healthcare industry in KSA has been developing a strategy to counter epidemics. In the summer of 2009, an unprecedentedly dangerous situation developed in Saudi Arabia (for the first time in the country’s modern history). The spread of the A/H1N1 virus has become an epidemic that demanded drastic measures. This required the development of cooperation with the World Health Organization (WHO) and regional interaction, and closure within national borders should have become a thing of the past.
Internal transformations that have already been carried out have created the necessary prerequisites for this (Altayep et al., 2017). These transformations are a consequence of the challenges that accelerated the modernization process at the turn of the century. They were the Kuwaiti crisis of the early 1990s (in the spring of 1992, the first constitutional acts in Saudi history were adopted – the Basic Law of Government, the Law on the Consultative Council, and the Law on Governance of the Provinces) and the events of September 11, 2001 (Altayep et al., 2017).
The authorities acted even more decisively in 2019-2020 during the spread of the coronavirus COVID-19, when, without resorting to any religious authority (Saudi or foreign), they banned collective Friday prayers in mosques, suspended the small hajj, closed the Forbidden Mosque of Mecca and the Prophet’s Mosque in Medina. By a special decree of King Salman bin Abdel Aziz, during the epidemic, a quarantine regime was introduced throughout the country (which took the form of a curfew in both “holy cities” – Jeddah and the capital), movement between the provinces was categorically excluded (Adly et al., 2020).
In the framework of the medical direction of “national projects,” the implementation of the “comprehensive national health care program” based on the recommendations of the WHO took place (Chowdhury et al., 2021). This system involved the creation of medical complexes, polyclinics, and outpatient clinics in all settlements. A significant undertaking by the Minister of Ar-Rubai was the introduction of accreditation of national medical institutions based on American standards, an increase in the salaries of doctors, and an improvement in their working conditions (Chowdhury et al., 2021). By the end of 2014, after the minister’s resignation, this part of the “national projects” was almost completely implemented.
An essential component of the changes in the field of Saudi health care was the research work initiated by Al-Rubai: centers and laboratories appeared in the most prominent universities that were engaged in the study of viral diseases. The task before them assumed that, in cooperation with foreign colleagues, the scientists working in these centers would contribute to the development of antiviral vaccines.
The Main Functions of HR
There are five main HR functions. First, HR management is involved in developing strategic solutions to meet the organization’s workforce needs. For this, personnel managers must have information about the personnel policy of the state as a whole and the corresponding trends in the labor market and the field of higher and vocational education. HR managers actually supervise employment in the organization, from forming a talent pool to the selection and recruitment of personnel. An example is the development of appropriate incentive programs for medical personnel and the introduction of cross-cultural management (Frazier et al., 2021). This strategy increases the value of the staff to the organization and creates the conditions for reaching highly qualified candidates, expanding the boundaries of the labor market.
Second, HR management performs the function of coordinating the organization of the labor of personnel. The primary attention in this direction is paid to forming and preserving corporate relations between the employer and employees by developing a strategy for effective relations between these entities. For example, a clinic can reduce labor risks by reviewing current workplace policies and educating employees and managers on the effective relationship strategy (Brennan & Rajan, 2020). This process minimizes the frequency of complaints among healthcare personnel due to misinterpretations or misunderstandings of company policies, including HR.
Third, HR management directly forms the training and development strategy of personnel and managers and organizes its practical implementation through the development of advanced training programs, professional retraining, educational seminars, and training. Because of this, HR managers assess quantitative and qualitative staffing needs to determine the duration and type of training required to increase productivity and productivity in the organization. For example, clinic managers conduct employee performance evaluations to identify areas where employees could improve their performance through training or professional development (Flynn et al., 2021).
Forth, HR managers develop strategic compensation and benefits programs for staff. Within the framework of this direction, monitoring should be carried out, the purpose of which is to align the overall labor productivity of the organization with the structure of the compensation and benefits program. In addition, it is necessary to provide and maintain employees with all information about the organization’s compensation and benefits program for personnel. Research shows that HR managers if required, should recommend appropriate improvements to management so that the HR policy in terms of compensation and benefits programs covers all groups of employees (Kang & Lee, 2021).
Finally, HR management should carry out regular research on various issues related to labor and industrial relations and ensure that all requirements of federal, regional, and industry regulations are met in the organization’s personnel policy. In this direction, HR managers assist management in interpreting labor legislation, the results of scientific research in the development and implementation of an organizational development strategy, and all personnel programs aimed at achieving the organization’s goals (McConnel, 2019). Thus, HR managers have strategic and functional responsibilities for all areas of HR management.
Therefore they must have general business skills, managerial competencies, and the ability to resolve administrative issues. Critical competencies for HR managers should include strong communication skills and decision-making abilities based on analytical skills and critical thinking about HR processes.
Performance appraisal (PA) is a complex procedure for determining the performance of personnel, based on measuring the individual performance of each employee and their level of competence. Based on the results, the company gets an accurate picture of the organization’s efficiency as a whole and each employee individually. PA is focused on two objects: the level of competence of the employee and the level and quality of the result of his work (Setiawati & Ariani, 2020). There is a detailed Management by Objectives (MBO) system based on the assessment of the effectiveness of each employee – performance management. The essence of this approach is that a list of critical tasks (work criteria) is formed for the employee in a single standard. In this case, it is imperative that the performance of each task is measurable. At the end of the approved period, the employee and the manager evaluate the fulfillment of each goal (usually in percentage) and the entire personal plan of the employee (Daley, 2017).
The “360 degrees” system aims at decreasing the level of subjectivity in assessment. The procedure is carried out in several stages: assessment criteria are determined, questionnaires are compiled, the actual questionnaire is carried out, in the end, the results are analyzed, and a plan for the development of insufficiently developed competencies is developed (Cousar et al., 2020). For each position, its own circle of competencies is determined, with pre-developed indicators for assessment – behavioral examples (Cousar et al., 2020). The advantage of this rating system is its relative simplicity. However, it should be mentioned that when conducting a large-scale study, the process of processing the obtained data becomes difficult. In addition, clearly defined evaluation criteria are needed. Besides, the collection of information should be organized appropriately, informing people about the purpose of testing.
The Assessment Center targets a whole range of an employee’s competencies and particular employee’s personal and professional qualities. The most important part of this procedure is an expert interview aimed collection of the relevant data collection, including such characteristics as the employee’s knowledge and experience, psychological and professional tests’ results (Simonsen et al., 2017). In addition, this method can involve a biographical questionnaire, and a description of professional achievements. An expert observation is another essential step in this procedure (McConnell, 2019). This tool allows a comprehensive assessment and development of recommendations for each employee.
An example of the importance of performance appraisal in the case of a network of pediatric hematology-oncology clinics. In 2017, Morgan et al. (2017) conducted a series of quality improvement interventions to assess and enhance the effectiveness and of antibiotic administration for immunocompromised patients in terms of timing. The CLABSIs before and after implementing a central line care bundle for implanted catheters in ambulatory patients in terms of compliance and time between the procedures. The method of assessment was defined as a system of monitoring with annual clinical audits.
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