The Organizational Aspect of Human Resource Management as a Determinant of the Potential of Polish Hospitals to Manage Medical Professionals in Healthcare 4.0
Abstract
:1. Introduction
- Strategy creation and reconstruction of organizational structures [10];
- The judicious management of healthcare resources aimed at greater efficiency in the delivery of care and improved quality of healthcare services [11];
- Better allocation of resources [12];
- Increasing the ability to monitor and manage the flow of activities performed by healthcare professionals [15];
- Personalized medicine [16];
- The permanent development of knowledge within the healthcare sector [9].
2. The Main Actors of Human Resource Management in Hospitals: Literature Review
- Shipton et al. [25] stressed that in hospitals, the adoption of strategic partners and commitment-creator managers by hospitals apparently fosters affective commitment.
- Sheridan, Vredenburgh et al. [26] observed that when hybrid managers display leadership behaviors, the work efficiency of their subordinates increases.
- There must be a competent HR manager and a board of directors that is aware of the importance of human resources in hospitals.
- HR specialists must be of the required level of competence.
- There must be an increased status of HRM issues.
- The HR department must permanently improve its competences.
- There must be an integrated IT system supporting the management of employees from administrative to strategic issues.
3. Material and Methods
- (1)
- A question concerning the extent of HM involvement in the medical personnel management practices (five-point Likert scale).
- (2)
- A question on the activities aimed at HM management competence development—this was included in the ‘Director’ and ‘HM’ surveys.
- (3)
- A question to evaluate the HRM competences of HMs—this was included in the ‘Physician’ and ‘Nurse’ surveys.
- (4)
- A question regarding organizational solutions for HR specialists/HR departments—this was included in the ‘Director’ and ‘HM’ surveys.
- (5)
- A question on the roles of HR specialists/HR departments (five-point Likert scale).
- Cohort ‘Directors’: Most of the respondents were between 45 and 54 years old; 80.4% were female and had worked for 10–19 years.
- Cohort ‘Hybrid Doctor–Managers’: Most of the respondents were between 45 and 54 years old; 57.7% were male and had worked for 20–29 years.
- Cohort ‘Hybrid Nurse–Managers’: Around the same proportions of respondents belonged to age groups 35–44 and 45–54 years (approximately 33% per age group), all were female, and most of them had worked for 20–29 years.
- Cohort ‘Physicians’: 95.5% of respondents belonged to the 35–54 age group, 57% were female, and 51.2% had worked for 10–19 years.
- Cohort ‘Nurses’: 95.5% of respondents belonged to the 35–54 age group, all were female, and 42.5% had worked for 10–19 years.
4. Results
- ‘Directors’ declared that line managers are mostly engaged in performance appraisal, team management, conflict management, and training. However, they are actually not present in career management, recruitment, and selection.
- ‘Hybrid Doctor–Managers’ (HDMs) declared that they are highly involved in team management, performance appraisal, introduction, and staffing. They also highlighted dismissal of employees, career management, and the implementation of changes within HR functioning as practices in which they do not participate.
- ‘Hybrid Nurse–Managers’ (HNMs) declared that they are highly involved in team management, training, introduction, and HR planning. However, they are not involved in the dismissal of employees, the implementation of changes within HR functioning, or remuneration.
- ‘Physicians’ declared that HDMs are highly involved in team management, conflict management, and performance appraisal. However, they are either rarely or not at all engaged in career management, remuneration, or the implementation of changes within HR functioning.
- ‘Nurses’ declared that HNMs are engaged in conflict management, team management, and performance appraisal, but are rarely involved in remuneration, career management, or the dismissal of employees.
- The administrative role of HR specialists was generally appraised as high by ‘Directors’ and ‘HNMs’.
- The role connected with shaping interpersonal relations was appraised the highest by ‘Directors’. Interestingly, ‘Physicians’ and ‘Nurses’ appraised this role higher than HMs.
- Strategic partnership was appraised differently only by ‘Physicians’.
- ‘Directors’ appraised the role of the change agent strongly. Their answers differed from those of other cohorts.
- HNMs obviously perceived HR specialists as initiators of the projects within hospitals. By contrast, HDMs appraised the role the lowest.
- Answers of ‘Directors’ differed from those of other cohorts in relation to the provision of effective HRM tools and methods. ‘Physicians’ appraised the role the lowest.
5. Discussion and Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Role Performed by Hybrid Manager (HM) | Characteristics of the Role |
---|---|
Innovator | This role considers contemporary determinants of healthcare organizations’ performance, namely life quality and life expectancy. Due to the fact that the healthcare sector is knowledge-driven, HMs as innovators need to be entrepreneurial, highly motivated, and responsible. These managers need to implement innovations in the context of daily operations. |
Broker | This role is about ensuring the continuity of the organization and obtaining external resources. The strength of the negotiation position of the HM in performing this role comes not only from the organization, but also from the broker themselves. In addition, HMs’ power also comes from their specialized expertise. This power helps them to influence the flow of resources. Furthermore, this role is determined by an HM’s capability to build alliances and partnerships with other organizations, e.g., academic centers. |
Producer | This role refers to the creation of a productive work environment, optimizing performance, and managing stress and time. |
Director | This role involves the communication of a vision and the operationalization of goals and objectives as defined in the organization strategy. |
Coordinator | This role is connected with the maintenance of the team structure and schedules and the coordination of staff efforts. |
Monitor | This role is about managing information effectively, problem-solving, and decision-making in order to effectively manage risky core processes. |
Facilitator | This role involves the ability to build and manage teams, especially therapeutic teams, which are constructed by a group of various professionals. It also requires assurance of participative decision-making and the ability to manage conflicts via collaborative approaches. |
Mentor | This role of the HM is associated with understanding not only others, but also themselves. It requires effective communication and the development of employees through delegation and participation. |
Role Performed in HR Department | Role Characteristic |
---|---|
Strategic partner | This role requires being able to create a human resource management (HRM) strategy that is an integral part of the organizational strategy. |
Administrative expert | This role is concerned with carrying out administrative activities in such a way that the focus is not only on the performance of activities, but also on increasing their efficiency and reducing their cost-effectiveness through better organization of the tasks being carried out. |
Change agent | This role is associated with preparing and implementing changes within the organization. It assures that organizational culture is considered when changes are being planned and convinces employees to embrace changes and innovations. |
Employee champion | A person in this role listens and responds to an employee’s personal needs. They provide a working environment in which employees are motivated, productive, and happy at work. |
Directors | HDM * | HNM ** | Physicians | Nurses | |
---|---|---|---|---|---|
Age | |||||
No response | 7.7 | 0 | 0 | 0 | 0 |
25–34 | 1.4 | 0 | 4.2 | 0.4 | 1.8 |
35–44 | 26.3 | 16.8 | 33.3 | 45.3 | 46.0 |
45–54 | 38.9 | 43.9 | 35.8 | 50.2 | 49.5 |
55–64 | 24.9 | 38.2 | 26.7 | 3.9 | 2.8 |
65–74 | 0.7 | 1.1 | 0.0 | 0.4 | 0.0 |
Gender | |||||
Female | 80.4 | 42.5 | 100 | 57.2 | 100 |
Male | 19.6 | 57.7 | 0 | 42.8 | 0 |
No response | 1.4 | 0 | 0 | 0 | 0 |
Seniority | |||||
0–9 | 23.9 | 4.2 | 14.0 | 26.7 | 30.9 |
10–19 | 29.8 | 32.3 | 28.4 | 51.2 | 42.5 |
20–29 | 24.9 | 45.3 | 41.1 | 21.4 | 25.6 |
30–39 | 16.5 | 16.5 | 15.8 | 0.7 | 1.1 |
40–49 | 3.2 | 1.1 | 0.7 | 0 | 0 |
50–59 | 0.4 | 0.7 | 0.0 | 0 | 0 |
MPMP * | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
DIRECTORS | HDM | HNM | PHYSICIANS | NURSES | |||||||||||||||||||||
HR planning | 0.4 | 2.8 | 7.7 | 70.2 | 18.9 | 1.8 | 8.8 | 2.1 | 69.8 | 17.5 | 2.8 | 4.6 | 2.5 | 65.3 | 24.9 | 4.9 | 1.1 | 9.5 | 58.2 | 26.3 | 3.5 | 1.4 | 10.5 | 59.3 | 25.3 |
Recruitment | 0 | 0 | 14 | 72.3 | 13.7 | 4.9 | 2.1 | 6.3 | 67.0 | 19.6 | 3.5 | 4.2 | 4.9 | 63.9 | 23.5 | 3.2 | 3.2 | 10.2 | 55.8 | 27.7 | 4.6 | 2.8 | 10.9 | 55.8 | 26.0 |
Selection | 0 | 0 | 14 | 67.4 | 18.6 | 1.8 | 3.2 | 5.3 | 63.9 | 26.0 | 3.2 | 3.5 | 3.9 | 66.0 | 23.5 | 3.5 | 2.8 | 9.1 | 53 | 31.6 | 3.9 | 2.5 | 11.6 | 51.9 | 29.8 |
Introduction | 0.4 | 0 | 10.9 | 60.0 | 28.8 | 4.2 | 1.1 | 3.9 | 59.3 | 31.6 | 2.5 | 1.4 | 2.8 | 55.8 | 37.5 | 3.5 | 2.5 | 10.2 | 47.4 | 36.1 | 5.3 | 3.2 | 6.0 | 48.4 | 36.8 |
Team mgmt. | 0 | 0 | 8.8 | 54.7 | 36.5 | 1.4 | 0.7 | 1.1 | 60.0 | 36.8 | 1.1 | 1.4 | 1.4 | 54.7 | 41.4 | 2.8 | 0 | 9.1 | 44.6 | 43.5 | 1.8 | 0.4 | 8.1 | 48.1 | 41.8 |
Performance appraisal | 0 | 0.4 | 6.0 | 51.2 | 42.5 | 1.4 | 0.4 | 7 | 53.3 | 37.9 | 1.1 | 2.1 | 6.3 | 53.3 | 37.2 | 0 | 4.9 | 9.5 | 45.3 | 40.4 | 0 | 1.4 | 9.1 | 45.3 | 44.2 |
Staffing | 0.4 | 0 | 5.6 | 55.1 | 38.9 | 1.8 | 0.7 | 6.7 | 58.9 | 31.9 | 0.7 | 1.8 | 11.9 | 55.8 | 29.8 | 2.5 | 0.7 | 9.8 | 48.1 | 38.9 | 1.4 | 0.4 | 12.6 | 47 | 38.6 |
Training | 0 | 0 | 8 | 54.4 | 36.8 | 1.4 | 3.9 | 2.1 | 58.9 | 33.7 | 1.1 | 0.7 | 2.5 | 60.7 | 35.1 | 2.1 | 4.2 | 10.9 | 41.4 | 41.4 | 2.5 | 4.2 | 8.8 | 47 | 37.2 |
Career mgmt. | 0.4 | 5.3 | 8.4 | 52.3 | 33.7 | 7.7 | 8.8 | 6.3 | 58.9 | 18.2 | 5.3 | 9.5 | 4.2 | 58.6 | 22.5 | 4.6 | 2.1 | 17.5 | 49.1 | 26.7 | 4.2 | 2.5 | 17.2 | 49.5 | 26.3 |
Remuneration | 0 | 2 | 11.2 | 60 | 26.0 | 10.2 | 7.0 | 3.5 | 64.2 | 15.1 | 14 | 6.3 | 3.2 | 59.6 | 16.8 | 9.1 | 0 | 15.1 | 47.0 | 28.8 | 6 | 0 | 19.3 | 47 | 27.7 |
Conflict management | 0 | 0 | 8.8 | 56.5 | 34.7 | 2.1 | 5.3 | 7.7 | 56.1 | 28.8 | 2.5 | 4.9 | 7.4 | 48.8 | 36.5 | 1.4 | 3.9 | 8.1 | 50.5 | 35.8 | 0.7 | 3.5 | 4.9 | 53 | 37.9 |
Dismissal of employees | 0.4 | 2.5 | 8.4 | 57.2 | 31.6 | 7.7 | 10.5 | 6.0 | 58.9 | 16.8 | 9.5 | 11.6 | 9.1 | 57.2 | 12.6 | 3.9 | 2.5 | 13.7 | 46.3 | 33.7 | 5.6 | 4.2 | 14.0 | 50.2 | 26.0 |
Implementation of changes within HR function | 0.4 | 5.6 | 5.6 | 59.6 | 28.8 | 7.0 | 5.6 | 10.2 | 59.3 | 17.9 | 8.4 | 3.2 | 11.6 | 58.2 | 18.6 | 1.8 | 1.8 | 17.2 | 47.4 | 31.9 | 2.8 | 0 | 18.2 | 47.4 | 31.6 |
MPMP ** | Kruskal-Wallis Statistic | p | The Significant Differences in Distribution of the Cohorts’ Answers (Individual p) |
---|---|---|---|
Career management | 22.7151 | 0.0001 | Director—HDM (0.0369) Director—HNM (0.0002) Director—Physicians (0.0864) Director—Nurses (0.0859) |
Remuneration | 22.0312 | 0.0002 | Director—HDM (0.0092) Director—HNM (0.0033) |
Dismissal of employees | 67.2169 | <0.0001 | Director—HDM (<0.0001) Director—HNM (<0.0001) Director—Nurses (0.0319) HDM—Physicians (0.0016) HNM—Physicians (<0.0001) HNM—Nurses (0.0053) |
Implementation of changes within HR function | 29.8615 | <0.0001 | Director—HDM (0.0024) Director—HNM (0.0033) HDM—Physicians (0.0276) HDM—Nurses (0.0381) HNM—Physicians (0.0359) HNM—Nurses (0.0491) |
Response Options | Directors | HDM | HNM |
---|---|---|---|
DAs * are not performed | 0.0% | 9.1% | 6.3% |
DAs are performed rarely | 3.2% | 10.9% | 12.6% |
DAs are performed sometimes | 2.8% | 50.2% | 46.3% |
DAs are performed moderately regularly | 23.9% | 24.6% | 26.7% |
DAs are performed very regularly | 70.2% | 5.3% | 8.1% |
Response Options | Physicians | Nurses |
---|---|---|
They are very low | 0.0% | 0.0% |
They are low | 0.0% | 0.0% |
They are neither low nor high | 44.9% | 37.5% |
They are high | 37.5% | 42.8% |
They are very high | 17.5% | 19.6% |
Response Options | Directors | HDM | HNM |
---|---|---|---|
There is no position in the hospital where an employee deals with personnel issues. | 0.0% | 0.0% | 0.0% |
A specialist is employed in the hospital who, among other things, deals with personnel issues. | 2.8% | 9.1% | 8.4% |
A specialist is employed in the hospital who only deals with personnel issues. | 20.7% | 43.9% | 42.5% |
The organizational structure of the hospital has a department for personnel matters managed by a mid-level manager. | 46.7% | 34.7% | 31.6% |
There is an HR department in the hospital, which is managed by a top manager (a member of a board of directors). | 29.8% | 12.3% | 17.5% |
Scale: | Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree |
---|---|---|---|---|---|
It handles administrative matters of employees | |||||
Directors | 0.0% | 0.0% | 0.4% | 79.3% | 20.4% |
HDM | 6.7% | 2.5% | 6.3% | 67.4% | 17.2% |
HNM | 0.0% | 0.0% | 0.4% | 65.6% | 34.0% |
Physicians | 2.1% | 3.5% | 9.1% | 67.7% | 17.5% |
Nurses | 2.5% | 1.4% | 10.5% | 61.8% | 23.9% |
Participates in the process of shaping interpersonal relations at the hospital | |||||
Directors | 0.0% | 8.4% | 8.4% | 65.6% | 17.5% |
HDM | 5.3% | 6.7% | 16.1% | 64.6% | 7.4% |
HNM | 7.7% | 6.3% | 12.3% | 66.7% | 7.0% |
Physicians | 7.4% | 4.6% | 18.2% | 56.8% | 12.6% |
Nurses | 7.4% | 3.2% | 22.1% | 57.2% | 10.2% |
It is a strategic partner in solving important problems within the hospital | |||||
Directors | 0.0% | 8.8% | 2.8% | 77.5% | 10.9% |
HDM | 1.8% | 10.5% | 11.9% | 64.6% | 11.2% |
HNM | 2.8% | 4.9% | 11.9% | 70.2% | 10.2% |
Physicians | 6.7% | 3.9% | 20.7% | 55.4% | 13.3% |
Nurses | 6.3% | 3.2% | 18.2% | 59.3% | 12.6% |
Participates in the processes of organizational change, acting as a so-called change agent | |||||
Directors | 0.4% | 4.9% | 5.6% | 62.5% | 26.7% |
HDM | 0.7% | 13.3% | 15.4% | 58.9% | 11.6% |
HNM | 1.8% | 10.2% | 10.2% | 66.3% | 11.6% |
Physicians | 4.6% | 5.3% | 19.3% | 51.9% | 18.2% |
Nurses | 7.7% | 2.5% | 20.7% | 50.5% | 18.6% |
It is the initiator (leader) of important projects in the hospital | |||||
Directors | 3.2% | 8.1% | 5.3% | 54.4% | 29.1% |
HDM | 12.3% | 18.6% | 22.1% | 31.6% | 15.4% |
HNM | 0.7% | 2.1% | 2.1% | 80.7% | 14.4% |
Physicians | 7.7% | 2.5% | 20.7% | 50.5% | 18.6% |
Nurses | 4.9% | 2.5% | 21.4% | 50.2% | 21.1% |
It provides effective methods and tools for managing medical personnel. | |||||
Directors | 2.5% | 6.0% | 0.0% | 59.6% | 31.9% |
HDM | 2.8% | 12.3% | 17.9% | 53.7% | 13.3% |
HNM | 1.8% | 11.9% | 11.6% | 60.7% | 14.0% |
Physicians | 6.3% | 3.9% | 14.4% | 52.3% | 23.2% |
Nurses | 9.1% | 2.5% | 18.2% | 52.6% | 17.5% |
HR Specialist Roles | Kruskal–Wallis Statistic | p | The Significant Differences in Distribution of the Cohorts’ Answers (Individual p) |
---|---|---|---|
Handles administrative matters of employees. | 64.6973 | <0.0001 | Directors—HDM (0.0213) Directors—Physicians (0.0490) HDM—HNM (<0.0001) HNM—Nurses (0.0004) HNM—Physicians (<0.0001) |
Participates in the process of shaping interpersonal relations at the hospital. | 27.768 | <0.0001 | Directors—HDM (0.0030) Directors—HNM (0.0040) Directors—Physicians (0.0128) Directors—Nurses (0.0009) |
Is a strategic partner in solving important problems within the hospital. | 15.2560 | 0.0042 | Directors—Physicians (0.0266) |
Participates in the processes of organizational change, acting as a so-called change agent. | 47.1213 | <0.0001 | Directors—HDM (<0.0001) Directors—HNM (0.0001) Directors—Physicians (0.0001) Directors—Nurses (<0.0001) |
Is the initiator (leader) of important projects in the hospital. | 114.6863 | <0.0001 | Directors—HDM (<0.0001) Directors—Physicians (<0.0001) Directors—Nurses (0.0483) HDM—HNM (<0.0001) HDM—Physicians (0.0019) HDM—Nurses (<0.0001) HNM—Physicians (<0.0001) |
Provides effective methods and tools for managing medical personnel. | 66.2373 | <0.0001 | Directors—HDM (<0.0001) Directors—HNM (<0.0001) Directors—Nurses (<0.0001) Directors—Physicians (0.0014) HDM—Physicians (0.0450) |
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Buchelt, B.; Frączkiewicz-Wronka, A.; Dobrowolska, M. The Organizational Aspect of Human Resource Management as a Determinant of the Potential of Polish Hospitals to Manage Medical Professionals in Healthcare 4.0. Sustainability 2020, 12, 5118. https://doi.org/10.3390/su12125118
Buchelt B, Frączkiewicz-Wronka A, Dobrowolska M. The Organizational Aspect of Human Resource Management as a Determinant of the Potential of Polish Hospitals to Manage Medical Professionals in Healthcare 4.0. Sustainability. 2020; 12(12):5118. https://doi.org/10.3390/su12125118
Chicago/Turabian StyleBuchelt, Beata, Aldona Frączkiewicz-Wronka, and Małgorzata Dobrowolska. 2020. "The Organizational Aspect of Human Resource Management as a Determinant of the Potential of Polish Hospitals to Manage Medical Professionals in Healthcare 4.0" Sustainability 12, no. 12: 5118. https://doi.org/10.3390/su12125118
APA StyleBuchelt, B., Frączkiewicz-Wronka, A., & Dobrowolska, M. (2020). The Organizational Aspect of Human Resource Management as a Determinant of the Potential of Polish Hospitals to Manage Medical Professionals in Healthcare 4.0. Sustainability, 12(12), 5118. https://doi.org/10.3390/su12125118