Human Resources in Health Care

How can company health management, employer branding and talent management fit together with the permanently intensified pressure to save money in German hospitals?
Professor Bernd H. Mühlbauer, lecturer for health care management at the Westphalian University of Applied Sciences, discussed this question in a round table held by Personalwirtschaft magazine with Dr. Christiane Dithmar, partner at MP, and others.

Growths in staffing levels are unthinkable at German hospitals. Jobs are being eliminated due to mergers; a shortage of physicians is forcing departments to close; and the oft-cited demographic changes are making it more difficult for hospital HR professionals to find employees. In such a situation, consultants recommend that hospitals act strategically rather than react on a case-by-case basis to a lack of specialist personnel or high illness levels. But in reality, HR managers in German hospitals are paid "for implementation and not for long-term strategies", reports Dr. Nicolai Kranz, former HR head of Cologne University Hospital and today general manager of Stegdoc. This approach increases staffing problems.

The level of absences due to illness is above average in the health care field. This does not improve even when back strengthening or smoking cessation programs are offered on an ad hoc basis, that is, when company health management is implemented only for specific problems. Company health management must be understood and carried out strategically. Action for action's sake, procurement of uncoordinated consulting, and the mere naming of health management representatives without equipping them with the needed competencies do not solve the problem, but are much too often what is done in practice.

Flexible work models

When looking around hospitals for work models for older employees, it is hard to find positive examples. There is an urgent need for action here to avoid being inundated by the demographic wave. "It's important to see older employees not just as a burden, with rising absenteeism and falling flexibility. Rather, the experience and loyalty of this group of employees should be appreciated and used effectively," says Dr. Anke Freckmann. As a first step, the labor law expert at the law firm of Osborne Clarke recommends analyzing the personnel structure, including "hidden reserves". From this, the actual need for personnel and associated requirements should be determined. In a second step, the leeway for design should be exhausted and work time models consciously planned. Hospitals can tap into employees' unused potential if, in addition to conventional part-time work, they offer alternative models, such as flexible work time, job sharing or accumulation of work hours in a long-term work time account.

Healthy organization - healthy employees

Company health management can reduce absences and personnel fluctuation and prevent loss of motivation of entire departments. Innovative hospitals have recognized this need to act and have trained suitable employees as company health management and prevention managers. The company health management position is ideally filled by a full-time employee who does nothing else and is placed high in the hierarchy near top management, so that health management will be carried out as a priority. But what value does strategic company health management have if individual employees suffer under such increased workloads that they repeatedly become sick? In practice, it is especially the motivated, experienced and qualified employees who are asked to do additional work. This not only frustrates employees, but makes them sick.

Equalizing increased workloads

HR departments also suffer under the immense increase in workloads at hospitals. Whether for company health management, employer branding or human resource development, there are not enough employees and time to plan and implement strategies. But these resources can be optimized, since 60 to 70 percent of an HRM department's work consists of administrative activities. The need here is to develop processes that make resources available in the longer term. Process optimization in areas such as payroll, travel expenses and personnel files can reduce administrative effort by 40 percent and so increase capacity for value-creating human resource work.

Human resource development measures have also fallen victim to the higher workloads: Whereas a few years ago around 40 hours were budgeted for management seminars, employers now expect the same content to be taught in 1.5 days, reports Dr. Christiane Dithmar, Management Partner. But the reduction in measures to support managers stands in direct contradiction to the greater challenges these managers must handle. "If the assignments given to consultants and employees only specify 'faster, higher, further', the results, namely improved handling of HRM tasks, will often be lacking," says Dr. Dithmar.

Being an attractive employer - changing the leadership culture

A currently popular recruiting instrument is to entice qualified employees away from other hospitals. To secure their positions in the market, hospitals must therefore establish a leadership culture and values and strategically build up their employer image, that is, they must do employer branding. But can an organization undertake all actions needed to make it an attractive employer brand all by itself? Frequently not, since the HR manager's day-to-day work involves hopping from one project to the other, so something always falls by the wayside.

A central obstacle in surmounting challenges lies in the mentality of hospital employees, explains Dr. Christiane Dithmar: "Employees in hospitals often think in a patient-centered way. Precisely for this reason, hospitals must work systematically on building up a dynamic and, above-all, solution-oriented culture." This can be introduced, for example, by having managers learn how to promote a solution-oriented attitude in day-to-day work rather than the usual discussions of problems. Many hospitals also need a new understanding of leadership that is no longer vertical, that is, from top to bottom, says Christiane Dithmar. This will have to change. "Leadership will become more and more a quality characteristic of systems and no longer of individual persons. In the future, organizations most of all need leadership teams that are able to work." And so successful hospitals work on enabling their managers to talk and act together as leadership teams - including across organizational boundaries.
This is a short version of the article: "Politik der kleinen Schritte" (Policy of Small Steps), which appeared recently in the special edition for the health care industry of the professional HRM journal Personalwirtschaft.

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