Name: MAMTA MARU

Subject: STRATEGIC HUMAN RESOURCE MANAGEMENT &

INERNATONAL HUMAN RESOURE MANAGEMEN

REPORT ON HR PRACTICES IN HEALTH SECTOR AT NATIONAL &

INTERNATIONAL LEVEL

SUBMITTED TO: DR. CHETAN LAD

STRATEGIC HUMAN RESOURCE MANAGEMENT

Strategic human resource management is designed to help companies best meet the needs of

their employees while promoting company goals. Human resource management deals with any

aspects of a business that affects employees, such as hiring and firing, pay, benefits, training and

administration. Human resources may also provide work incentives, safety procedure

information and sick or vacation days.

Strategic human resource management is the proactive management of people. It requires

thinking ahead, and planning ways for a company to better meet the needs of its employees and

for the employees to better meet the needs of the company. This can affect the way things are

done at a business site, improving everything from hiring practices and employee training

programs to assessment techniques and discipline.

Companies who work hard to meet the needs of their employees can cultivate a work

atmosphere conducive to productivity. Human resource management is the best way to achieve

this. Being able to plan for the needs of employees by thinking ahead can help to improve the

rate of skilled employees who chose to remain working for a company. Improving the employee

retention rate can reduce the money companies spend on finding and training new employees.

When creating a human resources plan, it is important to consider employees may want or need

and what the company can reasonably supply. A larger company can usually afford training and

benefit programs that smaller companies cannot afford to offer. This does not mean that a

smaller company should not engage in strategic human resource management. Providing

specialized on-site training, even if provided by senior members of the company and offering

one-on-one assessment and coaching sessions can help employees reach peak performance rates.

An important aspect of strategic human resource management is employee development. This

process begins when a company is recruiting and interviewing prospective employees. Improved

interviewing techniques can help to weed out applicants that may not be a good match for the

company.

After being hired on, a strong training and mentoring program can help a new member of the

staff get up to speed on company policies and any current or ongoing projects they will be

working on. To help employees perform at their best, a company can follow up with continual

training programs, coaching, and regular assessment. Investing in the development of its

employees can allow a company to turn out more consistent products.

Strategic human resource management is essential in both large and small companies. In small

companies, this may be as simple as the owner or manager taking a little time every day to

observe, assist, and assess employees, and provide regular reviews. Larger companies may have

a whole department in charge of human resources and development. By meeting the needs of the

employees in a way that also benefits the company, it is possible to improve the quality of staff

members. Taking the effort to provide employees with the tools they need to thrive is worth the

investment.

WELCOME TO HUMAN RESOURCES FOR HEALTH IN INDIA

The responsibility of delivering health services falls primarily on health workers making them

central to the health systems’ capacity to deliver health services. The health sector in India faces

several challenges in human resources for health. At one level, information on the size,

composition and distribution of the health workforce is limited and fragmented. The lack of

health workers, doctors, female doctors in underserved areas is a cause for concern. Though the

public sector has made serious efforts to place qualified health workers in under-served areas,

institutional constraints in the production and recruitment of health workers pose their own

challenges.

According to a research report by Job science, top talent in the healthcare industry is hard to

come by and even harder to retain in this competitive hiring market. Hospitals cannot afford to

continue operating without giving more serious consideration to recruiting, hiring and retaining

top talent and then addressing it as a primary improvement initiative for the hospital as a whole.

The other key findings include:

The top concern reported by hospital HR professionals is recruiting quality employees

(80%)

More than 50 percent of HR professionals are dissatisfied with current recruiting processes

Best practices in recruiting and staffing are not consistently implemented (less than 50%)

In order to deal with the concerns of hiring and retaining top employees, you must first start by

addressing the HR staff needs such as strategic investments in the technologies and best

practices available. HR professionals must take a practical role in the strategic management of

their institutions proving the value of HR to high-level administrators. Talent is the

differentiator between industry-leading organizations and the rest, and the best practices for

recruiting, hiring and retaining that talent is constantly changing. Once HR professionals

proactively manage that talent and increase staffing effectiveness, they will become valued

members of their hospital.

The hiring market is changing, not only on the availability of qualified staff, but also in how

those staff members apply for positions. Successful HR professionals must be continually aware

of their location and the methods of their search to find the top talent. These methods are

constantly changing and it is up to the HR professionals to educate themselves with the new

processes available. Those who effectively leverage their HR procedures incorporate the

following into their course of action: partnering with an HR provider focused on service,

implementing the latest technology to facilitate hiring and hospital recruiting process and

proactively recruiting and talent pool building.

Leveraging technology and metrics to support the strategic value of HR

Positively affecting the economics of the institution by managing HR

Utilizing search agents and job boards to capture top talent

Creating an employment brand that attracts top talent

National Rural Health Mission

The National Rural Health Mission (NRHM), launched by the Honourable Prime Minister of

India on 12 April 2005, is an ambitious strategy of the government. It aims to restructure the

delivery mechanism for health towards providing universal access to equitable, affordable and

quality health care that is accountable and responsive to the people’s needs, reducing child and

maternal deaths as well as stabilizing population, and ensuring gender and demographic balance.

Formulation of transparent policies for deployment and career development of human resources

for health, strengthening capacity for data collection, assessment and review for evidence-based

planning, monitoring and supervision and technical support to national, state and district health

missions for public health management are part of the core strategy of the mission. These

strategies have several HRH dimensions and need to be examined as per the model given below:MANAGING FOR PERFORMANCE

HUMAN RESOURCE ACTION

· Numeric adequacy· Skill mix· Social outreach

· SatisfactoryRemuneration· Work environment· Systems support

· Appropriate skills· Training and learning· Leadership &Entrepreneurship

Work force OBJECTIVESCoverage:Social &Physical

Motivation:Social &Physical

Competence:Training &Learning

EquitableAccess

Quality &Responsiveness

Health systemPerformance

Health of thePopulation

Efficiency &Effectiveness

HealthOutcomes

Building HR Capacity for Health Reform

It is important to recognize the distinctive features & historical legacy of HR management in

the health sector if reform is to be effective

HR issues need to be consider at an early stage in health care reform and not to be add on

Health care reforms have frequently been over optimistic about what can be achieved

without the necessary resources: human or financial to make it happen. The commitment of

senior policy makers to the Hr agenda is vital otherwise it won’t be taken seriously

The process of health sector reform- who is involved, the sequencing of developments &

the institutional mechanisms to support reform as much consideration as the content of

reform

Human resource for the health work is frequently focused narrowly on workforce planning

& training , effective HR is characterized by much wider agenda

Developing an effective HR strategy requires ensuring that ownership, external fit &

internal fit issues are addressed

The focus on reforming pay systems which has yielded limited results has diverted attention

from the important issues of non-pay rewards, work reorganization & questions of

performance management

The HR Function

Developing HR capabilities requires investing in the training & development of both HR

specialist & line managers with staff management responsibility

It is vital that any investment in specialist HR capacity evaluates the different ways to

deliver the HR functions. Even if out-sourcing is rejected the in-house HR function should

be properly audited & monitored

To be effective HR function must develop both an operational & strategic HR capacity. The

HR function should not try to run before it can walk- robust HR policies & practices should

be developed before attempts at devolution or more radical changes in employment practices

should be pursued.

The Compensation Discipline deals with the various forms of direct compensation i.e.

employees’ pay—that employers use to attract, recognize and retain workers. It includes

designing and administering compensation systems including base pay, differential and

incentive pay, and overtime. It also includes matters that focus on compensation-related careers,

communications, legal and regulatory issues, technology, metrics and outsourcing, as well as

effective compensation practices and global compensation issues. It does not include the various

forms of indirect employee compensation—commonly referred to as “benefits,” which are

encompassed in the Benefits Discipline.

Variable Pay: How to Manage it Effectively : Variable pay is a significant element of the

direct compensation package of a growing number of organizations.

The Compensation Scorecard: What Gets Measured Gets Done : Employee compensation,

one of the largest expenses in any organization, is also one of the least managed.

FAQs on Rewards Strategy

Implementing Total Rewards Strategies

CASE STUDY SERIES: Designing a Pay Structure: A Case Study and Integrated Exercises :

Compensation is a critical area of HR that can greatly affect employee behavior. To be

effective, compensation must be perceived by employees as fair, competitive in the market,

accurately based, motivating and easy to understand.

Employers Assessing Salary Programs for Affordability, Competitiveness : Communication

challenge: Just 51% inform employees of their position's full salary range

IT, ITES Sectors Lead The Pack In Salary Increments This Year : Although firms are

expected to add more staff, most of the talent especially in the middle to senior management

roles will remain in their current organizations, reveals Kelly Services' Employment Outlook

and Salary Guide 2010-11.

Attrition woes spark salary increases; focus on pay for performance to intensify : Employees

in India can expect an overall average salary increase of 11.6% in 2010, according to a

recent Mercer India Monitor survey.  

10 Executive Comp Issues For Aligning Pay Strategy : Understanding these key executive

compensation issues can help HR professionals to better integrate executive compensation

with overall pay strategy throughout the organization.

Bonuses Are Back, With Emphasis On Hard Measures : More companies globally are

awarding bonuses in 2010, but bonuses are more likely to be strongly tied to the bottom line

with more challenging targets and greater focus on return on investment.  

INCENTIVE PAY PLANS

Firms develop pay-for-performance culture in response to economic recovery in Asia :

According to the Mercer Asia Executive Remuneration Snapshot Survey, approximately 30-

40% of an executive’s total pay package is linked to variable pay regardless of the type of

organization.

Setting Goals for Executive Incentive Plans : With increased scrutiny of executive

compensation and greater transparency attributable to enhanced disclosure requirements,

having a pay-for-performance compensation philosophy is practically a must for U.S.

companies.

Executive Comp: Rethink Incentive Plans for Difficult Times : The troubled economy is

causing fundamental shifts in executive compensation bonus and equity-based incentives

plans, according to a November 2008 report by pay consultancy DolmatConnell & Partners.

Avoid Bonus Blunders as Economy Slows : The end of the year brings bonus and

performance review discussions for many employees.

Incentive Plans Hit Hard by Economy; Retention Efforts Increase : Decreased earnings and

falling stock prices have shredded the value in some companies’ annual incentive and long-

term incentive plans, according to a survey by Deloitte Consulting LLP.

Keeping Comp on Track: Some Practical Tips : CHICAGO—It’s the economy, said Sharon

K. Koss, SPHR, consultant and author of Solving the Compensation Puzzle (SHRM, 2007),

during her June 21, 2008 workshop on “Compensation Basics,” held here.

The Bombay Hospital has decided to only hire candidates with strong credentials, after a fake

doctor worked at the hospital for six years undetected until Wednesday, Currently, junior

doctors are hired on the basis of their documentation. “We plan to start getting at least two

cross references for junior doctors as well. We also plan to cross check their SSC & HSC

certificates,” said Dr DP Vyas, medical director at the hospital. “It will help if the medical

degree certificates display the candidates photograph.”

This change in procedure came after Zuber Qureshi, a medical college drop out, assumed his

old classmate Meraj Shaikh’s identity and used his documents to secure a junior resident

doctor’s post at the hospital. This continued for six years until the police arrested him on

Wednesday after the real Dr Meraj Sheikh, lodged a complaint against him.

The hospital said that at the time of appointment, the original certificates submitted by the

doctor seemed reliable. A statement released by the hospital on Thursday said: “Though we

are very stringent about checking the authenticity of certificates submitted by candidates, this

is a clear case of impersonation and fraud.”   The hospital currently has 200 resident doctors.

Qureshi was working under Dr CA Somaya, a cardiothoracic surgeon. His seniors had no

cause to complain about his work.

“We did not receive a single complaint against him. As a junior resident doctor he was not

directly involved with the treatment of the patients and was not authorized to take any

decisions regarding treatment on his own,” added Vyas.  Qureshi is currently in police custody

under charges of forgery and impersonation.

RECRUITMENT, SELECTION AND INDUCTION PROCESS IN SAHARA HOSPITAL

CULTURE OF SAHARA HOSPITAL

The organizational culture plays a significant role in making organization gets the best out of

themselves. An optimum level of development climate is essential for facilitating H.R.D. Such a

climate can be observed in “SAHARA INDIA”   consisting of following tendencies and

attributes:-

There is a tendency at all levels and specially the top management to treat people as the most

important resources.

There is a perception that developing the competencies in the employees is the job of every

manager/supervisor.

The employee has easy interaction with the seniors in respect to official work and personal

problems.

There is a general climate of trust.

The psychological climate in the organization is very conductive to the employees.

Tendency on the part of the employees to be generally helpful to each other.

Team spirit and employees are encouraged to take the initiative.

There are tendency to discourage favoritism and Biases.

Supportive personnel policies.

RECRUITMENT PROCESS IN SAHARA HOSPITALS

PURPOSE

Human Resource is one of the key resources, which contributes to the success of the hospital. It

is imperative that human resource department will have to identify the right talent to achieve

organizational effectiveness. The success of identification of right talent depends upon finding

the applicants with the most appropriate level of skills, qualifications and experience, who will

identify themselves with the organizational objectives, values and culture and in turn contribute

their best to the organization.

The objectives of the recruitment are,

To lay down and follow an operating procedure for recruitment function of the HR

Department.

To identify and select qualified manpower for the various roles as per the job specification

lay down by the management.

To follow a systematic procedure to select a right person for the right job at the right time.

To recruit people who have a positive attitude towards customers, themselves and other

employees and who are able to contribute towards quality service.

To follow a recruitment procedure this is applicable to all categories of employees.

Recruitment Policy

The recruitment process is carried out in alignment with objectives and major organizational

principles. The major policies include:

Appointments in the hospital will adhere to the qualifications and the skill sets as mentioned in

the job description for various job titles.

Wherever experience has been specified, effort will be made to recruit persons with such

number of years and nature of experience.

The recruitment process shall be made transparent and should screen the best talents in the

industry.

Provide equal employment opportunities irrespective of gender or community.

Whenever vacancies arise, preferences will be given to applicants within the hospital.

Recruitment of employee’s relatives will not be encouraged except in certain situations and

categories.

Selection of unskilled workmen will be restricted for jobs that involve rigorous manual Labor

keeping in mind their capacity to perform.

Age limit for unskilled / untrained personnel should preferably be below 30 years of age.

Selection will be strictly on merit taking into consideration the knowledge, skill sets, mindset

of service, attitude and overall personality.

Responsibility

The HR department is responsible for the observance and adherence of the approved recruitment

policy and procedures.

Procedure for Recruitment

Sahara Hospital is now ready to be operational. The requirement of Human Resource has been

determined and the same is approved by Management. Staffing process is now beginning & The

Manager – HR and his team is responsible for the recruitment process.

Sources of Recruitment

Internal Sources

The internal source of recruitment is to provide an avenue for the existing employees within the

organization to perform a new role. This will be based on the suitability of an employee for that

particular vacancy. This may be termed as Promotion (if there is a change in salary / grade) or

Transfer (with or without any effect on Salary / Grade) as stated by the management. The

process starts by sending a note to different departments stating the vacancy. The profiles are

later collected and stored in the data bank followed by the different steps involved in recruiting

the employee.

All internal recruitment will be done through:

Internal Circular

Intra – mail

External Sources

The various external sources used for Recruitment are as follows:

Advertisement

Recruitment through Job portals such as Jobsahead, Naukri, etc.

Head Hunters / recruitment consultants

Campus recruitment

Walk In interviews

Advertising

When compiling an advertisement, the job profile should be made clear, concise and non

discriminatory. Clear indication should be given regarding the level of competence the position

requires.

Advertisements for recruitment are done in such a manner that it provides the maximum

required reach to the public. There is reliance in more than one source of advertisement.

Advertisement in newspapers magazines / journals shall be considered when the vacancies are

not filled through other sources of recruitment. Identification of the right media for advertising

the jobs has to be made to:

Attract suitable personnel.

Discourage unsuitable individuals from applying.

Project a good image of the hospital.

The HR. Head is responsible for preparing an advertisement based on the current job description

and job specification. The respective Department shall provide all necessary details regarding

the job profile to the Human Resources Department.

An effective advertisement will include:

Job Title – should match that on the job description

Department & Location

Grade and Pay Scale or Range – where ever necessary

Type of Contract – where ever necessary

Key responsibilities – the essential elements of the job description

How to apply – All applications should be sent to the ‘Human Resources Department’ stating,

the post asked for quoting the reference number.

Closing Date – normally a minimum of two weeks after publication

INTERVIEWS

Campus Interview

This source has to be used only for entry-level jobs. The directory of relevant educational

institutions may be referred for identifying institutors for conducting campus recruitment.

Process for campus interview…

Obtain permission from the institutional authorities.

Communication of the same to the interview panel members.

Ad display at the college campus (10-15 days in advance stating position, date, time & venue).

Presentation of the Hospital.

Registration.

Tests (Written/Group discussion).

Short-listing of candidates.

Personal Interview.

Finalization of candidates.

Campus interview kit requirements

Booking of tickets

Boarding & Lodging / Vehicle arrangements

Impressed Cash

Presentation arrangements at the venue. Requirements include (Slide Projector/Slides,

Laptop/Computer, OHP / Transparencies, OHP markers, Laser pointer, PampWets/Brochures)

Pay scales and details of other benefits are to be communicated.

Stationery: requirements include A4 sheets, ball point pens, pencils, erasers, sharpeners,

stapler / pins, gem clips, ball pins, plastic folders, punching machine, flat files, box files,

rubber bands, binder clips, paper weights, ruler, post-it, gum and calculator.)

Reports of the interviews conducted are to be submitted at the end of every such exercise and

recorded by the concerned authority.

Walk-in Interview

Confirmation of date, time and venue

Permission to be sought if necessary from local authorities

Communication of the same to the interview panel members

Preparation of advertisement

Release of ad (one week in advance & on the day of the interview)

Travel plan to be decided with the panel members.

Booking of tickets for interviewers

Boarding/lodging/vehicle arrangements

Venue arrangements (Interview & Seating arrangements for the candidates)

Report of the interviews conducted.

Walk-in interview kit requirements

Stationery (A4 Sheets, Ball point pens, pencils, erasers, sharpeners, stapler/pins, gem clips,

ball pins, plastic folders, punching machine, flat files, box files, rubber bands, binder clips,

paper weights, ruler, post-it, gum, calculator).

Application forms.

Pay scales and details of other benefits.

Interview rating forms.

Copy of Ads released

SELECTION PROCEDURE IN SAHARA HOSPITALS

Selection procedure is the most important part of the recruitment process. It should provide

evidence of the required capabilities and should be a completely transparent. It should be a

timely, cost efficient, effective and equitable process.

Scrutiny of applications

Applications received from the candidates are scrutinized and short listed as per the required job

specification. Short listed applicants are called for an interview through an interview call letter

by post or courier / phone call / e-mail /telegram/phonogram. A minimum time frame of 7 to 10

days shall be given to the applicants to make necessary arrangements to appear for the

interview.

Preliminary Screening I Verification

This screening shall be done based on the job requirements and specifications. During the time

of interview, the candidate’s authenticity of the original certificates I testimonials of age,

qualification and experience shall be verified, updated and recorded by the HR personnel. On

completion of verification, the candidates are asked to appear for the written test I group

discussion.

Written technical Test

A standard questionnaire or a practical test shall be held for testing the skill of the candidates.

Based on the marks awarded the candidate will be short-listed for a personal interview.

Personal Interview I Selection

On successful completion of the written I technical test, the short listed candidates will attend

the personal interview. The Interview panel will consist of Director (Medical Health), the

concerned departmental head, representative of Corporate HR and the representative / HR Head

of Sahara Hospital. The panel members will look for the required criteria, based on which the

candidate will be selected or rejected.

The following traits shall be looked upon during the Interview process:

Willingness to learn

Willingness to change

Self-starter

Ability to concentrate

Willingness to learn multiple skills

Team Player

Good family background

Personal grooming & etiquette

Loyalty to the organization

Dedication to the profession

Good communication skills

Positive attitude towards life

Caring Nature and helping tendency Decision making ability

Active & quick to respond to situations

Antecedent check

Due diligence antecedent check shall be carried out for key positions before the offer letter is

sent.

Medical Examination

A pre-employment medical examination shall be done for all employees recruited from the level

of a probationer onwards. The medical fitness of candidate has to be certified by the Staff

Medical Officer for appointment.

Provisional Selection

Provisional selection letter shall be sent / issued to the final short listed candidates subject to

being found medically fit.

Appointment

On receipt of the pre-employment medical fitness certificate and found fit for employment, an

appointment letter will be issued / sent to the candidates enumerating the terms and conditions

discussed during the personal interview. On receipt of the appointment letter, the candidate has

to confirm their acceptance and date of joining by signing and returning the duplicate copy of

the appointment order to the Hospital.

Appointing Authority

The appointing authorities for various categories are as follows:

SR. No. CATEGORY APPOINTING AUTHORITY

1Senior Management (Medical and Non

– Medical)

Hon’ble Dy. Managing Director

(C. & A.)2

Doctors (Consultants, Registrars,

Residents, Medical Officers)

3 Managers / Executives

4 Staff / Workers

Placement and joining formalities

A selected candidate has to report a day in advance with the following to complete the joining

formalities and creation of a personal record:

Proof of age, qualification & experience

Licenses / Registration Certificates, etc.

3-passport size photographs.

The Following forms are to be filled

Employment form

Communication form

Nomination form

Dependants declaration Form

PF Form

Gratuity Form

The Recruiting officer In – charge at Corporate HRD shall verify all the above documents on the

date of joining and complete the check -list formalities. The joining intimation report shall be

prepared and sent to the following areas.

Sahara Hospital HR

Time – office

Security office

Pay – roll Section

ID cards and uniforms shall be provided on the date of joining

Procedure for New recruitment / filling vacancies

The department in need of manpower will send in a properly completed personnel requisition

form to the HRD Development..

The HRD Development will have to process the requisition and will have to place a person

within 30 days of receipt of the requisition.

The HRD Development may place a position on hold if it is not justifiable. In such case the user

department, which has made the requisition, will have a suitable alternative for ensuring service

delivery.

The HRD Development will do an internal search before starting the external recruitment

process. However if the position demands and need is urgent the HRD Development will

embark on the external recruitment process.

Recruitment Process for Nurses

The deployments of nurses are being done in two stages depending on the occupancy projected.

In the initial phase of operations, nurses are required in two cadres; staff and supervisory.

Initially the number of supervisory nurses will be limited and allocated according to the

functional areas of operation in the hospital.

The Nursing Head would also have to simultaneously arrange for meetings with the Principal of

Nursing colleges for Campus Recruitment.

Recruitment Process for Paramedical Personnel

The recruitment of paramedical staff has been conducted as per approved man power planning

under the direction of Director (Medical Health).

Recruitment Process for Administrative Personnel

The staff requirement during the years will be constant since it is not dependent on the variation

in the occupancy of the hospital. The following points have been considered while drawing up

the recruitment plan.

1. The heads of most administrative departments have been recruited in advance owing to the

fact that many of them will have to be deputed for orientation program.

2. The HRD Development Team have been identified and recruited in the very beginning so

that they can oversee the entire recruitment process of staff at various levels.

3. The clerical level staff will be recruited just before the soft commissioning of the hospital.

However adequate training period has to be accounted for while drawing up the recruitment

plan.

The recruitment process for all heads of departments will follow similar schedule. The only

exception to the general rule is in the case of the HRD Development who has been to be

recruited earlier than most administrative heads.

The Executive and clerical level staff can be placed in the hospital just before operations

commence. The schedule however accounts for their training period before the date of soft

commissioning.

Recruitment Process for Support Service Personnel

The following departments will constitute support services in the hospital:

1. Engineering and Maintenance

2. Biomedical Engineering

3. Information Technology

4. Medical Records

5. Front Office

6. Food and Beverages

7. Security

8. House keeping

The recruitment of all the above departments has been be conducted in the following staff

categories:

1. Heads of Departments

2. Executive staff / Clerical staff

3. Contract staff

The pattern of recruitment will be uniform in all cases with the exception of the following:

1. HOD- Engineering and Maintenance

2. HOD-Biomedical Engineering,

3. HOD-Information technology

The above departmental heads will have to be in place by the time the installation of

Engineering equipment, biomedical equipment and LT hardware and networking takes place.

They would be placed in the hospital prior to the date of soft commissioning.

INDUCTION & ORIENTATION IN SAHARA HOSPITALS

All new incumbents shall undergo a comprehensive induction program for familiarization of the

organization’s process, structure and people.

The induction period sows the seeds for bringing out the best in the employee and enables

employees to settle down quickly to perform their duties well.

During this process the employee gets to know the mission and goals of the organization, its

values and norms and his expected behavior pattern.

During this process, the new employee is provided with Induction Kit comprising the induction

manual, service rulebook, all forms related to joining formalities of an employee.

It is mandatory that all the employees should attend the Induction program before they start

reporting to their respective departments. After the successful completion of this program an

Orientation form is filled up and attached in the personal file of that employee.

INDUCTION PROGRAM

Induction Program is a 3-4 days program, which is given to the newly employed staff (doctors,

nurses, technicians, administrative staff etc.) and would include a series of lectures on various

topics. The induction program introduces the employee to the Hospital about the general

functioning of the Hospital and would also include hospital rounds. Manager – HR is

responsible to organize this in the Hospital with timely integration with the commencement of

operations and in relation to the joining dates of batches of employees.

The Induction Program provided by the Hospital would include:

Introduction to the Hospital

Organization structure

Role of various departments

Importance of infection control

Communication and team work

Psychology of patient.

Human values etc.

Need Based Training Program

The training is general to all departments and at all levels except for a few topics, which are

specific to executive and managerial cadre. These program are mainly aimed at developing the

behavioral aspects of individuals and will be more focused toward employees who interact

directly with the patient.

Technical Training Program

Technical training program consist of on-the-job training and would be given to the technical

employees of the hospital. The technical training program is aimed at updating the technical

skills and knowledge of the employees according to the latest development in the fields.

Technical training is generally given to the employees of the medical, nursing and paramedical

departments.

What to avoid in Induction

Providing too much, too soon; the inductee must not be overwhelmed by a mass of

information on the first day. Keep it simple and relevant.

HR rather than local personnel providing all the information – it should be a shared process.

Creating an induction program which generates unreasonable expectations by overselling the

job.

Having to repeat the unproductive learning curve of the leaver damage to the company’s

reputation.

New HR Tactics for New Challenges

Increasing rates of attrition are compelling HR departments in hospitals to rethink their

strategies. Rita Dutta reports

It was an entertaining and competitive evening with scintillating dancing and singing

competitions and games at the Mumbai-based Dr LH Hiranandani Hospital. Winners were

gifted with TVs, DVD players, microwave ovens and so on. Surprised?

It was a part of the well-crafted HR strategy to scale up the happiness and satisfaction quotient

of employees. Whether it is cheering employees by celebrating their birthdays, weekend cricket,

creating a sense of empowerment by making them stakeholders, weaving a cocoon of safety and

security, extending medical benefits after superannuation, or emphasizing training and

development, the Human Resource Developments (HRD) in major hospitals are rolling out

innovative plans to woo employees.

Dynamics Are Changing

Why this sudden awakening of hospital HRDs? The change is

fuelled by an attrition rate of 15 to 20 per cent in hospital

administrators and managers in the last six months, a result of

the burgeoning USD 23 billion Indian healthcare industry,

growing at an annual rate of 13 per cent. New hospitals in

Mumbai, Delhi and Bangalore are poaching employees from

established hospitals by upping their salaries by 30 to 40

percent, say analysts. (See box for an estimate of salary hike in

new hospitals)

Having weekend cricket with

employees is an HR strategy at

Dr LH Hiranandani Hospital

Gone are the days when an employee stuck to an organization for decades together working for

a modest salary, while a few years back, a fresher with MHA received a salary of Rs 12,000 to

Rs 15,000, today he commands a salary of Rs 20,000 in corporate or upcoming hospitals. A

manager with three years experience, who used to earlier receive Rs 35,000 to Rs 40,000, today

pockets Rs 1lakh and above says unofficial estimates.

An opportunity for better career growth, stagnation and lack of job enrichment at the present

organization are also driving employees to new hospitals"

Ankush Gupta

Senior Manager,

HR and Administration,

Hiranandani Hospital

The flip side of the boom is faced by the hospitals losing their top guns. In the last six months,

Hiranandani Hospital lost eight key people, while Wockhardt Hospitals, Mumbai and PD

Hinduja Hospital, Mumbai lost eight and four people, respectively to the upcoming hospitals.

Rockland Hospitals, Delhi has lost four key people. The sudden exits sometimes have HRDs at

their wit’s end scouting for immediate replacements within 24 to 48 hours. “I had to replace my

materials manager within 24 hours. Sometimes, it becomes quite challenging,” says a harried

Gupta. Coping with the crisis has made most hospitals realize that their HR policies needs to be

better defined. Opines Gurushant Phatate, General Manager, HRD, Jaslok Hospital and

Mumbai, who worked in the steel industry earlier, “Hospital HR is definitely less well-defined

when compared to other industries.”

And why is it sketchy? S Patnaik, Senior General Manager, HR, Apollo Indraprastha Hospital,

New Delhi explains, “Hospitals have always accorded more importance to doctors than their

internal customers—administrators, nurses or ward boys. Hence, HR for other employees never

took concrete shape, until recently.” Additionally, there is lack of trained HR personnel in

healthcare. “Most of the HR personnel in healthcare come from the FMCG and pharma sector,

without any training in hospitals and thus fail to address the finer nuances,” avers Dr Alok Roy,

Vice President, Operations, Fortis Hospital and Noida.

Where the Problem Lies

It’s only a handful of hospitals which chart out a career graph for their employees while

recruiting them, convey the group’s vision, train them or take steps to appreciate their work.

Asian Heart Institute (AHI) learnt the importance of communicating with its employees the hard

way. A host of people left the organization in its first year of operations. Dr Bhaskar Shah,

Director, AHI reveals, “Employees were unsure of their growth and future in the organization as

we did not clearly define our group’s vision to them. But, now we have learnt from our mistake.

We hold regular training sessions with employees.”

According to Tufan Ghosh, CEO, Columbia Asia Hospital and Bangalore, “HR in hospitals is

hierarchy-driven, which does not necessarily translate into career growth. There is no unified

chain of command as the medical and the administration departments are mostly at loggerheads,

preventing one from taking the right decision.” He feels that the recruitment process in hospitals

is heavily skewed towards people with the right technical knowledge than those with the right

behavioral approach.

Different hospitals are beset with different HR problems. Mumbai-based Jaslok Hospital, like

many other hospitals, has to cope with high degree of absenteeism and indebtedness in class III

and class IV employees. Every year, around 30 people are suspended from Jaslok Hospital

because of absenteeism. This is after they are served innumerable warnings and show cause

notices. “We also have a hard time trying to pay cheques of people with high debts,” says a

distressed Phatate. To avoid such problems, most hospitals have started outsourcing Class IV

staff.

"Hospital HR is definitely less well-defined when compared to other industries" - Gurushant Phatate,

General Manager, HRD, Jaslok Hospital

Unions Matter

The dynamics of hospital HR are different in a unionized hospital, which often prevents the

authorities from taking immediate and stringent punitive measure against an errant employee.

For instance, when an employee was found to be inebriated during duty in a major Mumbai

hospital, the hospital authorities could not take any immediate action against him. Only after the

enquiry committee filed its report after one and a half years, the employee was suspended for

three days. “Does such punishment hold any meaning?” asks an HR person.

Lack of proper appraisal system can also lead to disgruntled employees and thus poor

performance. Most unionized hospitals do not have performance-based appraisal, except for

managers. The yearly hike is decided during the time of appointment, which is a demotivating

factor.

According to Dr SK Biswas, VP, Duncan Group, Kolkata, “Often employees grudge the hikes

given to them, without knowing the dynamics behind that hike. A hospital needs to explain its

Key Result Areas (KRAs) to the employees, monitor their progress during the course of the

financial year and then make them understand why a particular salary hike was given. This is

the KRA for the HR Department of a well-administered hospital.” The concept of ‘Balanced

Score Card Approach’, a management tool introduced by Kaplan and Norton of Harvard

University thus assumes significance in HR. In this frame-work, the approach is to ensure better

focus, accountability, alignment and communication at all levels, with the objective of four

inter-dependent perspectives of training and development, well-defined internal process,

customer satisfaction, therefore more patients inflow and hence revenue viability.

“The impact of behavior of employees on the revenue and the importance of balanced

score card needs to be explained to them,” says Dr Biswas, a firm believer in this innovative

concept.

Even as HR policies are taking shape, are all HR personnel given the power to execute policies?

Dr Shreedhar V Sherigar, Chief Manager, Personnel & Human Resources, Breach Candy

Hospital, Mumbai fumes, “Most hospital managements twist HR for their own benefits. HR

personnel end up being lackeys of the management.”

Ways to Curb Attrition Rate

To curb the high attrition rate, the success mantra for a hospital is not just offering a fat pay

packet, but chalking out long-term development and career growth for employees, along with

giving them a sense of empowerment. “A hospital should always innovate, keep their

employees busy with various projects,” suggests Dr Roy.

So that the functioning of a hospital is not plagued by somebody’s sudden exit, it is important to

keep a databank of apt substitutes ready. “I always chat with my employees trying to

understand who is not happy and may leave the organization. I try to address their

problems and grievances and always keep the replacements ready,” says Gupta. Anupam

Verma, Director, Administration, PD Hinduja Hospital agrees, “We always keep a second line

of people ready so as to avert a sudden crisis.”

Multi-tasking also comes handy in times of crisis. “It is the job of HR to identify the right talent,

encourage and train them for multi-tasking,” says Dr Biswas.

Winds of Change

According to Dr Bidhan Das, Director, Administration, Rockland Hospital, “It is the role of

HR to analyze behavioral patterns whether it is a high-skilled surgeon or a low-skilled

security guard, chart their behavior for months together and then use targeted

intervention, which is accomplished through behavioral and motivational training.”

Manipal Hospital, Bangalore, like some of its counterparts, is consciously creating a working

environment that facilitates a performance-driven culture. “Performers are motivated with ample

opportunities to take up challenging assignments. We empower employees to take decisions and

thus instill self-confidence and sense of pride in working for us,” says R Basil, CEO and

Manipal Hospital. The hospital also conducts sports and cultural activities for a span of three

months in parallel with regular work every year, which culminates in the annual Manipal

festival called Manifest. “All these go a long way to instill a sense of loyalty not only among our

employees but also among the consultants, who are not on our direct payroll,” says Basil. The

importance of well-defined HR is slowly taking root. With a spate of new hospitals, there is

renewed emphasis on training and development. “From focusing on Industrial Rules (IR) or

union-related activity, hospital HR is now making a paradigm shift towards training &

development and customer satisfaction (both internal and external),” says Patnaik.

“Listen to the winds of Change.” Welcome to the employees’ world!!

‘HR Should Never Cave In To Any Favoritism’

The Chairperson for Mumbai Hospital HR Forum and Head of HRD with Reliance’s (ADAG

GROUP) Kokilaben Dhirubhai Ambani Hospital (previously Mandke Heart Hospital), Sunil

Karanjikar, is a busy man these days crafting HR strategies for the upcoming hospital. In a

career spanning 12 years, Karanjikar has worked with Tata SSL (Wire Division), a subsidiary

company of Tata Iron & Steel Company, Voltas, Norwegian conglomerate Norsk Hydro and

Saint Gobain Sekurit India. Dabbling in the healthcare industry for the last two years, he is

respected in the industry for setting the HRD standards in PD Hinduja National Hospital and

Medical Research Centre, when he was the Deputy Director, Personnel & HR. An Executive

Committee member and treasurer of National Institute of Personal Management, Mumbai

Chapter and HR Committee member of Bombay Management Association, he discusses the

paradigm shift needed in HR related to healthcare, in an interview with Rita Dutta

HR in healthcare is sketchy. Do we need to overhaul the present HR systems in hospitals?

A doctor’s role in treating patients is important, but the time he spends with patients is very less

compared to others. Yet, it is always the doctor who is treated as demi-god both by patients and

management, forgetting others who are also serving the patient. We need a 360-degree change

in HR approach, so that the support staff is also given the equal importance they deserve. A

hospital needs to have such HR standards, which act as a magnet to attract talent.

What changes did you bring in at Hinduja Hospital’s HR?

During the two years of my tenure, I have helped the hospital not only to attract the right talent

but also successfully implemented various HR initiatives to make the workplace people-centric.

‘Team HR’, which we used to call ourselves, started by designing an HR mission, based on

which various initiatives were taken.

In one year, almost 20 innovative HR practices were successfully implemented, including

celebration of birthdays of all employees by the department heads, presentations by employees

after attending external training programs for knowledge of other employees and union leader-

employee discussions. We also introduced dance classes for doctors and administrative staff,

training programs and HR survey to understand the needs of employees.

What are the main challenges faced by HR personnel?

To begin with, we have to maintain quality of service, which we attain by inculcating the right

philosophy and principles in our staff. Training programs are thus very important. It is a

challenge to create passion for work in people and that applies for HR people too. Secondly, we

have to battle with attrition, which is highest in nurses. Besides a good salary, we need to give

people fancy designations, career paths, and empower them, which will lead to better

productivity. We should also have a succession plan for at least the top two levels.

We have to attract the right talent, because there is a dearth of trained personnel. The parameters

of judging talent are different for various roles; soft skills have assumed immense significance

today. People are in a sensitive state of mind when they visit a hospital and one small mistake or

slip in service can be blown out of proportion. Even doctors cannot afford to be rude with

patients. Additionally, we have to increase the level of transparency and trust in employees and

make the hospital people-centric.

However, the most important challenge lies in not caving in to the demands made by doctors

and management to hike salaries or promote certain people, whom they think are good

performers.

We must put our foot down, because if we agree to their demands every time, we end up not

only upsetting the salary level of everybody else in the same category, but also the financial

goals at the end of the year. Rules and regulations apply to all and favoritism cannot be allowed

under any circumstances. Such situations mostly arise when the organization is dictated by one

person.

A renowned CEO of a prominent Mumbai-based hospital left the organization some years back

as the management were not ready to listen to his suggestions for improvement. What is the role

of HR in such situations?

It is very sad that sometime people at the helm don’t understand professionalism. It is the top

management which should support all strategic plans of its CEO. Nobody appoints a CEO

without understanding his professional status, credentials and the work he has done in the past.

What we need is more transparency while recruiting top people. There is a need to decentralize

power.

There is a sudden hike in salaries in healthcare. What impact will it have on employees’

mindsets?

The hike is well-deserved and expected considering the boom in the healthcare industry. Most

hospitals don’t pay heed to rewarding their own employees. They fail to understand that the

ranking they have is not only because of their technology or medical practitioners, but also due

to hard work put in by the employees working in Para-medical, nursing and administrative

areas.

Salary in healthcare has never been competitive, be it for marketing, finance, HR, administration

or technicians. I want people to feel cheerful while coming for work and not have Monday

morning blues. Rectifying salary is the one of the steps towards achieving that goal.

is lack of skilled HR professional in healthcare. Please comment.

Yes, that is true. HR is not seen as a lucrative career option in hospitals as students opting for

professional healthcare courses believe that they only go for administration in a hospital. There

are only a few institutes, like TISS, Mumbai, ASCI and IIHMR which have HR courses related

to healthcare. While we need more such institutes, keeping in synch with times, most of these

institutes need to modify their syllabus.

INTERNAIONAL HUMAN RESOURCE MANAGEMENT

The shortage of health human resources (HHR) has been identified as one of the major

challenges facing Trinidad and Tobago and the region of the Caribbean and the Americas for a

number of years. WHO estimates that a total of 4 250 000 health workers, are needed to fill the

human resources gap that exists in fifty-seven countries, and that without prompt action, the

shortage will worsen.

The health human resource shortage in Trinidad and Tobago has been exacerbated by the

migration of health care professionals from the country. This migration is not unidirectional,

however; statistics for 2008 show that there was a net inflow of medical doctors to Trinidad and

Tobago. There were 501 Trinbagonian doctors resident abroad, and 1180 foreign doctors

registered with the Medical Board of Trinidad and Tobago.

International Factors

The ability of the health system to effectively respond to the changing needs and health profile

of the population has been constrained by the shortage of health personnel and the absence of a

comprehensive approach to HR planning for health that adequately incorporates the

international factors. Some of these international factors include:

the international composition of the health workforce in Trinidad and Tobago;

the impact of the international labor market for health on the domestic health labor market;

the migration of health professionals into and out of Trinidad and Tobago;

national and regional codes of practice on recruiting of health care workers;

existing bi-lateral arrangements between Trinidad and other countries for the supply of

health workers;

the opportunities that exist to strategically pursue internal cooperation arrangements with

other countries;

the impact of international training institutions on the supply of health care workers to

Trinidad and Tobago;

the capability and capacity of local training institutions

Factors impacting on the national labor market determine the size and composition of the pool

of health care workers for the country. This pool comprises all persons that are willing to work

in the health sector in Trinidad and Tobago and possess the necessary qualifications and means

to do so. It is important to note that the labor pool is not limited to a geographic area or a

specific nationality. The health labor pool will comprise mainly nationals and residents,

however, eligible non-residents and non-nationals would also be a part of that pool.

The size of the health labor pool is determined by the national health labor market inflows and

outflows, which are themselves influenced by both national and international factors. Where the

labor market inflows exceeds the outflows an increase in the size of the labor pool results, and

when the labor outflows exceed the inflows, the labor pool decreases in size.

The health labor market inflows are in turn influenced by: inward migration; training program

available at local, regional and international training institutions and the throughput of health

graduates; the employment of effective recruitment and retention strategies; bilateral treaties and

arrangements on the recruitment of health workers; government’s policies and plans; and the

country’s foreign policy and international cooperation.

HEALTH SYSTEM LABOUR POOL

National Health Labor Market Inflows:

local and regional and international training institutionsEffective recruitment and retention strategiesMigrationInternational health labor marketGovernment’s policies and plansForeign policy and international cooperationSocial and economic conditionsBilateral treaties and arrangements on Recruitment of health personnel

National Health Labor Market Outflows

MigrationInternational health labor marketIneffective national retention strategiesInternational recruitment agencies Foreign policy and international cooperationInternationally relative social and economic conditionsInternational and bilateral treaties Absence of an international Code of Practice on Recruitment of health personnel

Labor market outflows are influenced by: the level of migration of health workers from the

country; demand and supply conditions in the international labor market; ineffective and poorly

instituted retention strategies; recruitment practices of international recruitment agencies;

superior living standards in countries that are competing for health workers; and foreign policy

and international cooperation; and the absence of an international code of practice on the

recruitment of health workers.

The challenge that nation states face is how to increase its health labor pool given the globalized

nature of human resources for health and the fact that there is an international shortage of health

human resources. Any manpower plan and strategy to increase the size of a country’s health

labor pool must therefore be international in scope

At the national level, these include:

1. The health needs of the population;

2. The health profile of the population;

3. The social determinants of health; and

4. Government’s policies and plans.

At the international level, these include:

1. The country’s commitment to regional and international health goals;

2. The growing numbers of multinational fast food establishments;

3. The multinational tobacco companies;

4. International marketing that induces health impacting behavior;

5. International trade; and

6. US deportation policies with respect to Trinidad and Tobago and the CARICOM region.