"It is becoming more and more difficult to find sufficiently qualified young employees for the health professions. The training and qualification of employees and also executives in the hospital sector is of special importance in this context. The course is set for success here. Executives and employees trained well create the prerequisites for positive motivation and successful qualitative processes and excellent results (efficiency and effectiveness)." Heinz Kölking, (E)Hospital Editorial Issue 2/2010
As early as 2008 the Global Health Workforce Alliance (GHWA) released a statement noting that more than four million workers worldwide are missing in the health professions; a problem that according to the statement affected many states in Africa and Asia in particular. Now, the lack of staff observed in health professions has also hit many European countries, as Heinz Kölking, President of the EAHM, already noted in his editorial in (E)Hospital 2010, excerpts of which are quoted above. Various measures are required to counteract this shortage, e.g. an increased appeal of health professions for young people, improved working conditions, implementation of conditions for longer turnaround- times, and many more.
Every insider within the business is aware of the importance of human resources in the hospital. The members of staff are the most important resource in operational processes, but also constitute a significant cost factor (a fact that unfortunately gets most of the attention in public discussion). A characteristic feature of hospital life is the imperative obligation for all staff members to work together. Ultimately, it is the immediate and direct work of physicians, nurses and other health professionals with the patient that has the most influence on a hospital's image, be it positive or negative. Human resources should therefore receive a high standing; the hospital management should view their staff as one of their major responsibilities.
Human Resources Planning
Human resources development is a key feature of staff management. It ensures the training of qualified personnel, the motivation of staff and their employment according to their individual skills and capabilities. The goal is to enable people, teams and the organisation to manage their tasks successfully and efficiently and to face new challenges confidently and in a motivated manner. The basis for this development is human resources planning, which from a strategic and an operative point of view should be given highest priority.
Human resources planning should ensure that staff members are available in the necessary number and quality to accomplish tasks in accordance with the hospital's goals. Basically, the functions of human resources planning can be summarised as follows:
- Identify the need;
- Deployment of staff;
- And if necessary, redundancy.
Example: The Viennese Hospital Association (KAV)
The general principles of human resource management are often contained within the visions and/or mission statements of hospitals and hospital federations. The Viennese Hospital Association (KAV), an enterprise of the City of Vienna, is one of the largest health institutions in Europe, comprising twelve hospitals, eleven geriatric centres and two care homes. The KAV employs more than 30.000 people.
In its mission statement, the KAV has set its basic principles:
- "We are all responsible for the success of the KAV."
- "Human resources development is a core duty of every executive. Encouraging young staff members has a high priority."
- "We offer training and further education to our staff, as well as the security and career opportunities of a large enterprise."
The principles of human resources development, as determined by the KAV head office, are directly derived from these orientations. The individual hospitals plan and implement their measures according to these principles. For example, basic nursing training courses are held in the KAV's own schools, in accordance with federal legislation. Training and further education are provided according to demand, both in an intra-corporate setting – the KAV's own Training Academy – or in an external setting. Executive training courses are held by the KAV in cooperation with universities such as the Vienna University of Economics and Business Administration and the Medical University of Vienna.
These courses have long been carried out in a multi-professional setting – something that was not a matter of course until recently. All co-workers are offered a broad spectrum of both work-specific and personalityorientated courses. According to the topics, some technical programmes might be carried out in a mono-disciplinary setting, while courses and seminars on personality-orientated topics are usually, for logical reasons, organised by several disciplines. Logical because these courses touch on matters of social competence, which in light of the absolutely necessary teamwork is a matter of singular importance in hospitals. Employees of KAV hospitals also regularly attend congresses, study trips and exchange programmes, such as the European HOPE-exchange programme, in order to develop their personality.
Target agreements with the individual employee form the basis for the structured application of the individual units of human resources development. Based on future need, the employee and his or her superior officer will meet for an employee orientation appraisal and determine together which measures make sense in order to best prepare the employee for future tasks. It is of the utmost importance – and compulsory in KAV guidelines – that these programmes and developmental steps agreed upon in that first discussion are appraised in a second meeting to make sure that the goals set are actually met.
Responsibility of Hospital Managers and Professional Associations
It is a matter of course that the main responsibility regarding human resources development lies with the individual hospital, the hospital associations and operators.
Even so, hospital managers and their professional associations should also view the question of further training and development of junior staff as a key task – and they do! While examples from Austria are presented in this article, other countries surely offer the same.
The Working Group of Hospital and Welfare Institution Administrators in Vienna constitutes the union of managers responsible for economic management. For many years now this association has organised the "Viennese Training Days for Hospital Management". Its goal is to discuss questions of interest for members, nursing and medical managers, with another focus on training of young employees. Seminars on personality development, an employee's own motivation and the motivation of other employees have already met with great success. Study trips to many European countries, but also to the US, Canada or Japan should also be seen as promoting human resources development.
The National Association of Austrian Hospital Managers (BUKO) constitutes the head committee of the working groups set up in the nine Austrian Bundesländer (provinces); this association has been a member of the European Association of Hospital Managers EAHM since its foundation. For many years, no formal training existed in Austria for hospital mangers, whoever wished to gain a higher level of training had to for example attend the (former) German Hospital Institute (DKI) in Düsseldorf. In order to change this, more than three decades ago BUKO founded its own training centre for hospital managers, the Austrian Institute for Hospital Management (ÖIK). This institute, still sustained by BUKO, is currently organising, in cooperation with the Vienna University of Economics and Business Administration, its 18th training course leading to a degree of hospital administration and the title of "Academic Health Care Manager", thereby lending an essential contribution to the fact that Austria can rely on highly qualified staff for its hospital management.
The European Association of Hospital Managers (EAHM) has set amongst its goals: "... to support the professional competence and assumption of responsibility of directors and executive staff of hospital management and in the hospital sector in European countries." This goal is met by organising congresses every two years, by publishing (E)Hospital as the official journal of the EAHM, by organising seminars (open according to topic either to hospital managers or to employees), and by commissioning interviews and their scientific analysis and publication, etc. All these activities should be viewed as supporting human resources development.
Human resources development represents a major function of hospital management. Especially in light of the tendencies described at the beginning of this article concerning the personnel sector of the healthcare business; this task will be even more important in the future than it is now. It is therefore vital that hospital managers identify with this task and recognise it as their own responsibility and do not retract to the viewpoint of "Oh well, human resources will take care of it". Possibilities opening up in the healthcare sector for further training of employees by means of national and European associations should be increasingly made use of in a targeted manner.
Human resources development, constructed carefully, conducted purposefully – will reap dividends, both for the hospital and for its employees, but most of all for the patients.