HUMAN RESOURCE MANAGEMENT

Human Resource Management

Process: Desired level of care to meet its patient demands

Purpose: is provide each unit with an appropriate and acceptable number of each category of workers
OBJECTIVES OF HUMAN RESOURCES IN ORGANIZATION

Productivity
 Outputs (goods/services)
 Inputs (people, capital, material, energy, etc.)
Efficiency
 Produce more with a few people
Therefore
 HRM aims to improve the production contribution of individuals while simultaneously
attempting to attain other societal and individual employee objectives

Strategies of HRM
1. Planning
2. Attracting
3. Placing, Developing & Evaluating
4. Motivating & Rewarding Employees
5. Maintaing High Performance
Key Points
1. The key to an organization’s success is its human resources
2. Organizations need human resources that:
o work hard
o think creatively
o perform excellently
3. The behavior of employees is the key to achieving effectiveness
4. Rewarding, encouraging, and nurturing the human resources in a timely and meaningful manner
is what is required
Assessing Quality health Goals
Goal
 The desired-for situation targeted by a performance improvement program
Standard
 Statements of expectations for the inputs, processes, behaviors and outcomes of health
systems, they can effectively limit variations by defining what is expected from the
organization in its daily activities.
Criteria
 Lay down specific actions that need to be done to meet the standard
Are developed to specify the attributes of structure, process and outcome components of
care.
Indicators
 These are measurable variables or characteristics that can be used to determine the
degree of adherence to a standard or achievement of quality goals.
GOAL
 Recruitment, selection and appointment of staff comply with statutory requirements
and are consistent with the organization’s human resource policies.

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 Standard
 All services are provided by staff members with appropriate qualifications, experience
or training
Indicator
 Percentage of staff with current licenses.
Criteria
• All doctors, nurses and midwives providing clinical care have current licenses and documented
evidence of appropriate training and experience.
All administrative, business and technical services staff have current licenses and documented
evidence of appropriate training and experience.

STAFFING
• Staffing is the process of filling positions/posts in the organization with adequate and qualified
personnel
• Staffing is the process of acquiring, deploying, and retaining a workforce of sufficient quantity
and quality to create positive impacts on the organization's effectiveness
• Staffing follows a predictable pattern before a nurse can be hired:
o preparing to recruit,
o attracting staff,
o recruiting and selecting staff through interview,
o induction, orientation, and job offer.
In summary
STAFFING - is the process of assigning competent people to fill the roles designated for the
organizational structure through recruitment, selection and development.

FACTORS AFFECTING STAFFING

1. type, philosophy and objectives of the hospital and the nursing service
2. Population serve
3. Number of Patients
4. Availability and characteristics
5. Administrative Policies
6. Standards of Care demands
7. Lay out of the various nursing units and resources, available within the department
8. Budget
9. Professional activities and priorities in non patient activities
10. Teaching Programs
11. Expected hours of work per annum
12. Patterns of work schedule

Steps in Staffing
I. Determine the number and types of personnel needed
Predicting Staffing Needs
 Accurately predicting staffing needs is a crucial management skill because it enables the
man- ager to avoid staffing crises. Managers should know the source of their nursing
pool, the number of students enrolled in local nursing schools, the usual length of
employment of newly hired staff, peak staff resignation periods, and times when the
patient census is highest. In addition, managers must consider the patient care delivery
system in place, the education and knowledge level of needed staff, budget constraints,
historical staffing needs and availability, and the diversity of the patient population to
be served.
II. Recruit Personnel
Recruitment
 is the process of actively seeking out or attracting applicants for existing positions, and it
should be an ongoing process. In complex organizations, work must be accomplished by
groups of people; therefore, the organization’s ability to meet its goals and objectives
relates directly to the quality of its employees. Unfortunately, some managers feel
threatened by bright and talented people and surround themselves with mediocrity.

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 Wise leader–managers surround themselves with people of ability, motivation, and
promise.
III. Interview
a. An interview may be defined as a verbal interaction between individuals for a particular
pur- pose. Although other tools such as testing and reference checks may be used, the
interview is frequently accepted as the foundation for hiring, despite its well-known
limitations in terms of reliability and validity. The purposes or goals of the selection
interview are threefold:
(a) the interviewer seeks to obtain enough information to determine the applicant’s suitability
for the available position;
(b) the applicant obtains adequate information to make an intelligent decision about accepting
the job, should it be offered; and
(c) the interviewer seeks to conduct the interview in such a manner that regardless of the
interview’s result, the applicant will continue to have respect for and goodwill toward the
organization.
There are many types of interviews and formats for conducting them. For example,
Interviews may be
1. unstructured,
 The unstructured interview requires little planning because the goals for hiring may be
unclear, questions are not prepared in advance, and often the interviewer does more
talking than the applicant

2. semistructured,
 Semistructured interviews require some planning since the fl ow is focused and directed
at major topic areas although there is fl exibility in the approach.
3. structured.
 The structured interview requires greater planning time yet because questions must be
developed in advance that address the specifi c job require- ments, information must be
offered about the skills and qualities being sought, examples of the applicant’s
experience must be received, and the willingness or motivation of the applicant to do
the job must be determined. The interviewer who uses a structured format would ask
the same essential questions of all applicants.
Limitations of Interviews
IV. The major defect of the hiring interview is subjectivity. Most interviewers feel confi dent
that they can overcome this subjectivity and view the interview as a reliable selection tool,
despite the element of subjectivity. In fact, McKay (2009) warns that interviewing is a lot
more dif- fi cult than people think, and many people think they are better interviewers than
they really are. “There is also a belief that interviewing is all about talking to people, and
interviewing is just about good conversation. The selection interview is much more than a
conversation, and good conversationalists aren’t necessarily good interviewers” (para 3).
Research fi ndings regarding the validity and reliability of interviews vary; however, the
following fi ndings are generally accepted:
The same interviewer will consistently rate the interviewee the same. Therefore, the intrarater
reliability is said to be high.
Examining Recruitment Advertisements Select one of the following:
1. In small groups, examine several nursing journals that carry job advertisements. Select
three ads that particularly appeal to you. What do these advertisements say, or what makes
them stand out? Are similar key words used in all three ads? What bonuses or incentives are
being offered to attract qualifi ed professional nurses?
2. Select a healthcare agency in your area. Write an advertisement or recruitment poster
that accurately depicts the agency and the community. Compare your completed
advertisement or recruitment flyer with those created by others in your group

IV. Induct or Orient the Personnel/Indoctination

V. Job Offer

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STAFFING PATTERN
1. Benchmarking
Benchmarking is a way to go backstage and watch another company’s performance from the
wings, where all stage tricks and hurried realignments are visible.
In Joseph Juran’s 1964 book Managerial Breakthrough, he asked the question:
• Management tool for seeking out the best practice in one’s industry so as to improve
one’s performance.
• Process of measuring products, practices and services against best performing
organization as a tool for identifying desired standards of organizational performance.
2. Regulatory Requirements-
• mandated by Republic act 5901, Forty Hour Week Law
3. Skills Mix
 percent or ratio of professionals to non œprofessional
Ex: 40 FTE (20 RN + 20 non RN) = 50% RN mix
4. Staff Support- in place for the operations of the units or department-
5. Historical Information-review of any data on quality or staff perception regarding the
effectiveness of the previous staffing pattern

Timetable showing planned work days and shifts for nursing personnel.
Factors Affecting Time Requirement of Nursing Care/ Issues to consider in scheduling staff:
 Acuity if the patient’s illness
 Degree of dependence of the patients on the caregivers
 Communicability of the ailment
 Rehabilitation needs and special treatments and procedure
Scheduling
•Timetable showing planned work days and shifts for nursing personnel.
Issues to consider in scheduling staff:
1. Patient type and acuity
2. Number of patients
3. Experience of Staff
4. Support available to the staff

Shifting Variations
1. •Traditional Shifting Patterns
a. 3 shift (8 hr shift)
b. 12 hr shift
c. 10 hr shift
2. •Weekend option
3. •Rotating work shift
4. •Self-scheduling – staff makes their own schedule
5. •Permanent work shift
6. •Floaters – “on-call”

Forty Hour Week Law – based on RA5901

•No work, no pay
•Entitled to 2-week sick leave and off duty for 2 days
 Special holiday with sick leave

PATIENT CARE CLASSIFICATION

Measuring tool used to articulate the nursing workload for specific patient or group of patients over a
specific time.
Patient Acuity – measure of nursing workload that is generated for each patient.

METHOD OF GROUPING PATIENTS ACCORDING TO THE AMOUNT OF COMPLEXITY OF THEIR NURSING

CARE REQUIREMENTS

1. “Self care” or minimal care patients

2. Intermediate or moderate care

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 3. Total care
4. Intensive care patients

1. SELF CARE
 ABOUT TO BE DISCHARGE
 NON- EMERGENCY
 NEWLY ADMITTED
 Capable of Carrying ADL

2. MODERATE OR INTERMEDIATE CARE

 Need assistance in activities of daily living
 Extreme symptoms of their Illness
 Vital signs ordered up to five times per shift
 special treatments or certain aspects of personal care (IV, Catheters)

3. TOTAL CARE PATIENT

 are those who are bedridden
 who lack strength and mobility to do average daily living.
 Ex: patients on CBR, immediate post-op, with contraptions.

4. INTENSIVE CARE PATIENT

 Completely Dependent
 On continuous O2 therapy
 With Chest or Abdominal Tubes
 Require close observations
 who are critically ill and in constant danger of death or serious injury. Ex: comatose, bedridden
etc

NURSING CARE MODEL/ FRAMEWORKS

1. The Case Method or Total Patient Care
2. The Functional Method
3. Team Nursing
4. Primary Nursing Method
5. Progressive Client Care
6. Managed Care Method
7. Practice Partnership
8. Case Management Method
9. Modular Method

1. CASE METHOD
 Case management describes a range of models for integrating health care services for
individuals or groups.
 case management involves multidisciplinary teams that assume collaborative
responsibility for planning, assessing needs, and coordinating, implementing, and
evaluating care for groups of clients from preadmission to discharge or transfer and
recuperation.
 A case manager, however, may be a nurse, social worker, or other appropriate
professional. In some areas of the United States, case managers may be referred to as
discharge planners

2. FUNCTIONAL METHOD
 The functional nursing method focuses on the jobs to be completed (e.g., bed making,
temperature measurement).
 In this task-oriented approach, personnel with less preparation than the professional
nurse perform less complex care requirements Clearly defined job descriptions,
procedures, policies, and lines of communication are required.
 The functional approach to nursing is economical and efficient and permits centralized
direction and control. Its disadvantages are fragmentation of care and the possibility

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 that no quantifiable aspects of care, such as meeting the client's emotional needs, may
be overlooked.

3. TEAM NURSING
 Team nursing is the delivery of individualized nursing care to clients by a team led by a
professional nurse.
 consists of registered nurses, licensed practical nurses, and un- licensed assistive
personnel. This team is responsible for providing coordinated nursing care to a group of
clients.
 The registered nurse retains responsibility and authority for client care but delegates
appropriate tasks to the other team members.
 Proponents of this model believe the team approach increases the efficiency of the
registered nurse.
 Opponents state that inpatients' high acuity of illness leaves little to be delegated.

4. PRIMARY NURSING
 Primary nursing is a system in which one nurse is responsible for overseeing the total
care of a number of clients 24 hours a day, 7 days a week, even if he or she does not
deliver all the care personally. It is a method of providing comprehensive, individualized,
and consistent care.
 Primary nursing encompasses all aspects of the professional role, including teaching,
advocacy, decision making, and continuity of care. The primary nurse is the first-line
manager of the client's care with all its inherent accountabilities and responsibilities.
 Primary nursing uses the nurse's technical knowledge and management skills. The
primary nurse assesses and prioritizes each client's needs, identifies nursing diagnoses,
develops a plan of care with the client, and evaluates the effectiveness of care.
Associates provide some care, but the primary nurse coordinates it and communicates
information about the client's health to other nurses and other health professionals.

5. PATIENT-FOCUSED CARE,/Progressive Client Care

 Patient-focused care is a delivery model that brings all services and care providers to the
clients.
 The supposition is that if activities normally provided by auxiliary personnel (e.g.,
physical therapy, respiratory therapy, ECG testing, and phlebotomy) are moved closer to
the client, the number of personnel involved and the number of steps involved to get
the work done are decreased.
 Cross-training, development of multiskilled workers who can perform tasks or functions
in more than one discipline, is an essential element of patient-focused care.

6. MANAGED CARE
 describes a health care system whose goals are to provide cost-effective, quality care
that focuses on decreased costs and improved outcomes for groups of clients.
 The care of a client is carefully planned from initial contact to the conclusion of the
specific health problem.
 health care providers and agencies collaborate to render the most appropriate, fiscally
responsible care possible.
 Managed care denotes an emphasis on cost controls, customer satisfaction, health
promotion, and preventive services

7. PRACTICE PARTNERSHIP/ SHARED GOVERNANCE

 is an organizational model in which nursing staff are cooperative with administrative
personnel in making, implementing, and evaluating client care policies.
 The focus of this model is to encourage participation of nurses in decision making at all
levels of the organization. Individuals may participate either at their own request or as
part of their job role criteria.
 More commonly, nurses participate through serving in decision-making groups, such as
committees and task forces. The decisions made may also address employment

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 conditions, cost-effectiveness, long-range planning, productivity, and wages and
benefits.
 The underlying principle of shared governance is that employees will be more
committed to the organizational goals if they have had input into planning and decision
making.

8. MODULAR NURSING
 Total client care and modular nursing are variations of primary nursing. Although these
systems imply that one nurse is responsible for all the care administered to a client,
responsibility for the client actually changes from shift to shift with the assigned
caregiver.
 This system uses both registered nurses and licensed practical nurses; the registered
nurses are assigned to more complex client situations. A unit manager or charge nurse
typically coordinates activities on the unit.
 Modular nursing attempts to assign caregivers to a small segment or “module” of a
nursing unit, ensuring that clients are cared for by the same personnel on a regular
basis.

9. DIFFERENTIATED PRACTICE
 Differentiated practice is a system in which the best possible use of nursing personnel is
based on their educational preparation and resultant skill sets.
 Thus, differentiated practice models consist of specific job descriptions for nurses
according to their education or training, for example, LVN, associate degree RN, BSN RN,
MSN RN, or APN.
 This enables nurses to progress and assume roles and responsibilities appropriate to
their level of experience, capability, and education.

Formula to Determine Staffing Patterns

 Full Time Equivalent (FTE)
 Forty-Hour Week Law, Republic act 5901, Forty Hour Week Law
o Standard Value for NCH
o Percentage (%) of Professional and Non-Professional (in ratio)
o Distribution per shift
o 40 hour/week
o 48 hour/week
Two Ways of Developing a Staffing Pattern
o Determine the # of nursing care hours needed/patient
o Generating the full time equivalents of an employee
o Determine the nurse-patient ratio in providing nursing care
FTE – measure of work committed of full time employee
1.0 FTE = works 5 days/week, 8 hours/day
0.5 FTE = part time employee who works 5 days/2 weeks

Guidelines for Determining the Nursing Personnel Needed

 Step 1. Determine type of hospital whether it is primary, secondary or tertiary.
 Step 2. Categorize patients according to levels of care
 Step 3. Find the NCH needed by patients per day and get the SUM.
 Step 4. Find the Total NCH x 365 days.
 Step 5. Find number of working hours per year.
 Step 6. Find the nursing personnel needed.
 Step 7. Categorize into Professional and Non-Professional.
 Step 8. Distribute by shifts.

JOB DESCRIPTION
 recruitment,
 placement and transfer,
 guidance and distribution,

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  evaluation of performance,
 reduction of conflict and frustration,
 avoidance of overlapping of duties,
 facilitating working relationships with outside bodies such as professional associations, and
 serving as basis for employees’ salary range.

CONCLUSION
 Staffing is the most vital asset with an organization, without which it cannot move ahead in the
competitive world. It can be equated with HR management as both have same sort of
objectives.
 Staffing is an open system approach. It is carried out within the enterprise but is also linked to
external environment.

Nurses are the heartbeat of health care

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