Hospital R (pseudo name) was assessed for the health of the human resources department. Particular focus was given to the human resources-related programs and processes within the organization. The assessment’s findings identified numerous areas requiring improvement. Some of the regions identified require urgent improvement measures to prevent or mitigate potential adverse events that might endanger patients’ safety. The most critical area that requires improvement is scheduling to ensure that nurses and doctors have reasonable schedules to reduce burnout. It was identified that nurses and doctors work for longer shifts than the recommended number of hours per shift. The other area requiring improvement is the compensation system and the employee improvement. The organization’s compensation and benefits system does not include total rewards, which could contribute to the high turnover and burnout, and there is no formal employee performance improvement plan for patient safety considering the increasing number of adverse situations regarding patient safety medication errors. The three areas are critical, as demonstrated in the next section of this paper.
Areas Requiring Improvement
Scheduling to Reduce Burnout
Burnout is considered a work-associated stress syndrome that is caused by chronic exposure to job-related stress (De Hert, 2020). Freudenberg first coined the term in the 1970s, and since then, it has become a widely studied concept due to its harmful and adverse impact on healthcare workers, patients, and healthcare organizations. Burnout comprises three main qualitative aspects. These include being emotionally exhausted, cynicism and depersonalization, and a decline in efficacy and accomplishment (De Hert, 2020). Although it occurs in different professionals, people working in the healthcare industry are at the highest risk of suffering from burnout. Burnout can have serious personal effects such as the onset of substance abuse, complicated relationships, and in some cases, suicidal thoughts (De Hert, 2020). The professional outcomes of burnout include reduced patient satisfaction, low quality of care, medication errors, and an increased risk of facing a malpractice lawsuit which could cause loss of employment or licensing and a high for the staff and the hospital cost due to litigation. Therefore, staying alert is essential in ensuring the well-being of the healthcare employee and patients.
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Existing evidence indicates that 3.7 percent of all inpatient episodes cause adverse events (De Hert, 2020). Besides, one in every twenty prescriptions given in the primary care settings has an error. These errors increase hospital bed days. There are multiple factors associated with burnout among healthcare professionals, and the most common one is prolonged work shifts. Nurses who work for shifts that exceed twelve hours have high burnout levels and are linked to increased dissatisfaction among patients. According to Stimfel et al. (2012), nurses who work for shifts that exceed ten hours are two and a half times likely to experience burnout than those who have shifted (Stimfel et al., 2012). Besides, they have a high level of job dissatisfaction, and their turnover intent is also increased.
In the healthcare organization assessed for the purposes of this assignment, doctors and nurses work for a shift of 13-14 hours six days a week. The situation is caused by many patients and a few healthcare employees due to a high turnover rate. Some of the surveyed employees indicated that most of their colleagues left because the hospital schedule does not allow them time to rest. Hence, they feel that the environment is not conducive. In addition, most of the surveyed workers indicated that they were dissatisfied with scheduling practices in the hospital. They were likely to turn over if they found an opportunity to work elsewhere.
Prolonged shifts negatively affect the well-being of healthcare professionals, especially nurses who are the most affected, and this can cause a costly turnover and adverse effects on patient care. (De Hert, 2020) recommended policies that regulate working hours for the nursing staff. Besides, the Human Resources Departments should promote workplace cultures that ensure days off and vacation for healthcare workers such as nurses, in particular, are respected. Also, nurses should be allowed to decline working overtime without retribution (Stimfel et al., 2012).
Compensation and Rewards System
The organization’s rewards system requires significant improvements to ensure that the organization attracts and retains employees and the best talent in the healthcare industry. An organization is established to effectively use different human and non-human resources to accomplish a particular objective or goal ( Mathis et al., 2016 ). One of the most critical resources is human beings. They are the most valuable assets that an organization can have to achieve a competitive advantage and realize its objectives. Therefore, it is essential for the management in the human resource department to ensure that they perform at their best so that the organization continues to exist.
One of the most important tools that organizations use to improve employee performance and productivity is a reward system ( Mathis et al., 2016 ). It is used to attract and retain employees. Besides, it helps motivate employees in their work. It aims to ensure that an organization is attracting and retaining suitable workers and encouraging a good relationship between the organization’s management and the employees ( Mathis et al., 2016 ). Besides, a rewards system promotes employee commitment and reduces tension and conflicts because it addresses all types of final returns and means for good relationships. Conflict is based on the idea that workers feel that their benefits are withheld hence the need for a compensation system to offer a suitable ground for ensuring equity and fairness at the workplace. The outcome of a rewards system is a challenging work environment and more productivity from employees.
A compensation system is linked to intrinsic and extrinsic aspects of an employee as long as it sufficiently offers compensation and rewards that improve the organization’s integrity, policies, processes, and practices to improve productivity ( Mathis et al., 2016 ). The focus of a reward and compensation plan is on the employee and the organization. A balanced and effective reward and compensation plan are essential for improved employee and organizational performance. Unfortunately, hospital R’s rewards and compensation system has failed to attract, maintain, and motivate its healthcare employees. Employees feel that the compensation is not competitive, and the few and rarely given rewards are usually in monetary terms only.
A reward system that does not manage to attract, maintain and motivate its employees is ineffective. Since Hospital R’s reward system has failed to achieve these three important aims, it would be appropriate to say that it is ineffective hence requires improvements. Although financial and other tangible rewards are needed because they promote extrinsic motivation, rewards that lead to more intrinsic motivation are needed. Therefore, it is vital to improving the hospital’s rewards system so that employees are motivated intrinsically and extrinsically and feel that they consider valuable assets.
Performance Management
Performance management is one of the organization’s HR processes that require improvement. Performance management refers to the continuous process of enhancing performance by establishing individual and group goals that match with organizational goals. It also involves planning performance in order to attain goals, progress evaluation, and skills and knowledge development. In performance management, workers and their managers or supervisors collaborate in planning, monitoring, and reviewing objectives. In Hospital R, performance reviews are only conducted on an annual basis. They happen towards the end of the year. Performance management is more than such reviews conducted once a year. It should be a continuous process involving identifying objectives, determining progress, and offering feedback and coaching continuously ( Smither & London, 2009 ). By doing so, employees are able to achieve their career goals. Regular feedback is essential in the hospital because it will help the management and supervision teams to identify and address practice issues quickly before they get out of hand and cause adverse outcomes, as well as ensure that all employees remain motivated and on the right path. In a healthcare organization such as Hospital R, performance management helps enhance care outcomes, guarantee the safety of patients, and improve efficiency. Besides, performance management helps minimize costs and liabilities in an organization and on healthcare employees.
In the past year, the hospital has experienced numerous events related to patient safety. Most of them entailed medication errors. Last year, the organization experienced an increase in the number of medication errors. This situation is a performance management issue that needs to be addressed. It is a priority area for the hospital because medication errors can lead to deaths in adverse events. The organization lacks some of the performance improvement activities required by regulatory bodies such as the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), to ensure patient safety. In the healthcare industry, effective performance improvement ought to pay attention to areas that involve the highest amount of risk, highest cost in terms of human beings and money, and areas that are vulnerable to problems. Therefore, it is vital to implement performance management improvement in the organization to ensure that all healthcare professionals align their performance with the organization’s mission, vision aims, and goals.
Initiatives, Goals, and Objectives to Address the Identified Areas
To address the issue of scheduling and burnout, the organization should recruit more doctors and nurses. The goal of the initiative is to achieve flexible scheduling hence reduced burnout among employees at Hospital R. The first objective towards achieving this goal is to develop fair work workloads for employees. According to De Hert (2020), the human resources department should ensure optimum staffing in order to reduce the amount of workload that employees receive. Employees in the organization have a high workload due to staff shortages. As a result, they are forced to work longer shifts. With adequate staffing, HR is able to distribute work and responsibilities fairly hence prevent or reduce burnout as well as enhance retention ( Stimpfel, 2012 ). Also, it is important for HR to communicate performance goals clearly every year and rework them at acceptable levels to align with the organization’s requirements.
After achieving adequate staffing to reduce workload, the next objective is to monitor schedules. Managers in the various departments within the organization should monitor scheduling to ensure an appropriate number of working hours and shifts. It is expected that through optimal staffing, scheduling will become flexible. Therefore, managers will be required to follow up scheduling to ensure that employees are not allocated long shifts. Managers should encourage open dialogue to schedule employees appropriately and provide them with some days off to relieve stress and rest. The other objective is to promote work/life balance by ensuring that employees have reasonable working hours and rotations so that they have adequate time for work and spending with their families and attend to other private matters.
Running periodic reports to ensure that there are no unused vacations will be necessary. It is vital to encourage workers to use their assigned vacation time ( Stimpfel, 2012 ). It contributes to burnout prevention and reduction and promotes employee satisfaction and engagement. Giving employees a mental health day can help them recover from work-related stress and improve their morale. This can have a significant positive impact on burnout and work-related stress. When employees feel that their managers support their well-being can eliminate the oppression of requesting some time off. Besides, giving them a small token such as a gift card to appreciate their efforts can have a positive impact on their mental well-being and performance.
The rewards system should be upgraded to a total rewards system. A total rewards system is different from the traditional rewards system because it goes beyond providing monetary rewards to employees. It involves offering monetary and essential, and developmental rewards to assist employees in realizing their career goals and at the same time contribute to the success of the organization ( SHRM, 2019 ). It is a strategy that implements compensation, benefits, and opportunities for individual development within a motivating workplace environment ( Schneier, 2017 ). The goal of implementing a total rewards system is to improve employee retention, satisfaction, and attraction of the best talent in the healthcare industry.
To design and execute a total rewards system, the organization would need an organization-wide approach to cause change. The first objective would be for HR to achieve buy-in from the executive for success in the implementation of a total rewards system, besides, including all the necessary decision-makers in the organization and employee representatives to make sure that the strategy is well-rounded and aligns with the needs of all the relevant stakeholders ( Greene, 2014 ). The other objective is to conduct an assessment of the present compensation and rewards system to determine its effectiveness of the system to achieve the hospital’s goals. Activities such as conducting a survey on employees to identify their perspectives about the existing rewards and compensation system and their perspectives about salaries, benefits, and professional development opportunities would be implemented. Besides, assessing the organization’s present policies and procedures is vital.
Another objective of the total rewards strategy is to identify different rewards to select the ones that would be the best and applicable for the hospital. In this objective, the team would determine what should be rewarded and the kind of rewards to be offered for the identified achievements (Maalderink, 2014) . In this system, pay rewards for goal attainment is not the only factor that is considered. The HR would be required to identify additional rewards such as flexibility in work schedule, professional and personal development rewards such as training that workers will be given because of meeting the set organizational goals and objectives. The next objective is to implement the designed total rewards system. Activities include communicating the new rewards system to workers. Also, managers and other individuals involved in decision-making are trained to how to determine accomplishments (SHRM, 2019) effectively. Also, employees are made aware of what they are expected to achieve to qualify for the rewards. The last objective is to measure the strategy’s effectiveness and the improvements made if they are required to achieve the goal of the total rewards system.
In addressing the annual performance management issue, we propose a performance improvement plan (PIP). A PIP is a tool that helps employees with performance-related problems a chance to succeed (SHRM, 2020). The plan can be used to address the issue to achieve particular work goals or change behaviors that affect performance negatively. It is a formal document that states recurring performance problems and the goals that workers should achieve within a specific time. The employee’s manager and the human resource are usually involved to go over the plan with the employee and address any questions that might arise.
The plan should be written by the employee’s manager and then presented to HR. Such plans have a deadline which in most cases lasts between 30 to 90 days. Also, it highlights the possible consequences of failing to meet the set goals and continued poor performance (Peter, 2009). The goal of this initiative is to improve employee performance and, in particular, reduce the number of medication errors and other practice-related issues. Through using a performance improvement plan, continuous feedback is promoted. However, the plan should be customized according to the employee. This would help ensure that the needs of each employee are adequately met. The main objective would be to develop a performance improvement plan document, introduce it to employees, and inform them of its purpose. Since employees tend to see a performance improvement plan as an initial step towards being fired, it is vital to inform them that the purpose of the document is to enhance their areas of weakness so that they perform better.
Strategic Actions Taken by the Organization
The strategic actions taken by the hospital include the implementation of an organization-wide pay increment in an effort to provide a competitive salary hence reduce turnover. The high turnover rate has had a negative impact on the organization’s performance since the nurse or doctor to patient ratio is extremely high. By providing a competitive compensation package, Hospital R hopes to attract and retain employees.
Expected Outcomes as a Result of the Proposed Intervention
The proposed plan to recruit more employees will reduce the workloads that result in longer shifts that contribute to burnout. Adequate staffing will help ensure that the organization has flexible scheduling. This is expected to improved employee performance, less burnout, and enhanced employee engagement and satisfaction. Besides, it will lead to reduced turnover across the organization. The proposed total rewards system will lead to reduced turnover since employee satisfaction and engagement will improve. Total rewards help motivate employees intrinsically and extrinsically. Both types of motivation are essential for the success of any organization. The strategy will also improve employee commitment. When employees are offered an opportunity for professional; and personal development, they feel that the organization cares about them, which is why it is investing in them. The result is better performance due to the knowledge and skills gained during training, mentorship, or coaching. The utilization of a performance improvement plan will lead to better employee performance due to more accountability (SHRM, 2019). Workers understand that they must meet the goals identified collaboratively or be subjected to discipline.
PIP also leads to a positive organizational culture because employees who invest a lot of effort in their work feel appreciated as they understand that each person has to work hard. Besides, struggling workers understand that their managers and HR will offer the support they require when they fall behind by giving feasible objectives and goals. It is essential to remember that the performance improvement plan is not used on employees with performance issues only. It can be used on employees who desire or are identified for higher positions in the organization and those who are suitable for another position. Improved employee performance in the organization means that the quality of care offered by the organization improves and patient safety is ensured. Clinical practices and behaviors such as failing to confirm a patient’s identity at the bedside are eliminated, leading to improved patient safety due to fewer medical or mediation errors. Outcomes can be varied, including employee’s general performance and identified skills gap, a likely employment action such as a transfer or termination.
References
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Maalderink, Y. (2014). Human resource management: Functions, applications, skill development . CreateSpace.
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Schneier, E. (2017). Total rewards communication handbook version 7 . Lulu.com.
SHRM. (2019, August 16). What are total rewards strategies? Can you give me some idea on how to develop a total rewards strategy? https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/totalrewardsstrategies.aspx
SHRM. (2020, February 19). How to establish a performance improvement plan . https://www.shrm.org/resourcesandtools/tools-and-samples/how-to-guides/pages/performanceimprovementplan.aspx
Smither, J. W., & London, M. (2009). Performance management: Putting research into action . John Wiley & Sons.
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