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Are patients suffering because of hospitals’ poor staff management?

As previously mentioned, a National Forum on Safety and Quality in Healthcare is underway in Canberra this week, and Croakey is running a series of posts from various presenters.

One of the topics being discussed is whether improving human resources management at hospitals might help improve outcomes for patients.

Dr Keith Townsend, a Senior Research Fellow in the Centre for Research on Work, Organisation and Wellbeing at Griffith University’s Business School, writes:

Approximately 70% of an average hospital’s budget is spent on its people: the doctors, nurses, allied health professionals, administrators, managers and support staff that keep the place running.

However, hospitals are a long way behind the game when it comes to implementing human resource management (HRM) initiatives and high-performing work systems that go beyond the basics to deliver good outcomes.

It’s a basic premise in HR theory that if you look after your people they will perform better, and studies in various sectors such as manufacturing and construction have proved this to be true. Much debate comes down to ‘how’ managers should best look after their people.

However, it is generally agreed that the approach used in attracting, selecting, recruiting and appointing staff to make sure you create the right skill mix and level of competency within your work group will impact on the success of the organisation.

It also means staff need access to excellent training and development opportunities and, most importantly, that they have support for any challenges they might face in their professional journey.

As a researcher in high-performing workplaces, I have to say this is often not the case in our overly bureaucratic health system, where HRM operates a long way behind business school models of best practice.

What we don’t know yet is how this HRM lag might impact on clinical outcomes. While there are many exceptional people working very hard in healthcare, would improved HRM improve outcomes for staff and patients? And if so, how long would it take from the HR policy change before we see measurable improvements to the staff and patient experience?

HRM systems are one of the criteria considered in the system of accreditation for Australian healthcare organisations, overseen by the principal independent authority on the measurement and implementation of quality improvement systems, the Australian Council on Healthcare Standards (ACHS).

Through a research project funded by ACHS I have been investigating whether HRM systems have a positive impact on accreditation results across the continuum of patient care.

In the analysis of accreditation, we are looking at the management systems, the HRM systems, the information systems, safe work practices and the continuum of patient care system.

This continuum includes: access to the system of care prior to clinical need, delivery of competent professional care, a system of planned care, evaluation by healthcare providers and finally discharge from the system.

What we have found is that the most important system when it comes to influencing the continuum of care for patients is the management system. This makes perfect sense – what starts at the top, filters throughout the organisation.

Good management leads to good results. Once the management system is in place and provides adequate resources to the HR department, Human Resources are the next system influencing continuum of care.

Good managers within hospitals already know the importance of professional HR management systems and some are already investing in the key areas of attracting, selecting, recruiting and training staff to deliver their product – high quality, safe healthcare.

It’s now up to the rest to follow.

***

For the previous posts in this series of articles from the forum (which is hosted by the Australian Council on Healthcare Standards, ACT Health and the Australian Commission on Safety and Quality in Healthcare):

Brenda Ainsworth
http://blogs.crikey.com.au/croakey/2010/10/22/kicking-off-a-series-on-safety-and-quality-in-health-care/

• Jeffrey Braithwaite
http://blogs.crikey.com.au/croakey/2010/10/25/how-health-care-can-learn-from-disasters-like-chernobyl/

Stephanie Newell
http://blogs.crikey.com.au/croakey/2010/10/26/listen-to-patients-and-improve-the-safety-of-health-care/

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