Human Resource Management of St. Lukes Medical Center - Case Study Example

 Human Resource Management Report: St. Luke’s Medical Center Table of Contents Abstract……………………………………………………………………………………. 3 Introduction……………………………………………………………………………….. 4 Industry Overview………………………………………………………………………… 5 Company Background…………………………………………………………………….. 5 Leadership………………………………………………………………………………… 7 Vision, Mission and Values………………………………………………………………. 7 HRM Case………………………………………………………………………………… 9 Problem……………………………………………………………………………………. 9 Case Background…………………………………………………………………………. 10 Alternative Courses of Action……………………………………………………………...11 Analysis of the Options…………………………………………………………………….11 Recommendation…………………………………………………………………………..14 Conclusion…………………………………………………………………………………15 Reference List……………………………………………………………………………...18 Abstract The human resources management case report is written to address the following objectives, to wit: (1) ) to identify some HR situation which appears to be amenable to analysis using the course material wherein the situation must be sufficiently complex to generate enough material for the writing of a case which meets the indicated specifications; (2) to consider the concepts and general ideas discussed in class, and see which help make sense of the situation being described; (3) to engage in research activity which allows you to test the relevance of the different through the accumulation of relevant information and data; and (4) to write up the report in a way which relates evidence to theory, to provide an appropriate analysis and explanation of the situation described. The case of St. Luke’s Medical Center is hereby proffered to comply with the abovementioned requirements. Human Resource Management Report: St. Luke’s Medical Center Introduction People constitute an organization’s most important and vital factor in its success or failure. In order to function efficiently and effectively, people must be managed well. Human resources management is the art and science of dealing with people at work for the optimum achievement of individual, organization and society’s goals. While general management is the orchestration of all the resources, human resource management is limited to people management – their motivation, acquisition, maintenance and development. Human resources management solely involves man. Through and by men, the other m’s are acquired and utilized. The quality and utilization of the rest of the resources are almost always affected by decisions about and by human resources. Indeed, the accomplishment of the goals of an organization depends upon the availability and utilization of all these ingredients, the interaction of which, are people-caused. Due to the intricate and diverse characteristics, personalities, values, and preferences of people in the organization, it is only natural that problems on human behavior in organization exist. In this regard, this case report is written to address the following objectives, to wit: (1) ) to identify some HR situation which appears to be amenable to analysis using the course material wherein the situation must be sufficiently complex to generate enough material for the writing of a case which meets the indicated specifications; (2) to consider the concepts and general ideas discussed in class, and see which help make sense of the situation being described; (3) to engage in research activity which allows you to test the relevance of the different through the accumulation of relevant information and data; and (4) to write up the report in a way which relates evidence to theory, to provide an appropriate analysis and explanation of the situation described. The case of St. Luke’s Medical Center is hereby proffered to comply with the abovementioned requirements. One of the most innovative organizations in Asia is St. Luke’s Medical Center in the Philippines. It is the number one hospital in the Philippines but its vision is to be one of the top five medical institutions in Asia by 2010. The mission of St. Luke’s Medical Center is to improve the delivery of quality health care conforming to the strict standards of the Joint Accreditation Commission of Health Organizations (JACHO). In this regard, management is devising strategies to make innovations on its administrative structure as well as diversify its operations in a new and larger location to expand its clientele. Industry Overview According to an article published by DLSU – Manila, the thrust of the health care industry in the Philippines is to position itself as a medical tourism site inviting guests and patients from other neighboring countries to avail of the best health care service Philippine medical institutions accord. As such, the article averred that “the Philippines is positioning itself as a medical tourism site where people from developed nations can go to avail of high quality medical and health care services. The emerging Philippine medical tourism industry is projected to be successful considering the length of medical education of local physicians, the fluency in the English language of majority of the personnel, the state-of-the-art health care facilities, and the wide array of diverse and exotic travel and recreational destinations.” (DLSU – Manila, 1) Company Background St. Luke's Medical Center (SLMC) is located in the Philippines and has provided high-quality healthcare for over a century. Founded in 1903, its mission is to provide outstanding out-patient care. Today it is the foremost and most admired hospital in the Philippines and an acknowledged leader in Asia. (SLMC: About Us, 2010, par. 1) The following excerpts detail the company’s relevant information which makes it one of the top health care institutions in the country and in Asia: ”St. Luke's delivers on its mission of healing by gathering under one roof the finest medical expertise, the most sophisticated medical technology and facilities, and a deep-rooted culture of compassion. It supports this mission with research and continuing education for those who serve. The total dedication to quality and caring of the St. Luke's family is what distinguishes the hospital as a center of healthcare excellence in Asia. The 650-bed hospital is home to nine Institutes, 13 Departments, and 19 centers. These centers of excellence bring to the Philippines the latest medical advances and treatment modalities. Over 1,700 hospital-affiliated medical consultants see out-patients in more than 450 private clinics. SLMC is the undisputed leader in virtually all medical specialties, including cardiovascular medicine, neurology and neurosurgery, cancer, ophthalmology, and digestive and liver diseases. It is the first choice of medical and health-related practitioners and patients for executive check-ups. SLMC receives patients from around Asia, Micronesia, the Middle East, Europe and the United States. With its rich legacy of excellence and with plans in place to build a second new and modern facility at the Fort Bonifacio Global City, SLMC is in a position to realize a bolder vision of the institution as one of the top five hospitals in Asia by 2010.” Leadership Established in 1975 as an important part of the reorganization of St. Luke's into a non-stock not-for-profit charitable corporation, the board provides overall leadership and direction for the organization. It is responsible for all professional and policy issues that arise in the course of managing the hospital. Members of the board are nominated and chosen on the basis of what they can contribute in terms of resources, talent or wisdom. They are all volunteers who do not receive nor seek remuneration, perks, or privilege. Since 2005, a Board of Advisers composed of some of the best and brightest in the world of business and medicine in the United States and in the Philippines has provided counsel and guidance to the Board of Trustees. (SLMC: Leadership, 2010, par.1) The hospital is being managed by the President and Chief Executive Officer, Mr. Jose F.G. Ledesma, who has taken the helm since 1986, when he was initially appointed as Executive Director. He became the chief honcho ten years after and has since then, steered the institution in the course that spells excellence in the delivery of health care. Vision, Mission and Values According to the Official Website of SLMC (2010, pars. 1 & 2), the vision and mission of the hospital are indicated as follows: “VISION: St. Luke's Medical Center will be one of the Top 5 medical institutions in Asia by Year 2010. MISSION: To deliver excellent healthcare through caring and highly competent professionals, utilizing world-class technology and research. This we shall do in the most financially viable way without losing sight of our primary purpose - to be of service to God and mankind.” Further, SLMC adheres to six corporate values which they consistently uphold: (1) social responsibility; (2) passion for excellence; (3) innovation; (4) customer focus; (5) expertise; and (6) teamwork. By social responsibility, SLMC acknowledges the importance of social service, community health and environmental safety. Their passion for excellence is exemplified in all services rendered to the customers conforming to the standards required by the Joint Commission International and with the efforts focused on achieving their mission and vision of being one to the top 5 medical institutions in Asia by the year 2010. The value of innovation is management’s drive and commitment to discover new ways to deliver efficient and effective health care. This is done by encouraging new ideas in every aspect of patient care. Customer focus is addressed by giving priority to patient care. Regular feedback is solicited by SLMC from customers through customer satisfaction surveys which would solicit response to the delivery of health care. The Customer Services Department is always ready to assist customers in times of complaints or concerns which need to be immediately resolved. To sustain leadership in the delivery of healthcare, SLMC is aware that each and every personnel, medical staff, administrative team and management, exercise expertise and professionalism in the execution of their responsibilities. Finally, by working as a team, SLMC cares and treats each and every individual with respect. They encourage open communication to ensure active participation and immediate response in areas which require decision and appropriate action. The mission of St. Luke’s Medical Center is to improve the delivery of quality health care conforming to the strict standards of the Joint Commission International (JCI). St. Luke's is the first and only hospital in the Philippines and the second in Asia to get accreditation in 2003. (SLMC 2010) HRM Case Problem The mission of St. Luke’s Medical Center is to improve the delivery of quality health care conforming to the strict standards of the Joint Accreditation Commission of Health Organizations (JACHO, 2008). It came to the attention of the Vice President for Nursing that their Nurse Managers are torn between prioritizing functions which are administrative in nature vis-à-vis functions that cater to the delivery of patient care. Due to the Nurse Managers’ theoretical orientation for health care, the administrative tasks such as completion of reportorial requirements, monitoring and upkeep of equipment and supplies, staff requirements and budgeting are frequently neglected or seconded with priorities being focused to patient care. However, completion of reports is likewise critical to ensure that all aspects of the nursing operations, including accomplishments of responsibilities, monitoring to medical equipment and supplies, replenishment of medications, monitoring of emergency cart, among others, are also being properly and appropriately undertaken. Without reports being completed on time, Department Managers of Nursing Units would not be apprised of activities and tasks that need to be immediately addressed. The administrative responsibilities of the nurses coupled with their desire to focus on the delivery of patient care create confusion, discomfort, and problems in terms of prioritizing tasks to meet deadlines in reports and to ensure that no medication errors occur. In addition, the customer service department of SLMC encourages patients to give feedback through customer satisfaction surveys to determine the efficiency of nurses in the delivery of health care services. In this regard, the VP for Nursing sought the assistance of the VP for Human Resources and the CEO to resolve this issue. Case Background Every nursing unit in the hospital is headed by a nurse manager who is assigned as the chief head nurse on duty. Her job responsibilities entail patient care as the primary task and managerial functions such as planning, directing, staffing and control. These multi-task functions coupled with low pay contributed to low morale and low productivity. These nurses opted to gain the minimum experience required to enable them to leave the country and work abroad. The leadership function assigned to nurse managers conflict with their functions as providers of patient care. They are expected to deliver timely reports on a daily, weekly and monthly basis. They monitor staffing requirements. They prepare the time sheets for payroll purposes. And most importantly, they are expected to know all the nursing intervention requirements for all the patients are their nursing units. There is this question on prioritization of function. As nurses, of course, they should prioritize patient care. But as managers, the function of attending to the human resource needs of the unit suffers. Reports are not completed on their specified time schedules. Upkeep of facilities in patients’ rooms and hospital areas are not regularly attended to. Equipments that need repair and reorder are forgotten. Staff vacation leaves are not properly plotted and thereby not taken as scheduled. Performance evaluation and appraisals are not conducted regularly for monitoring purposes. All of these functions are important managerial functions which would create an improvement in productivity and morale of a hospital unit. All of these should be attended to ensure customer satisfaction and efficient delivery of health service. Alternative Courses of Action Given the facts of the case and the priorities that need to be resolved, the alternative courses of action open for management to solve this problem as detailed below. The officers and top management of the hospital were aware that there were several options open to them, among which are: 1. Status quo, meaning, do nothing and retain the present set-up. 2. Separate the patient care and managerial function from the nurse managers by either assigning the administrative functions to internal personnel or hire new managers for the position. Analysis of the Options The first option, status quo, would ensure that nothing is disrupted in the current system. However, doing so would pose the following disadvantages: (1) the set-up would eventually create tremendous back-logs in reports to significantly affect the future operations of nursing units; (2) it would eventually demotivate nurse managers who could not comply with the completion of the required reports and at the same time, ensure the high quality delivery of patient care; and (3) poor performance in nurse units due to back logs, poor inventory of medical and office supplies, as well as the upkeep of equipment and facilities could possible lead to poor feedback from customers. Option 2 is a much viable alternative – separating patient care and managerial function. Implementing this option requires either hiring new personnel to do the administrative tasks or assigning other internal personnel to accomplish the required responsibilities. The advantage of this option is that the nurses would be completely focused on patient care and the high quality delivery of health care services. The disadvantage would be possible apprehension and fear for those who would assume the administrative and managerial responsibilities. This option could possible be met with resistance and complaints especially from the nurse managers who perceived the new position as a threat to their existence. They feared that they would eventually lose their “managerial” position and revert to a “staff” position since they would be relieved of the managerial functions and concentrate on patient care. In this regard, department managers of the nursing units were tasked to design motivational incentives to increase morale and productivity during the transition stage. One of the most famous theories was Maslow’s Hierarchy of Needs who averred that man’s needs fall into a hierarchy of relative prepotency. A need ceases to be potent when it is met and man strives to satisfy the next rung of needs – from physiological, safety and security, social, esteem and self-actualization. (Maslow, 1970). People have a variety of needs; and needs manifest themselves in many forms. Abraham H. Maslow placed human needs in a hierarchy of relative prepotency. This scheme is used by managers depending on diverse factors affecting needs satisfaction. The need hierarchies can differ between cultures and indeed among individuals within the same culture should not be overlooked by a manager. The value of Maslow’s theory to the manager, whether he is an American, Filipino, Japanese or German executive and whenever he or she manages people, lies in the insight that the concept of marginal utility applies also to human needs. Human needs are not absolute. The more one need is satisfied, the less it satisfaction matters. As the need for economic rewards becomes satisfied, it becomes less satisfying to obtain more of the same. This implies that at some point, the provision of additional rewards for the satisfaction of one particular need, regardless of hierarchical configuration, may no longer bring about corresponding increases in productivity. Thus, for individuals who are already receiving substantial financial rewards, an increase in pay may no longer be motivating. What they may need are challenging work, growth, responsibility, and/or autonomy, among others. The presence of motivators leads to high levels of satisfaction, but their absence puts workers only to a neutral state. Looking at the hygiene factors (job context, extrinsic factors and dissatisfiers); on the other hand, their absence leads workers to high levels of dissatisfaction while their presence generally brings employees only to a neutral state. For example, employers should ensure that their organizations have clear and explicitly stated company policies and procedures. The absence of this would lead to chaos and dissatisfaction due to the conflicts that are possible to arise. On the other hand, the presence of company policies are not seen as motivators since they are assumed to be pertinent to the organization – and thereby; only brings the employees to a neutral state. From a managerial standpoint, the distinction between hygiene and motivation factors is a significant one. Thus, managers should focus their attention on hygiene factors if they aim to prevent dissatisfaction. However, if they want to motivate employees, they should concentrate instead on the motivator (job content, intrinsic factors and satisfiers). Managers must thereby use recognition, achievement, responsibility, advancement and growth as motivational factors to improve the level of discretionary effort. The employees would intrinsically be prompted to increase their production and efficiency when they are duly recognized and given higher levels of promotion for jobs well done. To motivate employees, managers can use job enrichment techniques. It means making the job challenging and meaningful. As Herzberg (1981, 226) enumerated, the following techniques can assist managers in motivating employees to elicit discretionary efforts: By removing some controls while retaining accountability, the department managers of SLMC must motivate their employees through responsibility and personal advancement. By increasing the accountability of the individuals for their own work, managers should give responsibility and recognition. Giving a person a complete nature unit of work entails responsibility, achievement and recognition. Introducing new and more difficult tasks not previously handled by employees is tantamount to growth and learning. Finally, by assigning workers specific or specialized tasks which enable them to become experts on their field or line of process entails responsibility, growth and advancement. (Herzberg , 1981, 226) A very significant factor in the efficient performance and retention of workers is their motivation and strength. Management should be aware of and recognize people’s motives in order to guide, lead and direct them appropriately. The dynamics of behavior is indeed a very challenging area to unravel and, if properly handled, assists in morale building and development among employees and which, in turn, results in job satisfaction and high productivity. Thus, the strategy to hire non-nurse unit managers to take over administrative and managerial tasks paved the way to increase morale and productivity in the nursing units, and increased patients’ satisfaction with regard to the delivery of efficient and effective healthcare. Recommendation The officers, members of the board of directors, and the CEO of the hospital deemed it appropriate to hire non nurse unit managers who possess graduate degrees in business, to head the different nursing units. These unit managers have the sole responsibilities of ensuring compliance to reportorial requirements, human resources issues, facilities and equipment, budgeting, and other aspects of the units’ operations – except patient care. Top management assured nurse managers that this strategic move would enable them to focus on their primary concern as nurses and at the same time, take additional training courses to improve their nursing skills. Management developed another career path open to them which would eventually make them capable of becoming department managers and maybe, eventually, vice presidents for nursing. Conclusion Every organization exists to achieve a purpose. In order to attain organizational goals, a set of policies and strategies are defined and developed by management. As averred by Christensen, Andrews, & Bower (1978: 3), policy is “the study of the functions and responsibilities of senior management, the crucial problems that affect success in the total enterprise, and the decisions that determine the direction of the organization and shape its function”. Policies and strategic management are responsibilities of the chief executive officer (CEO). A major task under these responsibilities is corporate governance which is simply defined as “controlling, restraining and directing the making and administration of these policies” (Webster 1997: 327). Any leadership approach involving top management entails a form of governance. An important ingredient in boosting the morale of the individual worker and in improving productivity is motivation. This very elusive dimension propels people to think, feel, and act in certain ways. Motivation is predicated mostly on his values and needs. An effective manager endeavors to know and understand the motivation of his constituents and uses such knowledge to help them meet their needs and improve their productivity. Since motivation carries a lot of culture underpinnings, the manager should be able to apply any theory of motivation in the light of cultural diversity in the workforce. It is possible to become entrapped in the intricacies of human behavior and it is easy to go astray in a maze of theories. Furthermore, since there are no complete theories of motivation and there is no one theory on which all managers and workers agree, an efficient manager must be able to apply relevant theories depending on the traits, characteristics, values and behavior of their employees. To the manager, motivating people is perhaps the highest challenge. His task is to motivate employees towards excellent performance, not once, not usually, but at all times. In the end, both management and personnel must work together towards the achievement of personal and organizational goals In resolving issues pertaining to management changes, it is pertinent that problems are properly and accurately identified. Leaders are assigned and employed to do their tasks. Systems are installed to implement the necessary changes. However, when a gap still exists between knowing and implementing the solution, the top honcho should take the helm and assume responsibility in decision making. As timely recommended by O’Neil (2008), the leaders should create and head the teams to solve the problems. It should be a direct application experience. Leaders should not be wary or afraid to get their hands dirty for the sake of saving lives. By being part of the action team, only then can these leaders be assured that the solutions carefully drawn and crafted are efficiently and effectively implemented. As presented, it can be deduced that it takes an effective collaboration of all factors to ensure the success of an organization, like SLMC, in the achievement of their well defined goals. When the leaders, systems, and strategies are truly effective, the institution is transformed. Work becomes exciting and fun. Learning and competence are highly valued. Leaders lead by example and the values they hold are seen in their actions. The values are lived by leaders in the ordinary day-to-day interactions with the followers. There is a shared vision. This vision is to the best in their field. With all the innovative human resources strategies being continuously employed by St. Luke’s Medical Center, it future appears bright and optimistic. Their vision of being included among the top five medical institutions in Asia by 2010 would very soon culminate to reality. Reference List Christensen, C.R., Andrews, K.R., & Bower, J.L. ,1978. Business Policy: Texts and cases. Richard D. Irwin, Inc. Homewood, Illinois. DLSU – Manila, 2009. Health.[Online] Available at: http://pinas.dlsu.edu.ph/gov/health.html. [Accessed 27 July 2010]. Herzberg, F, 1981, “One More Time: How You Motivate Employees?” in Nestor N. Pilar & Rafael A. Rodriguez, (eds.), Readings in Human Behavior in Organizations, JMC Press, Inc. Quezon City. Martires, C.R. & Fule, G.S., 2000. Management of Human Behavior in Organizations. National Bookstore. Philippines. Maslow, AH, 1970, Motivation and Personality, Harper and Row Publisher, New York. O’Neil, M. , 2008. Human resource leadership: the key to improved results in health. Human Resource for Health, [Online] Available at: http://www.human-resources-health.com/content/6/1/10. [Accessed 27 July 2010]. St. Luke’s Medical Center (SLMC), 2010. One of the World’s Best. [Online] Available at: http://www.stluke.com.ph/index.php?page=parent&pageID=10&parentID=10. [Accessed 27 July 2010]. The Joint Commission 2008 Requirements Related to the Provision of Culturally and Linguistically Appropriate Health Care, April 2008, [Online] Available at: http://www.jointcommission.org/NR/rdonlyres/6941959E-D4BE-48D7-A2F8-A4834E84B263/0/JC_Standards_D... · Cached page · PDF file. [Accessed 27 July 2010]. The Merriam-Webster. (1997). Definition of Governance. Merriam-Webster, Incorporated. Springfield, Massachusetts, USA. p. 327. Read More