D OI: http://dx.doi.org/10.20534/EJEMS-17-2-37-41
Khaleifah Ahmed AlHefeiti, MBA Student, University of Fujairah, United Arab Emirates
Layla Murad Yousif, MBA Student, University of Fujairah, United Arab Emirates
Ali Mohamed Alkindi, MBA Student, University of Fujairah, United Arab Emirates
Nouf Sabir Alhammadi, MBA Student, University of Fujairah, United Arab Emirates
Fermin G. Castillo, Jr. (Post-Doc), Associate Professor, MBA Program University of Fujairah, United Arab Emirates Email: [email protected]
AI Hayat Hospital: The Challenges in Managing Hospital Administration
Abstract: Al Hayat Hospital is one of the early hospital in the GCC region. Its growth and development can be attributed to the hospital administrator's desire to become of the leader in healthcare services. Lead by example in compensation and benefits to health care professionals is their top priority in retaining and sustaining competitive staff.
Keywords: hospitals, recruitment, hospital administration, rewards, turnover.
1. Introduction
Al Hayat hospital is considered as the home of diverse team of worldwide recognized doctors in UAE. Since its
establishment in the year 1995, it grew over the years and now one of the famous hospital for its specialty in treatment of cardiology issues, cosmetic, orthopedic, and laparoscopic surgery, diabetics, neurology, sleep medicine, and 64 slice CT scan. The patients are treated with similar attention, ability, and esteem that could have been given to the family members of the doctors.
The hospital undergone series of transformation and leadership throughout its operations. The organization implements various HR policies that will enhance wellbeing and capability of their hospital personnel. Hospitals offer special kind of personalized services to customers and in order to deliver consistent high level quality services, they need reliable, expert, and committed employees to offer imperative and steady care of patients. When workers leave hospitals, it is only patients who suffer directly. There is also huge monetary cost associated with hiring new workers for hospitals. It has been evaluated that monetary cost of losing one nurse is around equal two times of the salary that nurse was earning. Hospitals tend to lose millions for any rise in the normal turnover rate of losing employees. These expenses are eventually added in the worker's salary, enlarge hiring and development expenses, and consequently loss
of patients specially in the countries where there exist strict conditions to main minimum number of nurses to patient ratios. Healthcare industry is run by skilled labor force and it relies heavily on the skills and ability of each and every member of hospital staff. The ability of hospital and medical institutes to find the right talent and later on keep it for longer period is important to run hospitals that offer consistent quality services to patients. There is a saying that actions speak louder than words and when it comes to service providers like hospitals there are talks about minimizing the worker's turnover but there have not been proper strategies devised to actually do something in that regard. As per recent study, around 82% of the services sector businesses have confirmed retention as important strategic choice but in actual only 52% of the service providers have real retention schemes. Healthcare sector has the third highest ratio when it comes of turnover rates of employees at 19% according Computer Data's 2015 survey of more than 28,000 corporations [1].
The presences of people with strong management and leadership attributes are essential for not only corporate triumph but also for the success of human resources in the corporation. It is the responsibility of the human resource professional to not only formulate the structures and procedures for employees' control actions and to also demonstrate leadership qualities and advance
programs to develop such skills in the management personnel in all departments of the company [2]. The time at which the importance of corporate development and ability to adapt is becoming stronger, leadership attributes and ground level management ofworkers have become important. If corporate is determined to bring in change the manner in which the business operations are conducted and controlled also need to be changed accordingly.
Corporate change is related to people and the development schemes that emphasis only on the structures and system are not going to be successful. For businesses to formulate culture focused on superior performance, the management personnel are required to be the individuals who show the path to other below them, guiding workers to attain triumph and sustainability in terms of development. It has also been confirmed through various studies that consent, assistance, and dedication of top management is important in order to implement any kind of change in the corporations [3].
2. Importance of Understanding the Workers for Better Management:
21st century has been blemished with corporate scandals like that of Enron and many others after it. If there has been any hesitation regarding the importance of people management in organization, they were put ofbed in the aftermath of financial crisis around the globe in 2008. There is clear indication that businesses have been controlled poorly with disturbing impact on the prosperity of the workers and the overall business environment. Organizations can be in the form of businesses, army, product or service delivery, educational institute, and so forth. All of these are run by people and it is these individuals who offer leadership skills, mentorship, and fol-lowership to every corporate. Individuals working in the top management in corporation form strategies to assist corporation attain their targeted end objectives. It is the employees who keep on evolving with time and come up with novel techniques to support businesses to develop and reach the heights of greatness. Therefore, it is important for the corporation's heads to understand the attitudes of the people working in the organizations in order to develop strategies to run the businesses in an effective manner [4] Even understanding of the importance of employees for the corporates, it is them who are most of the times neglected by the corporate while taking important decisions. When corporates attain their targets, it is mostly the top management who is appreciated for their roles in the achievement of those objectives but the people who actually performed on the ground to help
organizations attain that success are often neglected or in some cases singles out as culprits if corporate fails [5].
Reasons for High Turnover in Hospitals
It has been found out to be the normal practice of hospital sector that whenever they face issues related to sudden increase in turnover ratio, they tend to pick up the recruitment policy and by doing this ignore several other factors that could have led to that issue. These elements include internal issues like increasing workload, lack of direction, and less opportunities to develop which can result in worker's decision to leave the hospitals.
Perhaps one of main reasons why healthcare professionals leave their work is because the administrator don't know how to value their contributions. They are already saturated with the work plus the pressure to perform is expected for them to perform. Having a Hospital Administrator who understands their work is plus. According to various health sector experts, the internal issues are mostly responsible for high turnover ratios and management of hospitals should focus of these issues rather than re-evaluating the retention policy. Though the internal factors are important to recognize, external elements like information about the local employees' economy and health sector rivalry must be taken into account when addressing the turnover issue. For this reason, the best solution is to carry out comprehensive survey analysis to find out the real reasons for high turnover rate and that can also act standard for the other hospitals. The analysis can also help to understand the position of the hospital in the competitive market [6].
Another factor is employees' rights are not being heard by the management and they are not being protected. Aside from the fact that their working hours is shifting which is difficult if employee (s) are married. Mr. Ali address the issue by giving a short forum for every hospital unit to determine their concerns and issues surrounds their work schedule.
Impact of Replacing Workers in Hospitals:
A study carried out by Rainmaker consortium evaluated that expense ofreplacing inexpert employee and found that the cost is about half of that unskilled worker's yearly wage. Whereas for highly skilled and qualified employees, that cost is expected to be around three to five times of the yearly wages. So it can be easily stated that there exist huge monetary costs when companies decided to fill in positions in the organizations vacated after resign of employees. The behavior of repeatedly change in the worker can also have serious effects on the performance levels of other employees as most of the jobs in the health sector are interrelated. In order to deliver high quality services
on consistent basis, health sector institutes need stable, prolific, and reliable teams of health professionals. Even if a health service provider decides against hiring of the staff which has left and keep on running the daily operations with less staff members, the remaining staff will become over burden and demotivated and that can also have led to more loss of workers for hospitals [1].
In order to limit the damage control Mr. Ali ask the HR Director Mr. Abdullah to create a database of existing hospital staffs. Balanced Score Cards (BSC) and 360 degrees feedback are the suggested tools in identifying competency and proficiency of staffs.
3. Problems/Challenges/Opportunities
The robust nature of business environment keeping in mind the global economic and competitive landscape demands a basic reevaluation in terms of how businesses should manage employees working for them. No business anywhere in the world can become successful without giving enough attention to the people who actually make things happen for it. These employees have emotions, feelings, goals to achieve, and make their respective corporations to become successful but they demand to be handled in equal terms with respect to their peers. When employees feel unwanted by the management they tend to lose motivation and commitment to work and ultimately leave. Al Hayat Hospital in Abu Dhabi is currently facing issue with respect to high turnover ratio among the medical staff [7]. The sudden increase in employee turnover rate represents an opportunity to understand the underlying causes and reasons for workers to leave the hospital. The outcome will help as a standard not only for Al Hayat but other hospitals too in order to take precautionary measures and resolve issues that may have led to high turnover rate among medical staff.
Because of the nature and phasing of work in the Health care sector, Mr. Ali-Hospital Administrator decided to re-evaluate and re-examine the compensation and benefits of their hospital staff with immediate effect. Managing people in the organizations has become challenge for the top management of the company. special efforts are required to ensure that people in the organization are working under healthy working environment and there is no sense of anxiety among the workforce. As Al Hayat hospital is facing issues of high turnover and employee management in the hospital, the following strategies are recommended by Mr. Ali to solve the contemporary issues of the hospital.
Focus on Hiring Process
Mr. Ali-Hospital Administrator is a retired doctor and he is concentrating in the day to day operations of
the hospitals. He always track and monitor each patients because he believe that caring is sharing. His leadership style started to change over the years and he became more of leader by example. With his medical background helps him to oversee the whole operations of the hospital. Despite his age he constantly attending and participating to various seminars and workshops related to managing people and organization.
It all beings with the recruitment of the perfect individual for the right job in the organization. It is important for the management ofAl Hayat hospital to comprehend the job positions it requires in the hospital in the near future. Though, it is not possible to forecast every need of the hospital precisely, an employment prediction can assist the hospital management in appropriate planning for corporate development. After finalizing the job positions that are going to open in the near future in the hospital, the next step for management is to devise hiring plan that will entails highlighting duties, skills, important capabilities, and exact fit with the working environment. The management of the hospital should employ innovative techniques to target individuals ranging from social networking sites to other job hunting sites. It is also important to plan the interview session in such a manner that both parties can understand each other as much as possible [8].
Mr. Ali believe that hiring candidates with potentials are key ingredients in sustaining talents available in the job pool. He instructed Mr. Abdullah- HR Director to amend the hiring and recruitment process.
Training & Advancement
Workers are the most important resource of the organization and in case of hospitals, it is important that development of the medical staff is planned on frequent occasions. The management ofAl Hayat hospitals should employ the best worker's management tactics to highlight high achiever's workers and then devise training plans to maximize their potential output. These training plans also includes yearly training plan for compliance according to the agreed procedures in the hospital. The management of Al Hayat hospital can take support of the external experts in order to devise pin point training and development schemes for the staff members to reduce problems that have led to the high turnover in the hospital. An effective training and advancement scheme doesn't mean that the hospital management would need to invest huge amount of money. Rather, a well prepared and precisely plan training scheme can play an important part in the overall triumph of the hospital without having to spend huge lump sum [9].
Mr. Ali thinks local but act global therefore he wants only the best for his staffs. He invest in training and development of hospital staffs. His future plans includes international accreditation of Al Hayat Hospital with Joint Commission International (JCI).
Performance Administration
The evaluation of every individual performance is important to make sure that the team is reaching the set standards. It also permits for response, enable workers prospects to develop their skills and also tackle problems in the performance in case someone does not meet the set standards. In some organizations, the top management delay performance control till the yearly assessment of the workers. It is highly recommended to the management of Al Hayat hospital to plan performance management method that is spread over a year in which good performers are rewarded for their efforts and identify trouble makers in order to rectify the situation in time. The management of Al Hayat hospital should pre plan the forthcoming performance assessment criteria and also continuous control over staff' performance levels in order to find out the root cause of high turnover and distress among workers. If the problems are identified to be because of some trouble maker workers, then the management ofhospital can plan them on personal level development scheme and keep a close eye on their behaviors. If those bad performers do not improve themselves over a specific period, then it is in the best interest of the organization to remove those members from the hospital. Any extra delay in the corrective action can cause more distress among the other employee too which can be dangerous for the working environment of the hospital [10].
Mr. Ali thinks that employee must perform their best because patients deserve only the best care and attention. Therefore employee must adhere to that practice as a culture of change and innovation.
Evaluation ofWorker's Involvement
The best manner to have an idea about the mood of workers is to evaluate the level of gratification among them. Organizations plan out well-crafted questionnaire in which each and every important aspect of the organization's operations. However, the management of Al Hayat hospital should ask such feedbacks from their workers without stressing them to fill the survey with their own names. The idea is to understand the feel of the group rather than pin pointing those who feel dissatisfied. After receiving the feedback from workers, the next step for hospital management is to put the data in order in order to understand the positives and negatives and finally formulate a plan to tackle the dissatisfaction
workers. It is important to keep the motivation level among workers on high in order to help them focusing on their jobs while at the same time help the dissatisfied workers by resolving their issues [11].
Mr. Ali thinks about strategic plan for the hospital therefore the feedbacks of patients is highly needed. He wants to meet the department head of each units in order to identify key strengths and weakness of the hospital.
Rewards & Gratitude
Exhibiting the workers about their true value to the organization and highlighting the appreciation for their inputs in the hospital can help a great deal in enhancing the motivation and happiness level of the workers. Again it is not important to plan out huge amount of money for reward and recognition purpose. The management of the Al Hayat hospital should plan out these initiatives in a manner that give employees feeling that management do give importance to their input in the hospital. The appreciation can be in the form on gifts, birthday or wedding anniversary dinners, and other stuff like that [12].
Just like new born babies in the hospitals, Mr. Ali find time to thank hospital staffs for their utmost support and extra ordinary care in handling their work duty. As an incentive those birthday celebrant will be given an off during their birthday celebration.
It is very important to understand the needs and wants of the employees in order to give sustainable solutions and actions.
Inspire Kindness and Gratitude
The management of Al Hayat hospital should motivate caring behavior among workers. It can be done by giving employees prospect to interact with others by means of act of kindness and the manifestation of appreciation. By doing so, the staffwill respect each other more than before and there will be harmony and happiness among the workforce of the hospital. Workers should feel a sense of responsibility and ownership in the hospital in order to keep them with the hospital for long [13].
The leadership style of Mr. Ali started to evolve over the years, as a result he became more of a mentor rather than disciplinarian. He would like to establish a culture of camaraderie inside the hospital despite the nature of the work which is fast phasing.
Propose Suppleness in Jobs
According to [14] "In the today's robust business market, employee prefer to have a balance between their personal and work life. It has also been approved by the surveys conducted by some reliable organizations that the chances to retain worker's become high for any organization that offer its workforce flexibility in terms ofjob".
Certain degree of flexibility is needed in the hospital administration therefore Mr. Ali is open to new suggestions without sacrificing the patient's welfare and health. Mr. Ali think that culture plays important role in the success and failure of any organization. In the end, Mr. Ali listens to staffs in order to work on things for improvement and development.
Case Questions:
1. What type of leadership style does Mr. Ali possess? How will you assess his leadership style in managing the Al Hayat Hospital?
2. How will you rate his leadership style from 1-10 (low to high)? If you are Mr. Ali, identify top three (3) priorities in the aspect of HR?
Note: This case was written solely for the purpose of class discussion and decision making. It was not designed to illustrate neither correct nor incorrect handling of Management problems. Names, figures, and places have been disguised, some details modified/improved. No portion of this paper will be reproduced without written consent from the author/publisher.
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