New HR Tactics For New Challenges

Increasing rates of attrition are compelling HR departments in hospitals to rethink their strategies. Rita Dutta reports

It was an entertaining and competitive evening with scintillating dancing and singing competitions and games at the Mumbai-based Dr LH Hiranandani Hospital. Winners were gifted with TVs, DVD players, microwave ovens and so on. Surprised?

It was a part of the well-crafted HR strategy to scale up the happiness and satisfaction quotient of employees. Whether it is cheering employees by celebrating their birthdays, weekend cricket, creating a sense of empowerment by making them stakeholders, weaving a cocoon of safety and security, extending medical benefits after superannuation, or emphasising training and development, the Human Resource Developments (HRD) in major hospitals are rolling out innovative plans to woo employees.

Dynamics Are Changing

Having weekend cricket with employees is an HR strategy at Dr LH Hiranandani Hospital

Why this sudden awakening of hospital HRDs? The change is fuelled by an attrition rate of 15 to 20 per cent in hospital administrators and managers in the last six months, a result of the burgeoning USD 23 billion Indian healthcare industry, growing at an annual rate of 13 per cent. New hospitals in Mumbai, Delhi and Bangalore are poaching employees from established hospitals by upping their salaries by 30 to 40 percent, say analysts. (See box for an estimate of salary hike in new hospitals)

Gone are the days when an employee stuck to an organisation for decades together working for a modest salary. While a few years back, a fresher with MHA received a salary of Rs 12,000 to Rs 15,000, today he commands a salary of Rs 20,000 in corporate or upcoming hospitals. A manager with three years experience, who used to earlier receive Rs 35,000 to Rs 40,000, today pockets Rs one lakh and above, say unofficial estimates.

"An opportunity for better career growth, stagnation and lack of job enrichment at the present organisation are also driving employees to new hospitals" - Ankush Gupta, Senior Manager, HR and Administration, Hiranandani Hospital

It is not just swelling of the wallet that is drawing employees in droves to new ventures. Says Ankush Gupta, Senior Manager, HR and Administration, Hiranandani Hospital, “An opportunity for better career growth, stagnation and lack of job enrichment at the present organisation are also driving employees to new hospitals.”

The flip side of the boom is faced by the hospitals losing thier top guns. In the last six months, Hiranandani Hospital lost eight key people, while Wockhardt Hospitals, Mumbai and PD Hinduja Hospital, Mumbai lost eight and four people, respectively to the upcoming hospitals. Rockland Hospitals, Delhi has lost four key people. The sudden exits sometimes have HRDs at their wit’s end scouting for immediate replacements within 24 to 48 hours. “I had to replace my materials manager within 24 hours. Sometimes, it becomes quite challenging,” says a harried Gupta. Coping with the crisis has made most hospitals realise that their HR policies needs to be better defined. Opines Gurushant Phatate, General Manager, HRD, Jaslok Hospital, Mumbai, who worked in the steel industry earlier, “Hospital HR is definitely less well-defined when compared to other industries.”

And why is it sketchy? S Patnaik, Senior General Manager, HR, Apollo Indraprastha Hospital, New Delhi explains, “Hospitals have always accorded more importance to doctors than their internal customers—administrators, nurses or ward boys. Hence, HR for other employees never took concrete shape, until recently.” Additionally, there is lack of trained HR personnel in healthcare. “Most of the HR personnel in healthcare come from the FMCG and pharma sector, without any training in hospitals and thus fail to address the finer nuances,” avers Dr Alok Roy, Vice President, Operations, Fortis Hospital, Noida.

Where The Problem Lies

It’s only a handful of hospitals which chart out a career graph for their employees while recruiting them, convey the group’s vision, train them or take steps to appreciate their work. Asian Heart Institute (AHI) learnt the importance of communicating with its employees the hard way. A host of people left the organisation in its first year of operations. Dr Bhaskar Shah, Director, AHI reveals, “Employees were unsure of their growth and future in the organisation as we did not clearly define our group’s vision to them. But, now we have learnt from our mistake. We hold regular training sessions with employees.”

According to Tufan Ghosh, CEO, Columbia Asia Hospital, Bangalore, “HR in hospitals is hierarchy-driven, which does not necessarily translate into career growth. There is no unified chain of command as the medical and the administration departments are mostly at loggerheads, preventing one from taking the right decision.” He feels that the recruitment process in hospitals is heavily skewed towards people with the right technical knowledge than those with the right behavioural approach.

"Hospital HR is definitely less well-defined when compared to other industries" - Gurushant Phatate, General Manager, HRD, Jaslok Hospital

Different hospitals are beset with different HR problems. Mumbai-based Jaslok Hospital, like many other hospitals, has to cope with high degree of absenteeism and indebtedness in class III and class IV employees. Every year, around 30 people are suspended from Jaslok Hospital because of absenteeism. This is after they are served innumerable warnings and show cause notices. “We also have a hard time trying to pay cheques of people with high debts,” says a distressed Phatate. To avoid such problems, most hospitals have started outsourcing Class IV staff.

Unions Matter

The dynamics of hospital HR are different in a unionised hospital, which often prevents the authorities from taking immediate and stringent punitive measure against an errant employee. For instance, when an employee was found to be inebriated during duty in a major Mumbai hospital, the hospital authorities could not take any immediate action against him. Only after the enquiry committee filed its report after one and a half years, the employee was suspended for three days. “Does such punishment hold any meaning?” asks an HR person.

Lack of proper appraisal system can also lead to disgruntled employees and thus poor performance. Most unionised hospitals do not have performance-based appraisal, except for managers. The yearly hike is decided during the time of appointment, which is a demotivating factor.

According to Dr SK Biswas, VP, Duncan Group, Kolkata, “Often employees grudge the hikes given to them, without knowing the dynamics behind that hike. A hospital needs to explain its Key Result Areas (KRAs) to the employees, monitor their progress during the course of the financial year and then make them understand why a particular salary hike was given. This is the KRA for the HR Department of a well-administered hospital.” The concept of ‘Balanced Score Card Approach’, a management tool introduced by Kaplan and Norton of Harvard University thus assumes significance in HR. In this frame-work, the approach is to ensure better focus, accountability, alignment and communication at all levels, with the objective of four inter-dependent perspectives of training and development, well-defined internal process, customer satisfaction, therefore more patients inflow and hence revenue viability.

“The impact of behaviour of employees on the revenue and the importance of balanced score card needs to be explained to them,” says Dr Biswas, a firm believer in this innovative concept.

Even as HR policies are taking shape, are all HR personnel given the power to execute policies? Dr Shreedhar V Sherigar, Chief Manager, Personnel & Human Resources, Breach Candy Hospital, Mumbai fumes, “Most hospital managements twist HR for their own benefits. HR personnel end up being lackeys of the management.”

Ways To Curb Attrition Rate

To curb the high attrition rate, the success mantra for a hospital is not just offering a fat pay packet, but chalking out long-term development and career growth for employees, along with giving them a sense of empowerment. “A hospital should always innovate, keep their employees busy with various projects,” suggests Dr Roy.

So that the functioning of a hospital is not plagued by somebody’s sudden exit, it is important to keep a databank of apt substitutes ready. “I always chat with my employees trying to understand who is not happy and may leave the organisation. I try to address their problems and grievances and always keep the replacements ready,” says Gupta. Anupam Verma, Director, Administration, PD Hinduja Hospital agrees, “We always keep a second line of people ready so as to avert a sudden crisis.”

"It is the role of HR to analyse behavioural patterns, chart their behaviour for months together and then use targeted intervention" - Dr Bidhan Das, Director, Administration, Rockland Hospital

Multi-tasking also comes handy in times of crisis. “It is the job of HR to identify the right talent, encourage and train them for multi-tasking,” says Dr Biswas.

Winds Of Change

According to Dr Bidhan Das, Director, Administration, Rockland Hospital, “It is the role of HR to analyse behavioural patterns whether it is a high-skilled surgeon or a low-skilled security guard, chart their behaviour for months together and then use targeted intervention, which is accomplished through behavioural and motivational training.” Manipal Hospital, Bangalore, like some of its counterparts, is consciously creating a working environment that facilitates a performance-driven culture. “Performers are motivated with ample opportunities to take up challenging assignments. We empower employees to take decisions and thus instil self-confidence and sense of pride in working for us,” says R Basil, CEO, Manipal Hospital. The hospital also conducts sports and cultural activities for a span of three months in parallel with regular work every year, which culminates in the annual Manipal festival called Manifest. “All these go a long way to instil a sense of loyalty not only among our employees but also among the consultants, who are not on our direct payroll,” says Basil. The importance of well-defined HR is slowly taking root. With a spate of new hospitals, there is renewed emphasis on training and development. “From focusing on Industrial Rules (IR) or union-related activity, hospital HR is now making a paradigm shift towards training & development and customer satisfaction (both internal and external),” says Patnaik.

“Listen to the winds of Change.” Welcome to the employees’ world!!

rita_dutta@rediffmail.com