COVID 19 or Corona Virus has impacted the world in ways that we cannot imagine, we have new term the “new normalcy” that has become the new reality. What can HR do in this scenario, what we can do to benefit the hospital, should be the question in the minds of all HR professionals?
This is at a time that the private hospitals are facing various challenges, major reduction in numbers in footfalls, revenue, etc and are facing huge losses at the same time, the cost has all spiraled.
Manpower cost constitutes about 40% - 50% of the total cost of any hospital and HR would be given the task to reduce the numbers. In a hospital, there are 2 kinds of activities viz Core and Non-core. All core activities will be direct employees of the organization and they would be on various modalities of engagement like full time or part-time. All Non-core activities would/should be outsourced staff.
Core activities include direct patient care which is done by Doctors, Nurses, Technicians, and Operations staff and to support them we have departments like Finance, HR, Marketing, IT, etc.
Non-core activities or services are outsourced to the various organization that supply manpower to execute certain tasks like Housekeeping, Security, Attenders, etc.
In any hospital, Nurses constitute about 65% of the total numbers whereas the Doctors cost will have more than 50% of the cost, so to come up with the most amicable way to handle the cost will be the challenge.
Below mentioned are few practical suggestions to help with the numbers for Nurses, Paramedical and the Support teams.
- Relook at the manpower numbers in multiple ways viz;
a. Relook at the nurse to patient ratio (would have to discuss with the Indian Nursing Council). The other areas can be relooked based on available equipment and coverage required.
b.Relook at the numbers based on a scientific time and motion study across the hospital
c.Relook at the department numbers based on the quantum of work per shift and also look at the possibility of flexibility to handle multiple activities
d.Relook at the numbers from unit level (nurse station) and take it upwards
Combining all the inputs together we can arrive at a very practical and workable number. Care should be taken to take the buy in from the HoD’s, otherwise this whole exercise will be a failure.
2.Restrict compartments to the minimum (central pool)
3.Create the Job Descriptions that clearly portrays the job and activities that is been executed by each individual
4.Based on the JD arrive at the deliverables
5.Communicate these deliverables to the individual
6.Evaluate based on the deliverables
7.Regular reinforcement of training
8.Arrive at the manpower number which is bottom-heavy rather than top-heavy
9.To build a succession plan
While doing this exercise, we should not at any point loss our sense of humaneness. We should be caring and transparent with our staff and should have the ability to articulate our plan to them. Trust has to be developed between the leadership and the staff with HR being the bridge.
The doctors, a very sensitive topic to discuss in a hospital, but in a situation like this we have to handle it in a different but amicable way; for the next few years it is best to stick to basics (departments). The sub speciality or super speciality doctors can be brought on as part timers or on call basis, there by the numbers and cost can be controlled to some extent.The employment of junior doctors also can be structured so as to get full coverage for the hospital.
All support teams to be trained on the operational side as well so that they can take turns in handling shifts. This is also a time to “let go”, meaning for various reasons we would have staff doing only certain shifts, so this is the time to let off of those who are not flexible to match our needs. Multi-tasking and flexibility are the new normalcy.
The outsourced staff play a big part in the maintaining the cleanliness and security of the hospital. The challenge would be to go to the grass root level and understand the work and timing, please do remember in most cases we had relied on the supplier to come up with the numbers and their activities. It is time to take on this role and determine the numbers and their SLA’s. Here, we cannot get too much saving but we sure can bring in frugality and discipline.
As we do the study, we should also have in mind the natural attrition and this can surely help in the adjustments. Clarity on which position requires replacement and which one does not require, needs to be documented and processed accordingly.
On one side we are looking at reduction at the same time we are also looking at multi-tasking and flexibility from our staff so how are we going to reward them, this also needs to be carefully thought out.
Educate and train leaders on the 5 elements; humaneness, purpose, technology, owners and insights. Think about the role of the leaders not just at the time of crisis but at the future.
In all this, it is imperative that the employee engagement activities happen without any break because only an engaged employee is a productive employee and also engage them to think bigger for the future.
With fierce competition for hiring the best talent, organizations that are able to attract, retain and engage talent by transparent communication, recognition and development opportunities would be the ones who succeed to last for the future.
The above-mentioned suggestion caters to the HR side of a hospital.
There is another side which also needs to be looked at; learning to co-exist . Having a tie up with small hospitals and then cater to their requirements based on needs. All the basic aliments can be addressed in these small units but for severe cases the case can be referred to big hospitals. The hub and spoke model are the way forward. This solves 2 problems; 1, survival of the small hospitals and 2, consistent co-existence and cost control for big hospitals. This agreement would be even more effective if there is a similar philosophy to running hospitals. This hub and spoke model can be extended to cover even the whole state as a whole, the success will lie purely on transparent communication and cooperation between the hospitals.
One other item that needs mention is of course, Information Technology. We need to use it to the maximum and also ensure that our patients and attenders use it as well to support the operational process. Since lots have been said on this, it is best to leave it at this.
The hope is to bring sustainability and co-existence, once we get to this the rest will surely fall in place.