The WHO defines HRH (Human resource for health) planning as “the process of estimating the number of persons & the kinds of knowledge, skills, & attitudes they need to achieve predetermined health targets & ultimately health status objectives”˳
HR planning is a dynamic process, involves 3 stages; stocktaking, forecasting, & designing temporary workforce˳ In the first stage of stocktaking, recruitment & selection of key types of employees align with strategic business plan to achieve specific targets˳ The second stage of forecasting is subdivided into two phases, forecasting future people needs (demand forecasting) & forecasting availability of people (supply forecasting)˳ The third & final phase involves flexible strategy to recruit temporary employees as per need assessment & cost-effective benefits˳
1˳ Stock-taking: – The principle is to identify how many people are needed at every level of the organization to achieve business objectives- in line with overall strategic plans – & what kind of knowledge, skills, abilities & other characteristics these people need˳
The optimal staffing of modern health services requires many different types of staff˳ These include; –
1˳ Clinical workers – doctors & nurses˳
2˳ Technical staff for diagnostic services, such as laboratory & radiology, pharmacy staff˳
3˳ Environment health workers, such as health inspectors˳
4˳ Preventive & promotive staff, such as community health workers, administrative staff, etc˳
In a healthcare organization, traditional quantitative approach are used to make enumerative judgments based on subjective managers prediction to allocate certain budgets for employee’s payroll expenditure & need assessment of key employee potentiating responsive to organizational system & design˳ Resource allocations are best executed with the help of activity based cost management, that controls cost & labor required for specific job/event & reduce wastage˳
For example: Comparative rates of healthcare activity: –
Inpatient care bed days per capita
Acute care bed days per capita
Acute care staff ratio – staff per bed
Acute care nurses ratio – staff per bed
Inpatient admissions per 1000 population
Acute care admissions per 1000 population
Doctors consultation’s per capita˳
The types of health staff in a particular country are dictated by the kinds of health services provided & level of technology available˳
For example: –
Nature of health organization: primary, secondary, & tertiary˳
Types of sector: public, private, non-profit funded organization˳
Infrastructure: size of the hospital (200 beds, 400 beds, 1000 beds)˳
General (multispecialty) or specific care providers (cardiovascular, cancer)˳
2˳ Forecasting: –
Demand forecasting: – Planning for the medical workforce is complex & determined by relatively mechanistic estimates of demand for medical care˳ Dr˳ Thomas L˳ Hall (1991) proposed 5 generic methods for estimating demand for health care, such as
1˳ Personnel to population ratio method: – This method calculates ratio of number of health
Personnel as compared with the population count˳ However, with inappropriate data available, it has serious limitations, such as it is only applicable with acceptable health conditions, a stable health sector, & a limited capacity for planning˳
2˳ The health-needs method: -This method requires & translates expert opinion about people’s health needs to staff requirements˳ Health needs are derived from the determination of disease specific mortality & morbidity rates˳ The staff requirements are evaluated from the norms for the number, kind, frequency, & quality of services,& staffing standards that convert the services into time requirements by a certain category of health workers to perform the services˳ This method initiates the need for sophisticated data system & survey capabilities, & a high level of planning expertise which are not readily available˳
3˳ The service -demands method: -This method accounts the numbers & kinds of health services people will use at an anticipated cost of obtaining them, rather than their professionally determined need for such services˳ This specifically provides data about economical regression pertaining to utilization of private healthcare sector as compared to government funded health sector˳
4˳ The managed healthcare system’s method: – The managed health care system’s entails a known client population who would have reasonably good access to health amenities˳ But flexible socio-political trends & economical recession influence healthcare reform policies˳
Supply forecasting: –
Forecasting HR supply involves using information from the internal & external labor market˳ The calculation of staff turnover & workforce stability indices measures internal supply for HR Planning˳ External labor market gives detailed spectrum on tightness of supply, demographic factors, & social/geographic aspects˳
Internal supply: – The evaluation of the gross number of people needed for a specific job & arrange for other provisions of HR processes, such as training & developmental programs, transfer & promotion policies, retirement, career planning, & others have crucial importance in maintaining constant supply of HR in an organization˳
1˳ Stock & flow model: – This model follow the employee’s path through the organization over time, & attempt to predict how many employees are needed & in which part of the organization˳
a)Wastage analysis; – This analysis refers to the rate at which people leave the organization, or represents the turnover index˳
The number of people leaving in a specific period
Wastage analysis= x 100
The average number employed in the same period
b) Stability analysis ( Bowey, 1974): – This method is useful in analyzing the extent of wastage in terms of length of service˳
Total length of service of manpower employed at the time of analysis
Stability analysis=x 100
Total possible length of service had there been no manpower wastage
2˳ Replacement Charts: – Replacement chart is a list of employee’s for promotion, selected upon the opinions & recommendations of higher ranking people ( Mello, 2005)˳ Some replacement charts are more systematic showing skills, abilities, competences, & experience levels of an employee˳
3˳ Succession Planning: – An aging workforce & an emerging “Baby boom” retirement waves are driving the need for new management process known as succession planning that involves analyzing & forecasting the talent potentials to execute business strategy˳
Will Powley,senior consulting manager for GE Healthcare’s performance solutions group says, that the first step in effective succession planning is a quarterly talent review that begins with an examination of the hospital or health system’s organizational chart˳
In a 2008 White Paper on succession planning, GE Healthcare identified a few best practices for healthcare for succession planning:
1˳ Identify & develop talent at all levels
2˳ Assess top performer’s talent rigorously & repeatedly
3˳ Link talent management closely with external recruiting
4˳ Keep senior management actively involved
5˳ Emphasize on-the-job leadership & customized employee development
6˳ Create systematic talent reviews & follow-up plans
7˳ Maintain dialogue with potential future leaders˳
External supply: – HR managers use outside information, such as statistics concerning the labor market from the organization & external labor market, in other words external & internal statistics˳
External statistics: – Graduate profile
Unemployment rates
Skill levels
Age profile
Graduate profile: – There is substantial public sector regulation of all health care markets, & entry to labor market is highly constrained by licensing & professional regulations˳
Unemployment rates: – There is lack of economic principles, the role of incentives is largely ignored & supply elasticity in the labor market is mostly unknown & poorly researched˳
Skill levels: – Higher education (specialization & super-specialization) are proportionally restricted to limited seats of admission governed by medical regulatory bodies˳
Age profile: – The organizational charts of recruitment gives details of rates of recruitment, retention, return & early retirement of employee’s, which helps to enumerate future vacancy rates, shortages, & need for replacement˳
Internal statistics: – Demographic profile
Geographic distribution
Demographic profile: – Demographic changes (e˳g˳ the number of young people entering the labor force) affect the external supply of labor˳ Age composition of workforce will force to review recruitment policies˳ The trend of increasing proportion of women in employment has lead to progressive development of both organization & country˳
Geographic distribution: – The attraction of workforce to urban areas are influence by following reasons; employment opportunity, access to facilities – transportation & technology, & others˳
3˳ Temporary workforce planning: –
Herer & Harel (1998) classifies temporary workers as: temporary employee’s, contract employees, consultants, leased employees, & outsourcing˳
High social costs has initiated work sharing strategy which are flexible & provides more benefits, such as
1˳ Part- time temporary workers numbers & hours can be adapted easily with low maintenance cost to meet organizational needs,
2˳ Employees possessing appropriate/ specialized skills benefits functional areas within & outside the organization˳
3˳ No responsibility for exclusive benefit enrollments, such as job security, pension plan, insurance coverage, etc˳
In today’s work environment, outsourcing can be added as a temporary worker planning technique˳ Outsourcing requirement is assessed & evaluated on cost & benefit decision˳ Ambulatory services, pathological or diagnostic testing services, laundry, catering, billing, medical transcription, & others are most commonly outsourcing services promoted in healthcare organization˳
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