HR in the healthcare sector

Homes and hospitals: The term "home" comes from Middle High German and originally meant "place where you settle down". The word "hospital" is derived from the back part of the Latin term "hospitalis", which originally meant "hospitable" or "hospitable". Healthcare facilities still honour this name today. If I am really unwell, I know that I will be helped - no ifs, ands or buts. Whether I smell unpleasant or am highly contagious, I can rely on the hospital staff. Personally, I'm not a fan of footballers, but a real fan of nurses and doctors. However, this almost unconditional focus on patients comes at a price, which is often paid by hospital employees. They are exposed to infectious diseases, work in an environment where economies of scale are difficult to achieve, are under great psychological strain and have to cope with very specialised and long working hours.

But there is one area in every care home and hospital that is supposed to look after these highly stressed employees: HR. Without any ifs and buts. But how well does this work? Are HR employees treated with the same hospitality that patients experience?

In recent years, we have analysed the quality of HR processes in numerous companies. Last year alone, we conducted a comprehensive self-evaluation together with ten hospitals and their HR teams.

Value-adding processes vs. non-value-adding processes

In HR, a distinction is made between value-adding and non-value-adding processes. One example of processes that add little value is the payroll process. Such processes can be described as hygiene factors: If they function smoothly, everyone is happy. However, nobody says: "Well done for paying my wages on time." This is expected and legally required. These processes, which add little value, are generally characterised by a high level of administration. The situation is completely different with talent processes, which can make a significant value contribution if implemented well. With personnel selection, a company decides who it is and what it stands for. Goal-setting processes help to steer the company's focus and can motivate employees - or, in the worst case, demotivate them. Well thought-out employee development, on the other hand, retains talent in the long term and contributes significantly to the stability and development of the company.

Focus on administrative processes

HR certainly has a say in whether a hospital plays in the top league or not. Nevertheless, it is clear that many hospitals focus heavily on administrative activities. HR teams stated that they spend an average of around 60% of their time on administrative tasks. This is also reflected in the degree of digitisation: while relatively large investments have been made in areas such as the digitisation of salary administration and time recording, as well as in topics such as organisational and master data management, these are solutions that are primarily used by HR. In contrast, employee-centred solutions, such as self services for Onboarding & Offboarding, HR portals or travel and expense management solutions, are less common. The situation is also mixed when it comes to talent topics such as applicant management or goal-setting processes.

It remains difficult to clarify why this is the case. However, blaming HR alone is not enough. HR departments in hospitals often operate in an environment that makes it challenging to establish employee-centred digital processes and self-services. Some possible hypotheses:

• Challenges in the cantonal environment: It is often difficult to drive innovation in cantonal structures. Instead of developing a target image and gradually optimising and digitalising it, lengthy tenders and rigid specialist concepts are prescribed. Once a decision has been made, you are often tied to the solution, as a new tender is time-consuming.
• Dependence on hospital-specific solutions: Many hospitals rely on specialised solutions, for example for staff scheduling. However, these systems are often developed from the perspective of resource planning and are not employee-centred. In addition, they are often not integrated into other HR systems, which requires complex interfaces and architectures. Once established, these systems are rarely adapted due to concerns about the costs and risks of a change.
• Difficult buy-in in specialist organisations: In specialist organisations such as hospitals, HR departments that do not come directly from the medical field find it difficult to gain the necessary support for innovation. This can lead to HR being forced into a purely reactive role and mainly taking on administrative tasks. Although many hospitals work with business partners, these roles are often not fully realised.

How "good" HR succeeds

If "good" HR can be established in hospitals and healthcare facilities, a significant value contribution can be achieved. Almost 20 years ago, a study of 283 Canadian retirement homes showed that institutions with strong participation and close employee support have higher customer satisfaction. Various studies have shown that good recruitment and staffing can contribute to better patient outcomes, such as lower mortality rates. In addition, strong HR promotes employee well-being and reduces staff turnover. What good HR means in detail may vary, but some maxims can be applied universally:

• Create mechanisms to "hear" employees: an employee survey every two years does more harm than good. Regular dialogue and continuous feedback are more effective.
• Co-creative approaches: Early and strong involvement of "HR customers" in projects prevents too much focus on HR administration.
• Less is more: Hospitals should focus on a few, strong solutions when it comes to Digitization. Best-of-breed approaches increase complexity and rarely lead to the desired success.
• Everything in one place: Most hospitals lack a central platform on which employees can digitally initiate all HR services and processes. Such solutions have long been technically possible and should be standard.
• Keep it simple: Processes should be designed to be as simple as possible, as the framework conditions in hospitals are often complex anyway. X-stage authorisation processes can be avoided through good reporting. In the case of multiple hires, a main person responsible can be defined.
• HR must hold line managers accountable: Many authorisations and tasks are delegated to assistants in hospitals. Such pro forma exercises bring no added value and can pose legal risks for line managers.
• All power to the (small) Team: It is not primarily the task of HR to establish modern forms of organisation in hospitals. However, HR must recognise when employees do not receive enough Appreciation and point out the consequences of issues such as management spans.
• Leading, not being led: HR must lead management on HR issues and not the other way round. It should set priorities and point out the costs that arise from an investment backlog. Process costs are also costs - and nothing is more expensive than the paperwork that is still being used in many cases.