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Umer Shareef Sheikh Research Scholar Department of Commerce Aligarh Muslim University, India Muzamil 43, VM Hall, AMU Aligarh-202002 Contact No.- +91-99141-15109 Email: umer.amu25@gmail.com |
People are an essential element in any healthcare organization, whether that organization is a major research teaching hospital, a primary healthcare clinic in the inner city, the county public health office, or a health maintenance organization. However, quite often, it is seen that administrators, third-party payers, governments, and even boards of directors have due concerns only about the patients and technology. While, in reality, it is the people behind technology, treatment protocols, services, and activities of the organization that ensure quality care. Therefore, how healthcare organizations manage and invest in their human capital truly impact the quality of care and services provided. In this paper, an attempt has been made to explore the existing developmental climate in various healthcare institutions of Kashmir. A total of 285 healthcare employees working in different district level hospitals completely responded to the survey instrument. Notably, the results revealed existence of a satisfactory level of HRD climate in healthcare sector of Kashmir. However, there is still immense scope for further improvement.
Keywords: Performance appraisal, Training and development, Organizational development, Potential appraisal, employee welfare and QWL, Feedback and Counselling,
People are seen as the most important organizational resource and the key to achieving high performance by business practitioners and academic researchers all over the world (Becker & Gerhart, 1996; Brewer & Seldom, 2000). The organizations striving to succeed in today’s highly competitive business environment tend to depend heavily on employee skills and commitment. Besides, there is now a growing realization about the fact that human resources constitute a valuable component for any organization aspiring to develop strategic competitive advantage (Wright, McMahan & McWilliams, 1994). The Research Based View (RBV) has identified four required characteristics for resources to produce sustainable competitive advantage (Barney, 1991). These characteristics include rareness, value, imitability, and substitutability and people by virtue, are inherited with all such features. People are unique in their skills, approach and mental capacity. It may be easy for your competitor to imitate competitive advantage gained through technology or product but it is always hard to duplicate competitive advantage achieved via competitive human capital. Notably, the difficulty in duplicating people’s knowledge, abilities, experience and behaviours make them imperfectly substitutable. Therefore, in essence, the success of an organization depends, to a large extent, on the competencies of its workforce. Arguably, when human resources are employed strategically, firms compete more effectively in this dynamic marketplace, especially when the productivity of superior resources depends upon the nature of their employment and the skill with which a strategy, based on resource superiority is implemented (Peteraf, 1993, p: 186). Thus, people form organization’s most important asset, especially with service-providing organizations (Brewer & Seldom, 2000).
There is now substantial evidence about the fact that the employees of an organization can be a source for competitive advantage and can determine the ultimate success of the organization. The challenge however, before the organizations now, is how to develop and sustain this source competitive advantage. Grant (1996), Teece (1998), and, Teece et al., (1997) suggested that sustainability of advantage can reasonably be anticipated if firms satisfy two conditions. First, given the dynamic environment a firm is able to continuously identify, upgrade, rejuvenate and reinvent valuable resources. Secondly, to have the ability to create an environment in which they can be self- reinforcing and enhancing in value and strength, thus causing the imitating firms sustain major cost disadvantages. While, Barney (1991) asserted that if the existing resources are not renewed in conjunction with changing environmental conditions, the strength of a firm’s original strategic assets may soon be nullified by the changing competitive profiles. Therefore, sustainability of competitive advantage does not only depend on the nature of resource bundles but at the same time, also on the firm’s ability to renew, reallocate, rejuvenate and redefine its resources to help them cope with the changing business environment. Hence, to withstand competition and develop keen workforce, it is established for the organizations to ensure effective personnel policies and sound HRD climate, which is self-reinforcing, self-rejuvenating, and, self-enhancing in value and strength.
HRD in the organizational context is a process by which the employees of an organization are helped in a continuous and planned manner to; acquire or sharpen capabilities required to perform various tasks and functions associated with their present or future expected roles, develop their capabilities as individuals so that they are able to discover and exploit their own inner potential for their own and/or organizational development purposes, and to develop an organizational culture where superior-subordinate relationships, teamwork and collaboration, among different sub-units are strong and contributing to organizational wealth, dynamics and pride of employees (Rao, 1984). It focuses on the theory and practices relating to training, development and learning within organizations for individuals in the context of business strategy and organization competence formation (Gourlay, 2000 p: 99). According to Singh (2013) HRD is concerned with creating a climate of work culture, productive efficiency and integration by; building the capabilities of people, preparing them for change, improving productivity with quality development and achieving organizational goals in a dynamic and competitive business environment. In addition, successful organizations which hold the belief that HRD makes a difference have created proper HRD divisions for developing their employees. The positive HRD climate renders the existing systems more efficiency and makes the organizations more receptive to the introduction of relevant additional system (Athereya, 1988).
HRD climate has been defined as the shared perceptions which employees hold about that particular organization they work with. Eventually, it is proposed that an optimal developmental climate is essential for facilitating human development. Such optimal developmental climate is characterized as consisting of numerous tendencies on the part of the organization, thus, invoking a feeling among employees about the existing HRD structure at their work place. The few of these tendencies as suggested by Rao and Abraham (1986) include the following;
In a broader frame, the employee developmental climate may be seen as a part of larger system i.e., organizational climate (OC). OC is an extensively researched phenomenon in the organizational psychology literature and has been defined in various ways. For instance Schneider (1975) defined OC as individual’s perception about salient characteristics of the organizational contest. In the words of Tagiuri and Litwin (1968 p: 25) it is the relatively enduring quality of the total environment that; is experienced by the occupants, influences their behaviour, and, can be described in terms of the values of a particular set of characteristics or attributes of the environment. Such attributes include a supportive climate of risk taking, cohesiveness, and motivation to achieve (Denison, 1996). Forehand & Von Haller (1964) described it as a set of characteristics which are relatively enduring over time and that define organizations, differentiate them from others and influences the behaviour of the people in the organizations. Human resource development climate in this sense is thus, the attention that members pay towards various developmental systems such as personnel policies, appraisal, learning, rewards, and, management behaviour at their respective places of work. In other words, it is an understanding shared by every employee about that particular organization they work with.
The study is an attempt to explore the perception of employees regarding the existing HRD climate in selected district level healthcare institutions of Kashmir division of Jammu and Kashmir. Considerably, it is assumed that the prevailing developmental climate in healthcare is satisfactory.
The results of this study are primarily based on the survey information. The data for the purpose has been collected through a well designed structured questionnaire used in the works of Rao & Abraham (1986) with few changes as per requirement. The survey instrument contained thirty statements enquiring almost about every aspect of HRD climate in sampled organization. However, using principal component analysis (PCA) the researcher reduced these thirty explanatory variables to six broad components which include; performance appraisal and reward, feedback and counselling, potential appraisal and career development, employee welfare and quality work life, organizational development and training and development. The extracted factors were put to reliability test using Cronbach’s alpha coefficient. The scale was found highly reliable (See Table 1 in appendix for PCA and Reliability results). A total of 285 healthcare employees irrespective of differences in gender, age, job category, experience and salaries participated in the survey (excluding grade IV employees). The data has been analysed using statistical software SPSS_20.
The item-wise mean scores of the opinion of various employees working in different hospitals of Kashmir about different dimensions of HRD climate are presented in Appendix. Since the questionnaire used a five-point scale, average scores of 3 and around indicate a moderate tendency on the dimension existing in that organization. Scores around 4 indicates a fairly good degree of that dimension existing in the organization. To further simplify interpretations the mean scores are converted into percentage score using the formula;
Percentage score = (Mean Score – 1) X 25
As per Rao and Abraham (1986) it is certainly desirable for organizations to have percentage scores above 50 on each item as well as overall and organizations having percentage scores above 60 per cent are indicative of a reasonably good development climate.
The mean score for overall HRD climate in the health-care sector of Kashmir arrived at m = 3.264 (which is equivalent to 56%) for the organizations understudy, which, however, is good but maintains a huge scope for improvement. Table 1 presents the dimension wise mean scores, standard deviations and percentages of various dimensions used to analyse the overall HRD climate in health-care sector of Kashmir.
Table 1: HRD Climate (Valid N =285)
| S.No | Variables | Mean | Std. Deviation | %ages |
| 01 | Performance Appraisal and Reward | 3.0687 | .90300 | 51 |
| 02 | Feedback and Counselling | 3.4604 | .96765 | 61 |
| 03 | Potential Appraisal and Career Development | 3.5004 | .87284 | 62 |
| 04 | Employee Welfare and QWL | 3.1283 | .96648 | 53 |
| 05 | Organization Development | 3.2113 | .91520 | 52 |
| 06 | Training and Development | 3.1932 | .86626 | 54 |
| Overall HRD Climate | 3.2604 | .73652 | 56 |
Source: Survey, Results: SPSS Output
Among various dimensions of HRD climate studied in various district hospitals of Kashmir, only two have been found over a reasonably sound level of 60 per cent. While, all other measured dimensions felt in between 50% and 60%, indicating a satisfactory but not an excellent level of prevalence. Table 2 reports Potential appraisal and Career development dimension with the highest mean score (m = 3.5004 or 62%) followed by Feedback and Counselling (m = 3.46 or 61%). Besides, the lowest mean score (m = 3.06 or 51%) of all is reported for Performance Appraisal and Reward mechanism indicating a desirable system of appraisal and mechanisms for rewarding any good work by employees. Similarly the mean scores for Employee welfare and QWL (m = 3.12 or 53%), Organization development (m = 3.21 or 52%), and, Training and development (m = 3.19 or 54%) were also found above minimum desirable extent of 50%. Thus, indicating the existence of a satisfactory system of employee welfare and QWL, good organization development culture and occupancy of above average training and development climate. The results thus support our preposition that the HRD climate in healthcare sector of Kashmir is satisfactory. However, the in-depth and detailed analysis of existing developmental climate is carried under various dimensions of HRD climate as following:
Assessment of Potential Appraisal and Career Development system in hospitals
Potential appraisal is assessing an employee to identify his courage, calibre and potential to do different jobs or to take-up higher responsibilities within the organization. The potential appraisal and career development aspect of HRD climate in health care institutions of Kashmir has been analysed using five statements in the questionnaire. These five statements cover all essential aspects of potential appraisal and career development and provide a broad assessment of the phenomenon concerned. Table 5 (in Appendix) presents the item-wise mean scores and standard deviations of all the statements used. Besides, it also gives in percentage terms the existing status of potential appraisal and career development culture at various hospitals of Kashmir. The results reveal the existence of an excellent atmosphere for potential appraisal and career development in various hospitals of Kashmir. The overall mean score for the dimension is reported at m = 3.50 (62%) which is reasonably good for any organization to have. The highest mean score is recorded for item-04 (Employees sponsored for training take it seriously and try to learn from the programmes they attend, m = 4.04 or 76%). Item-05 (seniors guide their juniors and prepare them for future responsibilities/ roles they are likely to take) recorded the next best mean score (m = 3.60 or 65%). The other three statements also maintained the satisfactory levels of percentage of above fifty percent. The statement 01 (Job-rotation in this organization facilitates employee development) reported a mean score of m = 3.33(58.2%). While, statement 02 (Career opportunities are pointed out to juniors by senior officers in the organization) and statement 03 (People lacking competence in doing their jobs are helped to acquire competence rather than being left unattended) recorded their mean scores at m = 3.24 (56%) and m = 3.29 (57.25) respectively. The results are clearly indicative of the fact that there exist a fairly satisfactory system of potential appraisal and career development in the sample selected hospital of Kashmir which is a good sign.
Assessment of Employees Welfare and QWL in Hospitals
The assessment of employee welfare and QWL in hospitals is done using five statements in the questionnaire. These statements enquired about the general climate of work, management support and overall welfare of the employees in their respective work places. The overall mean score for the construct arrived at m = 3.12 (53%) suggesting an average level of employee welfare and QWL in various sample selected hospital of Kashmir and thus, indicating a good deal of scope for improvement. The item-wise mean and standard deviations are shown in the Table 6 (see Appendix). While observing the results it is revealed that statement 02 (The top management believes that human resources are an extremely important resource and that they have to be treated more humanly) secured the highest mean score m = 3.63 (65.75%) for the construct, meaning thereby that employees in health care sector of Kashmir are fairly treated. The statement 04 and 05 (The psychological climate in this organization is very conducive to any employee interested in developing himself/herself by acquiring new knowledge and skills, m = 3.18 or 54.5%; This organization ensures employee’s welfare to such an extent that the employees can save a lot of their mental energy for work purposes, m = 3.11 or 52.7%) both recorded a mean score of more than three suggesting the persistence of fairly satisfactory general as well as psychological climate for work. However, the lowest mean score is reported for item 01 (The top management in health care goes out of its way to make sure that employees enjoy their work, m = 2.75 or 43.75%) while item 03 (The top management in health-care is willing to invest a considerable part of their time and other resources to ensure the development of employees, m = 2.98 or 49.25%) also maintained a below par mean score and is otherwise, indicative of the fact that management is less interested in making employees stay at work comfortable.
Assessment of Organization Development Interventions in Healthcare Organizations of Kashmir
Organization development has been defined as a planned effort, initiated by a process specialist to help an organization develop its diagnostic skills, coping capabilities, linkage strategies in the form of temporary and semi-permanent system, and a culture of mutuality (Pareek, 1975 in Rao, 1991). This aspect of HRD climate has been measured using five statements in the questionnaire providing a wide assessment of the phenomenon concerned. All these statements have been analysed separately. The results reveal the existence of a satisfactory organization development system to which the above average score of mean (m = 3.21) or percentage (55.25%) stands evident (See Table 7 in Appendix). Table 5.13 reports mean score of three or above in every case. The highest mean score m = 3.49 (62.25%) is reported for item-04 (Delegation of authority to encourage juniors to develop and handle higher responsibilities is quite common in this organization), which indicates the existence of a good senior-junior relationship. The next best results are reported for item-02 (Employees in this hospital are not afraid to express or discuss their feelings with their superiors/supervisors or even with colleagues, m = 3.26 or 56.5%). The statement 01 (Development of human resources is considered while framing personal policies) with a mean score m = 3.00 (50%) is reported lowest of all. Statement 03 (When any employee makes a mistake his supervisors treat it with understanding and help him to learn from such mistakes rather than punishing him or discouraging him, m = 3.21 or 55.25%) and statement 05 (Weaknesses of employees are communicated to them in a non-threatening way, m = 3.09 or 52.55) also secured above par mean scores. The overall mean score of the organization development construct comes out to be m = 3.21(55.25%), which indicate the existence of a desirable system of organization development.
Assessment of Training and Development System in Healthcare Organisations
Training is essential to improve organizational climate, to help a company fulfil its future personnel needs or existing personnel alterations, to improve productivity, quality and company profits (Singh, 2013p: 45).This construct is assessed using five exploratory statements in the questionnaire covering all the facets of training and development. Table 8 (in Appendix) provides the item-wise mean score, standard deviations and percentage scores of all the scale items measuring training and development dimension of HRD climate in the hospitals of Kashmir. The highest individual mean score is reported for item-02 (Employees returning from training programmes are given opportunities to try out what they have learnt, m = 3.66 or 66.5%) which indicates a supportive environment for employees to try out new things while at work. The next best mean score is reported for item-03 (Employees are sponsored for training programmes on the basis of genuine training needs, m = 3.46 or 61.5%). The lowest mean score is reported for item-05 (The top management of this organization makes efforts to identify and utilize the potential of the employees, m = 2.88 or 47%) thus, demanding focus from the management for improvement. Item-01 and item-04 (Employees in this health-care unit are encouraged to experiment with new methods and try out creative ideas, m = 2.98 or 49.5%; Specific training programmes are organized by hospital authorities on regular basis, m = 2.98 or 49.5%) have reported similar mean scores which is slightly below par. Thus, indicating lack of commitment on the part of management to encourage employees for innovation and in arranging necessary training programmes for the development of employees in hospitals. The overall mean score of the construct arrived at 3.19(54.75%) which is satisfactory and thus, indicative of the fact that the hospitals in Kashmir do provide adequate training and development avenues to its workforce to enhance their compatibility with the changing trends of environment.
The government in Kashmir inherits a three-tier system of healthcare delivery which includes primary, secondary, and, tertiary care facility. However, the present study investigated secondary stage health-care institutions to get an insight of the whole health-care set up of Kashmir. The results of the study indicated the existence of a satisfactory level of HRD climate in the sample selected hospitals of Kashmir. The employees in general demonstrated a favourable attitude towards developmental policies being in practice in sample studied hospitals and looked contentious towards their work and the organization as a whole. However the results indicate substantial scope for improvement in the existing HRD structure of hospitals as well as in various factors affecting performance. It is recommended that in order to further strengthen the job related behaviours of employees for better and efficient performance, hospital authorities should patch out and focus on the areas that dissatisfy employees in health-care. The present study observed the following few week areas requiring concern;
Health-care is a service based industry which employs people to sell its services. However, to keep these people intact with the changing requirements of the complex business environment, they must continuously be developed. Therefore, to ensure the continuous development of the human resource it is necessary for the firms to create a system within the system which is self- reinforcing, self-enhancing to update, upgrade, rejuvenate, and re-invent new skills, learning and knowledge within people to help them maintain pace with the dynamic business environment. Hospitals in Kashmir must focus on ensuring a congenial developmental climate which is conducive to work and supportive for employees. The top managements are required to invest considerable amount of time and efforts to make sure that employees enjoy their work. They should also put in lot of efforts to identify and utilize the potential of employees. Training is an important tool to help people update their skills and also attain new skills. Management should go out of the way to identify training needs of the employees and ensure skill development via sponsored development programmes.
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