Friday, May 18, 2012

Manpower Planning In Hospital



Man Power Planning in Hospital

Manpower Planning is the primary function of the hospital human resource manager but before the stats filling individual jobs, he should consider the overall management problem of making the best use of available human resources. Just as the controller of finance budget for the best use of financial resources, the human resources manager is basically concerned with budget for the best use of human resources. Manpower planning call for the integration of information, formulation of policies and forecasting of future requirements of human resources so that the right personnel are available for the right job at the right time.
Manpower planning starts with the analysis of the future needs of the hospital and its objectives. It determines organization structure, decides what jobs have to be filled and what their requirements are.Short-term manpower planning –two year or so ahead is promoting planning. But the really important planning is the long-term planning –five or ten year ahead. In manpower planning the basic question of objectives organization structure and age structure of personnel have to be considered.
Nature and Scope of Manpower Planning
Manpower planning is may be defined as a technique for the procurement, development, allocation and utilization of the human resources in the organization. It views employees are scarce and costly resources, whose contribution must be developed to the fullest by the management. Manpower planning, which is at times described as manpower management is basically concerned with having the right types of personnel for the right job at the right times. This is done by studying three types of forecasts :
§  Economic forecast
§  Hospital’s expansion forecast
§  Employee’s market forecast
Systematic manpower planning is a must for every dynamic organization. The management has to meet the challenge of various pressure such as political,economical and technological, to ensure that the future of the hospital remains bright under all circumstances. The emergence of more hospital in the vicinity and better opportunities offered by hospital coming up in developed,developing and underdeveloped countries abroad can result in high employee turnover and a source of potential loss.



Need for manpower planning
Every hospital has to do manpower planning for the following reasons :
1.    Shortage of certain categories of employee
2.    Advancement of medical science and technology resulting in need for new skills and new categories of employee
3.    Changes in organization design and structure affecting manpower demand
4.    Government policies in respect to reservation of seat for handicapped person/women and others.
5.    Labour law affecting demand and supply of labour.
6.    International scenario of employment eg employment of nurses,doctors,paramedical personnel on USA,Uk,Ireland, the gulf countries etc.
7.    Introduction of computer.

Benefits
v  Enables an organization to have the right person at the right place and at the right time
v  Provides scope for advancement and development of employee through training development etc.
v  Helps in anticipating advertisement and salary budgets
v  Foresees the need for redundancy and plan eliminate it
v  Plans for better working conditions, fringe,benefits,training needs
v  Given an idea of the type of tests to be used and interview techniques in selection based on the level of skills,qualification,intelligence,value etc of future manpower and
v  Helps improve service to patients  and contribution of working personnel.

Objectives
·         Very wide and varied
·         Most important are :-
o   Ensuring maximum utilization of personnel
o   Assessing future requirements of the organization.
o   Determining recruitment sources
o   Anticipating from post records :
§  Resignations
§  Discharge simplicities (simple discharge)
§  Dismissals and
§  Retirements
·         Determining training requirements for mgmt development and org development

Manpower Planning Steps

Manpower planning covers the total activity of the personnel function such as recruitment selection, training career development staff appraisal etc. Manpower planning involves the following steps

1.    Scrutiny of the presents personnel strength
2.    Anticipation of manpower needs
3.    Investigation of turnover of personnel
4.    Planning job requirements and job description

Scrutiny of the present personnel strength of personnel

Scrutiny of the present personnel strength of personnel is the corner-stone in manpower planning. This helps in management development,in determining training needs and in the  optimum utilization of personnel whenever they are needed most. An examination of present staffing can further determine the exact number of personnel required and their skill-levels.


Anticipation of manpower needs
The anticipation of the needs for manpower generally involves taking an inventory of the existing personnel who are ‘in stock’ today,and what can be expected to be in stock tomorrow. This forecast is prepared every year for the next five year. It objectives is to determine the number of personnel likely to be needed an account of any reason what ever; promotion of employees to higher pasts,losses that are likely to occur through resignations,discharge simpliciter ,dismissals ,retirements etc. Ultimately the net requirements of the hospital are indicated.


Investigation of turnover of personnel
Labour turnover, as the world imply  means the rate of change in the number of employees, ie, the number of employees leaving and joining an organization during certain period. A study of labour turnover is helpful in manpower planning. A high turnover is a warning to the hospital authorities that something is wrong with the personnel policies and practices of the hospital. It may be due wrong selection placement,low salary,poor working condition lack of promotional avenues etc. A high rate of turnover not only costs in terms of money but also harms the reputation of a hospital,lowers the terms-sprit of the remaining employees and reduce the quality of patients care.

Some of the important factor which result in employee quieting their jobs are :
§  Low salary
§  Better prospects in other hospitals
§  Poor working condition
§  Transport problem
§  Housing problem
§  Marriage incase of female employees
§  Health grounds
§  Family circumstance
§  Family circumstance
§  Further studies
§  Maltreatment by superiors
§  Unfriendly relation with colleagues
§  The attraction of going back the one’s native place
§  The attraction of going to a foreign country

The exit-interview is a useful tool to study labour turnover. When a employee is leaving ,he is leaving,he is generally willing to be candid and may share his bitter experiences. The org weak spots are revealed,which can ultimately helps reduce turnover and in building the morale of the remaining employees in the hospital.


Planning job requirements and job description

Manpower planning consists of studying job requirements and preparing job description. The requirements of each and every jobs must be thoroughly studied through job analysis.

Job Analysis

Job analysis is the process of examine a job to identify its component parts and the circumstances in which it is performed . It is necessary to be familiar with this techniques because its application is quite wide and extends across the whole range of staff management function.

1.    Recruitment : Its aims at filing jobs by recruitment of the programme
2.    Salary : It is designed for finding the correct grading of individual pasts.
3.    Safety : It is meant for identifying job hazards
4.    Training : it is intended to decide the content of the programme.
5.    Annual performance appraisal : It evaluates the performance of the employee.


The steps in conducting job analysis are as follows :

1.    The analysis should commence with a fairly brief statement of initial requirements such as aptitude, educational, qualification, training and experience.
2.    The next main iteam should be a description of the responsibilities under broad headings such as physical effort ( amount of physical effort required for moving,lifting,duration etc )mental effort (the degree of intelligence needed) and responsibilities (for controlling staff,material, equipment, cash etc)
3.    Environment and conditions of service are to be considered and analyzed, such as physical surrounding (indoor, outdoor, temperature, humidity, noise etc) accident hazards, shift duties, prospects of advancement, occupational illness etc.
4.    The constraints,difficulties and pressure of the job should also be brought out. For instance,in the case of an account responsible for preparation of consolidated figure for the top management, the time by which these figures must be prepared and its impact on his other duties during this period must be spelt out.

           Job analysis should , therefore be concerned with realities and practical possibility. It should indicate how a job is taken care of within the limits of human capacity. It is a tools of the management aimed at eliciting detailed information about a job. At the same it can act as a problem-solving device.


Job Description

The job description is a broad statement of the purpose,scope,duties and responsibilities of a particular job. This is a resultant of the job analysis . It provides the detailed factual information required by candidates and selectors a like in order to obtain a thorough knowledge of the requirements of a job. To avoid confusion and misunderstanding, a job description should be prepared jointly by human resource department and concerned department head.

(format for job description)
Sharma’s Hospital
Job Description


JobTitle…………………………………………………………..Department…………………

Accountable to…………………………………………………Pay Scale……………………..

Job Summary………………………………………………………………………………………

Job Duties 1.
              2.
              3.
              4.
              5.Any other duty assigned by the department head

Qualification…………………………………….
Experience……………………………………...
Efforts……………………………………………
Working Condition…………………………….











Human Resource Requirement in Hospital
§  Requirement for human resource must be analyzed  in term of number of personnel needed for each types of job.
§  Employee means any persons who works in any capacity in a hospital eg Dr, nurse, paramedical……………skilled/semi-skilled/unskilled employee.
§  Depend upon size of the hospital ,types on the hospital and degree of care it provides are of the hospital,t ype of equipment used(automatic, semi-automatic or manually operated etc)
§  Under prevailing conditions, to manage every bed, whether in a small or big hospital, it requires 3 to 5 personnel.


Doctors to Bed Ratio

1: 5 (Indian Medical Council)                     However 1:10

Nurses to Bed Ratio

1:3 bed
1: 25 bed (Ward Sister)
150-400bed : Assistant nursing superintendent
401-700 bed : Assistant nursing superintendent + Nursing superintendent
( 30% leave reserve personnel should also be provided)







A nurse is to perform different procedure and function at different time,such as on admission of a patient,discharge of a patient and care during the stay of a patient in the morning,afternoon,evening and at night.
Department
Nurse
Bed
Remarks
Medicine
1
3

Surgery
1
3

Casualty
1
1

ICU
1
1

CCU
1
1

Paediatric
1
4
If mother are allowed to stay with patients

1
2
If mother are not allowed to stay with patients
Obs/Gyne
1
3

Labour Room
1
3

OT
2
1

Ortho
1
3

Well baby Nursery
1
3

Special Nursery
1
1


Patients care at the time of Admission
§  Nurse welcome a patients with smile
§  Remove bed cover
§  Make him feel comfortable,
§  arranges for fresh drinking water,
§  checks his weight, temperature and bp,
§  quarries about the history of illness, orientates the patients to his surrounding (Such as use of the call bell,bed pan,light,fan etc)
§  send the diet requisition
§  record his general condition
§  inform the dr about the admission and
§  queries of the patients and relatives

Morning care of the patients

This care is given to the patients in the morning by the day shift nurses. She visit the patients in his room, greets him,gives a sponge bath,change his clothes,rubs talcum powder,change bed sheets and pillow covers,check temperature,BP,administers morning medicines,makes the round with the dr,assists the diet-aides in giving breakfast,brings fresh water,sends the patients to x-ray,send urine and stool specimeans,if order to labouratory department,arranges for breakfast,lunch etc.


Afternoon care of the patients

Care given day shift staff after he has had his lunch, comb the patient hair, check temperature,BP,administers afternoon medicines,



Evening care of the patients
Pm shift nurse,takes report about the patients from the morning shift staff,check temperature,BP,administers evening medicines, places the patients in a comfortable position for sleep,wishes the patients a peaceful and comfortable night sleep,switches off the rom lights and switches on the night lamp if required

Pre –morning care of the patients
(Between 5am-7am by the night nurse)

§  provide bed pan, collect urine and stool specimens  if required
§  assists the patients in brushing his teeth
§  washes his face
§  Straightens the bed sheet and makes the patients comfortable.
§  If patients has any problem at night she contacts the dr on call, makes entries in the nurse note-sheets about the general condition of the patient finally reports to the day shift nurse before going off duty.


Care at the time of discharge

§  Prepare for the patients to return home
§  The whole aim of hospitalization is to try to help an individual recover speedily so that he may again take his place in society. If this is not possible, he should be prepared to continue his treatment at home.
§  When the dr decides to discharge a patients nurse informs the patients his family member so that they make the necessary arrangement.
§  Send the chart of billing,explain discharge policy to patients and relatives,hands over the bills to the patients relatives,collect home  medicines from the pharmacy from the patients request the dr to prepare the  discharge summary.
§  Receiving pay bill-give discharge summary sign it the inform admission office ,dietary department,explain follow up policy,enter the patients name and accuate time in discharge census.



Deciding work-load ratio and human resource strength in various department

X-ray Department

While deciding the number of employees in an x-ray department, the following tasks should be taken into consideration
§  Reception of patients
§  Recording the history of a patients,as concerned with x-ray
§  Prepare necessary paper,the slip to be pasted on the x-ray request entry in the register
§  Taking film fromstock,putting the same in the x-ray cassette
§  Explaining to the patients about x-ray procedure and taking the x-ray
§  Processing film
§  Sorting film
§  Reporting to the radiologist
§  Typing of report
§  Charting report or dispatching report

Keeping in view the quality of work required,one x-ray technician can’t be asked to do more than 30 x-ray investigation per day.

One x-ray technician  :
                             2        -        carotid angiography @ day
                             2        -        myelography phies  @ day
                             5        -        IVP @ day
                             5        -        OCH @ day
                             3        -        hysterosalpingiographies @ day
                             10      -        barium investigation @ day
                             2        -        carotidangiographies @  day
                             30      -        One –view x-ray
                             20      -        Ultrasound investigation
                             5        -        CT scan

(one x-ray supervisor require 7 x-ray technician)

Physiotherapy Department

The main function of this department are to rehabilitate or activate various limbs/parts of human body which might have become inactive due to accident/disease/ageing process etc.

1 physiotherapist -25 pts @ Day (8hrs)

Before giving treatment to the patients, he has to do some preparatory work:
1.    Examination of the patients
2.    Entry into register :
·         Name,age,sex
·         Present history of illness
·         Past history of illness
·         Family history if any
·         Diagnosis
3.    Aim of treatment
4.    Planning of treatment
5.    Progress report

( one physiotherapist – 7 assistant physiotherapist)


Medical Laboratory

One medical laboratory technologist – 35 tests per day
Less than 35 tests performance below average
More than 35 tests accuracy of his result should be questioned.
Technician
1        :         45      hematology tests
1        :         50      urine analysis tests
1        :         50      parasitology tests
1        :         20      blood bank test
1        :         40      serology tests
1        :         30      biochemistry tests
1        :         20      histopathology tests

If test are automated higher number of test can be performed.

One section head over -7 laboratory technicians, clerical staff and bottle-washer.

Pharmacy Department

Policy of the hospital (no of pharmacists)

One pharmacist can dispense medicine to 150 patients per day

8 hrs -1oo out patients and 50 in-patients

If >7 pharmacist – one chief pharmacist

Laundry

·         Depend upon frequency of changing the linen in the ward
·         The quality of linen
·         Depen upon laundry equipment-whether it has boilers,washingmachines , hydro-extractors,drying tumblers,flat-work ironers,flat bed presses and allied equipment.

1   :         25 to 30 beds (laundry operators )

Washman 1 : 150 to 200 kg per day
( washing,drying,folding,ironing and returning,thia includes collection of linen from different places)
Uses of linen kg
OT              1        :         7 to 8 kg
Labor room 1         :         7 to 8 kg
Each beds   1         :         5 to 6 kg

Food Service

1 dietary staff        -        15 to 20 persons will be applicable


Sanitation & House keeping

1 sweeper     -        1200 t0 1500 sq ft
1                 :         10 bed (30% leave reserved)

One supervisor      -        10 sweeper

If > 300 beds
Sanitation in charge = 4 supervisor = 40 sweeper


Security

1        :         10 beds


CSSD

1             : 25-30 beds (30% leave reserve)

ECG
1        :         20 ECG        -        one sift

Hospital Attendant
1        :         10 beds

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