Sunday, 8 August 2010

Healthcare HR at the AOM

One of two quick posts on excellent workshops at the AOM, both of which have important lessons for readers of this blog.

The first is about the influence of context and the disconnections between managers and employees over the effectiveness of HR practices.  Jaap Paauwe introduced a session that featured Louise Fitzgerald from Manchester Business School, Corine Boon from Amsterdam University and David Guest from Kings College.  Louise's work raised the importance of receptive contexts for change in that most complex of industries.  Her research over the past number of years has shown that transferring 'best practice' from the commercial sector to healthcare and even within the the healthcare sector itself is fraught with problems, e.g. lean service delivery and HR best practices.  Context matters a great deal, and if ever we needed lessons on this two of the most important dimensions of receptive contexts were (1) the relationships between managers and clinicians and the relationships among clinicians themselves, and (2) the extent of distributed leadership and willingness of clinicians to engage in leadership.  However, she also pointed out the impact of senior leadership actions on shaping such contexts, which is a lesson that most recent research has shown.  You need both transformational and distributed leadership to make things work.

The second point on the impact of HR practices on change was made by Corine Boon and re-inforced by David Guest's research in healthcare.  It is not the fact that HR practices exist but the signals they send and how they are perceived by employees that is important in predicting performance.  The correlation between managers reporting that they had such practices in place and the views of employees on their effectiveness was very low (0.25).  David Guest argued that there was a general lack of a strategic perspective on HR among his healthcare organizational sample, and a 'huge gap between what was intended and what actually happened' in HR.  He further proposed that the adoption of so called best HR practice was linked to low performance, a finding that is not without parallel in the private sector.  If everyone is doing the same thing, where is the advantage in that?

So beware of poorly researched case studies reporting only managers' views on the existence of best practices and beware of the airport books promulgating these views.  You have to understand the context in which these practices are adopted, how these practices are implemented, they signals they send and how effective they are perceived to be by staff.  Simple but powerful lessons.

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