HOSPITAL MANAGEMENT: A COMPARATIVE ANALYSIS OF EFFECTIVE UTILIZATION OF HRM IN SELECTED PUBLIC AND PRIVATE HOSPITALS OF KARACHI AND HYDERABAD, SINDH

IntroductionDeveloping a successful healthcare system is increasingly a complex phenomenon due to demographic changes, brain drain, globalization and developments in medicine. The core business of hospitals is to deliver satisfactory healthcare service to customers by institutionalizing 'best practices' through best manpower. Hospitals' doors are open 24/7, physicians, paramedics and core staff always present to treat patients from life-threatening emergencies to common cold and disaster relief. Consequently, hospitals are more relying on efficient and effective human resource. Normally, hospitals possess several departments to deliver life-saving care, using complex, multipart, sophisticated equipment, and handling business issues like policy development and compliance, therefore, hospitals need topquality human resource, this concept is called Hospital Management. The importance of HRM for the success of healthcare system has, until recently, been generally overlooked especially in developing countries, including Pakistan. It is only in recent years that significance of HRM in hospital management has been considerably realised. Despite the growing evidence on the impact of HRM on organisational performance in other sectors, there have been comparatively limited research evidence which may have investigated implications of HRM for healthcare sector in Pakistan. Consequently, this study investigates effective utilization of HRM in private and public sector hospitals in selected hospitals of Karachi and Hyderabad, Sindh through questionnaire survey.Literature ReviewDuring the past decade or so, pecuniary pressures on healthcare providers have led to a quest for more efficient service delivery through effective utilization of staff. Pertinent evidence was reported in some studies, such as Patrickson and Maddem (1996) who investigated the organisational responses to such pressures by four major South Australian hospitals. Donabedian (1980) reported a notable model of patient care quality and role of human resource in it. Study revealed couple of indispensable factors of patient care e.g. technical and interpersonal. Technical factors are concerning to adequate utilization of professional knowledge and skills of human factor to promote healthcare. Many other scholars suggested HRM 'best practices' may influence patient care quality. Preuss (2003) noted that 'high performance' HR systems can also improve healthcare outcomes in hospitals. Moreover, for effective management of hospitals staff training targeting higher levels of knowledge and skill relevant to patient care. Working as team by health professionals is another aspect of HRM that is widely applied in hospital management to enable shared knowledge and understanding about patient needs, good decision making, lower error rates, and more effective patient recovery. The recent study of Morey et al. (2002) tested a model of team-work developed for aviation crew team-training to handle emergency situations. Model mainly focuses on communication and coordination and applied among physicians, nurses, and technicians. Using an experimental design, study found that team-training positively affected emergency room staff attitudes and significantly reduced clinical error rates. HRM ensures employee involvement in healthcare referring to efforts taken by employers to find more participative ways in which to manage staff (Marchington, Goodman, Wilkinson, & Akers, 1992). Employee involvement in decision making process encourages employee ownership of the task or goals of the organisations and employees roles are clear and they remain, loyal to quality of patient care.Goldstein (1990) presented the framework of 'utilization management and quality improvement'. Model illustrates the effective utilization of management staff to ensure healthcare quality improvement. The goal of utilization management is efficiency. This model strongly relates to hospital management process such as preadmission authorization, admission review, patient's case management, and drug use evaluation. …