Effects of HRM on Staff, Organizational and Financial Results in Health Care Firms, Coursework Example

Abstract

One of the key missions of HRM is to enhance the performance of its firm. Nevertheless, limited research has clearly discussed the several dimensional features of performance and related human resource activities to multiple result dimensions. Thus, the research proposal aims to add to the previous works by comparing human resource practices to three result aspects: monetary, organizational, and staff (HR) results. The study further aims at analyzing how human resource practices affect the outcome dimensions, stressing the intervening role of job fulfillment. The study will use an exceptional data set, based on a benchmark survey conducted in one of the most famous home care, in the United States. Data from the year 2017 to 2021 will be examined. In total, more than one hundred firms are expected to have participated during the mentioned period. Staff data will be collected through a questionnaire. The questionnaire will be distributed among ten thousand people whose response rate is expected to be higher. Sampling will assess patients with the Client Quality Index for long-term care. Results will be gathered through annual reports. To test the hypotheses, a structural equation modeling examination will be conducted.

Introduction

Human resources are the main factors that promote an organization’s profit as they ensure all innovative resources in the firm. People remain to be significant factors besides the tools, methods, and assets used in developing the firm. Without people, operating organizational resources to bring the best outcomes for the organization becomes impossible. However, due to the present economic development, stiff competition has resulted in the effects of moving human resources between departments. In fact, sectors and departments with high profits and ideal working conditions are most likely to influence and retain quality employees to serve the firm and increase the job results of other sectors. Thus, it is essential to learn, study, assess, and evaluate the HRM practices that impact employees and organizational and financial results in a firm.

The term human resource management is a planned, incorporated, and logical approach to staff recruitment in firms. For Nguyen et al. (2019), it is focused on managing the job and individuals to follow the desired direction. It is described as a carefully developed combination of jobs that target improving a firm’s efficiency and therefore achieve better organizational performance. Several studies identify human resource management in varying ways. They have termed it using several names and phrases such as best practices, quality performance, professional practices, and sophisticated practices, among others (Alam et al., 2020). HRM practices are claimed to nurture positive change connections, particularly when managers can provide evidence of attention to the personal needs of employees.

Among the aims of HRM, increasing organizational performance is one of the main purposes. Human resource specialists stress the significance of obtaining an economic gain through staff and note the benefit of many Human Resource practices required to achieve that benefit. Pillai and Sivathanu (2022) emphasize the application of an incorporated and sound package of equally supportive human resource exercises over discrete ones. Aside from the capacity of the significant number of studies on the relationship between HRM and its performance, the correct nature of the connection remains indefinite in the health unit. It can be regarded as a challenge since researching HRM in this particular sector and its impacts on employees and the organizational and financial outcome have theoretical and academic importance (Ashton et al., 2018). HRM activities are seen as the foundation for promoting better compatibility in the healthcare sector since the rules and reinforcements from the employee unit are shown through HRM practices, thus promoting better job results. Moreover, with the many local and international researches that are continuously being exploited and put into action, departments in different sectors and disciplines should also do the same to increase financial and employee job results.

Theoretical Plan and Assumptions Development

HRM Exercises and Compatibility

Firsthand research has reported that human resource management practices have a positive effect on staff commitment and fulfillment. The practices have resulted in effective job outcomes. Nguyen et al. (2019) state that they improve financial outcomes, organization productivity, and financial efficiency. Recent studies show that the close integration of human resource practices is most likely to support the performance of workers, thus confirming that it has a positive effect on work compatibility, which in turn enhances job suitability, commitment, and relationship (Pillai and Sivathanu, 2022). Researches and analyses of HRM practices also report a positive contribution of HRM practices in increasing the three mentioned factors, which are job fit, connection, and sacrifice.

Human resource management helps in promoting the motivation to enhance staff’s efforts and persistence. It also enhances the opportunity to motivate and inspire employees to apply their expertise to attain the goals of their company, teamwork, involvement during decision-making processes, and sharing of information. To develop job compatibility, human resource management practices are the key. Several researchers, including Wang et al.  (2022) and Aboul-Ela (2017), have reported that work compatibility is a transitional feature between staff views and HRM exercises such as staff development, performance analysis rewards, and financial efficiency.

HRM and Results

Examining the link between human resource management and performance results is significant. In Nguyen et al. (2019) overview article, the authors identify the key study issues within the human resources field as a primary concern of conceptualizing and measuring the main concept and multiple theoretical concerns about their link. The issues remain significant in the existing debate. HRM is often seen as a group of staff management practices, but there is no agreement concerning which human resource practice should be on the general HRM checklist. Additionally, the question concerning whether people should assess discrete human resource practices or apply a methodical HRM approach is even more important. Based on the system’s approach, a person should acknowledge the interlinked human resource practices that influence operation as a teamwork whole. This paper, however, will follow the systems strategy since it has been proven reliable and significant by previous research.

Moreover, there are other significant measurement problems concerning human resource management. Do people measure human resource guidelines at the firm level, for example, by inquiring HR leaders, or at the personal level, including the practices workers experience? Aboul-Ela (2017) answers the concern and addresses this issue by deciding among the planned, actual, and apparent human resource management. The idea behind it is that there may be variances between companies among the human resource policies tailored by the HR sector (intended by human resource management). Also, human resource practices developed by line leaders who are actual HRM and the views of staff who are perceived human resource management. According to Thomas Theorem, this research is concerned with perceived human resource management. He states that if people define circumstances as real, they are actually in their effects. Thus, if workers perceive that particular human resource practices are applied in the company, they will act based on that perception.

HRM and Results in the Health Care Sector

Within the past years, much research on human resource management performance has been performed in the healthcare unit. In the analysis of healthcare research, Ha (2020) concludes that human resource practices are mostly concerned with patient-based performance results. Pillai and Sivathanu (2022) note the significance of conducting further studies on the system or management approach applied to produce a result issue, also known as the black box. The black box is a significant theoretical concern that has overwhelmed the human resources discipline in the last years, focusing on the correct feature of the system connecting HRM and performance results. Moreover, several healthcare types of research link human resource management to organizational and human resource-related results. However, research focusing on financial results that have been widely discussed in the private sector of human resource management works seems very limited.

Performance is not a notion that can be straightforwardly explained and hypothesized. Wang et al.  (2022) state that it is effective for the concept of results rather than performance. An individual can then determine the three different results, which include financial, organizational, and human resource outcomes. Researchers observe that human resource and firm results are more proximal, for instance, closely associated with human resource practices adopted by a firm, whereas financial results are more distant. The distance occurs since they are not likely to be directly influenced by human resource practices. Furthermore, particular HR results are frequently used as transitional results that link the black box between human resource activities and financial or company results.

The multidimensional notions of results appear to be important for healthcare firms since financial results are not the only goal of an organization. Not regarding the many research studies on HRM in healthcare, limited reviews have clearly and widely delivered the multidimensional nature of performance and related human resource activities with several different dimensions (Abate et al., 2018). This paper is, therefore, a research proposal aiming further to examine many result dimensions of health care institutions. It seeks to determine the extent to which human resource activities in healthcare firms are linked to multiple result dimensions.

The study will focus on the United States health care sector under home care, nursing homes, and care homes. The contribution of these care sectors focuses on aspects addressed in the paper. First, the paper will use multidimensional performance ideology and focus on three result dimensions which are a financial, organizational, and human resource. It will be creative because while many healthcare researchers have assessed care, organizational, and human resource results, financial indicators have not received maximum attention. Furthermore, the paper is unaware of health sector research that has evaluated the connection between the three result dimensions simultaneously. The black box issue is another concern since multiple types of research use staff attitudes as a result variable. Nevertheless, an important perception of the black box means that staff attitudes will resolve the relationship between HRM and performance. With job fulfillment as an indicator of staff attitudes, the paper will test whether it holds for the entire three result quantities considered in the paper. Therefore, the paper aims to test the following hypotheses.

 H1: Job fulfillment intervenes in the relationship between Human Resource practices and financial results in healthcare institutions.

H2: Job satisfaction intervenes in the relationship between Human Resource practices and organizational results in health care institutions.

H3: Job satisfaction intervenes in the link between Human Resource practices and Human Resource results in health care organizations.

Literature Review

 HRM Activities

 Nguyen et al. (2019) define human resource practices as consistent internal rules and approaches developed and applied to enable a firm’s resources to contribute to fulfilling the organization’s aims. HRM management practices are also essential in finding solutions to help develop HRs and HRM activities, thus improving the capacity and opportunity and empowering the workforce. Human resource management practices of improvement are such as recruitment, training, and growth activities, practices that promote the ability to contribute to establishing the suitability of the job and the company. HRM practices of opportunity enhancement create ways of conducting activities associated with work structure, team utilization, staff engagement, and misunderstanding and the process of solving an organization’s dispute and sharing information broadly (Aboul-Ela, 2017). In addition, HRM improvement practices include employee empowerment to sacrifice to fulfill the company’s mission, including those relative to performance assessment, compensation, job security, and incentives for the job.

Job Compatibility

The first knowledge of work compatibility includes firm and community compatibility expressed using the factors that are suitability, commitment, and connection. Suitability is the employees’ understanding of comfort within a company (Aboul-Ela, 2017). If the suitability is better, an employee is most likely to feel involved, skilled, and attached to the employer. Sacrifices or commitments are distinguished by physical or mental rewards, which can be lost when the employee quits their present job. Therefore, financial losses such as high compensation or attractive rewards and mental losses such as loss of support from the firm are significant measures of commitment to the employee’s job. Connections, on the other hand, are formal or informal links between one and the firms or an individual and their colleagues.

Thus the more links that tie a worker to others in the same company, the more the employee develops an attachment to their job and the firm, thus becoming reluctant to quit their job. Therefore, job compatibility can be described as how workers feel comfortable and involved in the firm and their attachment to the company leaders and their workmates. In research that mentions job compatibility, several examiners agree that work compatibility involves three independent factors that are suitability, commitment, and connection.

Work Outcome

The employee’s job outcome shows their financial or non-financial outcomes are directly related to the firm’s outcome and achievement. At the same time, to improve employee job results, firms should concentrate on promoting staff involvement or participation. Sakka et al. (2022) show that the existence of a high level of employee involvement is necessary to enhance their job outcomes through the performance of civic firms’ roles and behaviors, productivity, efforts, mental engagement, flexible effort, and existing commitment. Aboul-Ela (2017) states that job results are the direct and indirect roles played by the worker on the job to attain the goals of the firm. A more recent description by Villajos et al. (2017) states that job outcomes are the total anticipated value people perform on their delegated duties. Most importantly, job outcomes are hard to trace by a single indicator, and rather, it closely resembles an existing model, evaluated and calculated by different aspects.

Methods

Data

The structure of the United States healthcare sector includes both public and private healthcare units, based majorly on public financial assistance. The U.S healthcare system has both short and long-term care sectors. It contains firms giving home, somatic and psychogeriatric care, mainly acquiring funds from public aid, but the study will focus on the long-term healthcare sector (Sakka et al., 2022). The main explanation for the few studies concerned about the purpose and multidimensional result data is the difficulty of collecting such data. 

The study will be advantageous as it will use data from several benchmarks in the healthcare environment. It will compare benchmarks from healthcare settings to the national level, thus significant in identifying HRM relationships with the organizational, employee, and financial outcomes in a firm. It will also provide the opportunity for further HRM improvements. The benchmark approach will contrast the performance of three different hospital units, that are, home, nursing care, and care homes. It will also contain staff, client, and financial performance data.

The study will assess the information acquired from autumn 2017 to 2021, in total, over 100 organizations are expected to have participated within the period, which is approximately 50% of all institutions providing nursing, home care, and care homes in the United States. The data will be evaluated at the organizational stage. Therefore, information gathered at the staff or client level will be summed up. Other variables, including financial activity indicators, will not need aggregation as they only exist at the organizational phase. Concerning financial results, the research will concentrate on the net margin. In contrast, for the organizational result, the study will focus on client fulfillment, and absence due to illness will be focused on obtaining human resource outcomes. Job fulfillment which can also be grouped as a proximal human resource outcome will be used as a variable to mediate the link between HR practices and results. 

Firstly, most financial performance information on healthcare firms is publicly assessed based on annual reports. The data is kept in health databases. The research will discuss the data with a finance specialist from PwC (Bleijenbergh et al., 2021). To collect staff data, a questionnaire will be distributed to all workers, and a total of approximately 70,000 people are expected to complete the survey in order to gain a response rate of at least 42%. Only employee responses with direct interactions with patients and other clients will be applied in the research examination. The responses will include job activities such as nursing care, patient-related domestic empowerment, and career therapy since they are related to organizational results such as client satisfaction.

To create an effective questionnaire, the research will ensure awareness and insight into the target sample and the aim of the research proposal. It will be clear what is being measured, such as business and operational areas of human resource management. A mixture of qualitative and quantitative inquiries of several types will be used to obtain relevant data (Bleijenbergh et al., 2021). The structure of the questionnaire will be ideal for every respondent to see the same question and contain neural and non-leading questions. The questionnaire design will also have several different types of quizzes to make participants involved and complete the survey. Moreover, it will contain a balanced number of open-ended questions to obtain more in-depth perceptions of the respondents on HRM, employee, organizational and financial incomes of the health setting. In addition, it will have at least some scheduled arrangements of the questions from simple to complex, for instance, beginning with the population of the employees’ questions before proceeding to multiple-selection or open-ended questions about the quality and quantity of work. The lengthy questionnaire will be avoided annoyance and difficulty in completing the survey.

Therefore, the response rate is expected to result in a database of over 51 000 workers. Within the staff database, every question will be answered by at least 89% of the participants. High validity in response is expected from women since a higher population of nursing, and home care and. care home health providers are predominantly females. Since the study subdivides age into several categories, it could only assume something concerning the predominant age category. The predominant age group is between 45 and 55 years, suggesting that the standard age is slightly above the mean age of 42. Clients will be sampled using the Client Quality Index (for long time medication). Client Quality Index enables a stratified survey method whereby an independent agency samples a representative client survey for each firm (Bleijenbergh et al., 2021). Three groups will be constructed: home care, somatic care clients in nursing care or home care facilities, and psychogeriatric care patients in nursing or care homes. Home care patients will be required to complete a survey, while somatic care patients will be interviewed through a survey as an instruction. For psychogeriatric patients who suffer from mental conditions such as dementia, a recommended representative will complete the questions. To guarantee the comparability of staff data with the patient and financial performance information, the research will only include firms with data in all three databases. 

Dimension

The dataset designed will increase people’s understanding of the connection between Human Resource practices, job fulfillment, and outcomes. However, it is limited such that data is collected without minding academic objectives; rather, its primary aim is to be significant for the involved firm. Thus, it means that the items to be used in the research are only partially based on justified scales and existing ideologies. To ascertain the reliability of the measurements, reliability statistics will be calculated in possible areas. Cronbach’s Alpha will be applied as a measurement of reliability as it shows the consistency of the observed variable and estimates the potential dimension. The prescribed norm will be more than 70.

HR Practices

The staff questionnaire will include indicators often applied in HRM and performance studies which are training and growth, performance-related benefits, teamwork, job model, and autonomy. Ong et al. (2019) state that human resource practices that need to be implemented in HRM systems include high-performance job activities. These activities are suggested to affect performance in other sectors positively. The practices are commonly referred to as best practices. The practices do not derogate the specific medical care setting. The first two indicators included in the research are often used by examiners. The remaining three indicators also score greatly in the list of best human resource practices. Wang et al. (2022) confirm that the three indicators rank 5, 10, and 11.

However, human resource management and performance study show limited consistency in the choice of human resource best practices to quantify HRM. Sakka et al. (2022) assessed over 100 significant HRM and performance research and found over 26 different human resource practices applied in several studies. No single settled or fixed human resource list of practices is available to quantify human resource management. Regardless, a particular agreement with respect to HRM measurement has been used in the academic literature on HRM and performance over the past years. Over half of articles ad journals published in 2001 to date applied the Ability, Motivation, and Opportunity (AMO) concept (Villajos et al., 2019). The theory suggests that a human resource management system should be tailored to meet workers’ needs for expertise and empowerment. Moreover, after meeting the needs, they should give employees opportunities to make use of their skills in several ways.

The existing perception is that staff will perform competently if they possess requisite skills, when empowered, and when they are provided with the chance to profile themselves. Through the use of five human resource practices, all three scopes of the AMO concept are covered. Pillai and Sivathanu, 2022) have listed solid human resource practices that affect staff’s AMO. With respect to that, training and development are foreseen to improve staff performance, teamwork, work design, and autonomy. They are considered performance opportunities. They also play a significant role in measuring human resource management in medical care research.

Therefore, training and development will be quantified using three items. A sample item will be “My firm concentrates satisfactorily on my profession.” Responses will be provided using a five-point Likert measurement which is “totally disagree” to “totally agree.” All average loadings are expected to be greater or less than five. Contrabach’s Alpha will be determined by the standardized loadings (Ashton et al., 2018). Performance-related pay will be measured using a single item which is “my firm provides extra financial benefits to workers who perform exceptionally.” Responses will be based on a four-point Likert gauge that ranges from “never” to “always.” Teamwork will be quantified using two items. A sample item to be used will be “our firm encourages me to work jointly with other job departments or teams of workers within it,” while a four-point Likert scale of “never” to “always” will be used. All average loadings are expected to be greater or less than 0.5. Job design will be determined using three items. A sample item will be “My job roles are clear” with a four-point Liker scale of “never” to “always.” Finally, four items will be applied to estimate autonomy with a sample item of “I can make independent choices.” Four Likert never to always scale will be used.

The research will follow a systematic approach and thus combine the five indicators into a single human resource system variable. Since the evaluation will be done at the organizational level, staff data will be aggregated (Hassan, 2019). Only variables with enough difference across firms will be included. The interclass correlation will be calculated to find out whether the data could be accumulated. The aggregation will be allowed when the difference between categories is larger than the difference within categories

Job Satisfaction and Financial Result

It will be scaled by one item that is “I enjoy going to work,” where the five-point Likert measurement of “never” to “always” will be applied. Nguyen (2020) notes that quantifying job fulfillment with one item is more effective and more cost-efficient. Also, it has more face validity and is far much able to evaluate changes in job fulfillment. The net margin refers to the scale of a company’s net benefit to its absolute revenue. It will show what share of each currency earned is interpreted to profit and thus represented as a percentage.

Organizational Outcome

The organizational result will be quantified by centering on client satisfaction. Clients will be questioned on their satisfaction with the administered treatment. The indicator will have five items that are “do the health service providers have adequate time for their patient?” with a four-point Likert measurement of “never’ and “always” (Bleijenbergh et al., 2021). However, it should be noted that the Association of Client Quality only gives sum-up scales, partially due to privacy concerns. Therefore, the reliability of data and interclass correlation cannot be calculated. However, the robustness of the Continuous Quality Index, which, if frequently examined at the organizational phase, can show that a sum seems correct.

Human Resource Outcome

The HR result scale to be considered will be absent due to illness. Absence because of illness can be regarded as a major HR outcome since staff absence impacts the available HRs and is a significant success element for work procedure within the firm. Absence due to sickness will be computed in percentages using Vernet standard formula. For instance, each day a staff calls in ill will be computed by the part-time aspect and disability aspect of that day. The days will then be totaled and differed by the total sum of working days. Maternity leave will be excluded from the calculation. The human resource outcome will be computed for the company as a whole.

Control Variables

Control variables such as gender and age will be included. It will contain (1?=?female) and age (1?=?up to 24 years; 2?=?25 to 36 years; 3?=?37 to 46 years; 4?=?47 to 56 years; 5?=?57 and above). Moreover, diversity of care will be included to establish whether the relationship between the variables varies for firms hiring a diverse group of care practices as assumed to more specific firms. The variables will range from at least one and at most six due to the six different types of care in the sample of the study. The sample includes hospital, extramural residential, extramural personal care, daily activities, maternity, and youth care. 

Method of Analysis

The hypotheses will be assessed using Structural Equation Modeling and Robust Maximum Likelihood measurement. Structural Equation Modeling is helpful in examining the full theoretical design simultaneously (Hassan, 2019). Moreover, it allows simultaneous analysis of the direct and indirect connection between a dependent variable and an independent one. In addition, it facilitates the comparison of different models. Since the research hypotheses have a mediation impact, bootstrapping will be applied to measure the parameters of a design and their average miscalculations simply from the sample without referring to any practical sampling distribution. The study will create 220 samples (with substitutes) from the available scrutinized sample.

Limitations of the Research Proposal

The likelihood of considering different information sources, which are employee, patient, and objective performance data, is crucial, exceptional, and an advantage of this study proposal. However, it contains some limitations in the scales to be used since they are not based on academic works (Bleijenbergh et al., 2021). Therefore, future research with validated measurements should be applied. In addition, the problem with applying secondary data in the study is the inability to cover all research themes. Another limitation occurs with the sample size. While the primary dataset is large, data will be combined at the level of limited healthcare firms, which could seem quite low. However, Wang et al. (2022) recommend a scale of a sample size to unlimited parameters of a minimum of 5:1. In the paper’s evaluation, the model tested will be simple. The scale of the quantity of unlimited parameters to the quantity of occurrence will not be below 5:1. Nonetheless, future studies can try replicating the results using larger sample spaces.

Conclusion 

In conclusion, the research proposal underscores the importance of human resource management in organizations. It can be assumed that human resource management makes a distinction, especially for human resource and managerial outcomes. Its effect on financial performance is not very strong. Job fulfillment connects Human Resource management activities and organizational and employee results. However, the proposal will analyze human resource management in the healthcare sector, which will be a beneficial effort for both researchers and experts.

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