This research aims at unfolding the context of HRM-related innovations in Dutch general hospitals. The objective is to receive insights on present innovations, their key influencers, and success and risk factors.
Resulting from the analysis of four general hospitals within The Netherlands, it is found that there is a high frequency of multi-type innovations, which combine most often two of the three different types of innovations (employment, work, and organisational) as a consequence of necessary interactions between multiple innovations.
The majority of HRM innovations are related to the digitalisation of basic processes, or the alignment of HRM to the overall organisations’ objective to increase flexibility and self-responsibility. Work innovations, such as job simplification are used to decrease the remit and responsibilities of medical jobs, so that it is easier for employees to take on jobs, which e.g. are not originally theirs. Leadership development focuses on job enlargement, and communication trainings to encourage trust and strengthen management responsiveness. In some hospitals the entire staff additionally participates in continuous learning programmes in order to increase know how, creativity, and acceptance of the shift of the hospital towards including more business organisation management elements.
Within HR departments, digitalisation and automation of basic processes is increasingly used to implement a kind of self-service portal, with which the number of actions and actors is reduced so that basic tasks become faster and simpler.
It is this shift, which is often referred to as NPM that is the main causes for Dutch general hospitals to increase their efficiency and performance level. Especially the in 2005 implemented DBCs payment system, which follows the principle “money follows the patient”, increases the need for fast and efficient patient treatments. This in return requires flexibility and efficiency of the staff. Additionally, the changing demands of the overall ageing patients, as well as the speeding digitalisation influence this need. Another challenging factor is the external scarcity of educated medical personnel, and the internal ageing of staff, which partly results in growing shortage of nurses and medical specialists. These are all factors, which shape the Dutch health care sector and which distinguish the operational modes of local general hospitals.
Possible innovation triggers have been analysed in the course of this research. It became apparent that especially increased communication and knowledge sharing through internal and external networks, and separate stimulation of younger and older employees within the organisations are likely to increase the occurrence and acceptance of innovative changes in hospitals.
Close arrangements between regional health care institutions can increase the innovative thinking of HR professionals by exchanging knowledge and ideas, and receiving incentives for improvements. In this context, especially regional collaborations seem beneficial as they are influenced by similar prevailing regional-specific conditions
and thus incentives and collaborations are more useful and possibly need less adaption. Previous literature on HRM-related stimuli for innovation emphasise internal communication and teamwork encouragement to increase the chance for developments and innovations. By networking and sharing individuals’ knowledge, mutual understanding and interaction can be strengthened, and opportunities for improvements and innovations become more visible. However, it appears that teamwork and strong communication is still mainly present within wards, whereas interaction among different actors is scarce. This poses a risk as wide-reaching consequences become unnoticed. Additionally, teamwork has a positive effect on the level of learning, which is specifically interesting as continuous learning is a characteristic of learning organisations. Particularly as learning organisations are those organisations, which are held to be innovative. The studied hospitals were all found to recognise that continuous learning is essential in order to stay competitive and thus, promote continuous learning. Especially leaders, which change-management-literature identifies as key enabler in the change process receive comprehensive communication and leadership training. Increased communication and management responsiveness target the reduction of unknowingness and uncertainty of the staff towards the present and future changes in the hospital sector. Unknowingness and uncertainty pose a great threat as they can result in fear and eventually in resistance. In this context, it is beneficial to realise that (and also identify) the different employee groups within the organisations have different abilities to adapt to changes, and therefore need different approaches in order to be able to change and to detect opportunities. Whereas the younger generation needs to be challenged, the older generation needs a great amount of communication and information on sector trends, opportunities, and challenges in order to reduce their uncertainty and fear towards the future, and eventually increase their flexibility and adaptability.
In the course of this research it emerged that outsourcing of HRM activities is rarely used. It corresponds to the theory, which suggests that core competences should be kept in-house. Hospitals are service organisations in which the performance of the staff is very closely related to the overall performance of the hospitals. Thus, human capital is the most important capital in hospitals, and its management should be kept internally. In summary, this research identified a number of HRM-related innovations in Dutch general hospitals, which most often were multi-type employment or work innovations related to the organisations’ targeted cultural shift towards being more efficient, flexible and self-responsible. The main cause for this shift is the increasing necessity for business-like thinking and adoption of business organisations’ management characteristics, which also requires HRM to become less traditional and more strategic. Increased accessibility of information to all operational areas within the organisations has been identified as crucial for the organisations’ successful transition towards efficiency and innovation in order to raise acceptance and adaption to the new operational mode. Encouraging communication and knowledge sharing throughout the organisation and institutional associations is an effective method to achieve this goal.
However, it became apparent that external as well as internal networks, and internal communication as well as development is not yet fully aligned with the level needed for detecting and exploiting opportunities.
It can therefore be concluded that HRM departments in Dutch general hospitals are still in the transition towards becoming fully strategically aligned with the organisation as a whole. Furthermore, HRM innovations are only elaborated and implemented in order to achieve a certain objective; they are not used for the pure purpose of being innovative.