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November 7, 2016

​Naresh Khatri, PhD

Three Key Practices in Hospital HR Departments Linked to Exemplary Patient Care

Researchers at the University of Missouri School of Medicine have identified three HR practices for hospitals that can improve clinical work behaviors, leading to better outcomes for patients.

While employee salaries and wages can account for up to 80 percent of the total operating budget in health care organizations, human resources departments in many U.S. hospitals still rely on traditional, bureaucratic HR practices that can constrain employee effort and initiative. Now, researchers at the University of Missouri School of Medicine have identified three HR practices for hospitals that can improve clinical work behaviors, leading to better outcomes for patients.

"First, the hospital's CEO needs to play the role of the people's champion, as this would help to provide leadership and critical resources to the HR department, in addition to sending a clear message to the rest of the organization about the importance of HR," said Naresh Khatri, PhD, an associate professor in the Department of Health Management and Informatics at the MU School of Medicine and lead author of the study. "Next, the role of the HR director is almost as critical as that of the CEO in making sure the HR department has a compelling vision of how to use HR to enhance hospital performance. Finally, a successful HR department should have highly professional and competent HR employees who are capable of modifying, reconfiguring, and renewing HR practices and systems as needed."

Khatri and his research team surveyed senior managers from more than 450 hospitals across the United States. The team asked questions related to the relationship between the hospital's chief executive officer and its HR department, the leadership within the HR department and the quality of patient care.

The team used the survey answers to test whether the three HR practices could enhance quality of patient care via promoting proactive behaviors in their workforce. The researchers found that those practices had significant positive correlations with proactive employee behaviors that in turn improved the quality of patient care.

"Given the critical role that employees play in the service industry, and especially in hospitals where their role takes on a special significance, it is of utmost importance that we understand what motivates employees to better serve their customers," Khatri said. "This study found that proactive employee behaviors could boost employee productivity, leading to improved patient care."

Overall, Khatri said that the study findings show that the HR department plays a crucial role in improving the quality of patient care in U.S. hospitals and could be a source of sustainable competitive advantage for these organizations. To be able to do so, Khatri said that U.S. hospitals should build HR departments that are strategic and transformational rather than bureaucratic and administrative.

"If hospitals are to capitalize on their employee skills, knowledge and abilities, it is critical that attention is paid to finding the right individual to head the HR department, while empowering him or her to perform the role to the best of their abilities," Khatri said.


Khatri's study, "The Relationship between HR Capabilities and Quality of Patient Care: The Mediating Role of Proactive Work Behaviors," recently was published in Human Resource Management. The project was partially funded by the Agency for Healthcare Research and Quality of the National Institutes of Health (R03HS17549).

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