Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
Higher Education Institutions' Partnership, Addis Ababa, Ethiopia.
Front Public Health. 2022 Oct 20;10:915317. doi: 10.3389/fpubh.2022.915317. eCollection 2022.
Ethiopian public hospitals struggle to meet health care needs of the Ethiopian population, in part because of the persistent human resources crisis. The health reforms and tight human resource management (HRM) regulation of the government have resulted in limited progress toward addressing this crisis. This study aims to analyze how the strategic HRM practices adopted by Ethiopian public hospitals influence employee outcomes, organizational outcomes, and patient outcomes.
Structured interviews were conducted with 19 CEOs and HR managers from 15 hospitals. Four focus groups were also conducted, with 38 participants (professionals and line managers). The transcripts were thematically analyzed using ATLAS.ti 8. Deductive coding was used based on the Contextual SHRM framework, while remaining open for codes that emerged.
Intended HR practices are influenced by mandatory strict government regulations. Nevertheless, some room for self-selected (bundles of) HR practices is perceived by hospitals. Employees perceive that governmental steered HR practices may not match its intentions due to implementation issues, related to lack of support and skilled management and HR professionals. These problems are leading to dissatisfaction, demotivation, moonlighting and turnover of skilled professionals and perceived to consequently negatively influence performance (i.e., patient satisfaction and waiting time).
There are considerable contextual challenges for SHRM in Ethiopian public hospitals. Hospital management can benefit from having more leeway and from exploiting it more effectively to improve actual and perceived strategic human resource management practices. Adoption of commitment based practices, in addition to mandatory control oriented practices can help to motivate and retain health care professionals and consequently improve outcomes.
埃塞俄比亚公立医院在满足埃塞俄比亚人口的医疗保健需求方面举步维艰，部分原因是持续存在的人力资源危机。政府的卫生改革和严格的人力资源管理（HRM）法规导致在解决这一危机方面进展有限。本研究旨在分析埃塞俄比亚公立医院采用的战略人力资源管理实践如何影响员工结果、组织结果和患者结果。
对来自 15 家医院的 19 位首席执行官和人力资源经理进行了结构化访谈。还进行了 4 次焦点小组讨论，共有 38 名参与者（专业人员和一线经理）参加。使用 ATLAS.ti 8 对转录本进行主题分析。基于情境 SHRM 框架进行演绎编码，同时为出现的代码留出余地。
预期的人力资源实践受到强制性严格政府法规的影响。尽管如此，医院还是认为有一定的自主权可以选择（一揽子）人力资源实践。员工认为，由于实施问题，即缺乏支持和熟练的管理和人力资源专业人员，政府主导的人力资源实践可能与其意图不符。这些问题导致员工不满、士气低落、兼职和熟练专业人员的离职，并被认为会对绩效（即患者满意度和等待时间）产生负面影响。
在埃塞俄比亚公立医院中，战略人力资源管理面临着相当大的情境挑战。医院管理层可以从拥有更多回旋余地并更有效地利用它来改善实际和感知到的战略人力资源管理实践中受益。采用基于承诺的实践，除了强制性的控制导向实践，可以帮助激励和留住医疗保健专业人员，并因此改善结果。
