Manpower Planning

Introduction
• Manpower planning is the prime function of the hospital human
resource manager but before he starts filling individual jobs, he
should consider the overall management problem of making the best
use of available human resources.
• Manpower planning for the integration of information, formulation of
policies and forecasting of future requirements of human resources so
that the right personnel are available for the right job at the right
time.
• Manpower planning starts with the analysis of the future needs of the
hospital and its objectives
• It determines organisation structure, decides what jobs have to be
filled and their requirements are.
• Short term manpower planning – two years or so ahead – is
promotion planning
• Really important planning is the long-term planning – five years or ten
years ahead
• The direction of a hospital’s development efforts will be determined
by short-term as well as long-range family planning
• Manpower planning is essential to know the present and future needs
of the healthcare workers
• In case of health crisis, some under developed and developing
countries of the world will be able to provide minimum basic
healthcare to their citizens
Nature and scope of manpower
planning
• A technique for the procurement, development, allocation and
utilization of human resources in an organisation
• It views employees as scarce and costly resource, whose contribution
must be developed to the fullest by the management
• Concerned with having the right type of personnel for the right job at
the right time.
• This is done by studying three types of forecasts:
• Economic forecast
• Hospital’s expansion forecast
• Employee’s market forecast
• Systematic manpower planning is the must for every dynamic
organization.
• The management has to meet the challenge of various pressures,
such as political, economical and technological, to ensure that the
future of the hospital remains bright under all circumstances.
Need for Manpower planning
• Every hospital has to do manpower planning for the following
reasons:
1. Shortage of certain categories of employees
2. Advancement of medical science and technology resulting in need
for new skills and new categories of employees .
3. Changes in organization design and structure affecting manpower
demand
4. Government polices in respect to reservation of seats for
SC/ST/OBC/Handicapped persons and others
5. Labour laws affecting demand and supply of labour.

6. International scenario of employment, e.g. employment of nurses,

doctors, paramedical personnel in USA, UK, Ireland, the gulf
countries, etc.

7. Introduction to computers
Benefits of Manpower planning
• Enables an organization to have the right person at the right place and at right
time.
• Provides scope for advancement and development of employees through
training, development, etc.,
• Helps in anticipating advertisement and salary budgets;
• Foresees the need for redundancy and plan to eliminate it
• Plans for better working conditions, fringe benefits, training needs;
• Gives an idea of the type of tests to be used and interview techniques in
selection based on the level of skills, qualifications, intelligence, values etc. of
future manpower, and
• Helps improve service to patients and contributions of working personnel
Objectives of manpower planning
• Ensuring maximum utilization of personnel
• Assessing future requirements of the organisations
• Determining recruitment sources
• Anticipating from past records:
• Resignations
• Discharge simpliciter (simple discharge)
• Dismissals and
• retirement
• Determining training requirements for management development
and organization development
Manpower planning steps
• Scrutiny of the present personnel strength

• Anticipation of manpower needs

• Investigation of turnover of personnel

• Planning job requirements and job descriptions

Investigation of turnover of
personnel
• Rate of change in number of employees, i.e., the number of employees
leaving and joining an organisation during certain period.
• Some important factors which result in employees quitting their jobs are:
• Low salary
• Better prospects in other hospitals
• Poor working conditions
• Transport problem
• Housing problem
• Marriage in case of female employees
• Health grounds
• Family circumstances
• Further studies
• Maltreatment by superiors
• Unfriendly relations with colleagues
• The attraction of going back to one’s native place
• The attraction of going to foreign country
• Exist interview is a useful tool to study labour turnover
• An exist-form should also be filled up by the concerned department
head
Planning job requirements and job
descriptions
• Job analysis: process of examining a job to identify its component and
parts and the circumstances in which it is performed
• It is necessary to be familiar with this technique because its application
is quite wide and extends across the whole range of staff management
functions:
i. Recruitment
ii. Training
iii. Salary
iv. Safety
v. Annual performance appraisal
• The steps in conducting job analysis
1. The analysis should commence with a fairly brief statement of initial
requirements such as aptitude, educational qualification, training
and experience.
2. The next main item should be a description of the responsibilities
under board headings such as physical effort (moving, lifting,
duration etc.), mental effort (the degree of intelligence needed) and
responsibilities (controlling staff, material, equipment, cash, etc.)
3. Environmental and conditions of service are to be considered and
analysed, such as physical surrounding (indoor, outdoor,
temperature, humidity, noise, etc.), accident hazards, shift duties,
prospects of advancement, occupational illness, etc.
4. The constraints, difficulties and the pressure of the job should also
be brought out
Job description
• Broad statement of the purpose, scope, duties and responsibilities of
a particular job
• This is a resultant of the job analysis.
• It provides the detailed factual information required by candidates
and selectors alike in order to obtain a thorough knowledge of the
requirement of a job
• To avoid confusion and misunderstanding, a job description should be
prepared jointly by the human resource department and head of the
department
Job specifications
• List of various qualities which the person doing the job should posses
i. Mental requirements which include intelligence needed, and educational
and professional qualifications
ii. Physical requirements which include age, height, health and eyesight etc.
iii. Skills requirements such as dexterity required for doing a job,
communication, human relations and leadership skills
iv. Responsibility requirements in relations to machines, equipment's,
fellow workers, work schedules
v. Experience requirements to do the job efficiently
vi. Working conditions requirements such as physical surroundings
Human resource requirement in
hospitals
• Before the recruitment and selection of personnel can be undertaken,
the requirements for human resources must be analysed in terms of
number of personnel needed for each type of job
• According to WHO, a population of one thousand people needs at
least one qualified doctor
• And every qualified doctor in turn requires eight skilled paramedical
and nursing profeesional
Stay in interview
• HRM has become an indispensable tool to retain their workforce by
making them feel appreciated and motivated
• Contrary to exit interview, stay in interview is conducted to
understand the reasons why employees wish to continue working for
the organization.
• It is all about their work, the environment, the practices and the
behaviour of the supervisors managers that appeal to them and
motivate them to stay on.
• Stay in interview is held to understand the issues an employee may be
facing
• Stay in interview and exit interview can prove to be crucial as they
may actually bring forth an issue that the manager may have hitherto
ignored
• They can be used to judge if the expectations of the employees have
been met and the promises fulfilled
• The concept of stay in interview is a positive approach
• This ratio of 2 employees per bed cannot be applied in Indian
hospitals because the personnel required depend on the size of the
hospital, type of hospital and degree of care it provides, area of the
hospital, type of equipment used (automatic, semi-automatic, or
manually operated), etc.
• Under prevailing conditions, to manage every bed, whether in a small
or big hospital, it requires 3 to 5 personnel
Doctor- to- Beds Ratio
• According to the Medical Council of India, the doctor-to-beds ratio
should be 1:5, but this ratio is applicable only to those hospitals which
are attached to medical colleges and where the doctors required to
participate in teaching programmes of the medical colleges.
• This ratio depends upon the type of hospital, such as maternity,
paediatric, infectious diseases, referral, general, etc.
• However, it can be recommended that the doctor-to-beds ratio should
be 1:10 in general hospitals
Nurse-to-beds ratio
• The nurse to beds ratio to should be 1:3, according to the Indian Nursing
Council.
• The council has further prescribed that for every 100 beds and to cover a
24-hour period, there should be 4 ward sisters and 30 staff nurses and
for fractions of 100, the staff should increase in the proportion of 1 ward
sister to 25 beds and 1 staff nurse to 3 beds.
• There should be separate staff for special departments with sister in-
charge of the casualty department.
• The out-patients department should have a sister-in-charge and a
minimum of one staff nurse for each out-patient clinic operating daily,
but not less than a total of two in the department.
• Patient’s care at the time of admission: The staff nurse welcomes a patient with a
smile, removes the bed cover, makes him feel comfortable, arranges for fresh
drinking water, checks his weight, temperature and blood pressure, enquires about
the history of the illness.
• Morning care of the patient: this care is given to the patient in the morning by the
day-shift
• Afternoon care of the patient: this care is given to a patient by the day-shift nurse
after he had his lunch
• Evening care of the patient: this is the care given to the patient by the P.M. shift
nurse.
• Pre-monitoring care of the patient: this is the care which is given to the patient
generally between 5 and 7 A.M. by the night nurse
• Care at the time of discharge of the patient: preparation for patient to return home
should actually begin the moment he enters the hospital
• When doctor decides to discharge a patient, the nurse informs the patient and his
family members so that they make necessary arrangements
• Chart for billing, explains the discharge policy to the patient and relatives, collects
home medicine and requests doctor to prepare the discharge summary
Deciding work-load ratios and
human resource strength in various
departments
• X-Ray department
• Three different sections:
• Diagnostic radiology
• Therapeutic radiology
• Nuclear medicine
• The following tasks should be taken into considerations:
• perception of a patient
• Recording the history of a patient, as a concerned with X-ray
• Preparing the necessary papers; the slip to be pasted on the X-ray
request, entry in the register
• Taking film from stock, putting the same in the X-ray cassette
• Explaining to patient about X-ray procedure and taking the X-ray
• Processing film
• Sorting film
• Reporting to the radiologist
• Typing of reports
• Charting report or despatching report
Physiotherapy
• Main objectives :
1. To minimize physical disability through therapeutic exercises and
rehabilitative procedures
2. To assist each patient so that he may reach maximum functional
level
3. To contribute to the comfort and well-being of the patient
4. To re-train him in activities of daily living
5. To accelerate the patients recovery and decrease his length of stay
in the hospital
Main functions of the physiotherapy
• To speed up recovery of patients and shorten their stay in the hospital
• To prevent and minimize residual physical disabilities
• To restore physical functions of the body
• To make an individual return to his optimum way of living
• To provide assistance to the physicians, orthopaedicians,
nerologistists, paediatricians, obstetricians, etc. in implementing early
ambulatory care.
Physical therapy department, hospital planners
should pay attention to major functional areas.
• Treatment area consisting of cubicles
• Gymnasium
• Hydrotherapy area
• Space for office where clerical and administrative work can be carried
out
• Sufficient changing rooms for patients coming for treatment can
change their dress before going to the treatment room
• Sufficient number of toilets
Before giving treatment to patients,
he has to do some preparatory
work:
1. Examination of the patients
2. Documentation
a) Name
b) Age
c) Sex
d) Present history of illness
e) Past history of illness
f) Family history, if any
g) Special investigations, if any
h) Diagnosis
3. Aims of treatment
4. Planning of treatment
5. Results of treatment
6. Progress reports
Medical laboratory
• Clinicians depend more and more on laboratory tests as they want to
confirm their clinical diagnosis and at the same, want litigation
because of their own inadvertent wrong diagnosis.
• They prefer to ask patients for laboratory tests which are absolutely
necessary for diagnosis of their disease.
• The primary function of medical laboratory is to perform laboratory
tests in the eight main fields of haematology, parasitology, urinalysis,
histopathology, serology, biochemistry, bacteriology, cytology etc. to
assist medical staff making or confirming diagnosis
• Laboratories of diagnostic centres and of hospitals function round the
clock, engage specialized staff and perform all the tests relating to the
to their respective disciplines
• The haematology section analyses blood specimens, the biochemistry
section performs quantitative and qualitative analysis of blood
• Clinical pathology performs various studies such as urine analysis and
semen analysis
• In larger hospitals, there are generally two laboratories: one for the
indoor patients and the other for the outdoor and emergency
patients
• In all hospitals, a pathology is in-charge of the laboratory
Pharmacy
• The most extensively used therapeutic facilities of the hospital
• Each and every hospital administrator is required to plan, organize,
staff, control and evaluate the pharmacy department scientifically and
professionally by employing qualified and experienced pharmacists
• Each hospital should design its own pharmacy and follow norms and
requirements of keeping narcotics and preparing I.V Solutions.
• Mostly pharmacies keep the essential list of drugs, have their own
formulary, set up policies and procedures, and purchase, receive,
store and dispense drugs to outdoor and indoor patients
• The pharmacy department of any hospital is a major source of
administrative concern in term of cost control, quality of medicines,
pilferage, wastage, legal obligations, etc.
• It has been observed that one pharmacist can dispense medicine to
150 patients per day
• This excludes placing the order with the supplier, receiving supplies
and making entries in ledger but includes reading prescriptions,
dispensing medicines and explaining how to take medicines to the
patient
• One pharmacist who works 8 hours a day can take care of 100 out-
patients as well as 50 in-patients, but for every two pharmacists, one
pharmacy aid will have to be provided to assist them
Laundry
• Major role in hospital functioning
• Its one of the major consideration in planning, designing and
constructing a hospital
• The number of personnel required in the laundry department depends
upon the frequency of changing the linen in the wards, the quality of
linen, as well as upon its laundry equipment-whether it has boilers,
washing machines, hydro-extractors, drying tumblers, flat-work ironers,
flat bed presses and allied equipment.
• However, one laundry operator can wash the linen of 25 to 30 beds and
one laundry orderly can assist in washing the linen of 50 to 60 beds.
• The laundry should be located in ground floor in open area so that the
washed linen can be dried in sun as the sun is very good disinfectant.
• One washerman can take care of : 150 to 200 kg linen per day.
• (This includes collection of linen from different places, washing,
drying, folding, ironing and returning).
• Each operation in O.T. : 7 to 8 kg of soiled linen
• Each delivery in L.R. : 7 to 8 kg of soiled linen
• Each ward patient : 5 to 6 kg of bed linen
The space and equipment required
in hospital laundry
1. To open the bundles of the linen
2. For sorting linen
3. Sluicing and disinfecting area
4. Clean linen processing area
5. Drying area
6. Folding area
7. Pressing area
8. Material storage area
9. Clean linen storage area
10. Laundry supervisors office
11. Toilets
12. Water softening plant area, if required
13. Cart storage area
14. Solution preparation and storage room
15. Boiler area
List of equipment for laundry
1. Washing machines
2. Hydro extractors
3. Iron for pressing clothes
4. Dryers if open space is not available
5. Dry linen trolleys
6. Wet linen trolleys
7. Sewing machines
8. Weighing machines
9. Boiler
Food service
• The food-service department of any hospital caters meals to the patients
and plays a significant role.
• Meals prepared hygienically under the guidance of qualified dieticians,
according to the instructions of the doctors and attractively served to the
patients help in their speedy recovery.
• The food-service department ranks as one of the major departments of a
modern hospital.
• It is responsible for planning, organising and directing all phases of the
dietetic operations which include visiting patients, consulting their charts,
menu planning, food preparation, serving, budgeting, cost control, record
keeping, performance appraisal of its personnel, safety, sanitation, etc.
Food service department
i. Supply receiving area
ii. Dry storage area
iii. Refrigerated storage area
iv. Cooking area
v. For employees cooking
vi. Patients serving rooms where patients food trays are assembled \
vii. Food service manager office
viii. Dietician office
ix. Dishwashing area
x. Peeling of vegetables area
xi. Visitor’s canteen
xii. Pot washing area
• Generally, in the food-service department of a hospital, the dietician,
food storekeeper, cook, cook helpers, bearer and dish washer work in
close coordination.
• One dietician can look after up to 200 words. If the bed strength
exceeds 200 beds, another dietician should be appointed.
• One cook, one cook helper, one bearer and one dishwasher are
sufficient to prepare and serve meals for 20 patients/staff members.
• The food is served to the patients in their wards and to staff
members in the hospital cafeteria
Sanitation and housekeeping
• The housekeeping department deals with hospital hygiene. The
sanitation in-charge should know the simple facts about bacteriology.
• He should also be able to train his employees in cleaning techniques that
prevent the spread of disease, since all cleaning is meant to remove
organic matter in which bacteria is harboured.
• The time and effort of sanitation employees can be saved and more
efficient cleaning accomplished if set procedures and fundamental
techniques for dusting, sweeping, mopping, scrubbing, polishing and
washing are observed.
• In all these operations, clean equipment and clean solution should be
used. Cleaning cannot be accomplished with dirty hands and equipment.
Functions
1. They sweep and mop the floors, dust furniture, clean walls, windows and
bathrooms daily.
2. They scrub and wax floors
3. They collect and dump it near the burning site
4. They sweep and mop the patients room as when he is transferred or discharged
5. They prevent spread of infection by exterminating bugs and pests
6. They shift furniture from the place of hospital to another
7. They assist the staff nurse in shifting the patients
8. They water indoor plants in some hospitals
9. They switch off lights and fans of their area
10. They assist the staff nurse/ X-ray technicians/ laboratory technicians/
pharmacists/ physiotherapists manually as when required
Security
• With the passage of time, the security of any organisation is becoming more
and more problematic.
• This is particularly so for a hospital.
• Visitors often indulge in pilferage, with or without the connivance of
employees of the hospital.
• They also try to visit the patients during non- visiting hours, thereby violating
the rules and regulations of the hospital.
• Similarly, employees of the hospital try to pilfer hospital property as well as
break hospital discipline.
• The security personnel of a hospital have a dual role to play-that of watching
and controlling both visitors and the staff.
Sterile supply department
• The staffing norms of the central sterile supply department of a hospital
depend upon the model of the autoclave, other equipments being used
in the department, the policy for the distribution and collection of
articles, the interpersonal relationships of the staff of this department
with the staff of medicine, surgery, operation theatre, labour room,
casualty, etc.
• Since the nature of work is simple and can be learned after a short
training, one person in the central sterile supply department can take
care of 25 to 30 beds.
• This excludes the supervisory staff but includes a 30 percent leave
reserve.
• While determining the staffing norms for the central sterile supply
department, several points must be kept in mind:
• Method of collection and distribution of articles to be autoclaved
• Number of disposable articles being used in the hospital
• Repressible articles available for circulation
• Bed strength of the hospital
• Size of the autoclave
• Type of the hospital.
The main objectives of the central
sterilization and supply department
1. To prevent infection by sterilizing equipment and materials
2. To sterilize equipment's and materials so that reuse of these items
can be possible
3. To achieve higher efficiency in areas where sterilized equipment and
materials are used
4. To reduce the length of stay of patients by providing proper
sterilized the equipment and materials
5. To reduce the cost of maintenance of the hospital by sterilizing the
equipment and materials
Functions
• Receiving the used equipment and materials
• Sorting out the equipment and materials
• Deciding whether any of the equipment and materials are required to be discarded
• To disinfect prior sterilization
• Assembling equipment sets, linen packs and treatment trays
• Packing equipment sets, linen packs and treatment trays
• Sterilizing
• Labelling and dating
• Sorting equipment packs, linen packs and treatment trays
• Issuing
ECG department
• The staffing norms for ECG technicians depend upon the type of
hospital, size of the hospital and number of patients visiting the OPD.
• The staffing norms for ECG technicians can be formulated on the basis
of number of ECGs taken in one shift lasting eight hours.
• One ECG technician can take about 20 ECGs in one shift. If the
workload is less in the evening and night shifts, the technicians should
be assigned some other job such as making cotton balls, preparing
gloves foe obstetric and gynaecological check-ups, making gauze pieces
and eye pads, packing of dressing sets, etc. according to his ability.
• The technician can thus be kept occupied.
Admitting Department
• The admitting department is a window of a hospital because any person
who comes to hospital first reports at the enquiry office, which is a part
of the admitting department
• At time of admission, the admission desk collects data during the
admission process.
• Whenever a patient is referred either by general OPD or private OPD or
casualty department for admission, the patient and his family members
are worried and in mental shock
• Delay in admission or unbecoming behaviour of the staff of the
admitting department can cause them emotional trauma for nothing
because they are already worried about the illness
Main functions
• Admission of patients, transfer from one place to another because of
the condition of patients and discharge of patients from the hospital.
• Collecting information from patients at the time of admission.
• Generating appropriate patient’s records to pass on to the
department concerned such as wards/ICU/ labour room/OR etc.
medical records, billing and enquiry office.
• Collecting advance from patients at the time of admission as per the
policy of hospital, if any
• Booking patients for planned surgeries and deliveries on the basis of
written instructions by the doctors concerned
• Maintaining a bed index showing current occupancy of beds wards wise in
order to assign beds for other patients who are to be shifted out from ICU,
labour room and operation theatre.
• Arranging some one to take the patient and his family members to the
patient’s room and operation theatre.
• Arranging some one to take the patient and his family members to the
patient’s room where he has been allotted a bed
• Providing information about the hospital and its doctors to patients
• Telling the bed and room number of patients to their relatives
• Admitting day surgery and thalesiama patients who are just admitted for
four to six hours only
• Giving passes to the patients family members
• Explaining visiting hours policy
Medical Records Department
• The importance of the medical records department was always these,
but now it has become a more important department because of
increasing:
i. Medico legal cases such as assaults, attempted suicides, death from
criminal acts, industrial accidents, poisoning, and road accidents
ii. Consumer cases
iii. Teaching in hospitals to postgraduate students, and
iv. Research
MRD maintains records and
document relating to patient care
• Its main functions are filing, indexing and retrieving medical reocrds
by
i. Developing a procedure for the proper flow or records,
ii. Developing a statistical reporting systems that includes ward census, daily
census, out-patient census, etc.
iii. Preparing births, deaths and communicable diseases reports which are
mandatory, and
iv. Preparing statistical reports in relation to admission, discharge, coding all
diagnosis and operations according to the international classification of
diseases.
• The MRD requires space for its functioning as it is required to keep of
all inpatients, deaths, births, medico legal cases, etc. as per
notification issued by the government from time to time.
• Therefore, it requires
1. Reception area
2. Work area for record processing, assembling, numbering, indexing,
correspondence, etc.,
3. Record storage area,
4. Area for completion of medical record by the medical staff, and
5. Area for medical records staff
Public Relations Department
1. Delivery of quality care at reasonable cost
2. Growing public criticism against hospitals in general and doctors in
particular
3. Increasing interventions of government agencies
4. Non-availability of trained and qualified hospital personnel who
have real aptitude to serve the sick people
5. Lack of professional management in hospitals
6. Poor maintenance and service of costly hospital equipment
7. Scarcity of nurses all over India in particular