To most of us, a visit to a hospital fills us with apprehensions of long wait, multiple investigations, uncertain outcomes, high cost besides the pain and suffering associated with healing. But then, if we are fortunate to be met by a caring and competent clinician followed by a smiling nursing assistant with a ‘do not worry we will take care of you’ emphatic attitude; our apprehensions somewhat dilute. For the patient and family, the immediate interfaces in a hospital environment are the doctors and nurses. However, to meet the 24/7 demands of a super-specialty hospital a large pool of non-clinical personnel as well, work behind the scene to support the doctor. The doctor to other personnel ratio exceeds 1:7 for most tertiary care units. The engineer who ensures that the infrastructure is patient safe, the bio-medical staff who check and monitor the medical equipment, the hygiene staff who implement the waste segregation and environmentally safe disposal, are the “invisible staff” to name a few. In the low skill availability environment of this part of the country; to source, train, develop and retain a caring team of competent, qualified health care personnel is a key challenge for the private sector health care industry.
In Assam, till about three and half decades ago, hospitals were largely State run, with a few private nursing homes and missionary run hospitals in major towns. The number of Medical Colleges producing doctors and supporting an environment of professional health care were also far below the national average. Coupled with the above, the relative low level of industrialization and consequent poor work culture, does not support an ideal environment for hiring health care skills, be it technicians or other support staff. Consequently, till recently, the developments of appropriately skilled ready-made human resources to meet the need of the growing private sector hospitals have not been adequate. The gap between desired skill sets against availability is a reality which Hospitals accept. As an instance, to train a semi-literate housekeeping staff with nil prior exposure to concepts of infection control, to meet the exacting standards of a highly sanitized, sterilized work environment is not an easy task. The process requiring hundreds of hours of training and re-training on infection control to waste segregation norms.
In contrast to low availability of skills and low skill quality, hospitals have come a long way from the being welfare driven to being business driven, albeit with a patient centric approach. The customer too, is discerning. One cannot help noticing the young son accompanying the ailing mother check the internet to ascertain the “contradictions and side effects” of medication just prescribed. Health care leaders understand the need to be efficient, effective, competitive, productive, customer focused and financially sustainable. The business of saving and healing lives, demands the highest level of skills, commitment and ethical standards. To be accredited, the Quality Council of India NABH norms require Health Care providers to be compliant with appropriately skilled and certified staff. Quality health care and “patient first” is the focus. This delivery of emphatic quality care cannot be achieved without a pool of appropriately qualified, certified, continuously trained and upgraded skilled manpower. In recent years, there has been a sprinkling growth of privately-run institutes for skill development for health and allied services. Yet, the quality of locally available technical and non-technical skills for hiring hospitals, have not been adequate. The Hospital has to therefore constantly work at keeping the employees updated with a progressive mindset, technical competence and customer focus.
Unfortunately, in Assam, healthcare skill ecosystem continues to suffer from shortage of skilled personnel, be it super-specialized surgeons, GNM Nurses, OT Technicians, the front office staff or the invisible plumber. The triumvirate of poor availability of skills, poor skill quality and high skill costs, forms one of the biggest challenges for health care providers. The Covid-19 pandemic posed a further challenge for hospitals to retain qualified staff.
For hospitals there can be no compromise on patient safety and care, be it from clinical or non-clinical personnel. Therefore, keeping abreast of changing concepts and advancement in medical sciences, hygiene standards, infection control norms and so forth; and thereafter transferring the knowledge, techniques and skills to the appropriate level of employees is a non-negotiable prerequisite.
So, what is the solution to bridge this skill gap? Harnessing developments in artificial intelligence (AI), cyber medicine and robotics is a solution to be explored. Synergies between AI and tele-health are becoming real, as also hooking up smart phones to monitor health parameters. Using tele-medicine, IT backed remote diagnosis can to an extent ease the shortage of specialists. Online skill up gradation is a potential that needs to be leveraged as well. But these developments will take time to be fully integrated and affordable for our economy. We need to look at affordable solutions, where our demographic and large unemployed profile can yield dividend.
Can the Government alone meet this challenge? The Government’s recent upscaling in setting up colleges, institutes of medical sciences and skill centers to bridge the skill gap needs to be complemented by private sector initiatives. The private sector which has largely been impacted by this skill deficiency, needs to consider back ward integration. In fact, some progressive hospitals, have already taken the initiative to set up nursing and health care education institutes. The process has to be scaled up to include private Medical Institutes and learning centers for non-clinical disciplines as well, so as to turn out employment ready skilled human resources. Another supplementary solution is in scaling up health care provider’s in-house rigorous skill development programs supported by IT apps, well-developed SOPs and check lists. The process needs to begin with periodic skill gap analysis and training need assessments. An assessment process backed by well-developed HR tools to support compliance with government regulations, quality council requirements, certification parameters, medical standards of patient safety and ethics will complement the skill up gradation initiatives.
In the final analysis, the affordable skill solution for the private health care provider lies in developing strategic and dynamic human resource management policies, integrating innovative productivity improvement and in-house skill up-gradation solutions backed by IT and AI.
(The author is a Corporate Adviser and Management Consultant with focus in the area of IR, People & Performance and HRM. He can be contacted at sdlahkar@hotmail.com. The views expressed in the article are his own)
