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CHL Lesson Plans provide members with ongoing education focusing on supervisory or management issues. These lessons are designed for CHL re-certification, but can be of value to any CRCST in a management or supervisory role.

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Lesson Plan CHL 305
External and Internal Factors Impact Management of Central Service Employees
[Reprinted from Communiqué: January/February 2008]

Large healthcare facilities typically have staff specialists whose primary responsibilities focus on human resourcesconcerns. Managers in smaller organizations must assume these duties in addition to numerous others as an integral part of their job. Central Service managers in units of any size must recognize that there are numerous external andinternal influences that impact human resources activities, and they cannot make unilateral decisionswithout considering them.

Figure 1 identifies basic human resources responsibilities and indicates that they are influenced by external and internal factors.

Let’s review Figure 1 by first explaining the human resources activities with which Central Service managers are involved:

• Recruiting/selecting – Tactics and procedures to attract applicants to the facility and department (recruiting), and choosing the very best persons from among them (selecting).

• Training and development – Preparing new staff members to do required work, updating their experienced peers about job-related information, and providing opportunities for all interested staff members to assume more responsible positions are important concerns of all healthcare facilities.

• Compensation and appraisal – Personnel should receive pay and benefits commensurate with the contributions they make to the facility. Performance appraisal provides input to help employees attain the on-job success that can yield promotions with higher compensation levels.

• Protection and communication – Safety and security concerns are of obvious importance to all employees. Many laws and regulations mandate safety procedures, and numerous other tactics that Central Service managers should do (and should not do) impact employee safety. Many legal and procedural issues with safety implications are addressed by staff members with centralized human resources responsibilities in large facilities. However, managers in Central Service departments of all sizes can never delegate their responsibility for and concerns about employee and patient safety. As well, effective communication that flows up, down, and across the organization helps to ensure that staff members know about issues that affect them.

Figure 1 also indicates that human resources activities are impacted by several external influences. These include:

• Legislation and legal mandates – The impact of Federal, State, and other laws on the hiring process and their influence on management decisions affecting personnel cannot be overstated. The duties of care (required obligations) assumed by Central Service managers are extensive. They include those related to selection, discrimination based upon race, color, religion, sex (including pregnancy and childbirth), and natural origin.
  
  Central Service managers also may not discriminate against persons with disabilities. Protected groups include those with a qualified physical or mental ability including Acquired Immune Deficiency Syndrome/Human Immune Deficiency Virus (AIDS/HIV), cerebral palsy, hearing or visual impairments, and alcoholism as well as other identified disabilities.
  
  Age discrimination in employment is also illegal. For example, persons who are 40 years of age of older cannot be discriminated against based on their age with regard to hiring, firing, layoffs, pay, benefits, or training.
  
  Employee harassment is forbidden in the workplace. For example, there are two types of illegal sexual harassment: quid pro quo (asking for sexual favors in exchange for giving a promotion or raise, or punishing someone for reporting sexual favors) and hostile environment (creating, through language or conduct) an intimidating work environment.
  
  
• Marketplace preferences – The marketplace includes the community, patient base, physicians, and other constituencies who are served by and who impact the facility. What products and services must be produced, and when are they needed? How can costs be reduced without sacrificing quality? What products/services are desired? The answers to these and related questions drive employee recruiting/selecting, training and development, and compensation and appraisal activities (among others).
  
  
• Demographics – The characteristics of the local labor market and the patients are of obvious concern. Income levels in a community affect wage and salary rates, as do the compensation programs of competitive employers.
  
  
• Economy – The financial well-being of world markets and the country, state, and area within which the facility operates impacts the financial health of every local community. Is the community growing or declining? It may be hard to believe, but the global issues we read about everyday impact healthcare facilities and their need for and availability of staff members.
  
  
• Employee unions – Staff members may belong to an employee union that represents their interests in numerous aspects of most human resources activities.

Figure 1 also suggests that there are internal organizational influences on human resources activities:

• Policies – A policy states the rules and regulations established by an organization, and specifies how applicable staff members should act. These important communication tools significantly influence how managers treat staff members. In the absence of laws that regulate specific actions, employers and managers have discretion in establishing protocols that will likely affect the attitudes of staff members towards the facility and the Central Service department.

• Work Procedures – Work procedures involve steps to be used to accomplish an objective. They are usually developed to indicate how a work task should be accomplished. These procedures can be designed with (or without) input from applicable personnel. The extent to which equipment is used to ease physical work tasks, and the amount of employee empowerment, if any, impact how work is done and, in turn, required human resources activities. Note: Empowerment is the act of authorizing employees to make discretionary decisions within their areas of responsibility.

• Organizational culture – The perceived worth of employees to the facility is an integral part of its culture. It drives the philosophies and attitudes about employees and their role in the healthcare organization, and the human resources activities used to address personnel-related concerns.

• Long-and short-term plans – Longer-term plans such as expansion or down-sizing (activities implemented to eliminate jobs to generate greater efficiencies and cost savings), and shorter-term plans such as rolling out a new program or service impact present employees and also recruiting, selecting, and training activities.
• Management judgment and experience – Central Service managers and human resources specialists (in large organizations) bring their own judgment and experience to the decision-making process. This input affects the policies, procedures, and plans that are developed and implemented. They also influence numerous other decisions about human resources issues.
  

When one considers the external and internal influences that impact the management of Central Service staff members, new meaning can be attached to the old saying that “The manager is the boss!” The extent to which this is true must be modified by numerous factors that originate both outside of and within the healthcare organization.

ENDNOTES

Civil Rights Act of 1964 (Title VII).

Americans with Disabilities Act.

Age Discrimination in Employment Act.

Civil Rights Act of 1964 (Title VII).

Take the CHL 305 QUIZ

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