Abstract:
Hospitals in Sub-Saharan Africa (SSA) face major workforce challenges while having to deal with extraordinary high burdens of disease. The effectiveness of human resource management (HRM) is therefore of particular interest for these SSA hospitals. While, in general, the relationship between HRM and hospital performance is extensively investigated, most of the underlying empirical evidence is from western countries and may have limited validity in SSA. Evidence on this relationship for SSA hospitals is scarce and scattered. We present a systematic review of empirical studies investigating the relationship between HRM and performance in SSA hospitals.Following the PRISMA protocol, searching in seven databases (i.e., Embase, MEDLINE, Web of Science, Cochrane, PubMed, CINAHL, Google Scholar) yielded 2252 hits and a total of 111 included studies that represent 19 out of 48 SSA countries.From a HRM perspective, most studies researched HRM bundles that combined practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single HRM practices (instead of bundles). Training and education were the most researched single practices, followed by task shifting.From a performance perspective, our review reveals that employee outcomes and organizational outcomes are frequently researched, whereas team outcomes and patient outcomes are significantly less researched. Most studies report HRM interventions to have positively impacted performance in one way or another. As researchers have studied a wide variety of (bundled) interventions and outcomes, our analysis does not allow to present a structured set of effective one-to-one relationships between specific HRM interventions and performance measures. Instead, we find that specific outcome improvements can be accomplished by different HRM interventions and conversely that similar HRM interventions are reported to affect different outcome measures.In view of the high burden of disease, our review identified remarkable little evidence on the relationship between HRM and patient outcomes. Moreover, the presented evidence often fails to provide contextual characteristics which are likely to induce variety in the performance effects of HRM interventions. Coordinated research efforts to advance the evidence base are called for.
摘要:
撒哈拉以南非洲(SSA)的医院面临着巨大的劳动力挑战,同时不得不应对非常高的疾病负担。因此,这些SSA医院特别关注人力资源管理(HRM)的有效性。同时,总的来说,广泛调查了人力资源管理与医院绩效之间的关系,大多数潜在的经验证据来自西方国家,在SSA中的有效性可能有限。SSA医院关于这种关系的证据很少且分散。我们对SSA医院人力资源管理与绩效之间关系的实证研究进行了系统综述。按照PRISMA协议,在七个数据库中搜索(即,Embase,MEDLINE,WebofScience,科克伦,PubMed,CINAHL,GoogleScholar)获得了2252次点击量,总共有111项研究,代表48个SSA国家中的19个。从人力资源管理的角度来看,大多数研究都研究了人力资源管理捆绑包,这些捆绑包结合了来自动机增强的实践,技能增强,和增强赋权领域。激励实践是最经常研究的,其次是增强技能的做法和增强赋权的做法。很少有研究关注单一人力资源管理实践(而不是捆绑)。培训和教育是研究最多的单一实践,其次是任务转移。从性能的角度来看,我们的审查显示,员工成果和组织成果经常被研究,而团队结局和患者结局的研究明显较少。大多数研究报告说,人力资源管理干预措施以某种方式对绩效产生了积极影响。随着研究人员研究了各种各样的(捆绑的)干预措施和结果,我们的分析不允许在特定的人力资源管理干预措施和绩效措施之间提供一组结构化的有效一对一关系。相反,我们发现,特定的结果改善可以通过不同的人力资源管理干预措施来实现,相反,据报道类似的人力资源管理干预措施会影响不同的结果指标。鉴于疾病负担较高,我们的综述发现,关于HRM与患者结局之间关系的证据很少.此外,所提供的证据往往无法提供背景特征,这些特征可能会导致人力资源管理干预措施的绩效影响。需要协调研究努力来推进证据基础。