Skip to main content
Top
Published in: Human Resources for Health 1/2015

Open Access 01-12-2015 | Research

Human resource crises in German hospitals—an explorative study

Authors: Carsten C Schermuly, Michael Draheim, Ronald Glasberg, Vladimir Stantchev, Gerrit Tamm, Michael Hartmann, Franz Hessel

Published in: Human Resources for Health | Issue 1/2015

Login to get access

Abstract

Background

The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals’ organizational culture. To become more resilient to crises, a raised awareness—especially in the area of human resource (HR)—is necessary. The aim of this paper is to contribute to the process robustness against crises through the identification and evaluation of relevant HR crises and their causations in hospitals.

Methods

Qualitative and quantitative methods were combined to identify and evaluate crises in hospitals in the HR sector. A structured workshop with experts was conducted to identify HR crises and their descriptions, as well as causes and consequences for patients and hospitals. To evaluate the findings, an online survey was carried out to rate the occurrence (past, future) and dangerousness of each crisis.

Results

Six HR crises were identified in this study: staff shortages, acute loss of personnel following a pandemic, damage to reputation, insufficient communication during restructuring, bullying, and misuse of drugs. The highest occurrence probability in the future was seen in staff shortages, followed by acute loss of personnel following a pandemic. Staff shortages, damage to reputation, and acute loss of personnel following a pandemic were seen as the most dangerous crises.

Conclusions

The study concludes that coping with HR crises in hospitals is existential for hospitals and requires increased awareness. The six HR crises identified occurred regularly in German hospitals in the past, and their occurrence probability for the future was rated as high.
Literature
1.
go back to reference Deutsche. Krankenhausgesellschaft: Eckdaten der Krankenhausstatistik. Berlin: DKG; 2013. Deutsche. Krankenhausgesellschaft: Eckdaten der Krankenhausstatistik. Berlin: DKG; 2013.
2.
go back to reference Augurzky B, Engel D, Schmidt CM, Schwierz C. Ownership and financial sustainability of German acute care hospitals. Health Econ. 2012;21:811–24.CrossRefPubMed Augurzky B, Engel D, Schmidt CM, Schwierz C. Ownership and financial sustainability of German acute care hospitals. Health Econ. 2012;21:811–24.CrossRefPubMed
3.
go back to reference Carmeli A, Schaubroeck J. Organisational crisis-preparedness: the importance of learning from failures. Long Range Plann. 2008;41:177–96.CrossRef Carmeli A, Schaubroeck J. Organisational crisis-preparedness: the importance of learning from failures. Long Range Plann. 2008;41:177–96.CrossRef
4.
go back to reference Buchanan DA, Denyer D. Researching tomorrow’s crisis: methodological innovations and wider implications. Int J Manag Rev. 2013;15:205–24.CrossRef Buchanan DA, Denyer D. Researching tomorrow’s crisis: methodological innovations and wider implications. Int J Manag Rev. 2013;15:205–24.CrossRef
5.
go back to reference Manley WG, Furbee PM, Coben JH, Smyth SK, Summers DE, Althouse RC, et al. Realities of disaster preparedness in rural hospitals. Disaster Manag Response. 2006;4:80–7.CrossRefPubMed Manley WG, Furbee PM, Coben JH, Smyth SK, Summers DE, Althouse RC, et al. Realities of disaster preparedness in rural hospitals. Disaster Manag Response. 2006;4:80–7.CrossRefPubMed
6.
go back to reference BBK. Schutz Kritischer Infrastruktur, Risikomanagement im Krankenhaus. 2012. 20.05.2013. BBK. Schutz Kritischer Infrastruktur, Risikomanagement im Krankenhaus. 2012. 20.05.2013.
7.
go back to reference Fowler KL, Kling ND, Larson MD. Organizational preparedness for coping with a major crisis or disaster. Bus Soc. 2007;46:88–103.CrossRef Fowler KL, Kling ND, Larson MD. Organizational preparedness for coping with a major crisis or disaster. Bus Soc. 2007;46:88–103.CrossRef
8.
go back to reference Kunz N, Reiner G, Gold S. Investing in disaster management capabilities versus pre-positioning inventory: a new approach to disaster preparedness, International Journal of Production Economics. 2013. Kunz N, Reiner G, Gold S. Investing in disaster management capabilities versus pre-positioning inventory: a new approach to disaster preparedness, International Journal of Production Economics. 2013.
9.
go back to reference Rebmann T, Wilson R, LaPointe S, Russell B, Moroz D. Hospital infectious disease emergency preparedness: a 2007 survey of infection control professionals. Am J Infect Control. 2009;37:1–8.CrossRefPubMed Rebmann T, Wilson R, LaPointe S, Russell B, Moroz D. Hospital infectious disease emergency preparedness: a 2007 survey of infection control professionals. Am J Infect Control. 2009;37:1–8.CrossRefPubMed
10.
go back to reference Dückers M, Faber M, Cruijsberg J, Grol R, Schoonhoven L, Wensing M. Safety and risk management interventions in hospitals: a systematic review of the literature. MCRR. 2009;66:90S–119.PubMed Dückers M, Faber M, Cruijsberg J, Grol R, Schoonhoven L, Wensing M. Safety and risk management interventions in hospitals: a systematic review of the literature. MCRR. 2009;66:90S–119.PubMed
11.
go back to reference Ippolito G, Puro V, Heptonstall J. Hospital preparedness to bioterrorism and other infectious disease emergencies. Cell Mol Life Sci. 2006;63:2213–22.CrossRefPubMed Ippolito G, Puro V, Heptonstall J. Hospital preparedness to bioterrorism and other infectious disease emergencies. Cell Mol Life Sci. 2006;63:2213–22.CrossRefPubMed
12.
go back to reference Petrosillo N, Puro V, Di Caro A, Ippolito G. The initial hospital response to an epidemic. Arch Med Res. 2005;36:706–12.CrossRefPubMed Petrosillo N, Puro V, Di Caro A, Ippolito G. The initial hospital response to an epidemic. Arch Med Res. 2005;36:706–12.CrossRefPubMed
13.
go back to reference Volkman JC, Rebmann T, Hilley S, Alexander S, Russell B, Wagner W. Infection prevention disaster preparedness planning for long-term care facilities. Am J Infect Control. 2012;40:206–10.CrossRefPubMed Volkman JC, Rebmann T, Hilley S, Alexander S, Russell B, Wagner W. Infection prevention disaster preparedness planning for long-term care facilities. Am J Infect Control. 2012;40:206–10.CrossRefPubMed
14.
go back to reference Williams J, Nocera M, Casteel C. The effectiveness of disaster training for health care workers: a systematic review. Ann Emerg Med. 2008;52:211–22. 222.e1-2.CrossRefPubMed Williams J, Nocera M, Casteel C. The effectiveness of disaster training for health care workers: a systematic review. Ann Emerg Med. 2008;52:211–22. 222.e1-2.CrossRefPubMed
15.
16.
go back to reference Conry MC, Humphries N, Morgan K, McGowan Y, Montgomery A, Vedhara K, et al. A 10 year (2000–2010) systematic review of interventions to improve quality of care in hospitals. BMC Health Serv Res. 2012;12:275.CrossRefPubMedPubMedCentral Conry MC, Humphries N, Morgan K, McGowan Y, Montgomery A, Vedhara K, et al. A 10 year (2000–2010) systematic review of interventions to improve quality of care in hospitals. BMC Health Serv Res. 2012;12:275.CrossRefPubMedPubMedCentral
17.
go back to reference Ko HC, Turner TJ, Finnigan MA. Systematic review of safety checklists for use by medical care teams in acute hospital settings - limited evidence of effectiveness. BMC Health Serv Res. 2011;11:211.CrossRefPubMedPubMedCentral Ko HC, Turner TJ, Finnigan MA. Systematic review of safety checklists for use by medical care teams in acute hospital settings - limited evidence of effectiveness. BMC Health Serv Res. 2011;11:211.CrossRefPubMedPubMedCentral
18.
go back to reference Armitage G. Human error theory, Relevance to nurse management, Journal of Nursing Management 2009. 2009. p. 193–202. Armitage G. Human error theory, Relevance to nurse management, Journal of Nursing Management 2009. 2009. p. 193–202.
19.
go back to reference Morag I, Gopher D, Spillinger A, Auerbach-Shpak Y, Laufer N, Lavy Y, et al. Human factors-focused reporting system for improving care quality and safety in hospital wards. Hum Factors J Hum Factors Ergonomics Soc. 2012;54:195–213.CrossRef Morag I, Gopher D, Spillinger A, Auerbach-Shpak Y, Laufer N, Lavy Y, et al. Human factors-focused reporting system for improving care quality and safety in hospital wards. Hum Factors J Hum Factors Ergonomics Soc. 2012;54:195–213.CrossRef
20.
go back to reference Trucco P, Cavallin M. A quantitative approach to clinical risk assessment: the CREA method. Saf Sci. 2006;44:491–513.CrossRef Trucco P, Cavallin M. A quantitative approach to clinical risk assessment: the CREA method. Saf Sci. 2006;44:491–513.CrossRef
21.
go back to reference Farrington M, Pascoe G. Risk management and infection control-time to get our priorities right in the United Kingdom. J Hosp Infect. 2001;47:19–24.CrossRefPubMed Farrington M, Pascoe G. Risk management and infection control-time to get our priorities right in the United Kingdom. J Hosp Infect. 2001;47:19–24.CrossRefPubMed
22.
go back to reference Cure L, Zayas-Castro J, Fabri P. Clustering-based methodology for analyzing near-miss reports and identifying risks in healthcare delivery. J Biomed Inform. 2011;44:738–48.CrossRefPubMed Cure L, Zayas-Castro J, Fabri P. Clustering-based methodology for analyzing near-miss reports and identifying risks in healthcare delivery. J Biomed Inform. 2011;44:738–48.CrossRefPubMed
23.
go back to reference Jackson J. Ensuring emergency power for critical municipal services with natural gas-fired combined heat and power (CHP) systems: a cost-benefit analysis of a preemptive strategy. Energy Policy. 2007;35:5931–7.CrossRef Jackson J. Ensuring emergency power for critical municipal services with natural gas-fired combined heat and power (CHP) systems: a cost-benefit analysis of a preemptive strategy. Energy Policy. 2007;35:5931–7.CrossRef
24.
go back to reference Giorgi I, Fonzo-Christine C, Cingria L, Caredda B, Meyer V, Pfister R, et al. Risk and pharmacoeconomic analyses of the injectable medication process in the paediatric and neonatal intensive care units. Intern J Qual Health Care. 2010;22:170–8.CrossRef Giorgi I, Fonzo-Christine C, Cingria L, Caredda B, Meyer V, Pfister R, et al. Risk and pharmacoeconomic analyses of the injectable medication process in the paediatric and neonatal intensive care units. Intern J Qual Health Care. 2010;22:170–8.CrossRef
25.
go back to reference Merna T, Al-Thani FF. Corporate risk management. 2nd ed. Chichester: Wiley; 2008. Merna T, Al-Thani FF. Corporate risk management. 2nd ed. Chichester: Wiley; 2008.
26.
go back to reference BMI. Nationale Strategie zum Schutz Kritischer Infrastrukturen (KRITIS-Strategie), Bundesministerium des Inneren. 2009. BMI. Nationale Strategie zum Schutz Kritischer Infrastrukturen (KRITIS-Strategie), Bundesministerium des Inneren. 2009.
28.
go back to reference Adalja AA, Watson M, Bouri N, Minton K, Morhard RC, Toner ES. Absorbing citywide patient surge during Hurricane Sandy: a case study in accommodating multiple hospital evacuations. Ann Emerg Med. 2014;64:66–73. e1.CrossRefPubMed Adalja AA, Watson M, Bouri N, Minton K, Morhard RC, Toner ES. Absorbing citywide patient surge during Hurricane Sandy: a case study in accommodating multiple hospital evacuations. Ann Emerg Med. 2014;64:66–73. e1.CrossRefPubMed
29.
go back to reference Choi M, Ruona WEA. Individual readiness for organizational change and its implications for human resource and organization development. Hum Resour Dev Rev. 2011;10:46–73.CrossRef Choi M, Ruona WEA. Individual readiness for organizational change and its implications for human resource and organization development. Hum Resour Dev Rev. 2011;10:46–73.CrossRef
30.
go back to reference Leymann H. The content and development of mobbing at work. Eur J Work Organ Psychol. 1996;5:165–84.CrossRef Leymann H. The content and development of mobbing at work. Eur J Work Organ Psychol. 1996;5:165–84.CrossRef
31.
go back to reference Meschkutat B, Stackelbeck M, Langenhoff G. Der Mobbing-Report. Eine Repräsentativstudie für die Bundesrepublik Deutschland. Dortmund, Berlin: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin; 2002. Meschkutat B, Stackelbeck M, Langenhoff G. Der Mobbing-Report. Eine Repräsentativstudie für die Bundesrepublik Deutschland. Dortmund, Berlin: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin; 2002.
32.
go back to reference Compton WM, Thomas YF, Stinson FS, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2007;64:566–76.CrossRefPubMed Compton WM, Thomas YF, Stinson FS, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2007;64:566–76.CrossRefPubMed
33.
go back to reference Booth JV, Grossman D, Moore J, Lineberger C, Reynolds JD, Reves JG, et al. Substance abuse among physicians: a survey of academic anesthesiology programs. Anesth Analg. 2002;95:1024–30. table of contents.PubMed Booth JV, Grossman D, Moore J, Lineberger C, Reynolds JD, Reves JG, et al. Substance abuse among physicians: a survey of academic anesthesiology programs. Anesth Analg. 2002;95:1024–30. table of contents.PubMed
36.
go back to reference Thompson AK, Faith K, Gibson JL, Upshur REG. Pandemic influenza preparedness: an ethical framework to guide decision-making. BMC Med Ethics. 2006;7:E12.CrossRefPubMed Thompson AK, Faith K, Gibson JL, Upshur REG. Pandemic influenza preparedness: an ethical framework to guide decision-making. BMC Med Ethics. 2006;7:E12.CrossRefPubMed
37.
go back to reference Mounier-Jack S, Coker RJ. How prepared is Europe for pandemic influenza? Analysis of national plans. Lancet. 2006;367:1405–11.CrossRefPubMed Mounier-Jack S, Coker RJ. How prepared is Europe for pandemic influenza? Analysis of national plans. Lancet. 2006;367:1405–11.CrossRefPubMed
38.
go back to reference Yi P, George SK, Paul JA, Lin L. Hospital capacity planning for disaster emergency management. Socioecon Plann Sci. 2010;44:151–60.CrossRef Yi P, George SK, Paul JA, Lin L. Hospital capacity planning for disaster emergency management. Socioecon Plann Sci. 2010;44:151–60.CrossRef
39.
go back to reference Gomersall CD, Loo S, Joynt GM, Taylor BL. Pandemic preparedness. Curr Opin Crit Care. 2007;13:742–7.CrossRefPubMed Gomersall CD, Loo S, Joynt GM, Taylor BL. Pandemic preparedness. Curr Opin Crit Care. 2007;13:742–7.CrossRefPubMed
40.
go back to reference Krankenhausgesellschaft D. Key-data of Germany’s hospitals. 2015. Krankenhausgesellschaft D. Key-data of Germany’s hospitals. 2015.
41.
go back to reference Schmid A, Ulrich V. Consolidation and concentration in the German hospital market: the two sides of the coin. Health Policy. 2013;109:301–10.CrossRefPubMed Schmid A, Ulrich V. Consolidation and concentration in the German hospital market: the two sides of the coin. Health Policy. 2013;109:301–10.CrossRefPubMed
42.
go back to reference Gelfand MJ, Higgins M, Nishii LH, Raver JL, Dominguez A, Murakami F, et al. Culture and egocentric perceptions of fairness in conflict and negotiation. J Appl Psychol. 2002;87:833–45.CrossRefPubMed Gelfand MJ, Higgins M, Nishii LH, Raver JL, Dominguez A, Murakami F, et al. Culture and egocentric perceptions of fairness in conflict and negotiation. J Appl Psychol. 2002;87:833–45.CrossRefPubMed
43.
go back to reference Dal Poz MR. Handbook on monitoring and evaluation of human resources for health: with special applications for low- and middle-income countries. Geneva: World Health Organization; 2009. Dal Poz MR. Handbook on monitoring and evaluation of human resources for health: with special applications for low- and middle-income countries. Geneva: World Health Organization; 2009.
44.
go back to reference Camerino D, Conway PM, van der Heijden B, Estryn-Béhar M, Costa G, et al. Age-dependent relationships between work ability, thinking of quitting the job, and actual leaving among Italian nurses: a longitudinal study. Int J Nurs Stud. 2008;45:1645–59.CrossRefPubMed Camerino D, Conway PM, van der Heijden B, Estryn-Béhar M, Costa G, et al. Age-dependent relationships between work ability, thinking of quitting the job, and actual leaving among Italian nurses: a longitudinal study. Int J Nurs Stud. 2008;45:1645–59.CrossRefPubMed
45.
go back to reference Hasselhorn HM, Tackenberg P, Kuemmerling A, Wittenberg J, Simon M, Conway PM, et al. Nurses’ health, age and the wish to leave the profession–findings from the European NEXT-Study. Med Lav. 2006;97:207–14.PubMed Hasselhorn HM, Tackenberg P, Kuemmerling A, Wittenberg J, Simon M, Conway PM, et al. Nurses’ health, age and the wish to leave the profession–findings from the European NEXT-Study. Med Lav. 2006;97:207–14.PubMed
46.
go back to reference WHO, editor. Human resources for health: toolkit on monitoring health systems strengthening. Geneva: World Health Organization; 2009. WHO, editor. Human resources for health: toolkit on monitoring health systems strengthening. Geneva: World Health Organization; 2009.
48.
go back to reference Sprung CL, Zimmerman JL, Christian MD, Joynt GM, Hick JL, Taylor B, et al. Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine’s Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Med. 2010;36:428–43.CrossRefPubMed Sprung CL, Zimmerman JL, Christian MD, Joynt GM, Hick JL, Taylor B, et al. Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine’s Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Med. 2010;36:428–43.CrossRefPubMed
49.
go back to reference Timbie JW, Ringel JS, Fox DS, Pillemer F, Waxman DA, Moore M, et al. Systematic review of strategies to manage and allocate scarce resources during mass casualty events. Ann Emerg Med. 2013;61:677–89. e101.CrossRefPubMed Timbie JW, Ringel JS, Fox DS, Pillemer F, Waxman DA, Moore M, et al. Systematic review of strategies to manage and allocate scarce resources during mass casualty events. Ann Emerg Med. 2013;61:677–89. e101.CrossRefPubMed
50.
go back to reference Smithikrai C. Moderating effect of situational strength on the relationship between personality traits and counterproductive work behaviour. Asian J Soc Psychol. 2008;11:253–63.CrossRef Smithikrai C. Moderating effect of situational strength on the relationship between personality traits and counterproductive work behaviour. Asian J Soc Psychol. 2008;11:253–63.CrossRef
51.
go back to reference Yang L, Liu C, Nauta MM, Caughlin DE, Spector PE. Be mindful of what you impose on your colleagues: implications of social burden for burdenees’ well-being, attitudes and counterproductive work behaviour. Stress Health. 2014. Yang L, Liu C, Nauta MM, Caughlin DE, Spector PE. Be mindful of what you impose on your colleagues: implications of social burden for burdenees’ well-being, attitudes and counterproductive work behaviour. Stress Health. 2014.
52.
go back to reference Spector PE. The relationship of personality to counterproductive work behavior (CWB): an integration of perspectives, Human Resource Management Review. 2010. Spector PE. The relationship of personality to counterproductive work behavior (CWB): an integration of perspectives, Human Resource Management Review. 2010.
53.
go back to reference Palttala P, Vos M. Quality indicators for crisis communication to support emergency management by public authorities. J Conting Crisis Manag. 2012;20:39–51.CrossRef Palttala P, Vos M. Quality indicators for crisis communication to support emergency management by public authorities. J Conting Crisis Manag. 2012;20:39–51.CrossRef
54.
go back to reference Alsop RJ. Corporate reputation: anything but superficial – the deep but fragile nature of corporate reputation. J Bus Strateg. 2004;25:21–9.CrossRef Alsop RJ. Corporate reputation: anything but superficial – the deep but fragile nature of corporate reputation. J Bus Strateg. 2004;25:21–9.CrossRef
55.
go back to reference Bovey WH, Hede A. Resistance to organizational change: the role of cognitive and affective processes. Leadersh Org Dev J. 2001;22:372–82.CrossRef Bovey WH, Hede A. Resistance to organizational change: the role of cognitive and affective processes. Leadersh Org Dev J. 2001;22:372–82.CrossRef
56.
go back to reference Fernandez S, Rainey HG. Managing successful organizational change in the public sector. Public Adm Rev. 2006;66:168–76.CrossRef Fernandez S, Rainey HG. Managing successful organizational change in the public sector. Public Adm Rev. 2006;66:168–76.CrossRef
57.
go back to reference Tannenbaum R, Schmidt WH. How to choose a leadership pattern. Harv Bus Rev. 1958;36:95–101. Tannenbaum R, Schmidt WH. How to choose a leadership pattern. Harv Bus Rev. 1958;36:95–101.
58.
go back to reference Notelaers G, de Witte H, Einarsen S. A job characteristics approach to explain workplace bullying. Eur J Work Organ Psychol. 2010;19:487–504.CrossRef Notelaers G, de Witte H, Einarsen S. A job characteristics approach to explain workplace bullying. Eur J Work Organ Psychol. 2010;19:487–504.CrossRef
Metadata
Title
Human resource crises in German hospitals—an explorative study
Authors
Carsten C Schermuly
Michael Draheim
Ronald Glasberg
Vladimir Stantchev
Gerrit Tamm
Michael Hartmann
Franz Hessel
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2015
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-015-0032-4

Other articles of this Issue 1/2015

Human Resources for Health 1/2015 Go to the issue