HR in Healthcare: 9 Major Challenges to Solve

1. Hiring and Onboarding

By 2030, the US could face a shortage of 120,000 physicians. To maintain staffing, HR must explore new tactics to hire and onboard employees. According to Hospital & Health Networks magazine, only 29% of millennials use online job boards. To reach younger professionals, some HR teams are partnering with their marketing departments to use search engine optimization and lead tracking to better attract and pursue candidates. Others offer signing bonuses and help pay moving expenses. Automated systems can help improve the onboarding process by more efficiently scheduling new-hire orientation sessions, related training, and benefits enrollment, while assigned mentors can help accelerate and personalize the onboarding process, giving new employees valuable guidance and a sense of support and connection. Another best practice: On day one, make sure new hires have access to the technology they need—and understand how to use it.

2. Training

More than any other industry, healthcare needs employees to keep their training current, as outdated skill sets will degrade clinical care. Some HR teams partner with training institutes; others offer their own training onsite or remotely. One big focus area is helping ensure that clinicians and support staff are up to date on required licenses and certifications. A cloud-based training platform will automatically track compliance, notify employees of their obligations, and link them to the courses they need. Training is also a key part of talent development—an area many employers should seek to improve if they want to help boost job satisfaction and retention.

3. Managing Schedules and Payroll

Most people don’t think of logistics when they think about human resources, but managing hospital shift scheduling is a complex logistical challenge, especially during chronic staffing shortages. A large healthcare facility may manage hundreds of different rotations of doctors, nurses, contract employees, visiting physicians, and other staff. Getting the scheduling right is essential: One study showed that 33% of critical care nurses and 45% of critical care physicians have experienced severe burnout. HR should help create flexible schedules that are easy to communicate, access, and change when needed.

Payroll presents another HR logistical challenge. Some healthcare workers, such as therapists and surgeons, get paid as they treat individual patients. Others are salaried and may have bonus incentives. Absent a modern payroll system, organizations can struggle to capture all of the pay structures they need . Another key payroll challenge is managing labor costs. Healthcare employers are containing these costs in several ways, including by analyzing overtime and premium pay, such as double-time and triple-time pay, to pinpoint departments that are potentially overpaying. Another strategy is to scale back the use of contract employees—traveling nurse services and other temporary workers—who typically command high pay and are expensive to replace.

4. Staffing

Keeping up with industry staffing trends is a requirement for any employer, but healthcare HR professionals must cast an especially wide net. They need to be knowledgeable about global trends such as remote work and answer questions such as: How many employees are working from home? How many are needed onsite? Do we have the right technologies to enable virtual work? And what are the related cybersecurity concerns? But healthcare HR pros also need to think locally: Is our service area declining or increasing in population, and how might that affect staffing levels? Are new competitors snapping up talent and customers—if yes, do we have a plan to respond? As the population of a healthcare provider market ages or becomes younger, or if average incomes and quality of life decline, HR must anticipate and respond to these changes.

5. Fostering Diversity, Inclusion, and Equitable Treatment

The best workplace is one where everybody feels included and is fairly treated. The HR department sets and enforces policies that help make this ideal a reality. Clear guidelines covering hiring practices, pay raises, and career advancement all help build a transparent, equitable culture. And consistent enforcement of these guidelines shows employees that they’ll be protected should someone discriminate against them because of their age, race, ethnicity, gender, sexual orientation, or any other protected characteristic. These same protections must extend to patients, too. Most HR teams now require annual training on fostering diversity and inclusion, fighting harassment, and related topics. Without this kind of education, unacceptable behaviors are more likely to occur.

6. Maintaining Patient Satisfaction

It’s HR’s job to define how employees should perform. The challenge for healthcare systems is to ensure that higher performance translates to patient satisfaction. From writing job descriptions to defining the organizational roles of whole departments, HR sets the expectations that drive superior care. HR is also responsible for creating a workplace culture that empowers people to go the extra mile for their patients. Healthcare employers should reward employees who deliver exceptional care and then share their stories across the organization. Such publicity gives employees the credit they deserve and highlights the behaviors that make for satisfied patients.

7. Employee Management

In light of ongoing staffing gaps and nationwide talent shortages, employee management become a top challenge for HR departments. While HR professionals don’t actually manage nurses and doctors, they do manage all matters related to employees. For instance, HR oversees the process of gathering new-hire data and must do so in compliance with laws and regulations. HR also manages the employee performance process, making sure employees receive regular feedback so they can improve on the job and advance their careers. Additionally, HR helps shape the organizational structure, which sometimes involves the unpleasant task of laying people off, though in recent years health systems have tended to increase their workforce, not reduce it.

8. Discipline and Dispute Management

Disciplinary problems and employee disputes at healthcare organizations can hinder patient care. Employees can’t miss shifts and leave their teams understaffed or carelessly handle patient data and violate their privacy, leaving the hospital or clinic open to lawsuits. When violations occur, or when employees—including highly paid doctors and hard-to-find specialist nurses—disrespect patients or coworkers, HR must investigate and discipline the offenders. In unusually complex situations, some healthcare providers solicit the help of outside mediators.

9. Addressing Compliance and Legality

Healthcare HR teams face a big time-management challenge. They must continue to play a crucial role in addressing legal compliance—in records management, workplace safety, and other areas—while spending more time than ever solving staffing shortages. There’s no simple way to balance these competing duties. Clarifying roles within HR and delegating can help, but it may also be necessary to hire more HR staff, in particular people with proven compliance experience. HR must, as always, maintain a working knowledge of employment and healthcare laws, serving as a guardrail against violations and fines. In the US, these laws include the Health Insurance Portability and Accountability Act, violations of which can result in fines up to $1.5 million per year; the Affordable Care Act; and regulations set by the Occupational Safety and Health Administration (OSHA). HR also needs to review and enforce employment contracts, including those with traveling doctors and nurses, who are being used in greater numbers to plug staffing gaps.