Exploring the lack of progress in improving patient safety in Australian hospitals

Objectives: This study aimed to build on the increasing evidence of a link between good people management practice, and organizational and patient outcomes in public health care to document the important human resource management practices in our hospitals. Methods: The design included large scale survey of hospital managers' perceptions of the use of human resource management practices. The questionnaire included Human resource management (HRM) measures and additional questions related to the Australian hospital accreditation standards. Data were collected in December 2003 until April 2004 from a total sample of 92 hospitals/hospital organizations from the State of Victoria, Australia. The participants were Chief Executive Officers, Human Resource Directors and two other senior managers of the hospital organizations were invited to complete the questionnaire. There were no interventions. The main outcome measure, one-way analysis of variance was used to determine differences in the perceptions of the three groups of managers' concerning the use of HRM practices. Frequency and descriptive statistics were used to determine use of HRM practices. Results: A 67% response rate enabled us to document human resource management practices in Victorian hospitals. The respondents reported limited strategic and organizational HRM. Conclusion: This study found limited evidence of sophisticated HRM practices among hospitals and hospital organizations in the State of Victoria, Australia. Despite the increasing evidence of a relationship among effective HRM and health-care outcomes, these hospitals reported limited performance management, training and development, and employee empowerment and decision-making. The authors suggest that it is unlikely that attempts to improve patient safety in this sector will be successful until the deficits in HRM are addressed.