Hospital personnel management in the late 1980s: a direction for the future

Personnel management in hospitals is appreciably different today than twenty years ago, not only in terms of role and process, but also in terms of an approach and philosophy toward human resources. This change is largely a result of external forces, including legislation affecting manpower acquisition and retention, union activism, federal intrusions health services delivery, and constituent and client assertiveness in the purchase of healthcare services. The authors present four models of hospital personnel administration and offer reasons for their evolution. In each, personnel administration's approach, role and process, and the organization's philosophy concerning employees are described. One model, the human resource model, describes most hospitals today. However, a new model reflecting the risk-survival realities of the present turbulent health services environment is emerging. The matrix model of the future has as its base the human resources perspective, modified and limited by productivity improvement considerations. On top of this base is the participative-competitive organizational philosophy inherent in the increasingly risk-survival environment. Attributes of the matrix model are described; future trends and implications for hospitals are presented.