Human Resource Management, Complementarity and Hospital Performance: Evidence From the English NHS.

Area of Science:

• Healthcare Management
• Organizational Behavior
• Human Resource Management

Background:

• Individual human resource management (HRM) practices often have indeterminate impacts on hospital productivity.
• A systematic analysis of the complementarity, non-linearity, and interdependencies of HRM practices is lacking.
• Hospital performance variations persist due to the complex interplay of HRM strategies.

Purpose of the Study:

• To investigate the role of complementary clusters of HRM practices in explaining productivity variations in English NHS hospitals.
• To propose and test a novel framework based on complementarity theory, considering indeterminacy, non-linearity, and synergy effects.
• To identify distinct HRM clusters and their impact on hospital performance.

Main Methods:

• Utilized panel data from English NHS hospitals.
• Employed machine learning techniques to identify distinct HRM clusters.
• Applied correlated random effects models to test the significance of HRM practice clusters.

Main Results:

• Individual HRM practices often require a critical intensity threshold to significantly impact productivity.
• Identified distinct complementary HRM clusters, including incentives, workplace flexibility, training, team quality, and job design.
• High-performing hospitals adopt synergistic bundles of HRM practices, while low performance is linked to incomplete clusters.

Conclusions:

• Hospital performance is significantly influenced by non-linear and interdependent effects of HRM practices.
• Synergistic bundles of complementary HRM practices, such as job design, team quality, and incentives, are crucial for high performance.
• Policymakers and administrators should prioritize holistic, bundled HRM initiatives over isolated practices for organizational change.