King Faisal Specialist Hospital: Evaluation of Promotion System

Subject: Healthcare Institution
Pages: 65
Words: 19196
Reading time:
66 min
Study level: Master


The structure of incentives must be clear and simple enough to be easily understood by employees and should also provide measurable and realistic targets to be achieved. Promotion system helps improve services provision across a wide range of departments including health domains in terms of technical and allocative efficiency that in turn stimulates provision of quality services. For this case, I will examine the current promotion policy at King Faisal Hospital and Research Centre, identify areas that need amendment and devise strategies that can be used to improve the current policies in equal promotion polices for all.

I am grateful to all the participants from each of the four three groups contributing to the study. These senior employees, mangers and others (part time employees and affirmative organisation groups) gave their time to engage in my interviews. Most of the interview questions consumed over one hour long and all these individuals demonstrated their willingness to being open and honest commitment in their views.


An assessment of the Sentiments expressed by Staff of the King Faisal Specialist Hospital and Research Centre regarding the proposed new promotion system implemented in the institution. The research will be looking at how the various sentiments expressed reflects the general attitude towards the policy consequently the possible success that can be chucked or otherwise. To this end, this research paper therefore brings to the fore crucial issues that essentially assess the criteria for employee satisfaction particularly the underlying level of enthusiasm of employees to identify themselves as members of the team. It should be noted that this assessment is being conducted within the framework of the promotion scheme in question and by extension how employees perceive it as empowering too or not. The research has two pivotal areas worth researching; they include an evaluation of current practice and a look at the resultant effect of the overall personnel management policies in the King Faisal Specialist Hospital and Research centre. As a precursor to this it is absolutely relevant for further research to be carried out in order to establish the guiding framework for this work. Meanwhile, in the interim questions such as: The existence of a connecting linkage between employee satisfaction and total output? What are the established barometers to measure this? Is there any evidence that satisfied employees are potentially going to be long-service personnel? What are the inherent grey spots in the new promotion scheme?


Traditionally the hospital environment serves as a distinct social institution that is able to embrace the lives of both countless personnel and patrons alike. Prior to the period of conventional personnel units, there was no visible distinction between hospital administrators and frontline medical staff in terms of the discharging of duties. According to Lawrence & Lorsch (1967), under the above circumstance the hospital environment, if viewed within the context of the contingency theory of organizations, it is said to be a uniformly stable environment. The main point of emphasis about the uniformity is the fact that all that was done revolved around a single universal goal of placing patient care as the topmost premium. Consequently, there was no urgent need for systems of internal multi-functional management teams or what has become known as Human Resource Management units in conventional management circles. In addition it created the platform for the resolution of all forms of arbitrary personnel conflicts which is an indispensable ingredient for output efficiency. The principles lay beyond ordinary theories but evolved into an entirely cultural system that had deep roots in the organizational system itself. It should be noted that this was not a representation of a utopian system, because indeed there was considerable differentiation in the organizational structure yet all the facets worked together without hitches.

Owing to the foregoing, this study will be conducting preliminary assessment and critique of the most contending issues in classical Human Resource Managerial practices particularly in relation to those principles that have a covert and overt bearing on employee appraisal schemes. As the study advances, there will be empirical and qualitative assessments of how these are being replicated in the King Faisal Specialist Hospital and Research Centre.

Aims and Objectives

The aim of the research is to evaluate the current promotion policies at King Faisal Specialist Hospital and Research Centre and the outcomes of new proposed promotion policies. The research is also aimed at evaluating performance evaluation system, forms of employee appraising techniques such as training and higher education and also the effects of affirmative action implementations into promotion system. Research outcomes will basically be evaluated according to employee, managers and others (part-time and affirmative action groups) perceptions.

Background of the Research

The King Faisal Specialist Hospital and Research Centre as part of on going sweeping reforms in its Human Resource Department instituted a series of policies geared at mainstreaming the Human Resource policies of the institution to reflect fairness, merit and diligence in order to carry out employee appraisal for possible promotion. It was rumoured in some quarters that there is some covert discontent amongst the staff of the institution with regards to the new scheme.

Increasingly, the need to fully conceptualize public sentiments by way of feedbacks generated from an event or activity is being used for a host of purposes besides the conventional administrative requirements. Within the context of this work, the feedback being sought has to do with the new promotion scheme. For instance, full knowledge of the sentiments a policy has generated enables the process of carrying out tentative plans for relevant adjustments which could be structural or institutional. A practical adjustment may be an increase in awareness creation and education in order to drive home the policy; granted the policy makers have reasonable grounds to trust the possible gains of the intended policy. Human attitudes therefore play a crucial role in feedback processes in an organisation.

The study will be carried out within the premises of the King Faisal Specialist Hospital and Research Centre in order to create the platform for a clear interaction and contact with the main stakeholders, groups and individuals who are either directly or indirectly connected to the issue in question. For convenience, I will include a couple of staff members who are members of the various worker unions in the institution. Among other things, they will be giving a briefing and guiding framework that will explain all that needs to be achieved in this study. From this point, I will mandate them to have a team meeting to discuss the briefing in order to assign specific roles for each of them, then they will proceed to begin working. As part of the process they will have to meet twice weekly for half an hour to discuss the work being done. I will be present in each of these meetings for three consecutive weeks so that I will obtain a first hand observation of how they interact amongst themselves coupled with an assessment of how they are able to bring it to bare on the main project. The analysis process will use timeline series approach to asses and analyze the sentiments from stakeholders and patrons using a methodology popularly called “temporary sentimental analysis.”

As part of the inquisition the research will make use of timestamps such as Weblog and news articles to feed as input materials to generate results that will be presented graphical. The graphical details will highlight major sentiments like anxiety, despair and disappointment. In addition, the development that comes with each of sentiments will be presented to illustrate for instance how the news of the scheme was received by the employees on the one hand and the subsequent brouhaha that it triggered in some quarters was received by management on the other hand in order to see corresponding reactions that followed.

Essentially, the main motivation for using this method is for convenience since the participant dependent and independent variables are within meaningful reach.

Moreover, evidence from the literature gathered for the study does not present consistent conclusions that address the question of how promotion is linked to output. In order to account for these anomalies there is a deliberate attempt to separate the internal dynamics of promotion into constituents such as the general perceptions of opportunities for promotion, possible promotion satisfaction and the real promotion. From this position it is evident that the relationship between any of the variables stated is not so conspicuous and therefore leaving key questions unanswered.

Procedure for conducting the research will follow the following chronological order:

  1. A literature review will be carried out in order to draw the lines between what is already known in the field of personnel management and how it relates to the research interest and questions.
  2. Embark on a critical observation of events in the institution. Of particular interest will be a close monitoring of the two-man team’s twice weekly meetings and all other matters arising from them thereof. Of critical concern is how both unions and their members express themselves when it comes to the promotion scheme.
  3. Formal as well as informal interview sessions with staff members through their unions to delve deeper into the contending issues and controversies that the new promotion scheme has aroused. In principle, the interview sessions will be structured in such a manner that general questions will be asked in order to obtain the response of the interviewee. It will then be followed with the detailed questions that will enable them express their sentiments. The questionnaires to be administered are listed in the appendix section of this proposal. A total of 120 questionnaires will be administered for the study. Each package will consist of a disclosure letter, cover letter, consent form and finally the questionnaire.
  4. The field and interview notes will be analyzed at this point according to the procedures stated earlier in this work.
  5. A report about the research will be written to reflect my understanding of the main theories and how they will be incorporated into the empirical section of the research.
  6. Write a research report that combines my understanding of the relevant theory and previous research with the results of my empirical research.

Literature Review

Performance management is an organisational activity headed by department supervisors to track employees’ performances against set up targets and identify weak areas for improvement. OCG (2009) argues that employees’ performances should be evaluated according to past performances. Does the system provide any methods for measuring performances? Performance management should enable the organisation focus on future goals, how to achieve them and how they can do things better. Managing performance therefore concentrates on managing results. Efficient performance management should be able to have clear aims, draw distinguishing objectives, provide standards measures to evaluate employees’ progress towards company objectives. Performance management should also be able to detect employees’ performance problems and provide solutions in the shortest time possible. Business managers and department supervisors should be responsible for setting up goals and managing performance against set up targets.

Performance appraisal identifies opportunities and feeds into companies pay and set up promotion schemes and also enhances the skills and careers of employees who may want to climb up promotion ladders or are seeking greater responsibility. Performance management should be integrated into business lifestyle to help the organisation grow through designing and changing performance measures regularly by monitoring and reviewing the existing policies. Sound policies will need to be structured in order to achieve performance improvement otherwise monitoring employees’ performance alone cannot help the company achieve its objectives. What performance management does is to identify opportunities that will improve management performance and maximise improvements for future goals. Performance management helps the company make sound decisions about which route to take in investment, affordability of chosen targets and helps it in setting investment priorities. OGC (2009) identifies the shortcomings of performance management as it dwells entirely on outcomes that will meet business objectives rather than the outputs. Performance management should dwell entirely on the outcomes such as quality of services rather than striving to meet organisational objectives that are not in conjunction of improving organisational objectives and employees’ welfare.

Basic steps in performance appraisal require that the organisation develop performance plan that will conduct observation and measure employees track performance effectively. Supervisors need to take charge by keenly observing number of high quality prints, the hospital for this instance should observe high quality performances and record them. Fast and efficient feed back system is required in any organisation as it serves as the back bone of performance management and enables employees to receive communication on how results were achieved. The feed back system should be clear, timely, feasible in nature and able to identify and address important activities in the organisation that need improvement or reinforcement. The system should enable employees to contribute their ideas in areas that need improvement and support performance appraisal (Carter 2008, online).

According to OCG (2009), contract managers take the responsibility of monitoring service performance of employees from customer’s feedback and service providers are the ones who supply the managers with performance information to be used for promotion. In performance appraisal, supervisors are required to measure employee’s track performance by observing and recording their performances over a period of time. GROTE Consulting (2009) suggests that poorly managed performance appraisal becomes a waste of time and resources. He describes an effective performance management as one that focuses on employees’ attention on company’s mission, one that uses strategy, vision and prioritises values of the company. The hospital should use this system to help create and implement an effective performance appraisal system that will direct, examine and develop employees’ performances.

Across all industries, higher quality services achieved stimulate higher prices which at the end increase market shares and operational margins. This strategy should be borrowed by hospital institutions regardless of whether they are profit oriented or not in order to improve quality of services. When a hospital stops focusing on cost and efficiency, the quality of services provided diminishes. Medical and non medical department are indirectly linked to each other and should work together to achieve uniform goals. Improved quality means that medical department will realise reduced medical errors and higher levels of patient’s satisfaction that will reflect on greater performance in the non medical staff. The hospital should ensure that patient satisfaction levels are improved by reducing waiting times as it’s the key to realisation of high quality services. Cost-quality continuum employs trade-off strategy that enables the organisation to focus on one side of the equilibrium that might comprise the quality of services provided by the other side. Therefore if the hospital focuses on cost-quality continuum it may reduce quality of services provided at the expense of patient’s health (Langabeer 2007, p.11).

Performance appraisal contributes to positive organisational outcome by improving quality of services and products as employee will be pushed to perform better to be considered for promotion. Since the organisation has provided standardised method for measuring employees’ performances, conflicts within the system will be reduced. Performance appraisals enhance creativity and innovation, productivity increases and the organisation realises reduced cases of absenteeism and turn over (Crowley 1998, p.118).

Langerbeer (2007, p.12) point out that the hospital will realise improved operational effectiveness if it designs uniform goals throughout the facility. He adds that efficiency of resources inputs and usage contributes to the achievement of organisational goals and outcomes. A hospital organisation may not be subjected to a competitive environment but this does not mean that it shouldn’t operate effectively. Like any other industries, the hospital should be able to respond to environmental changes as quick as possible to impact changes in its organisation. Whenever new facilities come in, employees should be trained on how to use them. If a hospital can subject itself to a competitive world and able to maintain the position, then it will realise higher operational margins that will help it improve and expand its organisation.

The literature that is reviewed in this paper attempts to touch on a diverse arena of areas such as strategic career development, change management, human resource and personnel management.

Widespread HRM was a product of the “enterprise culture” of the 1980s (Legge 1995); and it created the platform for the so-called “soft normative model” of human resource management. The leading proponents of this school of thought argue that it was generally more sustainable as the years went by. Notwithstanding this, a good number of contemporary observers such as Bach & Sisson (2000) are convinced that conventional human resource principles are on progressive decline because they have outlived their usefulness, meanwhile another school of thought argue that all that is needed is improved research to reform the principles to reflect modern trends and realities (Guest 1997).

Most recently, West et la (2002) in part confirms what Lawrence & Lorsh (1967) described as the integrative needs of differentiated hospital organizations. According to West (2002), low mortality levels in the hospital setting is linked to the effectiveness and efficiency of staff appraisal schemes. To this point it is prudent to narrow the review to the central thesis of this paper.

There are a good number of published as well as unpublished literature on the subject of sentiment analysis in both the academic and policy circles. Incidentally, in this review the most astounding works that have significant bearings on the subject matter will be reviewed. To begin with, it is undoubtedly prudent to establish the internal dynamics of sentimentalism. The paper benefits from the earlier work of pioneers who discovered the so-called semantic orientation of examination of a statement or a written material (Turney 2002). Also according to Pang et al (2002), a sentence can be assessed to identify the positive and negative elements contained in it. Unlike the above mentioned works, this work will be influenced by the system of multi-polar analysis in order to draw the clear distinction between this and other previous papers.

In a related context, researchers Mishne and de Rijke (2006) have advocated for a system that can evaluate momentary changes in the moods of people, it is what they term “Moodviews.” Fundamentally, the analysis is carried out with the aid of over one hundred sentiments. A good number of scholarly works have been carried out on the question of “topic detection and tracking” with each of these groups making their own proposals depending on what is deemed fit for each circumstances. Interestingly, there is a gross limitation of work that fully addresses the utilization of sentiments under the “topic detection and tracking” column and this is precisely what this paper will be addressing. The process will also incorporate what Havre et al (2002), called information visualization.

Effectiveness of promotion policy in a hospital

Health care organisation has been facing intense pressure over the years to improve performance and drive organisational excellence. Promotion policy has driven healthcare industry to maintain standards of clinical care that are incorporated into employment policies to attain quality and management focus. Performance management tools in most cases are not designed for health care environment but for non medical management. In this research, I will evaluate new promotion policy designed to cater for all health care performance management needs. The new program is designed to merge the best business performance tools and comprehensive knowledge gained from staff interviews and experience in the King Faisal Specialist and Research Centre environments. Effective Performance Management for Health care Organisation provides a valuable and practical solutions for health care management for the benefit of profitability, improve performance and the quality in clinical settings in the King Faisal Specialist and Research Centre (IIR 2000, online).

Components of effective promotion policy

A hospital set up requires number of objectives to facilitate smooth running of the non medical faculties such as high quality health care, efficiency of services delivery and promotion access. Clear and explicit procedures about the behaviour to be rewarded as well as a well structured incentive plan are what constitute to an effective promotion policy in a hospital set up. Also, the reward system should be stable and involve all parties in the implementation process. With a transparent and stable reward system in place, the hospital and its environments will focus on quality services (Duckett 2008, online).

Offering promotion opportunities basing on employees behaviour may not be well measured as this system does not provide methods it uses to assess performances. Performance appraisal should follow standardised system for rewarding employees on behavioural basis that will include a follow up phase required to record expected performance improvements effectively and adequately and their achievements free from biasness and discrimination. Department managers assesses employee’s behaviour in terms of lack of cooperation, disrespect, absence, theft, substance abuse and other vices that will be used against them in performance evaluation. The Committee should therefore give employees chance to describe what happened to provide transparency in the system. The manager needs to enforce positive discipline measures to prevent these vices from reoccurring by drawing down clear rules to be observed by employees in carrying out their duties, ensuring conducive environment that is less likely to cause problems, provide a mechanisms that will focus on solving problems and reward desirable behaviour (Sims 2002, p.107).

The hospital should be able to organise seminars that will help employees identify what is expected of them in conjunction to organisational goals. The seminar should also provide employee performance results on how they are doing before promotion is awarded to allow time for improvement. Employees should be helped to identify what they can do to meet organisation expectations otherwise there will no basis for measuring employees performances (GROTE consulting 2009, online).

Promotion policies have been able to recognise weakness in measure of hospital products. These policies for instance lacked standard measure of employees’ activity and practical assumption about uniform quality of care and other services. These shortcomings arose due to the unmeasured quality of services provided by primary healthcare trust such as those in the United Kingdom or Area Health Authority as a whole. Since the advent of case mix in hospitals, patients have been exposing themselves to risks attributed by agents in order to lure them into using certain services (Duckett 2008 , online).

Instruments used for construction of promotion policies

There is no law requiring an organisation to follow certain rules of performance appraisal and promotion systems as each one of them faces different challenges in their administration. There is no formulated style of appraisal that works best for all organisations; however, performance appraisal should directly link to job description and tools that measure performances. For promotions to be awarded, employees’ performances must be effectively evaluated using methods such as narratives, rating scales, performance evaluation interviews, documentation of employee’s performances and use of audit systems (Crowley 1998, p.116).

The key objective of promotion policy is driven towards achieving certain goals such as access, quality care, prevention and coding quality. When a hospital invents multiple goals it conflicts its performance management such that it trades off between quality and access. Promotion design implemented should be able to deal with this trade offs by integrating multiple measures to determine who deserves to be promoted. The multiple measures should be designed in terms of instrument or mechanism used. First; incredible adjustment should be made to reflect quality of services provided and a particular level of performance achieve before promotion is rewarded. Timing incentive as used as promotion strategy needs to be continuous or awarded periodically. This means that promotion should be made available to non medical staff at the time close to performance being recognised on quarterly, half yearly and on annual basis (Duckett 2008, online).

Performance management has to begin with goals that will help define performance results that the organisation is aimed to achieve. Goals are the backbone of any performance management as it helps plan, appraise, reward and improve the performance of both employees and company. Luecke & Hall (2006, p. 2) adds that time and energy should be integrated to the goals to realise organisational success a strategy that OGC (2009) fails to point out. Goals can not be achieved without adequate time and energy invested into it. A company should focus the limited resources it has and time on individual employees in every department on things (goals) that matter the most. Company strategy should be laid out first before the organisation draws down its goals, for instance, if the company chooses to be market share leader, then the unit goals should strategise in increasing production, then after individual goals aligned with those of their department objectives to achieve uniform objectives (Luecke & Hall 2006, p.3).

The promotion structure should not be complex and a clear formula towards attaining certain hierarchy should be clearly defined. If rewards system is complex and not well defined, hospitals may find it hard to pursue its desirable targets. A valid and comprehensive policy structure in terms of management information system should be provided to allow managers to tract employee’s performance against set up goals that will enable them offer promotion to the desirable employee. In order to save on hospital cost, reporting burden of new indicators and transaction costs need to be reduced such that performance goals are built on already known and validated information system in terms of measures to be used, data collection and feed back tools (Duckett 2008, online).


The structure of promotion policies should be stable and wide to enable hospitals introduce new process. In order for the hospital to realise this changes, it should allow considerable amount of time before it designs and implements a new policy that will disrupt the already existing organisational routine. It should also provide resources to incorporate the necessary changes such as pay adjustments to promoted employees. Change of promotion policy should not be awarded on annual basis as it will be hard to realise the benefits attributed from it as internal costs for restructuring the policy will be very costly in terms of information system and documentation. Promotion policy needs to be aligned and consistence with hospital management goals and policy objects in order to ensure that there are no unattended perverse incentives that will jeopardise the efforts to drawing new objectives to achieve desirable goals towards promotion policy implementations (Duckett 2008, online).

Key lessons for development of promotion incentives

  1. Audit procedure provided to monitor performance evaluation for each employee on departmental levels.
  2. Ensure that reward structure is stable and meaningful.
  3. Provides clear and explicit strategies about the behaviour to be rewarded.
  4. Well designed promotion strategies that it provides equal opportunities to all employees at the same time benefiting the overall performance of the organisation.

Research Setting

Promotion Policies at King Faisal Specialist Hospital and Research Centre

Vacancy placements at King Faisal Specialist Hospital and Research Centre for non medical staff include a promotion package that defines Job Description, Job Promotion Form, Personnel Change Form, Consent Letter and Most Recent Performance Evaluation. The procedure for promotion process include vacancy announcement where an applicant gets a chance to send his CV to department head then Approval tested to Candidates Department. Manpower services then verifies the package completion if the candidate qualifies and if not the incomplete form is returned to the concerned department. Upon verification of package completion, MSR verifies the application and the form returned to the appropriate department if not verified. If an employee qualifies for the position, MSR department approves the applicant’s forms; Human Resource coordinator reconciles his qualification in terms of education, skills, experiences and job performance with job requirements on the Reconciliation Forms. After applications have streamed in, Manpower Secretary schedules a meeting with Administrative Credentials Committee to jointly sign off Promotion Effective Date. Scheduled Administrative Credentials Committee (ACCA) delegates its duties to three departments namely Respective Executive Director approves employees of grade 6 and below, ACCA approves Grade 7 to 11 and CEO approves from Grade 12. Once different grades have been allocated and Necessary Documentation Prepared by the manpower secretary, qualified employee is send a Congratulation Letter and Log Package is sent to Personnel Department for Processing and an employee is placed on the promoted job. If at any case the required documentation are disapproved or postpones, the forms are returned to concerned department (King Faisal specialist Hospital and Research Centre 2006, p.1).

Administrative Policy And/ Or Procedure used at King Faisal Specialist Hospital and Research Centre and that of Riyadh in Saudi Arabia requires that policies and procedures used at hospital are designed to allow standardised selection and approval of qualified hospital employees for promotion. (King Faisal specialist Hospital and Research Centre 2006, p.3).

The policies drawn out include:

Basic Policy

Basic policy requires that all qualified employees placed on open MSR positions through promotion process. Internal applicants should be given first priority as compared to external applicants. Qualified candidates are then required to apply for open position through her department then to Personnel Services Department of which coordinates the review of the application and transfer them to various departments.

Administrative Credentials Committee (ACC)

ACC is established within hospital administration and act as principle mechanism in the selections and promotions areas and in the placement of suitable applicants for open MSR positions. The established committee is required to form and operate a system for speedy reviews of promotion request, alignment and promotion adjustments of employees in job grades from 7 to 11 and the application forms forwarded to Counsel, Supervisor of Executive Management and to Chief Executive Director for approval (King Faisal specialist Hospital and Research Centre 2006, p.7).

Committee members comprises of Executive Director of the hospital operations and acts as the chairman position, Director in the Human Resources Department who acts as a coordinator, Deputy Executive Director in the Research Centre, Director in the Quality Assurance department, Financial Control Administrator, the Head of Personnel Services and a representative in the promotion department. A representative from the recruiting department vacancy is invited to appear before the committee to explain the vacancy position but he is not involved in the voting process. Committee operations are required to adhere to established Hospital Policy is selection and approval of promotions (King Faisal specialist Hospital and Research Centre 2006, p.8).

Initiation Salary Increase

Once an employee is promoted, his employment grade upgrades automatically and in turn raises his salary. Therefore, Employee Relations Manual is provided to regulate the actual promotion procedures. The policy also requires that employees who are enrolled in career development programs are qualified for promotion placement after a period of 6 months and he must also meet the recruitment requirements of Career Development Program (King Faisal specialist Hospital and Research Centre 2006, p.9).

Credential Verification

The Committee has the authority to attest the presented credentials by an applicant in a formal and appropriate manner. To speed up the review process, the committee not follow up on approval of the candidate’s credentials but upon realisation of falsified documentations, an employee may be called upon to terminate the position (King Faisal specialist Hospital and Research Centre 2006, p.9).

Ways to improve the current promotion policies at King Faisal Specialist Hospital and Research Centre

The inconsistency of non-medical department at King Faisal Specialist Hospital and Research Centre arose due to combination problems in all promotion departments and management system. On policy levels, King Faisal Specialist Hospital and Research Centre (2007) emphasises on offering equal promotion opportunity to all its staff members but the policies have not clearly defined the grounds to which it ensures employees of various backgrounds are represented in terms of religion, colour, religious grounds, gender, race, age, disability, sexual orientation and nationality. Equal employment opportunities should be justified in terms of recruitments and selections, training, transfers, promotion and in dealing with grievances. As the principle of equal opportunities in employment and diversity strategy are strongly emphasised in Chesterfield Royal Hospital NHS Foundation Trust, it should also be incorporated in King Faisal Specialist Hospital and Research Centre in collaboration with the existing promotion policy. The hospital should incorporate the following in its new promotion policies:

  1. The policy should continues to seek and develop the potential of work place. King Faisal Hospital should also work to develop the existing promotion policy over a period of time to improve the welfare of its employees in terms of allocating promotion positions
  2. Chesterfield Royal Hospital NHS Foundation Trust policy recognises patients, clients and staff members as part of the hospital community and works to ensure its social responsibility, a principle that should be applied at King Faisal Specialist Hospital and Research Centre.
  3. This policy strives to eliminate discriminatory practices in promotion placements and encourages good practice at all levels. Promotion process used at King Faisal Specialist Hospital does not provide clear channels for job promotion s evident at the first stage where an applicant sends a CV to the candidates department, the less qualified candidate CV should be revoked immediately before its send to Manpower Secretary for package verification to save on time. The whole process of sending application forms back at forth compromises the transparency in promotion process and employees loose trust in the management system therefore killing their promotion morale of ever attaining higher status in promotion ladder thereby decreasing quality of services offered as there is less motivation.
  4. Chesterfield Royal Hospital NHS Foundation Trust policy recognises the organisation’ legal responsibility provided by the Race Relations Act of 1976 and 2000, Human Rights Act (1998), Rehabilitation and Offenders Act (1974), Protection from Harassment Act (1997), Employment Act (2002), Disability Discrimination Act (1997), Employment Equality Act (SoR & RB) Regulations (2003), Sex Discrimination Act (1998) and Employment Equality Age regulation Act (2006). All this acts should be incorporated in King Faisal Specialist Hospital and Promotion Policy to help offer equal promotion opportunities to everyone. Equal employment opportunities at this hospital will not be realised without law enforcement.
  5. Chesterfield Royal Hospital NHS Foundation Trust policy has deployed strategies to provide equal promotion opportunity to all employees for self development by removing barriers by enforcing legal responsibility and implementing effective development programs. King Faisal Specialist and Research Centre has does well in implanting development programmes in its system through offering training incentive to its employees that would laiter offer them promotion opportunities but it should also recognise legal responsibility as its the back borne of fair and equal promotion opportunities to its staff members.
  6. King Faisal Specialist Hospital promotion policies are never subjected to any reviews to improve their effectiveness. I suggest that King Faisal Specialist Hospital and Research Centre should periodically review their promotion policies to make sure that they are up to date with employment polices as well as department goals and objectives.
  7. Chesterfield Royal Hospital NHS Foundation Trust policy monitors candidate’s application forms ensuring that prospective job applicants are made aware of Trust commitment to equal opportunities. King Faisal Hospital on the other sends a Congratulation letter for a successful applicant and also informs the employee whose application was rejected. From here the employee is not made aware of the Committee commitment to equal opportunity that would make the employee try harder to next time or work towards achieving the required credentials that would qualify him for promotion next time (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.1).


Chesterfield Royal Hospital NHS Foundation Trust involves employees in the practical application of promotion policies. Unsuccessful applicants who feel that promotion placements were unfair are called upon to raise the matter to the manager. King Faisal Specialist Hospital and Research Centre does not have such provisions for settling unfair barriers regarding unequal opportunity issues for unqualified employees. Department manager should ensure that employees’ issues are dealt with effectively, fast and taken seriously so that the underlying problems are solve to avoid future reoccurrence. Promotion system should also establish Grievance procedure to deal with staff complains in a timely and appropriate manner. Staff members included the selection Committee should be assigned specific responsibilities in relation to recruitment and training development and should not be involved in the voting process (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.1).


King Faisal Specialist Hospital and Research Centre should ensure that promotion policies observe legal provisions to ensure employees are not discriminated against on grounds of ethnical, gender, race, colour, religious origins, marriage, disability, sexual orientation and in terms of nationality. Chesterfield Royal Hospital NHS Foundation Trust puts more emphasis on marital status as it the most discriminated area in terms of promotion placement. Although promotion is discriminatory in nature since the best CV is chosen over the other, unsuccessful candidate suffers the disadvantage in the long run. If the criteria used are objective, legal and relevant to the post, employees gain confidence in the recruitment system as they are motivated to work hard to secure the positions in future (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.1).


Chesterfield Royal Hospital NHS Foundation Trust recognises disability in their trust policy in the sense that an employee may become ill in line of duty or was employed disabled. This hospital has provided further Guidance Notes in the Trust Recruitment and Selection Policy to further explain how disabled employees shall be dealt with in the process of promotion. King Faisal Specialist Hospital and Research Centre should provide a policy that would protect disabled employed in promotion process that would ensure they are treated equally as other applicants and they should be let to work equally as hard as any other employees to secure the position. They should also be made aware that the Committee will not favour them in job allocation on grounds of disability. If the candidate’s application did not go through, they should be communicated of the reason of their failure in a speedy and appropriate way (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.3).


King Faisal Specialist hospital and Research Centre needs to engage all the departments preventatives involved in the recruitment process in appropriate training in relevant legal matters as well as employment policies to make them well equipped with knowledge to be applied in selecting a candidate by offering equal promotion opportunities. The hospital also needs to design a separate policy that will ensure promotion practices are non discriminatory in nature, offers effective practices and offers transparent procedures in facilitating the selection of qualified candidate for the identified vacancy. All Committee members should adhere to Promotion Policy at all times in assessing applicant’s CV. If King Faisal Specialist Hospital and Research Centre incorporates all the legal practices in promotion requirement as the ones practiced in Chesterfield Royal Hospital NHS Foundation Trust, then the new promotion policies should include:

  1. Job Description clearly stating duties to be allocated to the new position and it should not discriminatory in nature without proper justification.
  2. Appropriate qualifications should clearly be stated and should suit the listed vacancy.
  3. Candidate’s Specifications, Job description and postings should be drawn without bias.
  4. All vacancy posted should be available for job share except in situations where the manager says otherwise.
  5. Trust application form should be used and data collected used for statistical monitoring to evaluate existing promotion process and provide provision for future improvement.
  6. Short listed candidate should be selected by placing application form against job description and educational credentials without bias.
  7. Committee should contact interviews with regard to legal requirement and should avoid judging candidates ability on the basis of ability, ambition, attitudes, motivations and many other stereotypes. Also any discriminatory advances on age, race, marital status, race, gender, nationality, disability, religious background, ethnicity and sexual orientation should not be encouraged (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.2; University of California 2000, online).

Training and Development

Chesterfield Royal Hospital NHS Foundation Trust has developed strategies and policies to ensure all staff members are not subjected to unjustified training barriers that will hinder their promotion. King Faisal Specialist hospital should also offer equal training opportunities to all staff members to open their promotion capabilities thereby improving quality of services offered at the hospital. The new policy should encourage and develop an equal opportunity culture within hospital management by supporting training awareness of equal opportunity to all staff employees and by offering appropriate training to enable the staff achieve necessary qualifications for promotion. The new policy should adhere to the following guidelines to ensure equal and appropriate training opportunities:

  1. Allow part time employees the same opportunities as full time staff in training opportunities.
  2. Identify training areas that will address staff needs. Each department has different training needs and each employee should be assessed individually regardless of religious background, age, sexual orientation, marital status, ethnicity, colour, race and disability to improve quality of services. Candidates should not be disadvantaged by unrealistic job requirements that cannot be attained within the hospital without justification. Staff members undertaking training course that require assessment of National Examining Board of Supervisory Management Certificate should be taken in a fairly manner without cheating (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.2).

Career Development

King Faisal Specialist Hospital and Research Centre should help their staff members plan their careers ahead by assisting them to develop their own potential through offering training facilities and other employee appraisal techniques. This strategy should be included in management policy in drafting new promotion policy and should include:

  1. Under the new policy should, department heads should encourage staff members to complete their training processes to enable gain extra skills and identify new development needs for adequate planning for future promotion.
  2. Performance management should identify training needs of each department and integrate them into the training lesson on annual basis in a justifiable and non discriminatory way.
  3. The hospital system should develop promotion opportunities by providing open learning that are subjected to service needs as pointed out by personal development to improve career development of an employee (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.3).

Terms and Conditions for Employment

Chesterfield Royal Hospital NHS Foundation Trust ensures that its promotion policies adhere to the law at all times. King Faisal Specialist and Research Centre should also stick to the legislation in amending its promotion policies. Apart from promotion incentive, it should also offer benefits, facilities and services to every staff member who have employed maximum potential in their service areas but have not qualified for the promotion yet. These benefits and services should be non discriminatory in nature (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.3).

Responsibilities for Managers

Chief Executive at King Faisal specialist Hospital and Research Centre should take the initiative of supporting promotion policies. Chief Executive will speedily enact the policy as compares to the long channels involved in Man power departments. Department managers hold major positions within promotion process, they should use the same positions to influence the promotion of this policies and ensuring that the new policies are developed from the current promotion system. These managers also need to receive appropriate training and guidance to enable them fairly choose qualified candidate for certain position. The managers’ new roles in influencing the policy will include:

  1. They should be made responsible for ensuring the new promotion policies are drawn and applied within their respective areas.
  2. Managers should be offered training to educated them on equal opportunity issues to eliminate discrimination.
  3. All department heads (managers) should be made responsible for encouraging equal promotion culture therefore encouraging employees to work hard towards attaining the promotion resulting to improved quality of services (Chesterfield Royal Hospital NHS Foundation Trust 2007, p.3).

Mater Hospital has developed new strategies that will encourage its staff in the participation and support of employment initiatives that will offer pathways to more vacancy opportunities. The key areas identified in improving promotion policy include:

  1. Enabling a flexible system that will ensure continuous improvement in promotion services such as recruitment, return to work and retention.
  2. Improving working life of its staff members.
  3. Good training facilities and higher education opportunities.
  4. The new policy will ensure quality and fairness.
  5. Improvising new ways of working.
  6. Evaluating performance management and development.
  7. Evaluating capacity, employee capability and provision of resources.
  8. Managers offering good leadership and direction.

Mater hospital under its Trust system supports training and development as well as educational services to all its staff members in respective departments in various disciplines including skills training and development programs by qualified and experienced tutors, trainers and course facilitators. The hospital also supports performance management as it stimulates effectiveness of Trust policy. If King Faisal Specialist Hospital and Research Centre establishes a clear and up to date promotion policy that would stimulate clinical outcomes, quality service delivery and improve efficiency in the management system will be realised. The new policies will only be realised if the polices are supported within Strategic plan and corporate objectives, Management and Directorate plans, an idea borrowed from Mater Hospital. Performance management should also provide measurable key indicators that will be used for reporting employees’ performance effectively (Donaghy 2005, p. 6).

Brigham and Women’s Hospital regularly reviews employees performance to enable the hospital evaluate staffs suitable for promotion. Leaders in respective departments are also required to give regular feedbacks both positive and negative to recognise employees’ strength and weakness and provide training where needed. These strategies gives employees’ opportunity to develop in service provision areas as well as feel recognised as the contributors of hospital overall performance. King Faisal Specialist Hospital and Research Centre promotion policies should design clear and well defined performance management and appraisal programs on basis of duties, responsibilities, job expectations and employee competencies which should be made transparent to other staff members at the time of hire or promotions. The hospital should evaluate employees’ performance on annual basis as it stimulates satisfaction, effectiveness and development of the policies. Performance evaluation should be in timely manner in order to realise results. Promotion policy can only be effective if all department representatives are involved in implementation. Statistical information based on employee performance should be computed and kept confidential and shared with senior heads of departments. Primary performance evaluation tool should be used to measure expectations. For instance, managers should be made responsible for handing in late evaluations, strategy used in Brigham and Women’s Hospital that should be incorporated in King Faisal Specialist and Research Centre to avoid sending a candidates application from back and forth (Ponton & Walsh 2007, p.1).

Performance Appraisal Program Guidelines

Brigham and Women’s Hospital has designed new policies in ensuring equality in promotion policy that should be incorporated in King Faisal Specialist Hospital and Research Centre. Effective performance evaluation should:

  1. Be able to identify weak areas in promotion system and be able to develop opportunities for its staff members in positions they currently hold as well as future promotions and also offer career development opportunities such as training.
  2. Provide open communication channels between all head departments and the director to employees on the listed vacancy requirements and other areas.
  3. Stimulate employee’s performance and morale. Performance Management should also enhance overall satisfaction of employees by offering clear communication channels by ensuring feedbacks are regularly communicated to employees and provides contusive environment that offers employee room for improvement.
  4. Performance appraisal should define clearly job duties, employee expectations, responsibilities and should be subjected to annual reviews to improve the system
  5. Human resource decisions should be based on legal framework in cases of promotions, demotions, pay increments and reductions (Ponton & Walsh 2007, p.2)

Determination of Merit Review Dates

Brigham and Women’s Hospital evaluates performance of part time employees on quarterly basis, a strategy that should be applied to Brigham and Women’s Hospital to ensure all employees get equal promotion opportunities. Brigham and Women’s Hospital allocates review dates for performance evaluation to non contractual employees in the following order.; October 1 for selected Management Staff, December 31, March 31, June 30 and September 30. New hires are assigned review dates on the dates they are hired and dates remain so until when promotion opportunities arise. The hospital promotion policy subjects all its employees to annual performance reviews and assigns each group review dates depending on the grades and nature of employment and approved by human resource. King Faisal Special hospital on the other hand should assign each employee groups specific review dates and this responsibility should be given to the head of Human Resource either than having to pass through long channels of communication from respective Executive director, then to ACCA and C.E.O. The hospital should one central authority body that will be responsible for reviewing employee performance, Human resource department for instance (Ponton & Walsh 2007, p.2).

Employees on Leave

  1. Employees who are either on paid leave or on Family Medical Leave and fail to be reviewed at the time of evaluation, they should receive their formal reviews once they return from leave and if any promotion arises their pay increment should date back their actual review dates.
  2. Employee from Family Medical Leave should have their review dates changed based on absent dates depending on paid or unpaid leaves.
  3. Employee on approved and unpaid leave should have their review dates changed according to number of days the employee was unpaid. Brigham and Women’s Hospital uses the following formula to calculate review dates and which should be applied to King Faisal Specialist hospital to ensure all employees’ performance are reviewed periodically and equal promotion opportunities awarded. The unpaid number of days should be counted and added to the original employees review date. Then the Human Resource manager picks the closest dates and assigned to the employees as a new review date. The employ should then be informed the new review date to make the whole evaluation system transparent (Ponton & Walsh 2007, p.3).

Performance Appraisal Program guidelines

At Brigham and Women’s Hospital, senior leaders such as Human Resources, Compensation Department of Partners HealthCare System work together in the approval of policy implementations, Wage approval and Salary program. They together design packages that contain formal guidelines and program overviews and submit them to managers. These packages present overview of Fiscal Year Wage and Salary and Performance Appraisal Program. It also describes and explains Merit Program Guidelines, Targeted Budget Averages, process of changing formal Salary Ranges and Range of Percent increase allowed to qualified employees. Before the senior managers design Wage and Salary Program and Performance Appraisal Program guidelines, they thoroughly review economic indicators, collect data internally, use external bench mark analysis and review financial data. King Faisal Specialist hospital and Research Centre has not provided any formular to which it uses to calculate employees wages and salary. It should incorporate this method of wage calculation in its promotion policy to ensure pay increments effectively reflect promotion status (Ponton & Walsh 2007, p.4).

Reminder Reports

Head of human Resource should constantly review employee reports of the upcoming and past due evaluations and act on the in a speedy manner (Ponton & Walsh 2007, p.4).

Procedures for filling a vacant position

When a vacancy opening arises, all employees should be allowed equal opportunities for the application, King Faisal Specialist Hospital and Research Centre should involve part time employees in the recruitment process. Vacancies should be advertised and posted for a minimum of five working days, a policy applied by Texas government for vacancy placement purposes (Texas Government Code 2006, p.1).

Internal promotions

  1. Applicants interested in open vacancies must complete promotion forms.
  2. Employee eligible for promotion must possess minimum qualifications or have necessary skills to perform the listen job.
  3. Increments should reflect employee new grade soon he assumed the position.
  4. Employees who apply for promotion positions must demonstrate their ability to perform the listed duties by submitting their credentials (Texas Government Code 2006, p.1).

Human resource should coordinate all the vacant positions together with all managers of respective departments and should adhere to all promotion policies and procedures at all times. Human Resource should review vacancy advertisements before they are placed in hospital intranets and bulletins to ensure that they actually exist, comply with promotion policies and are non-discriminatory in nature. King Faisal specialist Hospital should design a pre-placement testing to ensure employees fit the particular promotion position and this should be contacted by Human Resource services. Pre placement testing should design test scores of which a candidate is required to obtain minimum score requirements. Human Resources services should establish required test and design policies regarding test procedures and qualification required to be considered for specific positions. If test are contacted at departmental levels, then test content, test procedure and a brief description of the relationship of test scores to selection criteria should be approved by Human Resource services basing on analysis of the test content in relation to job requirements. Human Resource Services should also pre-approve testing content in terms of test administration and scores obtained. Testing scores should be validated and should not be biased (Texas Government Code 2006, p.2).


Human Resources services should take charge in screening candidates before hiring them. Human Resource Department after screening candidates CV should then refer the qualified applicants to hiring department for consideration. Deploying department should further reconcile applicants’ credentials against job requirements and all referred candidates from Human Resource Service department should be considered (Texas Government Code 2006, p.3).

Selection and Verifications of references

Hiring department and Human Resources Services at King Faisal Specialist Hospital and Research Centre should look for the following information on applicant’s CV before promotion considerations.

  1. They should countercheck two references in the employment and education History Form in the resume
  2. The applicant should also provide original documentations of professional certification at the time of the interview.
  3. Once a candidate has been referred hiring department for consideration, Human Resource service department should be notified once qualified candidates has been selected including changes in rates of pay, date to begin working and conditions for employment. Hiring department should also give Human Resources Services information collected during the interview process, a strategy that should be used at king Faisal Specialised Hospital and Research Centre to make sure that the selected candidate actually qualified for the position (Texas Government Code 2006, p.3).

Employment Offer

Vacancy advertised period should only be extended with approval of Human Resource Services. Human Resource department should coordinate starting date with the candidate and hiring department. King Faisal Specialist Hospital and Research Centre should coordinate its promotion processes with Human Resource department to improve the effectiveness of promotion policy. Once the promotion Committee in the hospital has approved applicant’s credentials, it should send the following documents to Human Resource services:

  1. Position Authorisation Form.
  2. Candidate’s performance reports.
  3. Letter of justification if required.
  4. Education and Education History Verification Form, (Texas Government Code 2006, p.4).

Sign Up

In a situation where internal staff does not qualify for the promotion position and the hospital management opens the position to the public, new employ should contact Human resources Services on the first day of work for a brief introduction. If the candidate the candidate is an immigrant, then IRCA documentations need to be prepared by Human Resource services. Then after Official position orientation scheduled is made soon the candidate assumes the position to avoid delay of benefits, performance review dates and delay in initial pay check (Texas Government Code 2006, p.4).

Deviation from Normal Recruitment Procedures

When King Faisal Specialist Hospital and Research Centre hiring department wishes to deviate from the normal promotion procedures such as offering salary rate in excess of the promotion grade, decides to waive educational credentials and posting period, then approval from Human Resource Services must be obtained (Texas Government Code 2006, p.4).

Vacancy Advertisement

King Faisal Specialist Hospital and Research Centre should always use EEO/Affirmative Action Institution in all its promotion advertisements and vacancy positions and should be approved by Human Resource Services before they are released for advertisement. According to the promotion policy provided by this hospital, no specified method of vacancy is announcement is provided. Promotion positions are advertised without use of affirmative action. Human Resource Services should work with department heads in placing promotion advertisements (Texas Government Code 2006, p.5).

Applicant disqualification

King Faisal Specialist Hospital and Research Centre only bases on educational credentials in selecting the most qualified candidates and disqualifies the ones that does not meet the promotion requirement. It should also reject candidates who possess records of dismissal, removal and those who provided false education credentials (Texas Government Code 2006, p.5).

Special Criteria for Employment

King Faisal Specialist Hospital and Research Centre has provided provisions for dealing with certain position for promotion but failed to provide special promotion requirements. Special employment requirements should also contain the following:

Applicants from the public who are service sensitive such as those holding criminal record history should be thoroughly securitised regardless of whether they hold the required qualifications. Also, if the promotion vacancy require the applicant to handle money, high profile personnel, medical, financial, legal and students academic records or have access to the Hospital research laboratories which are designated as security sensitive area or have access to master, then the normal promotion procedure should be skipped. Promotion vacancy identified as security sensitive should be stated so in the advertisement and hiring department and Human Resource services should be informed of the same. Internal candidates of criminal records may be offered the promotion position upon evaluation of criminal history as confirmed by Chief of Police. Chief of police report will then be send to Human Resource services then after applicants credentials evaluated according to the hospital’s employment policy. Human Resource Services should then send a report to hiring department to approve or disapprove the candidates (Texas Government Code 2006, p.6).

Applicants filling position that require valid nursing licence should be asked to place their current licence to Human Resource Services for inspection to make sure they are valid and are up to date. King Faisal Specialist and Research Centre should invite Nursing Examiners to verity validity of the licence before the candidate is approved for the position. Positions requiring employees to drive vehicles should state the requirement in job description and request applicants to include copies of their valid driving licences together with educational credentials. Human Resource services should be responsible for maintaining driving licences copies in employees file. Applicants filling positions that require medical training such as medical assistants, the hospital should request them to provide documentations to prove school completion within the promotion department. Other promotion positions that call for licences such as technologists and EMT, applicants should be required to present documentation of their licence before promotion is awarded (Texas Government Code 2006, p.6).

King Faisal Specialist and Research Centre also should directly provide promotion opportunities to part time staff members to full time faculty to employees who have held the position for more than three year. Promotion Committee from various representative departments should be appointed by the President of King Faisal Specialist Hospital and Research Centre and the Committee should be represented by members of various groups including women, minorities, different races and many others. The hospital should form various organisations to guard welfare of employees to ensure they are all treated equally in promotion placements. Examples of the organisation should include; Dean of Minority Affairs, Office of Equal Opportunity and Affirmative Action and any other offices that would deal with any forms of discrimination in promotion procedures. Members of the Committee should only hold the position for a period of three years then subjected to renewal depending on staff interest and effectiveness of Committee. If Dean of Minority Affairs is formed within the organisation, then the Committee role will be to advice the Dean on promotion requirements. Dean should ensure that the Committee adheres to affirmative action guidelines provided. The Dean should be informed whether the applicant position was granted or denied. The Committee should also submit annual employee’s performance review reports to the Dean, comparing analysis of employee’ performance from previous years to the current year and identify areas that showed improvements and grey areas that need reconstruction like training. The Dean should work with the Committee and department representatives at all stages of promotion process to identify and address specific problems affecting the current promotion policies and retention of women and minorities (Reiger 2008, online).

The Committee should periodically review hiring department affirmative action on performance to ensure they constantly adhere to promotion procedures as stated in Promotion Policy and Evaluation Procedures. The hospital should also form a faculty to deal with race and gender to handle employees’ grievances. The Committee should also meet regularly with new appointed departments head to review affirmative action and performance review procedures to ensure promotion policy objectives are accomplished and identify obstacles hindering progression. King Faisal Specialist Hospital and Research Centre should not only provide job description and qualification requirement, but should also describe:

  1. The position.
  2. Explain the need for the position.
  3. Criteria for evaluation.
  4. Bodies or persons involved in promotion processes.
  5. The bodies or people that make final decisions in selection of qualified candidate.
  6. The process by which promotion procedures take.
  7. Extra efforts applied by the hospital management in advertisement to reach potential participants like the disabled, women and minorities such as performance review. (Reiger 2008, online).

King Faisal Specialist Hospital and Research Centre should provide separate promotion procedure and evaluation procedures for external candidates seeking employment in the organisation. The hospital should ensure that effective advertisement option for external search is put in place that would reach the public on time. It should consider advertising using journals, registries and other widely known cost effective and reliable means. When advertising, the Human Resources Services should ensure that there is availability of the listed job, explain to the public the criteria that will be used for evaluating applicant and how the administration determines the qualifies candidates and bodies or persons that screens candidates CV, allocates interviews and one that makes the final decision. The advertisement should describe the process which the hospital management uses in screening applicant, chooses applicants for interview and steps for making final decisions (Reiger 2008, online).

Implementation of Affirmative Action Form

Affirmative action form should always be used whenever employees are recruited for the first time on full times basis, King Faisal Hospital and Research Centre should incorporate affirmative action forms for each applicant when selecting more candidates through single search. Affirmative action form should state name of the qualified candidate, department posted and areas of specialisation. Anticipated appointment date should be provided and must not be later than the next regular Committee meeting to allow adequate time for clearance. Affirmative action form should also ensure that promotion procedure adheres to Evaluation and Promotion Policies and the vacancy forms contain signatures of head of hiring department (Reiger 2008, online).

Affirmative Action Forms should also be submitted to employees who are excluded from normal promotion procedures such as post doctoral appointments and all other appointments as earlier mentioned before training resumes and each applicant name and qualification should appear on a separate form. Anticipated training start and end dates should also be stated. If the hiring department is forced to hire a candidate outside the hospital prior to start of the training period, then the hospital should design an external Promotion Procedure for Initial Selection of external positions. If candidates have not volunteered information on ethnicity or gender then the head of Human Resource should list them as non-minorities (Reiger 2008, online).

For effective and transparent promotion policies, every applicant’s name should be listed on the pool report including the successful applicant’s name. Each candidate’s application pool report should show current institutional affiliation, where the candidate got information from i.e. through job announcement, registry, advertisement or any other referral source. If the Committee categorises an applicant as less qualified should state the reason for their judgement and suggest ways the candidate could do for future considerations such as training. For qualified candidates, order of preference list should be provided indicating the names of the most qualified applicants in descending order. This way, employees will have trust in promotion process and make them work hard towards achieving the higher status. List of applicant’s names who withdrew or declined the position should be included in the list to show transparency in management system. The Committee should briefly state reasons for preferring certain candidate instead of others and for placing other candidates in the bottom list as less qualified. Internal members who request for training should submit their application forms one month prior to house staff training to give King Faisal Specialist Hospital and Research Centre adequate time to arrange training facilities (Reiger 2008, online).

On listing the open vacancy to the public and internal staff, Affirmative Action Advertisements should:

  1. Indicate the specific rank.
  2. Brief description of responsibilities.
  3. Clearly indicate degrees required.
  4. Specify all other prerequisites, i.e. additional requirement needed for the job, for example laboratory techniques, driving licence and many others.
  5. If multiple positions are advertised, then affirmative action advertisement should clearly distinguish one position from the other
  6. The name of the hiring institution should be included together with location map, Kin Faisal specialist hospital and Research Centre for this instance.
  7. Once King Faisal Specialist Hospital and Research Centre adopts this policy in its promotion processes, the advertisement should state that the hospital take affirmative action in ensuring equal promotion opportunity to all.
  8. Indicate that the hospital is interested in applicants from all back grounds regardless of their status.
  9. The advertisements should also appear in print one month before scheduled interview dates. This will give candidates time to prepare for the interview.
  10. If the company identifies suitable means of placing advertisements, the hiring unit should obtain permission from Affirmative Action Committee before it places the advertisement (Reiger 2008, online).

Human Resource Management at King Faisal Specialist Hospital and Research Centre

As earlier stated, Human Resources Services should be included in the promotion procedures as their services contribute effectively to hospital development and management and also provide initiate projects that are conceivable and feasible. King Faisal Specialist Hospital and Research Centre should include Human Resource Service in planning, performance assessment and reviews and help in managing constraints through internal re-allocation. Redefined roles of Human Resource Manager in planning process in King Faisal Specialist Hospital and Research Centre should include performing periodic reviews of manpower requirements. Its planning team should work with respective departments to provide information surpluses or shortages and work load statistics to be used in performance evaluation (Autonomous Hospital 2008, p.1).

When King Faisal Specialist Hospital and Research Centre experiences staffing shortages, Human Resource Department should be responsible for advertising the existing positions both internally and externally or appoint personnel in the recruiting department. It should also make sure the candidates appointed for job specifications are qualified and have the experience to meet hospital requirements expeditiously. King Faisal Special Hospital and Research Centre should support recruitment Committees efforts. Promotion Committee on the other hand should ensure the selected candidate to be offered to the hospital specifically fits the specifications indicates in the approved HR report. CEO should not only take part in promotion processes but should also ensure recruiting departments adopts changing needs in promotion policies like incorporating new policies as we have seen of affirmative Action organisations. Decision to appoint specific categories such as high profile positions like post doctorate positions should be a shared decision involving Human Resource services, recruiting departments and the autonomous of the hospital. If the appointment position required medical qualifications, hospital relevant departments should always be involved in the promotion process and Human Resource department should make sure the appointed candidates are recruited directly to the particular autonomous hospital (Autonomous Hospital 2008, p.3).

CEOs and department representatives should ensure that concerned recruitment Committee are fully informed about the expected vacancies and are required to quickly facilitate recruitment processes to so that vacancy dates are not delayed leading to disorderly delays resulting to disruption of services. Committee should try and fill the advertised position a quickly as possible rather than sending candidates CV back at forth and adhere to promotion policies at all times (p.3).

King Faisal Specialist Hospital and Research Centre should include Saudization in its promotion policy. Saudization is defined as effective treatment of an expatriate staff member with another staff member within a stipulated period of time. This method will ensure all employees receive equal promotion opportunities. Saudization process includes the following phases:

  1. Selection of the Omani candidate.
  2. Identifying the expatriate employee to be replaced.
  3. Appointing and posting the Saudization staff member.
  4. Training the selected Omani candidate.
  5. On job training of the Omani candidate.
  6. Hospital offering further education of the selected Omani employee.

King Faisal Hospital should adopt Saudization initiative in its management system. CEO, Human Resource Services, recruiting departments and employees should work together to make Saudization process effective. Saudization should also be applied to all specialised manpower categories in the hospital. All promotion departments should coordinate saudization initiative in planning for recruitment and processes further with Human Resources Services. Non medical staff management promotion Committee should always consult the hospital management before it selects candidates regardless of whether the position requires medical certifications or not. Once Saudization initiative has been adopted, the Committee should coordinate with the hospital in selecting the preferred candidate. Newly assigned Omani candidate should enroll for induction training soon he assumes the position. Omani staff should be formed and their responsibilities would include; 1). Deploy the Omani candidate in all unit departments to familiarise him with hospital activities. 2). assigning the candidate duties in a particular station for a period of time. 3).the candidate will then be shifted to another workstation to make him equipped with practical knowledge, skills and attitude to make him competent. Department representatives should closely monitor the candidate performance for a period of six months to one year within which he should demonstrate that leaning actually took place and if not the supervisor should highlight the areas that need correction (Autonomous Hospital 2008, p.6).

Once an Omani candidate has been exposed to necessary experience at the hospital, he may be considered for further education to maximise his potential. CEO and department representatives should encourage Omani employee to pursuing higher education by helping him forward his application to respective institutions. Employee promotion should not affect the functioning of any department as it mismatch job description will cause delays in form adjustments therefore affecting the functioning of recruiting department. As we have mentioned earlier, performance evaluation should be considered for promotion but the hospital management should not utilise manpower services at its expense. Improper utilisation of manpower should not be encouraged since staff members will be force to perform professionally inappropriate tasks so that it could be reflected in their performance reports. CEO, recruiting departments and Human Resource services should only utilise manpower in emergency services (Autonomous Hospital 2008, p.7).

King Faisal Specialist Hospital and Research Centre should continuously monitor staff performance and their effectiveness in carrying out their duty with a view to identify weak areas and improve employees’ productivity and performance quality. Performance evaluation should not only be based on filling performance forms by defining superior performances as excellent and inferior ones as weak but devising appropriate methods that will appraise employees performance in order to encourage them to work harder therefore improving their efficiency. An employee will be required to take part in evaluating his performance by keeping notes of critical incidents on his diary whether positive or negative, then he will be required to produce the notes to the supervisor while filling performance reports instead of using letting the department manager use his subjective judgement (Autonomous Hospital 2008, p.11).

Princes Alexandra Hospital NHS has formulated promotion policies that ensure highest quality of health care in the hospital by providing fair and non discriminatory recruitment system, development and promotion of its staff members. The hospital is also committed to ensure that recruitment Committee are well trained to carry out recruitment activities. King Faisal Specialist Hospital should also ensure that its promotion committee are well trained on promotion policies to operate on fair and open standards. Human Resource services should regularly monitor Committee activities and offer recommendations to enable planning of potential positive actions to be initiative to improve the system. Employees on performance evaluation should be informed that their performance will be monitored for promotion considerations. King Faisal Specialist Hospital and Research Centre should also specify Genuine Occupational Qualifications (GOQ) necessary to carry out the job when advertising for promotion vacancy. The Committee should check for quality for experience rather than length experience (The Princess Alexandra Hospital 2008, p.4).

Princes Alexandra Hospital requires its promotion policy to have an outline detailing all the required level of competency. It has also designed Knowledge and Skills Framework (SKF) that offer connection between effectiveness of services delivered and demonstrate how individuals can apply their knowledge and skills to deliver this services. King Faisal Hospital should also link its promotion policies with those of employees’ needs to ensure quality in provision of services. The job description should always describe the relevant task and responsibility on each job listing. Selection of candidates for promotion should always be a competitive process and exemptions should only apply in cases of disability, maternity, training or health needs. Advertisements should be in a clear language and made available in a variety of formats and advice given to applicants should be coherent and unbiased. Every department representative involved in the promotion process should undergo some training to ensure fair and objective promotion process by attending Trust Recruitment and Selection training course, a strategy that should be used at King Faisal Specialist Hospital and Research Centre in selecting its Committee members (The Princess Alexandra Hospital 2008,.p.6).

Human Resource Services should take the responsibility of data analysis in terms of performance evaluation right from recruitment date to when an employee is promoted. Training and development team responsibility should be to coordinate the analysis of data training in collaboration with staff representatives and forward the report to recruitment Committees for consideration. Managers in respective departments should maintain records of recruitment and promotion and reasons for their decision in selecting particular candidate. Human Resource team should give out census forms to employees to countercheck that all the information offered are correct in terms of qualification and performance review reports and if a staff is identified to be missing clinical professional registration as his job specification, they should be suspended from work without pay or relocated to a less qualified position until they produce required documentations and if he fails to bring the certifications in a reasonable timeframe, he should the be dismissed (The Princess Alexandra Hospital 2008, p.7).

Before posting a vacancy, recruiting department should review the existing positions and other duties or amend the existing one and restructure the department before the position is filled. Recruitment panel at King Faisal Specialist Hospital and Research Centre Promotion Committee for this instance should:

  1. Consist of the same members for all applicants in case of multiple selection.
  2. Recruiting department head should chair the meeting.
  3. Committee members should not be related to any of the applicant for fair judgement.
  4. Where applicants are applying for promotion in the same department they work in, then the Committee should include Human Resource team.

During the interview, the panel should ensure that the external applicants are able to take up employment legally within the UK as referred by Asylum and Immigration Act 1997. After the interview, Promotion Committee should ensure that they have adhered to promotion policy and selected the best candidate. They should also justify their decision, show coherence in their evaluation and provide evidence. Recruiting department representative should collect all documents relating to the application, such as copies of notes, identification forms, and performance evaluation sheets for internal staff (The Princess Alexandra Hospital 2008, p.14).

Affirmative action

University of California has developed and implemented affirmative action compliance program that ensures all external applicants and employees get the right to equal employment opportunities. Affirmative actions ensures that all internal and external employees are offered equal opportunities for recruitment and promotion regardless of their colour, race, age, sexual orientation, sex, religious status, disability and any other forms of discrimination. King Faisal Specialist Hospital and Research Centre should adopt affirmative action compliance programs especially for women and minorities in:

  1. Identifying the problem areas within department and job groups.
  2. Developing work force analysis.
  3. Development of utilisation analysis by job groups that will be used for evaluation.
  4. Establishment of responsibilities for this employees that will call for implementation of affirmative action programme.
  5. Establish methods of formal dissemination for both internal and external applicants, of the EEO and promotion policy.
  6. Statement of EEO policy and promotion policy should be applied to all Personnel actions.
  7. Should design and initiate internal audit and reporting system to measure the effectiveness of promotion policies.
  8. Implement Sex Discrimination policy to safe guard the interest of women.
  9. To actively support local community action programs and services structured to improve employment opportunities for minorities and women. This way, King Faisal Specialist Hospital and Research Centre community problems and amend employment and promotion policies where applicable.
  10. Initiate action-orientated to eliminate employment and promotion problems and offer solutions that will help in hospital achievement of goals and objectives (University of California 2000, online) (Purdue University 1982, online).

Affirmative action program covers individuals of disabilities and veterans in the following areas:

  1. Promoting policy regarding non-discrimination and affirmative actions in all employment practices.
  2. Development of action oriented programme that increases the opportunities of qualified disabled and veteran individuals to getting equal promotion opportunities.
  3. Annual review and amendment of affirmation action program to make sure its up to date with employees’ changing needs.
  4. Affirmative action programs should review all job specifications to ensure the listed job is safe and is inconsistence with job necessity.
  5. Employment practices should be reviewed to make sure that recruiting departments and Human Resource Department have adopted affirmative action program for employment and promotion of qualified internal and external disable and veteran candidates.

Hospital Committee dealing with recruitment, promotion, training and development should strongly emphasise on promoting equal employment opportunity to all and promotion of affirmative compliance programs. Vacancy advertised should be limited to skills, educational experience and knowledge in relation to satisfactory performance of duties and responsibilities of the listed position and should also be subjected to periodic reviews to keep up with employment changing needs. In recruitment process, all candidate application forms should be reviewed without discrimination of any kind and vacancy advertisement should identify new and modify existing advertisement methods to broaden the scope of search. Affirmative action should always be applied in recruiting women and minority applicants where underutilisations in recruiting departments were earlier determined. Applicants with disabilities and covered veterans should also be included (University of California 2000, online).

Once promotion policies have been implemented, Human Resource services should assist in reviewing the new policies, application forms and tools and offer advice on any changes that should be made and new approaches to tackle the policies. Also, the department should ensure that the new policies are inconsistence with promotion policies and performance management best practices. The department should also consult various department representatives to identify each employee gaps in performance in terms of performance scores and implement corrections. Human Resource services should also train department representatives and Committee members regarding the best practices to be incorporated in the new promotion policy and provide appropriate tools accordingly. With efficient Human Resource Services in place, good performance results realised thereby increasing individual and organisation management effectiveness (IUPUI 2009, online).

Research Method

In my study, each employment department was organised differently in relation to how questionnaire activities were managed. In the first instance, I approached each department with my questionnaires for their own views about shaping promotion policy in work place. The research was intended to determine whether the current promotion system at King Faisal Specialist and Research Centre offers equal promotion opportunities to all and where amendments needs to be made. I used qualitative research where I collected, analysed an interpreted data by recording what employees said. The questions were open ended and were drawn to assess employees’ dissatisfaction areas and propose solutions that would improve working conditions at the hospital.

The research philosophy was aimed at examining the current promotion policy at King Faisal Hospital and Research Centre, identifying areas that needed amendment and device strategies that can be used to improve the current policies in equal promotion polices for all.10 participants from each group with 15 questions were chosen to asses their view on the current promotion policy. Null hypothesis were formulated for each comparison to be made.

Qualitative research

Research Design

The research protocol was approved by King Faisal Specialist hospital and research centre. Purposive sampling technique was used, with 30 participants enrolled from different non-medical departments in the hospital. Purposive sampling technique measures the views of employees, managers, training teachers with the intention of capturing their perspective towards current promotion policies. The interviews were supported by framework of performance evaluation program (Ponton & Walsh 2007, p.2) which refers to evaluating employee performance periodically so that they all get equal promotion opportunities. It acted as a guideline to an informal conversation between the researcher (me) and participants (employees) and also guided the analysis. The research was aimed at collecting views of managers and employees occupying different roles within the hospital to be explored. The views of part time workers and affirmative action employees referred to as others in the chart will also be captured on their view to how best promotion policies can harness an employee into pursuing higher employment status. An experimental group of three subjects were distributed the 45 questionnaires to give their views on the current promotion system. Verbal permission to contact the employees regarding the possible study enrolment was granted by each participant working at the hospital. Written informed consent was obtained from each participant and if participant could not provide informed consent, written consent was provided. The level of analysis used in the research was work group. Purposive sampling technique was used because participants possessed particular characters. Participants were employees of King Faisal Specialist Hospital and Research centre and subjected to current promotion policies (Bryman & Bell 2006, online).


This study took place at King Faisal Specialist Hospital and Research Centre, a residential treatment centre that accommodated non-medical staff in its promotion policy. Sociological profiles reveal that the typical non-medical staffs at the hospital were subjected to the promotion policy at one time of their employment and it was crucial to the organisation to improve the system. The current promotion system did not adequately meet employee’s demands as employees experienced promotion difficulties, interpersonal problems and inadequate training facilities. Employees who were recruited five years ago admitted that they had never received any promotion opportunities.


A sample was used in this study. The sample was chosen by randomly picking participants (employees and managers) from each department to fill questionnaires regarding their perception towards the current promotion system.

Subjects included in the sample met the following criteria:

  1. The subjects had prior experience with the current promotion system, as determined from answers they gave to a questionnaire
  2. The same had met minimum qualifications prior to employment and therefore subjected to equal promotion policy which the management failed to enforce.

It was important that the experimental subjects have prior experience with the current promotion policies in order to eliminate the possibility that change in the experimental subjects’ of the new promotion opportunities could be attributed to recall of current promotion system. Since this was an important consideration for the experimental subjects, it was also a criterion that questionnaires were based on. It was also important that subjects in this study have minimum employment qualifications to adequately access equal promotion opportunities in the current promotion policy. A more detailed description of the questionnaires can be found in the Appendix.

Selection of Subjects

During the research period which is expected to span seven month beginning October 28, 2008. Essentially, I will observe the staff situation before proceeding to administer the questionnaire. During the course of the research, I will attend a number of the staff union meetings and in the process interview a number of people on an informal level.

This exploratory research uses questionnaires interview with department managers and employees to help understand the factors that influence the development and initiation of promotion policies for non medical staff at King Faisal Specialist Hospital and Research Centre. The research period is expected to span a seven month period beginning from the October 28, 2008 from 30 key participants mainly being employees employed, managers and others groups representing women and minorities within the hospital.

Subjects were chosen from already employed staff at the hospital since they could easily enrol in training classes, complete the requirement at their own pace, and promoted when they had earned required credit. Each participant was asked to respond to a questionnaire to determine if he/she had prior experience with the current promotion policy. At this time, I checked the employees’ academic credentials records to ascertain whether the employees qualified for the position they currently hold. The purposive questionnaires consisted of 45 questions which determined their perception towards the current promotion policies. Negative answers to all the questions were required for inclusion in this study. The questions were simple and direct, and employees answered them accurately. Purposive sampling technique represented all the three groups to the problem under this study. Purposive sampling technique was selected because the participants possessed certain characteristics; they were all working at King Faisal Specialist Hospital and Research Centre under the current promotion policies.

The research used questionnaire to sample data since the method was inexpensive and the questions were quickly administered in the distributed groups. The questions were well formulated to explore complex issue that could not be well addressed in other methods of data collection such as oral interview. I preferred questionnaires over interviews because interviews compromised confidentiality of information obtained therefore making the results unreliable. It would have not been possible to obtain all the answers to 45 questionnaires based on the research. Research questionnaires were obtained from this literature analysis after I reviewed the current promotion policies of the hospital and compared it with other institution. Employees’ different employment groups and different methods of vacancy announcement were elements that could have suggested conflict. However, the questionnaires were not definitive as to prevent participants from their experience to analyse the current promotion policy situation.

The rationale for using questionnaire to measure the problem is based on the assumption that current promotion system requires the use of employees ideas to break problems into parts and to formulate solutions. In order to answer questions about this particular problem, the participants first brought their ideas into the process and then demonstrated how the new promotion policy should be amended to solve their problems. The use of questionnaires seemed the appropriate method of assessment. The sampling was is written format and required written responses from the participants. In the form given to the participants, it was called “Analysis” in order to avoid the suggestion that was a test with right and wrong answers. By avoiding this, it was hoped that the participants would respond honestly and completely to the questionnaires. The questionnaire analysis was examined for content validity by two professionals: The hospital training personnel specialised in testing and an employee representative who has an interest in promotion policies. These experts were asked to individually examine the questionnaires then make a statement describing the type of information that would be used from the questionnaires from participants who were answering the questions while looking at the current promotion policies. All these experts agreed that all the questions would elicit information concerning identification of a problem, their feelings, motivation and information about resolution of the problem.

Data Sampling and Presentation

As stated earlier in this work, all the data will be analysed and represented in the form of a topic graph. Therefore in what follows, I will outline all the steps that will lead to the presentation of the information derived. The alphabet “S” will be used to denote a particular sentiment expressed by an individual in this case employees of King Faisal Specialist Hospital and Research Centre at a given time D=[d1,d2,….d]. The exercise proceeds as follows: sample a few respondents who will be asked to express their feelings through questionnaires administered to participating respondents. A look through all the letters, circulars and official correspondences that flowed between management and staff will also be evaluated to identify and extract keywords.

In the next step, the Dice coefficient is employed to calculate for correlations in the averages of the extracted keywords denoted “w” which expresses any of the sentiments, such that the phrase can be entered into the “S” column.

Establish the main keywords “n” as contained in the data obtained in the previous step. In the next step, I take note of the frequency of the appearance of the keywords, to be followed by an inverse of the frequency and finally, the score results to be presented by GENSEN-Web.

The next major activity to be carried out is to group the keywords based on the correlation coefficient over timeline and the Dice coefficient in each of the sources outlined. Finally, create a momentary graph for the individual “n” groups.

The next major part of the work is to produce the sentiment graph. The process is practically similar to what has been outlined above for the topic graph. Except that in the latter, there is a special provision for a momentary graph of frequency of sentiment category under each of the groups created. The data obtained was reliable since the information provided was confidential and up to date on employees’ perception towards the current promotion policy. Ethical issues arose where employees of certain background such as Blacks, Women and disabled complained about inadequately of the current promotion policy in addressing their needs. Due to this, it was hard to retrieve information from them as they considered themselves less important in the implementation of new promotion policy.

Data Analysis

This research is built l around questionnaires regarding promotion policies development of future health care for non medical staff workforce. A purposive sampling technique was used in identifying participants for interview. The idea behind the technique was to select participants that were able to offer me information-rich data from a variety of employment sectors. The selected questionnaires were meant to cut across the structure of the non-medical staff work force and their views on the proposed new promotion policy, to look for their diverse views and perspectives. King Faisal Specialist Hospital and Research Centre offered some variations in employment grades such that employees with higher educational levels received higher pays as compared to the less qualified ones. Nevertheless, promotion policy on job specifications required applicants to provide education qualifications and years of experience. It also required employees to undergo training which was evaluated on the basis of performance scores and some admitted to have been given time to undergo training. Performance evaluation was measured in terms of training and promotion system in the hospital. As a result, a number of employment groups were set up to recommend changes and the new role of Human Resource Service in the propose promotion policies. Should funding be secured for employees who undergo higher education? Participants responded that higher education motivated them to pursue higher careers therefore improvement in the quality of services provided within the hospital but the hospital did not put much emphasise on higher education as few funds were allocated for that purpose and also few employees in a given period.

Promotion policies at King Faisal Specialist Hospital and Research Centre have been slow to establish according to participants reports. This has been attributed from lack of training focus on employees, department representatives, CEOs and Human Management Service departments and educational preparation for professional qualification. The hospital only considers full time employees for promotion opportunities and fails to consider part time employees. Although these promotion policies were particularly for promotion purposes, it seems that Committee representatives were appointed solely on recruitment responsibilities rather than engage in full promotion policies support. For employees, it is acknowledged that promotion policy programs leading to equal promotion opportunities vary across departments and can mean that women, minorities, covered veterans and disabled people may not be well represented.

Employees’ perception on higher education at King Faisal Specialist Hospital and Research Centre showed that promotion opportunities were awarded to employees who participated the practice areas were given priority. Now, recruitment flexibility is beginning to emerge between promotion consideration and educational background therefore the hospital should support training and offer opportunities for higher education. Performance evaluation programme identifies specific benchmarks in promotion processes and training against which educational qualifications are measures for awarding promotion opportunities. The subsequent indicators of evaluating quality of performance should be effective to attract the most qualified participants and influence achievement and progression employment grades and ultimately the credibility of the hospital management to sustaining their viability in employees’ welfare in the future. From our research, it was evident that King Faisal Specialist Hospital and Research Centre was interested in collaborating their promotion polices and training activities to ensure services provided to the community involving employees and patients were of high quality thus influencing job security.

From the research, participants identified lack of Human Resource Services involvement in the development of promotion policy where equal promotion opportunity culture was of concern. They strongly endorse the need to involve Human Resource Services in recruiting Committee in influencing promotion policies. Further participants on employment levels placed greater emphasise on the importance training incentives as it benefits them in providing quality services as well as raising their chances of promotion. Therefore is it important for the hospital to invest in good training facilities for employees and recruiting Committees benefit. King Faisal Specialist Hospital and Research Centre other priority should be to allocate funds for higher education for qualified employees. Not only will the hospital be involved in preparation, implementation and support of new promotion policy but also they should encourage and motivate employees to pursue higher careers. This strategy in place will enable service departments to function well.

Research Results

The views of the three specific participants combined, Participants in group A; employees recorded seventy percent despair scores in the current promotion system, managers’ views represented 50 percent scores while others (part time and affirmative action group) represented ninety percent. Participants in group B; employees recorded twenty percent scores in lack of satisfaction in the current promotion system as it hindered their way into meeting their promotion goals by lack of well structured performance evaluation system. Fifty percent of department managers showed mixed reaction while ten percent of others acknowledged lack of satisfaction in current promotion policy in meeting their promotion goals. Participants in group C; employees in this group recorded ninety percent anxiety scores in implementation of new promotion policies, managers on the other hand recorded 65 percent while others recorded seventy percent. Participants in group D; employees recorded 65 percent support in the implementation of new promotion policy as they anticipated that the policy will stimulate the progression towards promotion goals, managers recorded fifty percent scores in their support to the new system while others recorded ninety percent support towards implementation of the new goal.

Current promotion system

In relation to training, participants admitted that the hospital natures of training and educational development terms are not well understood in relation to scope of activity they represent. Employees training needs are not well identified as they are evaluated on group basis rather than individual assessment. Performance developments should emphasise on discovering employees’ problem areas, integration of knowledge, application to the work department and presenting a range of activities which the hospital should value them as equal and legitimate forms of training which King Faisal Specialist Hospital and Research Centre fails to do. Training is very essential for employees as it helps then develop skills to challenge the status quo and prepare them for complex work in higher departments. Part time employees proposed for radical changes in department leadership where only full time employees were considered for promotion. Due to complexity of promotion structure, the study mainly focused on promotion policies on the health care work, force.

At the end of the research the following outcomes represented below are expected to be generated. A graph will be plotted to highlight the sentiments generated especially in the wake of the announcement of the new promotion scheme for employees of the King Faisal Specialist Hospital and Research Centre. The X-axis of the graph will capture the dates where as the resultant sentiments will be presented on the Y-axis. The main sentiments expressed here are anxiety and despair.

Comparison of old and new promotion policies impact on organisation outcomes

New promotion policies system
Numbers 0 to 90 represent percentages indicating new promotion policies system had positive effects on outcomes


All participants acknowledged their responsibility both directly and indirectly in shaping promotion polices in non-medical healthcare departments. Department supervisors and overall managers demonstrated their commitment to helping in implementing promotion policies in their respective departments. Their support was evidenced by providing supporting environment which the research could take place, by provide training resources that will foster staff development as well ensuring its influence on promotion policies. On each employment department, they confirmed that they need to raise awareness for the use and implementation of performance evaluation as it provides solid foundation for good practice to stimulate promotion policies implementation. They also showed their willingness to improve performance evaluation, promotion policies and implement affirmative action to ensure promotion opportunities are non- discriminatory in nature. In spite of the number of successes identified with implementation of new promotion policy, the first priority should include sustaining the current promotion policies and Human Resource Services emphasised in realising this objectives. They confirmed the need to further improve affirmative action and performance evaluation tools.

Targeting employees towards promotion policies was recognised as problematic due lack of clear channels of communication within different employment departments. The management advocated on targeting new employees although time was crucial to be influential. Some participant groups acknowledged the management shift from using performance evaluation reports in considering employees for promotion. A number of creative solutions were offered to engage employees in recording their own critical comments in the diary whether positive or negative so that they could be given to their department representatives to be used for evaluation equal promotion opportunities to all without bias.

On academic qualifications, participants believed that management offered considerable support to equal promotion opportunities culture to the most qualified candidates in the organisation. In the research, I noted that department representatives were challenged by the need to organise their departments in identifying each employee’s specific problem areas that needed further training or higher studies whilst at the same time fulfil their commitment to supporting promotion policies in promoting equal promotion opportunities to all. Participants acknowledged the need to reward their efforts in both promotion and offering them opportunities in higher education. There was recognition of equal promotion opportunities for employees in spite of the competing demands on those who were more experienced. Those of higher education and higher salary grades such as employees with doctoral illustrated the need to support all employees at all levels with managers recognising the challenges they faced to facilitate promotion policies.

Majority of participants confirmed their general understanding of promotion polices but failed to describe the promotion processes. Nevertheless, there was considerable variation in participants’ belief as to the transparency expected from promotion process as it failed to define the channel to which the candidate’s CV is passed before approval. Also, performance evaluation form did not adequately specify what was needed of them in terms of output to be considered for promotion. Training facilities in the hospital did not stipulate the time required for training as each participants had various needs and the available facilities did not adequately support them. Participants believed that engaging good training facilities within the hospital was a high strategy towards achieving quality services within the management and the hospital at large. There was also concern on how hospital management should supports saudization candidates. Some participants believed that engaging Human Resource Services in implementing new promotion policies would contribute to quality services. Unless there was change in the current promotion policies, it would be difficult to achieve quality services within the hospital organisation. Nevertheless, they believed that future promotion policy changes should originate from the current practice that should be reflected in the new policy.

During my interview, participants admitted of not knowing of the existence of Saudization in the organisation that brought to my conclusion that King Faisal Specialist Hospital and Research Centre did not have such option and should implement it in future. Employees identified barriers in the current promotion system as inflexible employment models and promotion policies in areas such as unsatisfactory promotion procedures, competing agendas, lack of transparency in performance evaluation and less emphasise on affirmative action. Participants also admitted lack of sustainability for the promotion posts and poor job security. At the supervisory levels, several participants admitted to lack of accountability for employment output by several service organisations that focused on employee’s responsibilities rather than quality expectation that were stimulated by effective promotion system.

There were mixed views as to specific responsibilities Employees, Department heads and Human Resource Services should have in enforcing promotion policies. There was general consensus that ideas from employees and department representatives should be integrated into the new promotion policy clearly defining roles of each Committee member in passing a candidates CV and the structure be openly visible to all employee, Human Resource Services and recruiting department. Some participants admitted that lack of clear structure for passing the CV prevented the hospital management from picking the most qualified candidate and prevented them from achieving a healthy work balance. Priorities included in implementing new promotion policy will require sustaining the current level of the policy as well as developing it furthering in terms of improving the transparency of promotion procedures and the employee involvement in the initiation of the new policy across different departments and practice.

Participants of managerial positions acknowledged their responsibility in influencing departments in relation to promotion policies e.g. by offering equal promotion policy leadership by actively supporting structuring of the policies and enabling a supportive environment for promoting its influence within departments. Participants (managers) articulated their own emphasis on the need to support their employees who are employed on full time and part time basis. Therefore, realisation of this polices will involve collaboration work with senior managers and department managers to develop practice focused promotion policies. Some managers believed that providing skills training and personal development such as higher education and Saudization will promote the sustainability of promotion policies, while others ways to fund higher education opportunities rather than remain reactive to promotion opportunities. Priorities for the majority of participants included sustaining the current promotion policies as well as further development of the policies. The capacity of promotion policy in work force as well as in practice will result to increase in employees output in delivery of services. Some participants articulated to the need to narrow the focus on developing promotion proposal in whole hospital management and concentrate on department levels as each one of them is set up with different needs.

Some participants recognised the need to improve the link between promotion opportunities and training and request the hospital management to increase training opportunities and facilities as well as offer more opportunities for higher education programs that will increase their chances of promotion and effective implementation of promotion policies. Employees generally believed that the hospital management offered considerable support for them within equal promotion opportunities culture. Nevertheless, there was also belief that employees with who were less privileged like women and minorities should be best supported. Organising departments to achieve balance across training, higher education and promotion policies whilst fulfilling their commitment to equal promotion opportunities was seen as a challenge for managers. Majority of participants acknowledged that higher education scholarship was the best strategy in appraising employee’ performance but few opportunities were available. There was considerable variation in employees’ belief as to what was expected of them in relation to output and time in performance evaluation and resources available to support them for promotion consideration.


Information gained from this research has a rather narrow generalizability. The results applied to employees of the hospital who held minimum qualifications for their jobs. The participants were randomly selected samples, since the participant cooperation and participation were necessary in order for questionnaires to take place. The conditions of the study did not control for the influence of staff members on the subjects during the course of the research. As the test was administered to elicit specific information from particular groups for comparison scores, no standardised data are available for the questionnaires used in this study.


Participants embraced the idea of inclusion of medical practitioners in the recruiting Committee since they would support continuous profession development throughout the process. Although some vacancies were excluded from the normal promotion process, some believed that engaging medical profession in promotion process and policy implementation were a high risk strategy. From employees perspective, they believed that engaging practitioners into policy development would ensure concrete decision is made before employees are promoted to department that need medical certifications and licences. Participants confirmed lack of employment models across department such as that of affirmative action. In spite each department head represented at the Committee, there was recognition that currently, there existed no affirmative action organisation within the hospital in ensuring equal promotion opportunities. Three notable success of the implementation among participants expressed their ebullience about the initiative. One of participants recognised the difficulties earlier experienced in different departments in offering equal promotion opportunities to covered veterans and disabled people to women and minorities. In spite of all this, they see flexibility in employment system in terms of making real connection between affirmative action and promotion policies in practice. Another participant believed strongly in the need for promotion opportunities for those, like herself who is a woman.

Participants identified the following barriers that were hindering equal promotion opportunities; 1). Employees on part time basis were less considered for promotion opportunities. 2). Participants acknowledged that they were faced with increased workload in absence of one employee in their department therefore unable to score high marks on performance evaluation. 3).The current financial climate for sustaining future for higher education was problematic. One of the participants acknowledged that available money at the hospital was used for other priorities either than for educational purposes. They went on to lament that; some of the Committee members were inexperienced in knowledge of promotion policy therefore difficult to practice the policy when choosing a candidate. 4). There was lack of transparency, particularly when engaging in developing new promotion policies. Once CVs have been sent for assessment, candidates who fail to be selected are often seen as failures and their applications may be prejudged the same way in the next selection. 5).The use of practitioner’s expertise was never used in the selection Committee in the past recruitments and needs to be used for future promotions in order to develop mutual goals with those of medical staff.

There was lack of balance between promotion opportunities and performance evaluation tools used. Participants recognised that the hospital management failed to specify what was required of them in terms of performance. There also admitted to lack of proper structure in defining the roles they played in their respective departments resulted to a sense of isolation among some. One of the participants admitted that department heads did not lay down any structure expected them to complete their duties and the myriad of agendas they are involved in compromised their effective functioning. On my interview, one participant acknowledged that he operated on different level and the demands were overwhelming and his biggest obstacle was maintaining his balance between putting forward the best services to be evaluated in performances. The finding from this research illustrate the need for non medical staff departments to be involved in training so as to promote equal promotion opportunities, in departmental and managerial levels.


Although each of the strategies I proposed to be incorporated in the new promotion policy in this study presented different strategic visions of different departments, it was easy to pinpoint the common issues that emerged. Long term strategies such as affirmative action, training services and selecting candidates for higher education serve to emphasise the relentless pace of change within which King Faisal Specialist Hospital and Research Centre promotion policies should incorporate. The introduction of new organisations for promoting equal employment opportunities for all employees such as those of covered veterans and disabled people should be practiced by departments at all levels. From this study it’s clear that participants perceive themselves as having major roles in developing and implementing new promotion policies for the next generation by involving themselves in writing critical incidents in their diaries to be used for performance evaluation performance therefore equal promotion opportunities for all.

A number of flexible promotion models, embracing full time, part time, affirmative action for covered veterans and disabled, women and minorities should be pre-approved by employment contracts to make sure that they strictly adhere to promotion policies. The new organisations should also be incorporated in hospital management to facilitate a range of different employment patterns. The research shows the commitment of participants; employees and managers, to sustain and develop their promotion policy and equal employment opportunities.


  1. Where training group is wide, training departments should divide the employees into small groups to improve concentration of effort
  2. Departments should encourage collaboration working with a mixed range of ability, from covered veterans and disabled to women and minorities. This system will enhance support and move away from employees working from isolation
  3. Employees from different levels should be encouraged into training and higher education in a more systematic and formal way and should be supported at all levels, not at least at the doctoral level employment.
  4. King Faisal Specialist Hospital and Research Centre should acknowledge the scholarship and take the available resources to support deserving employees as well as Saudization candidates.
  5. When medical practitioners elected are deployed to non-medical department, the Committee for instance, they should retain their clinical networks to help them develop successful collaboration between job requirements and hospital policies to make sure they work hand in hand in delivering quality services that will benefit directly to the employee and indirectly to the patient.
  6. There should be greater clarity in recruiting department expectations of employees to permit them to function realistically and effectively within promotion policies. The proposed promotion system should be integrated into employment policies to promote an equal promotion opportunity environment at all levels of employment.

Appendix A



  1. What are the weaknesses in the current promotion system?
  2. What strategies should the hospital implement in dealing with multiple goals?
  3. Does the system provide performance evaluation periods?
  4. Does the current system provide fast and transparent feedback system?
  5. Are target scores reasonable?
  6. Are promotion indicators specific?
  7. Are promotion target clear and simple to understand?
  8. Is the promotion process fast or slow?
  9. Are staff members represented in promotion selection?
  10. Does the Committee rigidly insist on certain education qualifications that are not essential for job requirement?
  11. Does the Committee choose senior employees for promotion and neglect junior ones?
  12. How soon should the position be posted to the public before interview date commences?
  13. Do department heads help employees plan ahead of their careers?
  14. Does the new policy provide clear channels of communication to enable employees get feedback on time?
  15. Do the advertised promotion vacancies really exist?


  1. Is there any funding secured for higher education?
  2. Has the organisation sought employees’ perceptions on implementing new promotion policies?
  3. What place do employees, recruiting department and Human Resources Services have in promoting promotion policies?
  4. Are there any impacts of incentive in the quality of health care?
  5. Do multiple goals reduce the quality of services provided?
  6. Should promotion incentives be focused on individual departments or at organisational levels?
  7. Does the organisation recognise any legal responsibility?
  8. What are the adjustments made on performance evaluation system to reward employees with multiple goals?
  9. What are the behavioural indicators used for measuring employee’s performance?
  10. What are the target scores on performance evaluation forms that qualify for promotion?
  11. Does the promotion system recognise Saudization candidate?
  12. Does the hospital provide any training to staff representatives who take part in recruitment?
  13. Does the Hospital management continuously assess employees’ performances and identify areas that need training?
  14. Has the new system provided better training facilities and allocated money for higher education?
  15. Has the new system provided any direction for legal presentation?


  1. Are members of affirmative action represented at recruiting Committee?
  2. The current promotion policies concept does not meet all your needs, how will you impact changes been made to the new system?
  3. Are the available procedures for dealing with grievances effective?
  4. Are the available promotion procedures transparent?
  5. A candidate can be rejected in the recruiting department regardless of Committee approval; does this mean that the system is biased?
  6. Is the hospital working to eliminate discriminatory practices?
  7. Is there any legal framework to protect members of affirmative action organisation?
  8. Are staff grievances dealt with in a timely and appropriate manner?
  9. Are part time employees eligible for promotion?
  10. Does the system offer part time employees training incentives?
  11. Should the new system force outside applicants to volunteer information on their gender and religious background
  12. Does the new system encourage quality and fairness?
  13. Does the new system effectively evaluate performance of employees?
  14. Does the method of advertisement use any effort to reach the disabled, women and minorities in the society?
  15. Are performance action groups represented at the Committee?


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