Talent Identification and Selection for Key Administrative Positions in the Health Care Sector

Subject: Administration and Regulation
Pages: 20
Words: 4166
Reading time:
14 min
Study level: PhD

Overview of Research Proposal

The research proposed in this study will document and describe the practices pertaining to internal talent identification and selection currently in place at King Faisal Specialist Hospital and Research Centre, which is a 9,000-employee health care service provider in Riyadh, Saudi Arabia. The research will further seek to explore the gap between the literature and the organisation’s identification, screening, and selection practices for qualified employees, in the case of talent pool identification and selection through promotions to senior administrative positions from within the available workforce on board.

The proposed research will further offer a rich description of the identification and selection of talent for a Saudi, publicly funded hospital and research centre, as evaluated through the descriptions of models represented in the literature. Although the role of human resources management (HRM) in traditional business environments and manufacturing industry is a rich subject to many authors, HRM as it relates to the healthcare sector has less coverage in the literature (Sidani and Ariss, 2014).

It is apparent from an examination of the literature that implementation of talent management in hospital settings in Saudi Arabia has not yet been done in using all the tools that are available to HR practitioners in the developed world. The proposed research seeks to add to the body of knowledge on talent identification and selection, a strategic HR practice, in the following ways:

  • Critically evaluate the HRM policies and practices in the selected healthcare organisation governing talent identification and selection;
  • Analyse the impact of Saudi culture and traditions on the identification and selection processes, if any;
  • Analyse the extent to which there is consistency in the organisation in regard to talent identification and selection;
  • Examine the perceptions of different sections of employees in the context of fairness in the organisation’s talent identification and selection, which will allow determining how employees perceive the current selection of talent pool from within the institution; and
  • Recommend achievable changes to HRM processes designed to address perceived shortcomings or gaps in the organisation’s talent identification and selection process.

Subject and Objectives

According to Ariss, Cascio and Paauwe (2013), the healthcare industry has been the subject of much debate and scrutiny in recent years. It is common knowledge that a lot of debating has been done in the recent past about the US healthcare system in the context of the spiralling costs of healthcare and the associated problems of underinsurance. In addition, there is considerable strain on existing healthcare resources and facilities (Lamiere et al., 1999), all of which eventually led to the controversial and highly polarising law, the Affordable Care Act of 2010.

At the same time, there have been the repeated critiques and calls for action for the UK National Health Service to initiate policies and practices to improve patient satisfaction and make the delivery of patient services more efficient (Crow et al., 2002). It is because of such circumstances that Gulf Cooperative Council states are faced with high unemployment among the youngest members of the labour force and a large migrant workforce. In attempts to resolve this problem, governments in the Middle East are making the nationalisation of their health care sectors a top policy priority (Toledo, 2013).

While certain challenges may be country-specific, there are several strains on healthcare services that are consistent throughout the literature, including rising costs, issues with the quality of patient care, the challenges of workforce retention, and the management of people and information in an industry that is predominantly service-oriented, employee-driven and knowledge-based (Fottler et al., 2010).

In a climate of complexity, competition, globalisation, and continuous change in markets and technology (Khatri et al., 2010) and as the political and social environments in which health service organisations operate become more turbulent (Grandy and Holton, 2013), the successful application of strategic talent management techniques amongst middle and senior management administrators becomes one of primary importance. This is because governments in the Middle East now consider it very important to keep citizens satisfied by providing opportunities of employment and career growth.

In addition, this situation becomes more complex because of the unique Middle Eastern organisational culture, which is characterised by factors such as tribal affiliations, family relationships and an overreliance on trust as compared to competency (Ewers, 2013). Citizens in the Middle east are highly attached to their culture and would not compromise in allowing people from other nations to take away career opportunities in their own homeland. Given that such circumstances will continue to remain persistently standard there arises an opportunity for important study into the HRM practices of talent identification and selection in a uniquely Saudi healthcare context.

Primary Objective

The primary objective of this study is to examine the practice of talent identification and selection for key administrative positions that is currently in use by the administration of King Faisal Specialist Hospital and Research Center. This study will also evaluate perceptions of fairness of these practices.

Research Questions

  • What notions of good practice Is the King Faisal Specialist Hospital and Research Center’s management applying and whether they are relevant in the context of identification and selection of talent pool from within the institution.
  • What is the expected impact of talent related decisions in the organization?
  • What are the barriers and facilities managers at KFSHRC anticipate in introducing a new approach to identifying and selecting talent and how they will perceive them in terms of being viable in the organization?

Literature Review

HRM and HealthCare Organisational Performance

Collings and Mellahi (2013) have posed important questions with regard to the meaning of talent, particularly in the context of how it proves to be an inherent construct in relation to competency being natural in employees or being required to be nurtured. It is apparent from the literature that the area of talent management has a lot of similarities with strategic HRM. Talent management is the internal process through which the organization ensures it has a constant availability of highly competent people for the given job at the required time.

Because talent management involves the planning of talent needs within the organization, it is apparent that it is an integral part of strategic HRM. Thus, there is need to focus on practices that have a strong influence on human capital. The current environment of globalisation is characterised with talent shortages, which is why organizations have begun to place greater emphasis on acquiring talent through internal sources (Khatri et al., 2010).

Harlos (2010) holds that although talent management has become more prevalent in organisations, there are very few theoretical structures that allow academic knowledge on the subject. From this perspective, Gelens et al (2013) have focused on workforce differentiation by highlighting the role played by organizational justice, which has a direct bearing on the extent to which the organization adopts impartiality and fairness in internal promotions.

It is apparent from the literature that organizations have now started placing greater focus on using talent management while selecting talent pool from within the organisation (Janus, 2010). In raising the issue of defining talent management and how it is effectively used by HRM, Lewis and Heckman (2006) made a review of talent management and concluded there is lack of relevant data in supporting the claims made by HR practitioners in regard to its effectiveness.

They used a systems oriented approach in defining talent management and found that talent management is most effective when it is focused on strategic management of talent in relation to meeting the objectives of human resources management. The systems oriented approach involved capturing the complex systems in the human working systems and relating them with the policy and decision making processes in the organization, in terms of the circumstances under which the given decisions were taken. Sidani and Ariss (2014) have argued that although scholars in the field of HRM have highlighted the need to make greater efforts in researching on different systems of talent management, the research so far remains underdeveloped and highly disjointed.

It is in this context that Kneeland et al (2010) explored notions of inclusivity and exclusivity and found that it is very important to involve wide-ranging stakeholders within the organization, which is best done by encouraging role-modelling of the required values and behaviours in the organization. In particular, middle level managers have to be encouraged to believe in developing talent from within the organization so that a business focused task force is developed within the organization that drives diversity into the different working processes. It is not proper to make isolated interventions as they would prove to be exclusive.

In other words, there has to be a noticeable shift from exclusive or elitist approaches in talent management. The objective should be to facilitate all employees to perform at their optimum levels without any hurdles (Lamiere et al. (1999). Ariss, Cascio and Paauwe (2013) hold that research conducted on talent management continues to remain scarce and concluded that currently the most imperative need is to fill the gap in the research by providing research agendas that address hurdles in talent management.

Significance of Talent Management in the Healthcare Sector

It has been noted that talent management, as applied to other industries in manufacturing, is not an appropriate fit for health care organisations (Chilingerian and Glavin, 2010). It has been argued by Khatri et al. (2010) that the bureaucracy of traditional HRM, with an emphasis on front-line managers, top-down management, and control, does not serve the needs of service industries. Service work requires a greater degree of responsiveness, decision-making discretion and autonomy than other industries (Chilingerian and Glavin, 2010). But as a service industry, health care differs from other service industries in the fact that the people who deliver the service are also intimately involved in the communication and personal interactions that are critical to the service itself (Butler et al., 2009; Lok et al., 2011).

Researchers recognise that there is a strong need to discuss the extent to which talent is naturally inherent in individuals and the extent to which it can be nurtured in making people acquire the required skills. Collings and Mellahi (2013) hold that organisations should focus on maximising value creations by adjusting required talent levels with their needs and ensuring that talented people perform functions in strategic areas representing the core objectives of the establishment. The maximum focus should be made on value creation. Eventually, talent has to be translated into performance relative to meeting up with the organisational goals.

Gender and Discrimination

From the perspective of talent management, it is also important to examine the literature regarding the extent to which women contribute to the talent pool in health services. Brink (2011) holds that in the last one decade, the number of women have increased in the profession and now form almost half of the total employee strength in most hospitals. However, despite the growth in this regard, women continue to lag behind because of being discriminated against in promotions to senior ranks and leadership positions. The author critically examined appointment patterns in the medical profession in the Netherlands and found that there was a marked pattern of gender bias in the hiring of medical professors.

A dominating pattern came to light through her research whereby hiring in the profession was done through the mechanism of exclusion, inclusion and informal and formal networking. Moreover, given the male dominated culture in Saudi Arabia as outlined in this review, it is obvious that women will not be seen as obvious choices in being appointed to responsible leading positions in the King Faisal Specialist Hospital and Research Center (Brink, 2011).

Ahmadi and Nasari (2012) found that there is a distinct link between selection of talent pool from within the organization and succession management. To resolve issues emanating amongst hospital managers, succession management proves to be a strong means to assist in the defining and adoption of functional values. This is because the medical profession needs people with specific skills and value systems, the need for which has been outlined by Ahmadi and Nasari (2012). Marinelli-Poole et al (2011) is of the view that hospitals ought to focus on quality and patient safety while selecting talent pool from within the organisation.

In relying on the broad institutional literature to understand the ways in which medical centres in the GCC countries in the Middle East operate in terms of talent identification and selection of key administrative positions in the healthcare sector, Sidani and Ariss (2014) found that the variables that impact talent management in counries such as Saudi Arabia are far different than those that are present in the Western context. It is known that all organizations including hospitals have to abide with local rules and laws in sustaining their legal legitimacy and improving their services by way of actions that improve their economic viability and maintainability.

Heterogeneity in the workforce, varied standards of managing disparity in foreign and local talent and the differences in the regulatory environments in regard to employment practices are issues that have not been exhaustively addressed by research so far. But such shortcomings provide opportunities of understanding how healthcare establishments cope with the shortcomings in using them for their benefit. According to Sidani and Ariss (2014), Islamic ways of working are common amongst health care centres in Saudi Arabia.

Such circumstances combine with the prevailing system of social hierarchy in creating common perceptions about the ways in which internal promotions have to be made. In the context of required competency of health care, there is a vast difference between the competence levels of local people and the expectations of healthcare centres, thus making hospitals more eager to recruit foreign employees, which means many amongst the local population are left out as they do not meet the required competency levels (Sidani and Ariss, 2014).

Batt (2002) explored the link between what was evaluated as effective HR practice and talent management and found that attrition due to voluntary separation (i.e. quit rates) was lower and employee performance was higher in organisations characterised by high-competency jobs, employee participation with opportunities to collaborate in teams, competitive salaries and job security. These are established practices that play a major role in the advancement of better talent management in the organization.

Hyde et al. (2009) investigated the impact of employee expectations in terms of internal promotions at six high-performing National Health Services across the UK. This study identified three areas of expectations for healthcare service workers: infrastructure (i.e. workspace and equipment), workplace policies concerning training, flex time, etc., and support (i.e. help from colleagues, units).

The proposed research will seek to describe the TM model in place at King Faisal Specialist Hospital and Research Center and to exhaustively explore the impact of this model on employee attitudes of fairness in the selection process for key administrative positions. According to Behrendt (1991), an organisation’s staffing decisions can be the result of three possible processes: one-position staffing, replacement planning, and succession planning. One-position staffing is a reactive mode used to fill a post as a position becomes open.

Replacement planning is more systematic in that senior managers will be asked to periodically list those employees who might be appropriate candidates for future available positions. Succession planning is directly related to talent management because it is involved in the process of identifying high-potential employees and developing these professionals so that they are prepared to advance in the organisation. Firms with effective succession planning HR practices consistently outperform those who do not (Dalton, 2006).

According to Tansley (2011), talent management is, to a large extent, dependent on the identification and development of high-potential candidates that can take place of existing non-performing employees within the organisational structure. A high-potential employee is not only one that demonstrates top performance on current work activities, but also reveals an aptitude of being able to be groomed quickly for new, more demanding work roles (Dries et al., 2013). Having a pool of high potential employees ensures the present and future success of the organisation (Snipes, 2005), and ensures that there is greater depth in the leadership workforce from which to draw (Behrendt et al., 1991).

According to a 2011 AMA Enterprise survey, despite the clear importance of talent identification and retention, there are still many organisations who struggle to retain their high potential employees. On average, research reveals that between three and five percent of any organisation may be considered “high potential” (Nikravan, 2011). This implies that very few organizations are currently using TM interventions, which is why the current environment is characterized with a great deal of employee mobility because in the absence of good career opportunities employees prefer to switch jobs in seeking better career prospects.

According to Dries et al. (2013), learning ability is a major factor in deciding whether a given employee will be found suitable in proving to be a high-potential candidate for the given position. In addition, the authors found that practices of TM can prove to be highly supportive of the identification and selection of talent amongst a workforce that will measure high in learning agility, such as greater career variety, the incorporation of cross-organisational stretch assignments into employee job roles, and the inclusion of job-rotation schemes. The importance of designing HR practices that support employee access to training and in-time development assignments as means of increasing the overall workforce learning ability, an important success factor for knowledge-based service industries (Janus, 2010).

Effective succession planning is dependent on structured career path plans for job roles in the organisation, developmental opportunities, and fair evaluations of learned competencies (Behrendt, 1991). For example, the use of competency frameworks can help in identifying talent to articulate the qualities of leaders in hospital settings. Many organisations have attempted to define and encapsulate leadership qualities in competency frameworks designed expressly for health care services (Carrington et al., 2011).

However, Grandy and Holton (2013) argue that such an approach is often more concerned with the attributes of a leader (i.e. business and management skills) and less concerned with the elements of leadership (i.e. interpersonal skills, vision). They suggest that organisations have not done enough to incorporate leadership development programs into their succession planning HR practices.

Research on talent management activities for the healthcare sector is generally limited to nursing staff; other evidence derives mostly from industry. The proposed research intends to contribute to the body of knowledge on HRM practices as they relate to talent identification and selection, of which succession planning is a function, for middle managers and to quantify the degree to which the King Faisal Specialist Hospital and Research Center’s HRM practice (or lack thereof) of succession planning through internal promotion impacts the perceptions of fairness within the management ranks.

Human capital analytics is an effective means to make talent management more rewarding because it results in better internal absorption of new talent. This eventually results in the attainment of analytical maturity that allows organizations to make accurate assessments about the present skills and competence status of their employees and to then diagnose the reasons for the existence of the prevailing problems. By framing realistic objectives, companies can develop capabilities in predicting and optimising talent requirements so that the impending difficulties can be effectively resolved in time. The objective of such attempts is to ascertain if the organisation has the required skills mix in achieving its goals.

Such attempts allow the organisation to determine the kind of people that will add value to the organisation and maximise the results from all investments in human capital (Hariss et al, 2011). In this context, Gelens et al (2013) have held that talent management needs to be dealt with from the theoretical perspective through empirical research involving individuals, as opposed to the general practices of selecting employees on the basis of their qualifications and experience in the given field of operation. In addressing the apparent gaps in the current literature, it is important for organizations to determine if justice is being done to employees in terms of their calibre to imbibe new skills and to adopt better working procedures in keeping with standards required for higher responsibilities.

This is the same as adopting practices of organisational justice, which has to be considered as the main link between practices of talent management and diverse employee reactions. In this regard, Rawl (1971) had put forth his theory of ‘Justice is Fairness’, through which he devised his two approaches towards the difference principle and liberty principle. According to the theory, conduct of organizations should be guided by principles of justice so that there is a principled settlement of equality and liberty in the organizational environment.

In the context of talent management, justice can be done only if a strong element of liberty and equality is present in the decision making process, particularly in regard to internal promotions. Adams (1965) came up with his Equity Theory in explaining relational satisfaction in the context of fair or unfair distribution of resources amongst people. Considered an important justice theory, Adams’ theory was recognized as being highly relevant in the organizational setting.

This is because Adams (1965) believed that workers in an organization always seek to experience equitability amongst different inputs they contribute to the organization. In return, they seek to be dealt with fairly in keeping with their efforts and competence levels. Gelens et al (2013) analysed the varied reactions to talent management and its impact on organisational justice while proposing that the high potential of employees should be used as a precursor for varied distributive justice considerations.

Before embarking on a discussion of the appropriate TM structures for healthcare organisations, as suggested in the literature, it is important to characterise the workforce challenges within the healthcare sector. The management of health care professionals offer particular challenges for an effective HRM strategy. Health care professionals are knowledge-based, highly specialised workers at the centre of the health care system, in charge of patient services and care, but also major contributors to the cost of service (Janus, 2010).

Health care organisations are characterised by high levels of contact time between customers and employees that involve a deep exchange of information through intimate conversation. Such is the nature of patient care that it requires extensive employee knowledge and skills in the given fields so that employees attain greater competence in diversified fields of operation in an environment that is largely unpredictable and highly changeable. Management of health care employees, then, requires an employee-centric approach, one that emphasises HR practices that support healthy work environments, development opportunities, and autonomy for its employees (Khatri et al., 2010).

HRM, Saudization and Cultural Influences

According to Ariss et al (2013), there is a legal imperative to select greater percentage of local workers, a major problem arises in view of the fact that expatriates in the region are perceived by most employers as more qualified and competent and are thus preferred in being offered jobs in the country. This is not a problem associated with the concept of organizational justice or with unfair practices but is more related with the inadequacy of healthcare skills amongst the local population, which is why expatriates are given preference so that they can provide the required standards of hospital services.

Nevertheless, this proves to be a problem that is now a challenge to the process of Saudization of the public and private sectors, which has become a major priority for the Kingdom. The IMF’s 2013 report, Economic Prospects and Policy Challenges for the GCC Countries, published as part of the Gulf Cooperation Council’s annual meeting of finance ministers and central bank governors identified the nationalisation of the labour force as a key challenge for the region. The report suggests that while governments in the Gulf Cooperation Council (GCC) are implementing policies to achieve the objective of employment for a large and growing young population, more emphasis must be placed on raising educational quality in order to make the native workforce more competitive.

Despite the fact that expatriates are more skilled than the local population in Saudi Arabia, it is an assumption of the proposed research that the Kingdom’s Saudization policy will play a role in the identification and promotion of qualified incumbents for key administrative positions in the King Faisal Specialist Hospital, perhaps giving Saudi applicants an edge over the expatriate workforce currently employed. This assumption has been made on the basis of the Saudi government’s initiatives in facilitating higher medical education abroad for its youth, through varied schemes such as scholarships and funding through financial institutions.

However, this will become a reality only after sufficient numbers of Saudi nationals become appropriately qualified in acquiring the required skills to provide the given standards of hospital services. It is known in this regard that the Saudi government is involved in an ongoing program whereby Saudi students are being given government support to acquire higher qualification and competence in all fields from foreign institutions. This research would seek to analyse talent management practices in place used to identify qualified Saudi nationals to key administrative positions in the King Faisal Specialist Hospital and Research Center.