CHAPTER 1

1.1 Introduction

Human resource management is the application of management principles

to management of people in an organization (Aswathappa 2010). It is an
important part of managing any organization, particularly business
organizations. In recent times, these practices are increasingly being used
as a tool for meeting the objectives of the organization, rather than being
restricted to the traditional approach (Negi 2013) Human Resource
Management is the process of bringing people and organizations together
so that the goals of each are met (Rao 2005). This has emerged as one of
the major functions of any enterprise. This means focused human
resources planning, recruitment, selection, placement, training,
development, performance appraisal, compensation administration,
incentives, employee benefits, social security, industrial relations,
employee grievances, collective bargaining, personnel records and
accounting and many other fields directly or indirectly related to
management of human resources . According to Niles (2013) the
important role that human resource management activities play in the
operations of a healthcare organization. Human resources can be applied
to any activity of the operations of an organization, regardless of the
industry. The role of HRM as briefly discussed has different functions in
the health care management these are including legal and ethical issues of
the treatment, health and safety of employees and patients, careers in
health care, labor unions in health care, job analysis and design, recruiting
and selecting employees, employee benefits, training and motivating
employees, and terminating employees. Strategic planning, including
labor budget and forecasting, is addressed because of the contribution of
HRM to successful strategic planning. Emerging and current trends in
human resource management are also discussed. The increased diversity
of the patient and employee, the effect of technology and the
globalization of the economy on healthcare delivery, the new trend of
medical tourism, and the increased focus on accountability in the delivery
of services and teamwork education are exciting changes in health care,
which ultimately will improve patient care.

1.2 Objects of the Study

The main objective of this study were

To analyze the HRM PRACTICES in Housekeeping of ZIA

HEART FOUNDATION, DINAJPUR.

To assess the Human Resource Management processes and practices in

to Zia Heart Foundation, Dinajpur.
 To bring out the specific factors in health care HR in Zia Heart
Foundation, Dinajpur .

To prepare a detail proposal on the processes and the practices which

can be undertaken in large hospitals.

CHAPTER 2

2.1 ORGANIZATIONAL PROFILE

Zia Heart Foundation Hospital & Research Institute is a

non-government, non-profit-earning, voluntary
organization. A nucleus of excellence for the prevention
& treatment of heart diseases in Dinajpur, a
underdeveloped northern district of Bangladesh.

In view of the utmost need of creating facilities for

prevention and specialized medical treatment of
innumerable people suffering from heart diseases in
Dinajpur and adjacent regions; the then Member of the
Parliament & Minister Khurshid Jahan Haque, in
collaboration with social workers, doctors and
benevolent persons, established the Zia Heart
Foundation in Dinajpur, Bangladesh in 1992. The
organization has been registered to the Department of
Social Services, bearing No. 958/94 dated: 27-12-1994,
under the provision of voluntary Social Welfare Agencies
(Registration and Control) ordinance, 1961. Since then
this organization has been working for the treatment
and welfare of the patients of cardiovascular diseases of
the Dinajpur region and adjacent districts with a limited
resource. This hospital is sustainable by its earnings
from fees of different services.

In the beginning this hospital was confined to primary

medicare and research activities in a small building.
Efficient service facilities created an increasing demand
because of hi-tech specialized treatment services is
available at the doorstep and at a reasonable cost. The
patients of this region especially the poor are doubly
benefited. It is on this basis and patients need Zia
Heart Foundation, Dinajpur, initiated and implemented a
project 100 bedded Zia Heart Foundation Hospital &
Research Instituted phase-I (50 beds), in collabotion
with the Ministry of Social Welfare and the Department
of Social Services, Bangladesh, at a cost 362.55 million
taka in the year 2006.

In 2011 Institute of Nursing Science Dinajpur a

subsidiary Institute of Zia Heart Foundation has been
established. This Institute provides Diploma in Cardiac
Nursing and Diploma in Nursing Science and Midwifery
are recognized by the Bangladesh Nursing Council. The
trained manpower from this Institution shall
complement hospitals and health services.

The programs of this project are related to the national

plan and social sectored objectives/targets. It provides
specialized Medicare for heart diseases and its
complication and thus helping the sufferers to regain
normal health for normal and productive living. It help
the poor patients to get at free/discounted/reasonable
cost Medicare services and it also help create mass
awareness for prevention of heart diseases. This project
is also complementing in public health services to help
achieve national health goals.
At present, the provision of 100 bedded, machinery &
equipment is understood to be inadequate. A balancing,
modernization, rehabilitation & extension of the hospital is
an utmost need for a qualitative continuity, at the same
time some extension is urgent. The hospital services are
provided by 300 hands including 20 specialists, 52
doctors, 100 nurses, physiotherapist & others medical
technologists. As an organization it 21 member Executive
Committee serve voluntarily

2.2 DEPARTMENTS

Out Patient Department

Department Of Cardiology

Department Of Cardiac Surgery

Department of Cardiac Anesthesia & Intensive Care

Department of Radiology and Imaging

Department of Haematology & Pathology

 Department of Research and Education

2.3 DIAGNOSTIC SERVICES & FACILITIES

Zia Heart Foundation, The 50 bedded specialized cardiac hospital
provides the following services & facilities:

Diagonestic Pediatric Cardiology

Radiology and Imaging

Pathology , Bio - chemistry and Microbiology

CHAPTER 3

3.1 Housekeeping in Hospital

Housekeeping refers to the cleaning and upkeep of the hospital premises
which renders the environmental surfaces safe to handle by removing
organic matter, salts and visible soils

OBJECTIVE OF HOUSEKEEPING SERVICES

 General Sanitation, cleanliness and comfortable environment.
Developing courteous, reliable and congenial atmosphere.
Adequate support of motivated staff.
Good interdepartmental cordial relation.
Ensuring safety of staff, patient and relatives.
Quality control of sanitary equipments and cleaning agents.
Proper record keeping and feedback.

COMPONENTS OF HOUSEKEEPING SERVICES

Greenery comfort
Adequate water supply
Clean & appealing toilets
Sanitation & cleanliness
Proper disposal of biomedical waste
Hospital infection control
Pest & rodent control
Odour control
Appealing interior (indicators, lighting, designing)
Proper sewerage disposal

Hospital Housekeeping Duties

 Cleaning and disinfecting in hospitals can prevent the spread of
infectious diseases. Additionally, hospital housekeepers must work
toward adhering to federal, state and local health codes and regulations
to ensure a hygienic, safe and healthy environment. People who fill
housekeeping positions in hospitals must have the commitment and the
ability to coordinate with other team members and manage duties
efficiently to best serve patients.

Linen Management

Hospitals utilize a large quality of linens, such as gowns, towels and

bedding, on a daily basis. Housekeepers gather, wash, iron, mend, fold
and inspect all linens used in a hospital. They also discard old linens
where applicable. Additionally, housekeepers report to supervisors
which linens the hospital needs to replace to allow them to compile a
report for purchases.

Hygiene

Hospital housekeepers clean, mop and sterilize all the areas in a

hospital, including the waiting, operating and diagnostic rooms. When
a patient moves to another ward or is discharged, housekeepers
disinfect the room with specialized cleaning agents to prevent the
spread of germs. It is also the housekeeper's responsibility to maintain
 a good appearance of the windows, doors, curtains and other surfaces,
as well as a sanitary environment.

Patients Rooms

Patients' comfort and safety are a significant part of health care.

Housekeepers distribute clean laundry to patients rooms. They also
make their beds and arrange their rooms to maintain order and
neatness. Additionally, they sterilize sinks and toilets, and mop all
floors. It also is their responsibility to report any areas that require
repair to supervisors or maintenance staff.

Miscellaneous Duties

Employees in housekeeping learn on the job and do not require any

formal education. However, they must have the ability to withstand
work environments that sometimes can be uncomfortable. Their jobs
entail wearing latex gloves and using strong cleaning agents. They also
risk exposure to potentially infectious substances, such as blood.
Occasionally, housekeepers attend in-service training to get updates on
a hospitals cleaning policies and watch demonstrations about new
cleaning products or methods.
3.2 HOUSEKEEPING ORGANIZATION

EXECUTIVE HOUSEKEEPER
Heads the department. He/she should be able to plan, administer and
develop housekeeping services in hospital.

ASSISTANT EXECUTIVE HOUSEKEEPER AND FLOOR

SUPERVISORS
Trained and conversant with the housekeeping procedures and able to
manage the housekeeping staff

HOUSEKEEPING EMPLOYEES
Mostly unskilled and lowest paid. Must be well acquainted and oriented
to the housekeeping procedures by training and education.

3.3 Human Resource Management in Housekeeping

Quality patient care in hospitals is the responsibility of everyone working

for the facility. While trained and licensed health care professionals are
responsible for a range of patient outcomes, they also are the caregivers
who spend the most time with patients and are in a position to report
housekeeping issues as they arise. The housekeeping staff and
management must include every member of the hospital team when
developing quality improvement reporting procedures.

Housekeeping Surveys

Customer service reviews play a role in the patient release process.

Housekeeping should be a part of surveys; a section on the release
documents should ask patients to review housekeeping as well as nursing
and administrative services they received. Questions could include
information gathering about the attitudes of housekeepers on entering the
room, whether housekeeping staff was responsive when given requests
and if the housekeeping staff acted professionally. At the same time, the
survey might explore the level of cleanliness and timeliness of service.

Regular Reviews

Without adding too much additional paperwork to the nursing staffs

regular duties, housekeeping managers could request regular reports from
the nursing staff with a quick assessment survey. A process for lodging
complaints about the housekeeping staff or services should be in place so
the nursing staff easily can report problems. Regular reviews could be
part of monthly staff meetings. Reports that include a simple checklist are
easy for the nursing staff to fill out and could be a job requirement on a
weekly basis. Housekeeping managers would collect the reports and
create a summary of issues, including nursing staff in solution-based
meetings to improve quality.

Quality Improvement

Standard reporting procedures usually are in place for most departments

in the hospital. For example, nurses may have to report on the number of
mistakes made, how many patients they've seen, the number of sick days
they took in a period and how many times patients filed complaints with
an ombudsman. Nurse managers and hospital administrators select
representatives to meet monthly for a quality improvement meeting.
Assign a representative from the housekeeping department to join the
committee and bring mandated reports to the meeting for evaluation.

Patient Outcomes

Housekeeping plays a major role in reducing the spread of infections in a

hospital. When housekeeping managers create reporting documents for
their staff reviews, QI committee meetings or nurse reviews, they should
include a section that covers the number of patient infections that
developed. While exemplary customer service, timely cleaning of rooms
and hallways and exceptional staff interaction duties are important for the
housekeeping staff, members also need to have a way to measure the
results of their work. The reporting can help clarify and improve the
quality of care for patients from every staff contact they have in the
hospital.

Processes and Practices

On the basis of this preliminary study the following processes and
practices are being adopted in these large hospitals
The main function of the HR Department is recruitment, training,
manpower management and general administration. This includes:-

Recruitment function
The recruitment function includes collection and sorting of the resumes as
per the advertisement given in the newspaper or the website ; Conducting
of the interview session which is conducted by HR manager and the
Nursing Superintendent for the recruitment of the nursing staff like staff
nurses and ward attendants; Conducting of the interview session for the
new medical staff is conducted by the Medical Superintendent and the
Chairman of the Institute along with the support of the HR department .
The appointment letter is issued by the HR department on the basis of the
interview and mentioning the salary which the candidate will receive after
the signature from the account section of the organization. Thereafter the
appointee joins and is placed in the hospital.
Training function
The training facilities include the following topics Health hygiene, Safety
policy, Bio- medical disposal , Hand washing techniques, Various codes
for the emergencies , Hospital safety Policy , Fire safety management/
Disaster Management, Patients Safety , Ward Cleanliness, Biometric
machine for attendance and public dealing including politeness and
courtesy. Training is imparted to fresh appointees as well as regular staff.

HR management function
The HR management functions in these hospitals include maintaining the
service records of all employees including leave and other benefits;
processing various matters related to the staff; travel and other matters.

General administration function

General administration function includes protocol, attendance, security,
safety, biomedical wastes; labor, government regulations concerned with
labor, ESI and other matters.

CHAPTER 4

Recommendations

Based on this assessment recommendations can be drawn:

1) The organization structure of the HR department should comprise of
the Director as head, HR manager, Assistant Managers and a number
of HR executives looking after recruitment; training; safety, security,
general administration, labor, vigilance , government regulations and
legal issues

2) Regular trainings at the inductions and in service levels need to carried

out as frequently as possible both within the country and abroad.

3) The HR department needs to be an integral part of the top management

of these health care facilities so that HRM inputs and support for
attaining the mission and vision of the organization are available at the
highest levels.

4) Round the clock HR support to the functioning of the hospitals is

required because of the nature of the work of the hospitals.

5) Human Resource Management modules may be introduced in brief in

the training programmes for the medical and Para -medical staff.

6) The health care organizations also need to have a strong grievance

redresal mechanism both for the staff and users of the facilities. This
should be inbuilt in the HR policy.
7) Each hospital should have a HR policy drawn as per international and
national practices and standards. This should include human resources
planning, recruitment, selection, placement, training, development,
performance appraisal, compensation administration, incentives,
employee benefits, social security, industrial relations, employee
grievances, collective bargaining, personnel records and accounting
and many other fields directly or indirectly related to management of
human resources . Before adoption, this policy needs to be discussed
with stakeholders including staff, patients and others. This policy can
then become the basic document for HR practices and processes in the
organization, though it would need to be revised from time to time.
CHAPTER 5

CONCLUSION

Proper management of human resources is critical in providing a high

quality of health care. A refocus on human resources management in
health care and more research are needed to develop new policies.
Effective human resources management strategies are greatly needed to
achieve better outcomes from and access to health care around the
world. Zia Heart Foundation , Dinajpur also trying improvise HRM in
hospital management for insuring better health care for all of its patient