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Personnel costs typically account for 60% or more of total operating expenses in health systems, and as such beome a necessary focus in most if not all substantive health reform adaptations. This study sought to assess whether strategic alignment of the human resource (HR) and learning functions was associated with greater adaptive capacity in U.S. health systems.

Data were gathered using a survey that was distributed electronically to chief human resource officers from two U.S.-based associations. The survey included questions about organizational structure, strategic human resource management, strategic learning, and organizational response to health reform.

Significant correlations were found between strategic alignment of HR and HR’s involvement in responses related to cost control (r=0.46, p<0.01); quality improvement (r=0.45, p<0.01), and patient access (r=0.39, p<0.01). However, no significant relationships were found between strategic alignment of organizational learning and HR involvement with these responses.

Results suggest that HR structure may affect an organization’s capacity for adaptive response. Top-management teams in health systems should consider positioning HR as part of the core leadership team, with a reporting relationship that allows HR to maximally participate in formulating and implementing organizational adaptation.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

This chapter reviews significant advances in health sciences librarianship, highlighting developments between 1970 and 2005. During this time Advances in Librarianship published two chapters that dealt with health sciences librarianship. The first appeared in 1971 with volume two. Written by David Bishop (1971), then at the University of Arizona, it focused on developments in the 1960s and provided a review of the MEDLARS (Medical Literature Analysis and Retrieval System) system, the beginnings of the regional medical library (RML) program and advances in library services and information resources. The second chapter devoted to health sciences libraries appeared in the ninth volume of Advances in Librarianship. In it Donald Hendricks (1979) from the University of New Orleans highlighted collaborative programs among health sciences libraries, the growing reliance on computer applications, professional development programs, clinical medical librarian services and the accomplishments of the Medical Library Association (MLA).

Health care organizations are facing the dual challenge of providing high-quality patient care at an affordable price. In this article, we argue that the role of people, or human resource management (HRM), and information, or health information technologies (HIT), is crucial in surmounting the above challenge. Specifically, we contend that HRM and HIT in health care are fundamental rather than support functions, and health care organizations need to build internal capabilities in both HRM and HIT to manage these resources effectively. Health care organizations vary in their levels of HRM and HIT capabilities. A few exceptional health care organizations have built both of these capabilities and have derived significant complementarities between HRM and HIT that, in turn, have allowed them to be leaders in value-based health care delivery. Several health care organizations have developed capabilities in either HRM or HIT but not in both, and still others have developed capabilities in neither function. Outsourcing of HRM and HIT by health care organizations is likely to hamper the integration and embedding of these functions in organizational operations. Although HIT has attracted significant attention from policy makers and health care organizations alike, it is not so with HRM. Most large-scale HIT initiatives that proceed without strong HRM capabilities are likely to result in disappointing outcomes. This occurs because the organizational change and development embodied in major HIT initiatives often cannot be sustained without strong HRM capabilities.

Purpose – In an attempt to enhance patient safety, health care facilities are increasingly turning to crew resource management (CRM) and other teamwork training interventions. However, there is still quite a bit about such training interventions that remain unclear. Accordingly, our primary intent herein is to provide some clarity by providing a review of the literature, in hopes of highlighting the current state of the literature as well as identifying the areas that should be addressed by researchers in this field going forward.

Design/methodology/approach – We searched various electronic databases and utilized numerous relevant search terms to maximize the likelihood of identifying all empirical research related to the use of CRM training within health care. Additionally, we conducted a manual search of the most relevant journals and also conducted a legacy search to identify even more articles. Furthermore, given that as a research team we have experience with CRM initiatives, we also integrate the lessons learned through this experience.

Findings – Based on our review of the literature, CRM and teamwork training programs generally appear beneficial to individual employees, the groups and teams within such settings, and overall health care organizations.

Originality/value – In addition to reviewing the literature that addressed CRM and teamwork training, we also highlight some of the more critical aspects of CRM training programs in order for such initiatives to be as successful as possible. Additionally, we detail various factors that appear essential to sustaining any benefits of CRM over the long haul.

The five articles in this section focus on topics such as pay-for-performance (P4P), high-commitment/high-involvement work practices, and safety culture. Interestingly, the link among all of these articles is in understanding and translating best practices in HRM from manufacturing organizations to health care organizations.

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.

This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for providers enabling them to focus on customer service. A case study of a large medical center examines how organization culture affects clinicians versus support and managerial staff while adversely impacting patient satisfaction and organizational costs associated with turnover and the cost of replacing personnel. An agenda for managing internal customers and organization culture is presented.

This chapter studies the link between urban planning and health. Access to safe drinking water is already a very serious issue for large urban populations in fast-growing economies such as India. Water availability is further being impacted by climate change, leading to the drastically increased spread of water-related diseases.

Leh Town, which is located in an ecologically vulnerable semi-arid region of the Himalayas in Ladakh, has been considered for this study because it is undergoing large-scale transformation due to rapid growth in its tourism industry. In 2012–2013 our interdisciplinary group comprising researchers from Germany and India conducted field surveys, including geographic information system-based (GIS) mapping of point sources of water pollution, questionnaire surveys of 200 households and 70 hotels and guesthouses and semi-structured interviews. We also reviewed secondary medical data.

We found that diarrhoeal incidence has increased in the local population in Leh in the past decade, which may be linked to water pollution: Further, we found that rapidly increasing water consumption coupled with a lack of adequate water and sanitation infrastructure is causing serious water pollution.

Further, data is needed for causal connections between water pollution and health impacts to be conclusively drawn.

This study discusses the use of GIS to support a call for the need for more integrated urban planning and decision-making that holistically addresses water and health challenges in Leh and advocates the development of a decentralized or hybrid sanitation system to support water resources conservation as a central dimension of an integrated health management approach.

GIS is also a very useful platform for supporting participatory urban planning in Leh.

With such an integrated urban planning approach, Leh would be a lighthouse example for other towns in the region.

Human resources management (HRM) has evolved from primarily focusing on monetary incentives toward incorporating other nonmonetary aspects for managing professionals’ motivation. However, in health care organizations, paying professionals for performance persists although evidence for its return on investment is scant. This raises the question whether monetary incentives are, in fact, the (only) motivator for health care professionals or whether other incentives could substitute or complement them in the future. This chapter reviews the basic ideas of pay for performance (P4P) and its current challenges. Taking into account HRM's experience (and evolution) in other industries, I discuss the interdependence and the impact of extrinsic and intrinsic motivators in health care. On the basis of the health care market's standing as a knowledge-intensive industry in which multiple actors contribute their knowledge to multiple tasks, I will offer suggestions how to manage motivation based on individuals’ intrinsic needs instead of relying solely on extrinsic motivators.