CHAPTER 1

INTRODUCTION

INTRODUCTION

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The co-operative sector plays an important role in India. Especially in Kerala over
healthcare delivery system. Co-operative health care services in Kerala have grown and
diversified on the part of a socialist view. This industry now comprises a wide range of
companies offering services in rural and urban regions. Co-operative societies aim to
improve economic conditions of its members as well as the standard living of the entire
society. The successful expansion in these health sectors cannot thus be seen from a
purely profit perspective. This is because such hospitals are anchored in the communities
in which they live, which, as a main component of their operation, differentiate
themselves from other organizations, in the form of poverty reduction.

Human resource management practices not only takes place in firms or any business
organization, In hospitals, it was always done. The day-to-day tasks of a human resources
department in hospitals are recruiting, selecting, inducing, training, confirmation and
dismissals, but do more than only as part of administration. However, it is highly crucial
for each measure taken to decrease employee turnover at a period of higher expenses and
the lack of skilled hospital personnel. Good human resources strategies may create
greater results through well-selected, properly trained and successful working conditions
workers.

The co-operative entities were different from other private hospitals in its
moto. Co-operative forms of hospitals call interviews time to time, facilitates training
programs to improve skills of individuals, it deals with better motivation schemes,
providing insurance facilities, allowances, etc. The employees may be either temporary or
bonded staff. So, they need to develop human resource practices in Co-operative
hospitals to take policies and to prepare plans on regular basis, also to follow only
required guidelines to manage entire human resources by satisfy both the individual and
social obligations.

Management of Human Resources (MRM) plays an important part in the system of

healthcare and systematic management is crucial. The HRM implements not just the
present technique, but focuses on research, analysis and implementation of new strategic
plans to train and evaluate new and existing staff's competences. HRM contains three
fundamental principles. Physical, capital and consumables should be examined in

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addition to inputs from the health system. HRM focuses largely on healthcare based on a
variety of types of clinical and non-clinical personnel directly involved in the
administration and intervention of health systems in public and individuals. The results of
HRM's results and advantages primarily depend on the knowledge, skills and motivation
of those people who constitute the whole of health.

The health industry in India is making outstanding future progress by becoming

one of the major services industries. According to a joint report by CH-00 McKinsey
(2006), national spending on health care was equal to 5.2% of the national GDP in 2004.
(Rs.l58.20 billion). In India healthcare expenditure is expected to grow by 12 percent (in
rupee terms) every year in 2005-09 and by 2009 to around 5.5 percent of GDP. 1
Healthcare in India involves not just medical treatment but all elements of preventative
care. It covers healthcare provided by the public sector and private-sector efforts.

The Indian commitment to healthcare development has historically been motivated by

two ideas (Srinivasan R., 2004) 2: firstly, the State is accountable for all healthcare and,
secondly, free medical care for all, following Independence (not merely to those who are
unable to pay). Over the years, private out-of-pocket spending in India has dominated
healthcare finance costs 3. The public's health has become a serious problem. With the
country's changing demographic and socio-economic character, the public are
increasingly aware of a healthy society. Higher life expectancy followed by an
extraordinary increase in per person income and change in lifestyles resulting in higher
illness incidence have resulted in increasing health care need. The need for high-quality
health care services in the country has increased economic development and more
literacy. There are greater health care expenditures than before and this must rise, as the
Indian Brand Equity Foundation has forecast (IBEF).

The CMIE, Mumbai, has predicted that healthcare industry is growing 13 — 15% by
2006 in comparison with 20054. The Northern Indian Monitoring Centre. Similarly,
whereas a bed/population ratio of one:300 was suggested in 2000 by the World Health
Organization (WHO), the actual ratio is just 1:10005. The number of hospital beds in the
country is likewise estimated at approximately 5,5 million, if the real need are almost 6-
6,5 million (Outlook Arena, 2002) Six and India has over four million healthcare

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workers, which are scheduled to become 10 million by 2012 In the mid-80s the Indian
industry was recognised by the Confederation of Industries (CII) as an industry. This
industry includes a wide variety of sectors such as hospitals, pharmaceutical products,
insurance, outsourced workforce, medical tourism, hospital infonnation and medical
devices.

Hospital is a business entity that plays an important role in the community. It is a

temporary occupation facility for the ill and wounded. Hospital economics has been very
frequently the main consumer of expenditure in healthcare, representing around 40-60
percent in many different nations. Hospital economy Even in poor nations where the
health care system is frequently controlled by the hospital (Mills A., 1990) 7. The fact
that India often accuses the budget allocation of various states of pro-hospitalism is not
different from others is (World Bank, 1995) 8. The definitions of a hospital become
significant in this connection.

The hospital is "an institution for the care, cure and treatment of the diseased or
injured and for the study and formation of physicians and nurses" Hospital in Steadman's
medical dictionary 9. the medical dictionary of Dorland defines a hospital as a 'institution
suitably located and structured, organised, staffed to provide the whole of the complex
requirements for preventing, diagnosing and treating the physical, mental and health
aspects of social illnesses, scientifically, economically, effectively and without any
obstacles, with operating facilities for training the new medical dictionary; Current health
systems confront a variety of problems. The primary problems in management are lack of
healthcare experts and their low satisfaction. For the stabilisation and quality of their
medical job and performance, satisfaction and motivation are critical. HRM strategies
have a scientifically established positive influence on increased employee happiness and
engagement. HRM methods now only apply to healthcare in a limited sense, frequently
through HR or labour legislation and trade unions. This shows the poor degree of
development of human resources. HRM techniques in the field of healthcare should be
fully used. The purpose of this report is to identify and outline the problems of managing
human resources in healthcare and to show how important the use of proven HRM
practises is to improve healthcare quality. A literary search is the research approach

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utilised. The research into the link between quality management of human resources and
health care is deemed vital because the knowledge and skills of management in most
healthcare professions in Slovakia are not sufficient. HRMs having a positive influence
on employee satisfaction and medical indicators are created in the most successful
hospitals in the world.

Practices of HRM in the health sector are aimed at increasing service quality and patient
happiness. As part of human resources management, the use of a range of health care
professionals and improved coordination of health care services through interdisciplinary
team work is needed. Effective human resources management, since all health care is
finally provided by the people, will play an important part in the success of the health
care system in all countries. The methods of human resources management do not only
deal with each person but also with the team. Hospital organisation has several problems
in managing human resources. The real issue for hospital administration is the
management of human resources. Human resource management helps to create a healthy
organisational environment characterised by chances for advancement, good job sharing,
reward and excellent relations. Quality healthcare begins with the management of human
resources. All healthcare workers are crucial in the existing environment for the system
for providing health care services. Health companies must have a qualified and
competent workforce because of increased medical technology and the requirement for
more advanced patient care. Employment satisfaction among health care workers is
increasingly seen as a metric to be included in quality enhancement initiatives
(Chaulagain and Khadka, 2012).

In the framework of the treatments of the suffering people, the function of paramedical
personnel is important; they spend more time with patients than doctors themselves.
These paramedical workers are in many circumstances not required to be qualified or
trained for specific purposes. However, they should give the patients with calming
treatment. A non-organized sector is of interest to a research scientist to examine their
work satisfaction by such a function in private hospitals by the paramedical personnel.
The health care workers' happiness has a tremendous impact on quality, efficiency,

5
efficiency, and healthcare expenses. In addition, work satisfaction is closely linked to
lack, relationships with the people and work (Visser, et. al., 2003). Satisfied staff are
more productive, innovative and engaged with their health organisations (Ho, et. al.,
2009). Therefore, current research is undertaken at the private hospitals, in Chennai City,
to study human resources management practises (HRM) and the job content of
paramedical workers.

In conjunction with the expansion of the health industry, the environment for healthcare
organisation has developed and is unfamiliar, chaotic and yet distinctive. The design and
provision of care has been drastically changed and also the performance of the healthcare
provider has had repercussions. As a result, it requires suppliers to handle medical
personnel effectively. Effective HRM practises are therefore necessary to the success of
the healthcare organisations. The right participation of line managers and HR
professionals is a key prerequisite for HRM approaches to be effective. The reason is that
they fulfil the people architecture and develop organisational solutions which support
HRM practises inside the businesses. This research therefore aimed to investigate and
assess the responsibilities and involvement of HRM players in major healthcare
organisations, i.e. hospitals. By itself, the identification of the state-of-the-art role and
participation of line managers and HR experts defines the capacity of hospitals to fulfil
health care needs successfully. The reason is that HRM organisational solutions may
assist or create impediments to successful management of human resources.

These managers are responsible for the continuing management of medical professionals
in an ideal model of HM involvement in modern companies. The range of desirable HM
tasks extends from the planning, organisation, new employee recruitment and evaluation
of the work of subordinates to dispute resolution and change implementation. HM
participation therefore leads to improved medical staff performance, which can help
implement sustainable innovation. Research has revealed that HMs have a significant
operational engagement in the administration of human resources in Polish hospitals. In
respect to the great majority of HRM practises, respondents from various categories
overlapped. In fact, a study conducted between Kruskal-Wallis found variations between

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responder groups regarding such practises as: career management, salaries, employee
dismissal and modifications within the human resource function. It should be noted that
the comparison of the statistical analysis findings with the data showing the percentage of
answers of the individual cohorts of the respondents shows a general tendency of
response dependency on the cohort type, in terms of the reasons why these differences
occur. 'Directors' and 'Physicists' and 'Nurses' regarded HRM participation to be most
important. The findings of various study can support the reported inconsistencies. It
cannot be explained all of these. The fact that individual personal development, that is the
realm of these strong medical occupations, is regulated by physicians and nurses further
explains the various views of responders against the participation of executives in career
management. Due to the fact that not only the compensation strategy but also the
operations related to compensation are centralised or even governed externally by
industry standards, the disparity in the responses to payment may arise.

INDUSTRY PROFILE

Sanitary services have become one of the major industries in India both for revenues and
jobs. Healthcare includes hospitals, clinical devices, outsourcing, telehealth, tourism,
health and medical equipment. medical equipment. medical services. The Indian
healthcare industry is expanding rapidly, owing to its increased coverage, services and
spending by both public and private actors.

The system of Indian health services is divided into two main public and private
components. The government, i.e. the public health system, contains limited secondary
and tertiary care institutions in important municipalities and concentrates in rural areas on
the provision of basic health care in the form of primary health centres. The private sector
mostly provides secondary, tertiary and quaternary services with a significant focus on
metro, level I and level II towns. The private sector delivers services.

The competitive advantage of India rests in its huge pool of well qualified physicians. In
comparison to its counterparts in Asia and the West, India is also more competitive than

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its costs. The cost of operation in India is approximately one-tenth that in the US and
Western Europe.

COVID-19 dosages were provided in the nation at >26,69,14,930 as of June 15, 2021.

Market Size
The health industry may grow to Rs 8.6 trillion by 2022 by three times (US$ 133.44
trillion). India's public health expenditure was at 1.2% of the GDP in Budget 2021.

The increasing demand for health insurance benefits is boosted by a growing middle class
and increasing burdens of new diseases. The prevalence of health insurance is set to grow
in the future years with a growing need for cheap and excellent health care. Back in
FY21, gross written health prices increased to Rs. 58.584.36 (US$ 8.00 billion) by 13.7
percent Youth. The health sector accounts for 29.5 percent of the country's total gross
written premiums.

Developments recently made The FDI medicines and pharmaceutical industry was at
US$ 17.99 trillion between April 2000 and December 2020, according to the information
available in the Department of Industry Promotion and Internal Trade (DPIIT). The
following are some of the latest projects in the Indian health sector:

 A multi-center clinical study of an AYU SH 64 medication was finished in April

2021, and found helpful for the treatment of mild to moderate COVID-19
diseases, in which the Ayush Ministry and the Committee for Scientific &
Industrial Research conclude the trial.
 By March 2021, India exported more vaccinations than its residents had
administered, 60 million doses were sent to 76 countries and 52 million doses to
Indian people. In addition to the vaccinations, medicines indicates an export
tendency for Covid-19 therapy. Exports of Remdesivir, for example, increased
from $5.75 million in February, 2021 to $14.8 million in March, 2021.

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 In March 2021, Minister of Health Harsh Vardhan informed Rajya Sabha that 157
medical schools in India are being implemented at various levels. Of these, there
are 58 colleges in phase one, 24 in stage two and 75 in phase third.
 Because of the increasing demand for health insurance products in the COVID-19
spike in the context of the gross written premium, in March 2021 the gross nonlife
insurance firms grew by 41% to 2,194,05 crore.
 On March 17, 2021, 3 million (30 lakh) teleconsultations since its debut have
been covered by eSanjevani Telemedicine Services in the Ministry of Health,
which have allowed patient-to-doctor consultations from within their house and
physician-to-doctor consultations.
 By March 2021, Virchow Biotech, Hyderabad, announced a partnership in the
manufacture of 200 million doses of Sputnik V vaccine in India with the Russian
Direct Innovation Fund (RDIF).
 India approved the commercial provision of 24 million doses of COVID-19 in 25
countries in February 2021, more than 2 times the total export of 10.5 millions of
vaccines in January 2021. Seven nations were supplied >~10 million commercial
dosages, among them Brazil, Marocco and South Africa.
 On February 2021, the NBCFDC signed the MOU with Apollo Medskills Pvt Ltd.
to cofinance the COVID Vaccine Administration training programmes for nurses,
doctors & nursing students and pharmacists from the target population.
 In February of 2021, Siemens Healthineers Holding I GmbH was allowed by the
Competition Commission of India (CCI) to acquire Varian Medical Systems, Inc.
(SHS GmbH).
 The Minister for Trade and Industry of India, Ms Piyush Goyal, together with Ms
Elizabeth Truss, UK Secretary of State for International Trade, met to discuss the
Indian-UK trade-investment and economic ties bilateral. The Ministers were
particularly pleased with the development of bilateral health co-operation between
two nations, for example on vaccines, which enables India to act as a world power
to overcome the difficulties imposed by COVID-19.
 In February 2021, the foundations for the two hospitals were set by Premier
Narendra Modi and in Assam started the 'Asom Mala' plan, a programme of state

9
 highways and important municipal roads. He further stated that the
AyushmanBharat Scheme benefits ~1,25 crore people in the government.

Government Initiatives
The Government of India has taken the following important steps to promote the Indian
health sector:
 The state solicited proposals in June 2021 for the use of drones to transport the
vaccinations and medicines COVID-19 to distant regions which are hard to access
to ensure last-mile coverage at selected sites in the country.
 Since May 2021, eleven.9 lakhs health ID were produced, with the National
Digital Health Misión (NDHM) registering 3,106 doctors and 1,490 facilities.
 In May 2021 Defense Minister Mr. Rajnath Singh established the OPD portal
'EHAT Services' to provide telemedicine services for troops and for veterans of
the armed forces.
 The Drug Contributor General (DCGI) accepted the Subject Expert Committee's
(SEC) proposal on 12 May 2021 and authorised its manufacturers, Bharat Biotech
Ltd, to undertake the Phase II/III Clinical Studies of Covaxin (COVID Vaccine)
for age 2 to 18 years.
 A first batch of anti-cOVID anti-COVID medication, 2-deoxy-D-glucose (2-DG)
was introduced by the Ministry of Defense (MDD), which was created with Dr
Reddy's Laboratories (DRL), Hyderabad, and was developed in the Institute of
Nuclear Medicine and Allied Sciences (INMAS) lab.
 In May 2021, the government revealed its strategy for the build up of
amphotericin-B, the fungus medicine, to treat the "Black Fungus" sickness and to
improve the availability of it. Five manufacturers in the nation have also received
permission to make the medication.
 A campaign to reach out to those youngsters and pregnant women that are
missing or left out from routine vaccination owing to a COVID-19 pandemic
began with the 'Intensified Mission Indradanush 3.0' in March 2021. This is

10
 intended through a mission method procedure to expedite the complete
immunisation of children and pregnant women.
 The Parliament adopted in March 2021 the Bill 2021 of the National Healthcare
Professionals Commission for Allied, which seeks the creation of an institution to
control education standards and maintain healthcare professional service
standards.
 In the budget of 2021 the overall allocation of healthcare sectors for FY22 was
Rs. 220,846 (U.S. $ 30, 70 billion); in the healthcare infrastructure investments
were expanding by 2,37, or 137% YY.
 The Government announced in the Union Budget 2021-22 that the existing
'National Health Mission' has been expending 64,180 (US$ 8,80 billion) to the
health sector over the course of six years to strengthen primary, secondary and
tertiary care capacities, healthcare systems and new diseases detection and curing
institutions.
 In the 2021-22 Union budget, the Government announced its plans to establish
"Mission Poshan 2.0" to combine 'Additional Program Nutrition' with 'Poshan
Abhiyan' to increase nutritional output in 112 aspiring districts.
 With a budget of Rs. 57,130, the Government of India agreed to continue the
'National Health Mission' in the 2021-22 Union Budget.
 Rs. 2 970 crore ($ 407.84 million), up from Rs. 2 1122 crore ($ 291,39 million),
has been allotted for the Union Budget of 2021 by the Ministry of AYUSH.

India is a country rich with possibilities for medical device players. In addition, the
country has become a major destination for sophisticated diagnostic service, which
provides enormous capital investments for a wider part of the population. Furthermore,
Indian healthcare customers have grown more aware of their maintenance.

Indian healthcare industry is highly diverse and offers several chances in all segments,
including providers, payors and medical technology. As competition increases,
companies are eager to study the newest trends and dynamics which will have a
beneficial influence on their companies. The hospital sector in India is expected to rise by

11
the FY22 from Rs. 4 trillion (USD 61,79 trillion) for the year 17 to CAGR of 16–17% to
Rs. 8.6 trillion (USD 132.84 billion)

By 2025 the Indian Government plans to boost public health expenditure to 2,5 percent of
GDP.

India's competitive edge is also the growth in Indian businesses' success rate in obtaining
approvals of the Abbreviated New Drug Application (ANDA). India provides huge R&D
and medical tourism prospects. To summarise, there are huge investment possibilities in
both urban and rural India in health infrastructure.

IMPORTANCE OF THE STUDY

Needs to ensure the quality of each and every individual performance for the successful
accomplishment of organizational mission .The Management of the human assets in a
proper manner is a risky activity even in hospital . The role of nurses and para-medical
staff in a hospital having high impact over patients .So ought to ensure their satisfaction
along with providing adequate remuneration along with motivational schemes, training
programs ,allowances ,etc.

Hear we can make a systematic study to deals with the individuals at Co-operative
hospitals through identify policies and time to time plans as well as required guidelines
needs fall under the boundary of HRM

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 CHAPTER 2

REVIEW OF LITERATURE

AND RESEARCH DESIGN

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This chapter deals with several important concept related literature and theoretical
information which have been formulated for the support of the study.

Al-Aseeri (2005) has identified the association of nurses' perception of commitment with
the selective characteristics revealed the significant variations. Surprisingly, negative
association was found between the nurses professional status (clinical ladder and
education) with commitment.

Ali et al (2006) indicated that the employees working in the hospital sector felt that they
were satisfied with their jobs. Also they were provided with a good and healthy working
environment. The employees were satisfied with the pay and the benefits.
Edgar and Geare (2006) HRM practices would give a positive influence towards the
organizational fairness, employee job satisfaction and organizational commitment. The
employees job satisfaction in the workforce is very important in every organization
because it could help to decrease the absenteeism or turnover, behavior problem and
reduce the medical costs.
G.V.Chalam and L. Srinivas (2007) in this paper made an attempt to explore the basic
gender disagreement with respect to HRD Climate in 20 branches of SBI at Andhra
Pradesh. Findings of the study showed that women employees have much more concern
on HRD climate than men. They come up with high level of satisfaction in respect of
HRD Practices. Female Employees had higher degree of pleasure toward HRD Climate.
It was also revealed that women respondents closely observed and followed the Human
Resource development climate of the Bank and were also very loyal toward bank
regarding their commitment toward work.
Hemant Rao (2007) emphasized the changing role of HR. There was dramatic change in
HR during past five years. This study shows the significant role of human resource
managers in various areas like Empowerment of workers, Business process Reenergizing,
Total Quality management, Humanization of work, and Quality of work life. It was the

14
challenge of HRM to balance the impact of liberalization and globalization on
productivity. Earlier the role of Personnel department was to give advice or support when
asked but the changing professional employment scenario emphasized the role of HR
professional while dealing with employees of different regions, caste, language and social
backgrounds.
Kundu. Subhash C., DivyaMalhan (2009) in their article on "HRM Practices in
Insurance Companies: A Study of Indian and Multinational Companies" opined that
Competitive advantage of a company can be generated from human resources (HR) and
company performance is influenced by a set of effective HRM practices. The results of
this study indicated that both multinational companies and Indian companies have to
significantly improve their practices regarding performance appraisal, training and
financial benefits, and hr planning and recruitment. Service sector is human resource
intensive business. To gain competitive advantage, service organizations should
emphasize on human resource management practices, as has been indicated in the results.
A well-defined framework of human resource management practices benefits not only the
organization but also the employee. HR policies of an organization benefit the employee
by providing better opportunities for growth in terms of better compensation, benefits,
training and development opportunities, and career management, in turn leading to job
satisfaction and self-fulfillment.
Maitin, T.P. (2010) In his article "Dynamic Human Resources" stated that, out of wide
variety of resources which participated in the process of organizational growth, human
resources are the most dynamic element of efficiency and productivity. In the context of
modern information age, manpower owns the responsibility of information mobilization
and their profitable utilization, which increases performance of organization. The role of
human resource as great intellectual assets in management is too valuable to accelerate
the rate of economic progress.
Malik and sur (2010) in their study on "Human Resource Accounting in India" observed
that the progress of any organization is absolutely dependent on the skillful utilization of
its human resources. Even in the modern world, an organization may own adequate
financial resources and acquire physical resources with latest technology as it needs, it
would find difficult to manage its affairs, if the human organization of the concern is not

15
strong enough. However, the strange irony is that in India most of the organizations do
not recognize it properly. They do not adopt human resource accounting (HRA) although
it could contribute significantly both to internal and external management decisions.
HRA also helps the people of the organization in improving their performance and
bargaining capacity. It makes each of them conscious about the ratio between his
contribution towards the betterment of the concern and the expenditure incurred by the
concern on him.
Mishra and Bhardwaj (2012) in their research entitled ―HRD climate: An empirical
study among private sector managers‖ examined the nature and extent of HRD climate
over the hieratical levels in large private sector organizations located in eastern parts of
India. A sample of 107 managers at senior, middle, and lower levels is taken. The
standardized questionnaire on HRD climate developed by Rao and Abraham (1990) was
used consisting of a 5-point scale to measure the three categories i.e. general climate,
OCTAPAC culture and HRD mechanisms. For analyzing results mean scores and
percentage scores of each item was calculated, and t-test was applied to verify the results.
The conclusion was that the HRD climate prevailing in private sector organizations was
good and satisfactory. Further the authors recommended that the top-level managers
should be responsible enough to introduce a well-integrated sound training policy for
imparting training to the employees.
Mathuret. al (2013) in a study on work culture try to differentiate the internal work
culture of public and private sector organizations in India. He examined the how the
external socio-cultural environment and enterprise variables influence the internal work
culture, which in turn has an impact on human resource management practices. He
resulted that as compared to public sector organizations, the internal work culture of
private enterprises put greater stress on internal locus of control, future orientation of
planning, and employee participation in management and thereby result in better
performance. It was further point out that HRM Practices in private sector utilized more
effective motivational techniques like feedback, performance based reward, supervisory
control, autonomy etc as compared to public sector.
Naffetal (2014) identified that the employees were more likely to pursue training
opportunities because they believed in doing so was linked to the future promotion

16
opportunities or at least favourable consideration for merit increases and positive
performance reviews.
Patrick (2014) viewed that soft HRM was characterized with a resource perspective of
the employees and are characterized by an egalitarian culture, organic organization
structures, broadly defined jobs, and merit-based pay, gain-sharing and direct
communications with employees.
Raj Kumar (2015) was of the view that HR professionals needed to be encouraged
to see themselves as a lifelong learners in the multi faceted technological environment
and all high performing organization fostered a culture that encouraged the individual to
have exclusive leadership.
Rajangupta (2015) in his book entitled ―implementing human resource development‖
dealt with the implementation part of HRD. The work gives an insight to improve the
implementation process and develop theoretical understanding about HRD
implementation. In this book attention is given to different aspects and issues involved in
HRD like manpower planning, education and training, impact of liberalization and
globalization, total quality management and human resource accounting and HR
dimensions of the new economic policy.
Rao and Abraham (2015) stated in their research paper entitled ―HRD Climate in
Indian Organizations, that human resource is essential for making an organization
dynamic and growth oriented. The top-level executives have ultimate responsibility in
creating a healthy climate and providing adequate training, which is essential for the
overall development of employees. They hold the view that holds the view that existence
of development climate is a pre-requisite for facilitating HRD system in the organization.
Development climate constitute three variables:- general climate, HRD mechanisms, the
OCTAPAC culture. In general climate, human resource development is given high
importance by top & line managers. In this supportive climate is facilitating the good
personal policies and positive attitude toward development. This climate include positive
attitude of top management &line managers towards practicing HRD in the organization.
Saif andSartawi (2016)stated that the hospital managers had to pay serious attention to
the relationship between the HRM practices and performance. They should also consider

17
how to enhance the capabilities in the fields of human resource and skills development in
order to increase the hospital performance.
Saini R.R. (2016)in his article ―Human resource development in UCO Bank-A case
study of Chandigarh Region.‖ evaluates the Human Resources Development policies and
practices. This study identified the process and problems in designing and implementing
Human Resources Development Systems. This study was analytical in nature and consist
a sample of 100 respondents to analyse their opinion about HRD Policies and Practices.
The Important findings of this study were, qualification was the most important factor of
recruitment at all level of managers and employees. It also concluded that problem
solving strategy of the organization was very effective because all appropriate method
have been used to solve problems. Negotiation and Union involvement was the most
prevalent used method to solve the problem. This study also observed that the managers
were not aware sufficiently about the functioning of HRD Systems. Therefore a proper
action plan to improve awareness, Motivation, & serious concern among managers about
HRD should be implemented.
Sharma and jyoti (2016) in an article on "job satisfaction" concluded that job
satisfaction is an effective reaction to an individual's work situation, and has been
described as a positive emotional response resulting from appraisal of one's job. One of
the aspects that can lead to Dissatisfaction is one's attitude towards one's job. job attitude
can be defined as an overall feeling about one's job or career or in terms of specific facet
of the job or career and can be related to specific outcomes, such as productivity.
Subramanian, V. (2017) expressing his views regarding recruitment and selection of
employees stated that any organization which gives a fair share of attention to the
recruitment and selection of its people is bound to get good returns. Recruitment and
selection should be viewed in the wider context of the organizational future. What are the
strategic objects and hence what capabilities will the enterprise need in the future? Must
be the questions the organization should always address itself to. Therefore, an important
strategic issue to consider is how the recruitment and selection activity can contribute to
long term business goals.

Singh S.K (2017) in his research entitled ― HRD Climate: Interventions and challenges‖
examined that survival of the organizations in dynamic and complex environment require

18
employee involvement, productivity and this can be achieved with the help of quality
targets, quality circles, training and development & suitable method of performance
appraisal etc. Above these HRD interventions/practices should be implemented in a
suitable way and HRD Climate should be conductive so that cooperation of employees
can be achieved and conflicts can be sorted out which in turn increase the effectiveness of
the organization.

Tripathy (2018) observed that an organization can have competitive advantage by

utilizing its human resources. This can be achieved through sound HRD Practices.
According to him HRD include three C‘s- Competencies, commitment and culture. An
optimum level of progressive climate is essential for facilitating HRD in an organization.
It was resulted that good HRD Practices can influence financial and other performance
indicators in the organization.
T.V. Rao (2018) in his book entitled ―HRD audit describe the framework and
methodology of HRD audit. This is landmark work which makes corporations to conduct
an internal audit of their human resource functions. HRD score card has been developed
and tested by Dr. Rao. HRD dimensions are very essential for the contribution toward
organizational performance, HRD systems maturity, HRD competencies, HRD culture
and values, and HRD linkages to business goals. Many corporations have started
investing in HRD. They have started new human resource development, given top level
positions to human resource persons, created reasonable budgets and expect the HR
function to give a strategic advantage to their corporations..

Udaipareek&T.V. rao (2018) in ―designing & managing human resource system‖

depicts the fluctuating trends in designing & managing human resource system.
Recognize the importance of HRD and the limitations of personnel department. Many
organizations have established new HRD department. This book treats human resource
system. This work includes some new additions namely career planning & development,
induction training, socialization, mentoring etc. This also gives information about
professional bodies and academic institutions active in the field of HRD.

Venkateswaran (2018) conducted a study entitled ―A note on HRD Climate‖ revealed

that early identification of human resource potential and development of their skill are the

19
main tasks of the HRD department. The study based on the response of 132 executives of
large public sector unit of engineering organization. The study proves the existence of
favorable HRD climate in the organization. The results of the study revealed that the
HRD dimensions increases the employee interest in the work place thereby eliciting a
higher level of performance.

VenkataRatnam (2018) found that the Indian organizations needed to cope with the
need of developing a highly diverse workforce into a well-trained, motivated and an
efficient employees with the subsequent de-skilling, reretraining and multi-skilling
problems, workforce reduction policies, and retention and career development issues.

Wamuuru,G and Denis MuchangiJamleck (2019) in their Empirical studies, in order

to open the black box to get a better understanding of the relationship which would help
in guiding organizations to attain their objectives and achieve high performance.

Yafe (2019)found the job satisfaction to be independent of the gender and the job
experience of the employees of the hospital. Demographic variables such as age, gender,
current job position, marital status, and experience had the effect on job satisfaction or
dissatisfaction.

STATEMENT OF THE PROBLEM

The progress of science and technology for access to modern medications

and the use of health facilities in metropolitan areas has risen enormously. The facts lead
to the growing number of co-operative hospitals in the states making such medical
services available with minimal money. During the year 2000 the first co-operative super
specialty hospital was formed in Kerala in the name of N Sreedharan .Before the
establishment of such organization here was also other co-operative hospitals to manage
the discrimination of both private sector and public sector hospitals in charging expenses
for services, according to their own policies also .To exist in this competitive mixed
economy ,co-operative entities needs to manage entire their resources properly.

20
 However not munch research has been conducted with respect to HRM in Co-
operative hospitals in India. In this contest this selected topic entitled ‘A STUDY ON
HUMAN RESOURCE MANAGEMENT PRACTICES IN CO-OPERATIVE
HOSPITALS WITH SPECIAL REFERENCE TO EMS MEMORIAL HOSPITAL ,
PERAMBRA’ deals with how the HRM activities are make influences over individuals
who were working in co-operative sector.

SCOPE OF THE STUDY

Each of Co-operative hospitals are started to adopting advanced medical treatments

through implementing modern technology in its selves. It take palaces both in urban and
rural areas. To the success of all of these co-operative hospitals needs to utilise its human
assets like doctors, clerks ,securities and any other individuals who take various other
works , along with the effective management of other resources. Needs to also identify
about measures which ensures the workers satisfaction also .This study will be helpful to
understand about the human resource management practices and its effects over human
assets at co-operative hospital sector .

OBJECTIVES OF THE STUDY

• To identify the effective recruitment & selection procedures of human assets at

Co-operative sector.

• To evaluate the effectiveness of training programs over individuals.

• To identify common motivation schemes ,which ensures more satisfaction over

individuals.

• To examine the applicability of performance appraisal methods

21
 RESEARCH METHODOLOGY

RESEARCH DESIGN

The design of research sets forth the methodologies and processes for the
investigation. The study's research design is descriptive in nature.

AREA OF THE STUDY

This study covers the individuals placed over the EMS Memorial Co-operative
Hospital , Perambra.

SAMPLE SIZE

Sample size is the number of persons chosen for data collection. Here 100 samples are
selected for the study.

SAMPLING TECHNIQUE

For data collection convenience sampling technique was used. Convenience sampling
is one in which a sample is obtained by selecting such units of the universe which may be
conveniently located and contacted

SOURCE OF DATA

Primary data:

The consumers acquire primary data using a questionnaire with a questionnaire formal
list.

Secondary data:

22
Some other individuals are already collecting and analysing secondary data for their own
purposes and then another person uses the same data. These were collected from
journals , books, related to the topic and website ,etc

TOOLS FOR DATA ANALYSIS

1) Percentage method

TOOLS FOR PRESENTATION

 Table

 Chart

PERIOD OF THE STUDY

The study is confined to the period of three weeks.

HYPOTHESIS OF THE STUDY

H0: Training programs have no significant relation with performance level of employees.

H1: Training programs have significant relation with performance level of employees.

LIMITATIONS OF THE STUDY

• The study covers one Co-operative hospital only.

• 100 samples are not sufficient to cover opinion of entire population.

• The reliability of the data depends on the information given by the respondents.

• Time duration in conducting the research was limited.

23
.

CHAPTER 3

PROFILE OF THE SELECTED ORGANISATION AND

RESPONDENTS

24
 Human Resource Management-Introduction

Human resources is one of an organization's most precious and distinctive assets. The
success of every company hinges on human resources management. The department of
HR is responsible for turning the whole person into efficient and capable resources to
carry out different operations. Quality and staff improvements were important for
improving the speed of economic growth. Human resources are crucial to every
organization's success. This concept is actually origin from management . Earlier the
concept was labor and the approach of management was maximum utilization of labor.
Employees are regarded as the most valuable variable resources of organizations.
HRM is an act of managing people at work in the organization.
Management is the way to get people through. In other words, it covers the combined
understanding, skills and talents of an organization's personnel. The management of
human resources deals with the management factor of the "people." Byars and Rue say:
"Management of human resources comprises actions aimed at providing the human
resources of an organisation and at coordinating them." All organisations have employees
and use their services, improve their skills, motivate them to increase their performance
levels and ensure that organisational goals are achieved. This applies to all sorts of
government and non-government groups on education, recreation, healthcare, etc.
Various plans and policies are needed to acquiring and developing right type of capable
individual.HR departments necessary for the development of quality and performance of
employees.
If there is a shortage of skilled labors especially in co-operative
sector ,There needs to take the functions of HRM to develop the required skill among
such employees through training and development ,motivation , etc. In the previous
period, the word "personnel management" was used and a new phrase "human resources

25
management in the cooperation sector" was substituted. The management function assists
managers in recruiting, selecting, training and developing a company members. Human
resources management is a four-function process;
 Acquiring
 Developing
 motivating and
 retaining human resources.
The procurement duties begin with planning and finish with personnel management. The
function of development has three dimensions;
 employee training
 management development and
 career development.
The motivation function includes;
 identifying the individual motivational needs of employees
 and ways to motivates them.
The retaining function is concerned with;
 providing a conducive work environment to the employees and
 Nurturing them to make them feel committed and attached to the organization.
These functions also apply to non-commercial organisations. Education, health,
recreation and so on. Human resource management therefore refers to a number of
programmes, functions and actions developed and conducted to optimise the
effectiveness of both the employee and the business.

The sustainable economic growth is possible only when there is a centralized economy
,all other developments in other economies become fall after over a certain period of
time .The nations which were taken socialist ideologies, are always trying to make their
employee productive through expanse their knowledge’s .The co-operative societies are
follows this way to improve the value their members .They chooses proper mode of
recruitment ,training ,motivational factors ,etc...for its members to maximize the entire
standard living of the people. Human resources management activities, such as training,

26
employee involvement, pay, employee recruitment and selection procedures, internal
modifications to the workforce are good for employees so that their performance is
maintained. The HRD Department's primary duties are the identification of the potential
for human resources and the development of their skills, but it has also said that any
organisation, which pays due attention to recruiting and selection of its workers, is
guaranteed to obtain high profits. In the broader perspective of the organisational future,
recruitment and selection should be seen.
The external socio-cultural environment and the factors of business influence the internal
working culture and have an influence on the management of human resources. It
resulted in an increased stress of internal control locus, future orientation and
management engagement by employees compared with public sector organisations in the
internal working culture of cooperative companies, leading to improved performance. In
comparison to public sectors, it was further emphasised that HRM practises for the
cooperative sector used more effective motivating tactics such as feedback, performance-
based awards, control, independence, etc.

HUMAN RESOURCE MANAGEMENT IN HOSPITALS

Human resources management is the process by which people are employed and
developed so that they are more suited to their particular areas of work and the overall
business. This involves the process

 Recruiting
 Training and
 evaluating employees
 analyzing jobs
 communicating with staff members and
 managing salaries .

When it comes to the healthcare sector, it may perform various distinct role. The
American Society for Healthcare Human Research Administration (ASHRA) thinks that
an HR manager is important in providing successful services at a healthcare institution.

27
The HRM team is responsible for choosing people for certain jobs in a hospital.. The
employee salary and benefits are the responsibility of HRM team members. It must also
guarantee that new employees have the necessary education and experience for a certain
position. Since a health centre relies on topical specialists to provide services, the HRM
team also needs to evaluate existing workers. The staff also has to deal with personnel
problems and disagreements amongst workers.

Recent trends show that employees cannot be seen any more as commodities. The
socialist model of society, the arrival of state involvement and the notion of a welfare
state as a whole, must make the warning manager realise the significance of human
connections and his activities must lead to social justice. Today's workers are more
progressive. They are better organised by labour unions today. These elements emphasise
the necessity for motivation, moral development and the promotion of better
management-worker relationships. The management of human resources is not possible
by intuition or instinct. The HR manager must know the relevant discoveries in the
behavioural sciences. In addition to being conversational in the labour legislation of the
country, he should know of the contributions made by psychology, business management
and sociology. Governing boards, industry and hospital managers in sophisticated nations
such as the United States, Canada, Great Britain, Germany and Japan were aware of the
necessity of human resource management long ago. But in India alone, boards of
directors and managers in industry understood its relevance. Now is the time for the
boards of governors and government administrators and the voluntary hospitals to include
human resources management into the hospital system.

OBJECTIVES OF HRM IN HOSPITALS

Issues on also other strategic decisions at a hospital with successful HRM policies and
procedures ,HR department needs to satisfy the given objectives :
a) Defining Organizational Structure And Driving Productivity
b) Building Coordination Between Organizational Departments
c) Offering Employee Satisfaction

28
d) Keeping Up With The Societal And Ethical Models
e) Etc...
Human Resources Management function includes;
 Job Analysis
 Manpower planning
 Recruitment
 Selection
 Induction
 Training and Development
 Performance Appraisal
 Compensation Management and
 Industrial Relation
The study here focuses on four major functions are :
1. Recruitment & Selection
2. Training and Development
3. Motivation
4. Performance Appraisal

Recruitment & Selection

Recruitment refers to an entire process in which appropriate individuals (either
permanent or temporary) can be appointed, selected and appointed for employment. The
recruitment process may also be referred to in choosing persons for unpaid positions.
Recruitment may be performed by managers, generalists in human resources and
recruiting experts, although sometimes public employment agency, commercial
recruitment authorities and specialised search consulting companies are hired to execute
part of the process. Internet-based technologies have become widely used, which assist
all elements of hiring. Selection is the process to pick or select the appropriate applicant
for a position in an organisation which is best suited for vacancies. In other terms, the
selection process can also be explained by the interview and evaluation of the

29
qualifications necessary for a particular job and by the choice of the appropriate applicant
for the post.. Selecting a proper candidate for a vacancy will be a good thing for the
business to assist the company meet its goals.
Training & development
Training and development is an organization's subsystem which focuses on the
enhancement of people and groups' performance. Training is an education process that
combines strengthening skills, ideas, attitude changes and additional information to
improve employee performance. Good and effective training of staff contributes to the
development of skills and knowledge that helps a firm improve eventually. Training and
employee development are an expensive task, because both trainers and employees
demand much qualitative input. However, the firm must modify its objectives and
efficiency with the changing environment.

Motivation
The term "motivation" comes from the word "mover" in Latin. The Latin term 'Movere'
implies 'to move,' 'to move' and 'to drive,' and so on. Motivation may be described to
stimulate, inspire and encourage employees to do their best. Motivation is a
psychological word that does not mean employees may be compelled to use. It originates
from inside the employees automatically as it is prepared to perform the task. Motivation
is a process in which requirements lead to action oriented towards the objectives that can
satisfy the needs, described Joe Kelly as "Motivation." "Motivation is an effort to
encourage others to take action in order to achieve the intended goals," according to W.
G. Scot.
Performance appraisal
Performance assessments are the process of assessing and recording the performance of
an employee to improve job quality, productivity and effectiveness. Performance
assessment performs three key business tasks.
• They provide feedback to a person on their overall contribution for a period.
• They identify development needs and opportunities for improvement.
• They help inform salary and bonus reviews.

30
There has been a significant degree of satisfaction amongst personnel in hospitals that are
consistently and scientifically implementing human resources management techniques.
The staff are more engaged in improved performance. On the other hand, HR Dept. is
regarded at some of the well-known hospitals as a basic Cost Centre, which guarantees a
timely payroll tracking of the leave record. The degree of satisfaction of the employees is
lower in such hospitals. In a period of globalisation, when the hospital sector is
expanding and the demand for medical services increasing, all workers should be
successfully and efficiently managed, using methods in the management of human
resources consistently and scientifically. The function of HRM is more important for
hospitals as a service sector and as human intensive.

ABOUT EMS MEMORIAL CO-OPERATIVE HOSPITAL,

PERAMBRA
The establishment of EMS Memorial Co-Operative Hospital actually satisfies the desire
of peoples to the occurrence of an hospital having modern specialized medical facility
along with protecting the public interest also. Still it operates in its own building, which
were constructed by ULCSs but in past the hospital was taken it's activities at a rental
building . The first president was Mrs .NK Radha . Now the hospital is on the way of
development.

 The financial assistance of NCDC

 District Co-Operative Bank, Kozhikode and
 Other Co-Operative Banks were in Perambra
 Etc...

were given great support to these hospital for it's growth. Finance support for its blood
bank were also given by Cochin Shipyard also .By all means now the hospital totally
placed in the hands of people because of it's ownership is determines by the public
subscription of share's.
Various international level medical facilities are available
here,are;
 General Medicine
 Gynecology
 Cardiology
 Orth Pediatrics
 ENT
 General Surgery
 Dermatology
 Dental

31
  Ophthalmology
 Etc
Here available 24 hours casualty services along with trauma care
accessibility. When occurs any accident and to limit's its risk also mobile Ambulance
services and the support of skilled doctors and other professionals are also placed here.

CHAPTER 4

DATA ANALYSIS AND INTERPRETATION

32
 AGE WISE DISTRIBUTION OF RESPONDENTS
TABLE 4.01
AGE NO OF RESPONDENTS PERCENTAGE
Below 25 years 28 28
25-35 years 34 34
35-45 years 22 22
Above 45 years 16 16
Total 100 100
Source: Primary data
CHART 4.01

33
 IN PERCENTAGE
40

35

30

25
percentage
20

15

10

0
below 25 years 25-35 years 35-45 years Above 45 years

INTERPRETATION: Out of the 100 respondents, 28% % are below 25 years, 34% are
in the age group 25-35 years, 22% are in the age group 35-45 years, and 16% are above
45 years.

GENDER WISE DISTRIBUTION OF RESPONDENTS

TABLE 4.02

GENDER NO. OF RESPONDENTS PERCENTAGE

Female 45 45
Male 65 65
Total 100 100
Source: Primary data
CHART 4.02

34
 IN PERCENTAGE

Female
Male

INTERPRETATION: Out of the 100 respondents, 45% are female and 65% are male.

EDUCATIONAL QUALIFICATION OF RESPONDANTS

TABLE 4.03

Educational level No of respondents Percentage

Matric 21 21
Graduate 52 52
Post Graduate 18 18
Other 9 9
Total 100 100
Source: Primary data

35
 CHART 4.03

IN PERCENTAGE

60

50

40
percentage

30

20

10

0
1 2 3 4

INTERPRETATION: Out of the 100 respondents, 21% are matric level, 52% are
graduate level, 18% are post graduate level and 9% are included in others.

DESIGNATION OF RESPONDENTS

TABLE 4.04

DESIGNATION NO OF RESPONDENTS PERCENTAGE

Doctor 6 6
Nurse 15 15
Manager 19 19
Accountant 10 10
Clerk/ Secretary 12 12
Sub staff 28 28
Other 10 10
Total 100 100
Source: Primary data

36
 CHART 4.04

IN PERCENTAGE

Doctor
Nurse
Manager
Accountant
Clerk/secretary
sub staff

INTERPRETATION: Out of the 100 respondents,6% are doctors, 15% are nurses,19%
are managers, 10% are accountants, 12% are clerks/secretaries and 28% are sub staffs.

WORK EXPERIENCE OF RESPONDENTS

TABLE 4.05

NO OF YEARS NO OF RESPONDENTS PERCENTAGE

Less than 10 years 29 29
10-20 years 32 22
20-30 years 18 18
More than 30 years 21 21
Total 100 100
Source: Primary data
CHART 4.05

37
 IN PERCENTAGE

30

25

20
percentage

15

10

0
lessthan 10 years 10-20 years 20-30 years Morethan 30 years

INTERPRETATION: Out of the 100 respondents,29% has an experience of less than

10 years, 22%has 10-20 years of experience, 18% has 20-30 years of experience and 21%
has more than 30 years of experience.

RECRUITMENT METHODS FOLLOWED BY THE HOSPITAL

TABLE 4.06

RECRUITMENT NO OF RESPONDENTS PERCENTAGE

METHODS
Employee referrals 39 39
Advertisement 29 29
Recruitment consultants 12 12
Professional journals 10 10
Other 10 10
Total 100 100
Source: Primary data
CHART 4.06

38
 IN PERCENTAGE
45
40
35
30
25
20
15 percentage
10
5
0

INTERPRETATION: While analyzing the above graph, it is understood that the most
preferred recruitment method in baby memorial hospital is employee referrals. Whereas
Advertisement has the second position.

SELECTION METHODS ADOPTED BY THE HOSPITAL

TABLE 4.07

SELECTION
METHODS NO OF RESPONDENTS PERCENTAGE
Aptitude test 20 20
Merit of qualifying exam 22 22
Personal Interview 25 25
Direct appointment 18 18
Written test 10 10
Other 5 5
Total 100 100
Source: Primary data
CHART 4.07

39
 IN PERCENTAGE
25

20

15

10 percentage
5

INTERPRETATION: From the above graph, it can be concluded that almost all of the
selection methods mentioned above are being adopted by the hospital. It may vary
according to the preferred post of the candidates

FACTORS ON WHICH CANDIDATE IS ASSESSED FIT FOR THE

JOB

TABLE 4.08

FACTORS NO OF RESPONDENTS PERCENTAGE

Educational qualification 38 38
Experience 37 37
References 25 25
Total 100 100
Source: Primary data
CHART 4.08

40
 IN PERCENTAGE

educational qualification
experience
references

INTERPRETATION: Majority of the respondents agree that educational qualification

and experience are the important factors on which candidates are assessed fit for the job.
References has least importance.

LEVEL OF SATISFACTION OF RESPONDENT TOWARDS

RECRUITMENT AND SELECTION PRACTICES IN THE
HOSPITAL

TABLE 4.09

OPINION NO OF RESPONDENTS PERCENTAGE

Highly satisfied 20 20
Satisfied 42 42
Average 40 40
Dissatisfied 8 8
Total 100 100
Source: Primary data
CHART 4.09

41
 IN PERCENTAGE

45
40
35
30
percentage
25
20
15
10
5
0
highly satisfied satisfied Average Dissatisfied

INTERPRETATION: Majority of the respondents (42%) are satisfied with the

recruitment and selection practices in the hospital. 20% are highly satisfied. 40% opted
average and none of the respondents are dissatisfied.

RESPONDENTS OPINION ABOUT TRAINING PROGRAMS

TABLE 4.10

OPINION NO OF RESPONDENTS PERCENTAGE

Yes 69 69
No 31 31
Total 100 100
Source: Primary data
CHART 4.10

42
 IN PERCENTAGE

Yes
No

INTERPRETATION: Out of the 100respondents, 69% agree that they receive training
programs from the hospital. Only 31% explained that they are not receiving training
programs.

TRAINING METHOD UNDER WHICH RESPONDENT HAVE

TRAINED

TABLE 4.11

TRAINING METHOD NO OF RESPONDENTS PERCENTAGE

On the job training 36 36
Off the job training 23 23
Both 41 41
Total 100 100
Source: Primary data
CHART 4.11

43
 IN PERCENTAGE
on the job training
off the job training
both

INTERPRETATION: Out of 100 respondents, majority of the respondents(41%) had

undergone both of the training methods.

ON THE JOB TRAINING METHODS UNDER WHICH

RESPONDENT HAD UNDERGONE

TABLE 4.12

METHOD NO OF RESPONDENTS PERCENTAGE

Job rotation 19 19
Coaching 14 14
Internship training 47 47
Committee assignments 10 10
Other 10 10
Total 100 100
Source: Primary data
CHART 4.12

44
 IN PERCENTAGE
50
45
40
35
30
25
20
15 percentage
10
5
0

INTERPRETATION: Majority of the respondents explained that internship training is

the mostly adopted on the job training method in the hospital. None of them opted
committee assignments.

OFF THE JOB TRAINING METHOD UNDER WHICH

RESPONDENT HAD UNDERGONE

TABLE 4.13

Method No of respondents Percentage

Case study 19 19
Incident method 3 3
Role play 5 5
Business games 5 5
Lectures 51 51
Conferences 7 7
Other 10 10
Total 100 100
Source: Primary data

45
CHART 4.13

IN PERCENTAGE

case study
incident method
role play
business games
lectures
conferences
others

INTERPRETATION: From the above graph, it is understood that lectures is the mostly
adopted off the job training method in the hospital.

CRITERIA UNDER WHICH THE IMPACT OF TRAINING IS

ASSESSED

TABLE 4.14

CRITERIA NO OF RESPONDENTS PERCENTAGE

Performance 39 39
feedback 23 23
Efficiency 28 28
Other 10 10
Total 100 100
Source: Primary data

46
 CHART 4.14

IN PERCENTAGE

40

35

30

25 percentage

20

15

10

0
performance feedback efficiency others

INTERPRETATION: It is understood that the impact of training is measured by

considering the performance and efficiency of the employees. Feedback is also an
important factor.

PERFORMANCE APPRAISAL METHOD IMPLEMENTED IN THE

HOSPITAL

TABLE 4.15

METHOD NO OF RESPONDENTS PERCENTAGE

Rating scales 20 20
Checklist 9 9
Forced choice method 0 0
Field review method 28 28
Psychological appraisals 33 33
Other 10 10
Total 100 100
Source: Primary data

47
CHART 4.15

IN PERCENTAGE

rating scales
checklist
forced choice method
field review method
psychological appraisal
others

INTERPRETATION: From the above graph it is understood that psychological

appraisal is the mostly adopted performance appraisal method in hospital. Field review
method takes the second position.

SALARY INCREMENT AFTER PERFORMANCE APPRAISAL

TABLE 4.16

OPINION NO OF RESPONDENTS PERCENTAGE

Yes 63 63
No 37 37
Total 100 100
Source: Primary data

CHART 4.16

48
 IN PERCENTAGE
70

60

50

40 Series percentage

30

20

10

0
Yes No

INTERPRETATION: Out of the 100respondents, 63% agree that they receive salary
increment after performance appraisal.

CRITERIA USED FOR PERFORMANCE APPRAISAL

TABLE 4.17

CRITERIA NO OF RESPONDENTS PERCENTAGE

Quality of work 42 42
Quantity of work 18 18
Job knowledge 28 28
Regularity of work 12 12
Other 0 0
Total 100 100
Source: Primary data

49
 CHART 4.17

IN PERCENTAGE
45
40
35
30
percentage
25
20
15
10
5
0
quality of work quantity of work job knowledgeregularity of work others

INTERPRETATION: Out of 100 respondents, 42% agree that the quality of work
performed is the criteria used for performance appraisal in the hospital. But it is also clear
that job knowledge and regularity of work are also considered.

SATISFICTION OVER INCENTIVES

TABLE NO-4.18

CRITERIA NO OF RESPONDENT PERCENTAGE

Financial incentives 70 70
Non- financial incentives 30 30

Total 100 100

Source Primary data

CHART NO – 4.18

50
 IN OERCENTAGE
80

70

60

50
percentage
40

30

20

10

0
financial incentives non financial incentives

INTERPRETATION :The above table and chart shows that most of the respondents are
using financial incentives and remaining 30% are using non financial incentives.

FINANCIAL INCENTIVES PROVIDED BY THE HOSPITAL

TABLE 4.19

INCENTIVES NO OF RESPONDENTS PERCENTAGE

Bonus 43 43
Allowances 32 32
Perquisites 25 25
Commission 0 0
Others 0 0
Total 100 100
Source: Primary data

CHART 4.19

51
 IN PERCENTAGE
45
40
35
30
percentage
25
20
15
10
5
0
bonus allowances perquisites commission others

INTERPRETATION: It is understood that bonus and allowances are the financial

incentives that majority of the respondents receive. Only 25% are receiving perquisites.

NON FINANCIAL INCENTIVES PROVIDED BY THE HOSPITAL

TABLE 4.20

INCENTIVES NO OF RESPONDENTS PERCENTAGE

Recognition 33 33
Participation 34 34
Job enrichment 13 13
Organizational climate 11 11
Job security 9 9
Others 0 0
Total 100 100
Source: Primary data

CHART 4.20

52
 IN PERCENTAGE

recognition
participation
job enrichment
organisational climate
job security
others

INTERPRETATION: Above graph shows that recognition and participation are the
non-financial incentives that majority of the respondents receive.

REASONS FOR LABOUR TURNOVER IN THE HOSPITAL

TABLE 4.21

REASONS NO OF RESPONDENTS PERCENTAGE

Better job prospects abroad 19 19
Better job prospects within 41 41
India
Lack of motivation 23 23
Marriage 11 11
Others 6 6
Total 100 100
Source: Primary data

CHART 4.21

53
 IN PERCENTAGE

40
30
20
10 percentafe
0

INTERPRETATION: From the above graph, it is clear that better job prospects within
India is the major reason for labor turnover in the hospital.6%of the respondents
optedother reasons. They stated that poor salary increment and overload of work are also
the reason

SATISFACTION LEVEL TOWARDS THE SUPPORT FROM

HUMAN RESOURCE DEPARTMENT

TABLE 4.22

OPINION NO OF RESPONDENTS PERCENTAGE

Highly satisfied 28 28
Satisfied 28 28
Average 26 26
Dissatisfied 18 18
Total 100 100
Source: Primary data

CHART 4.22

54
 IN PERCENTAGE

30

25

20
percentage

15

10

0
highly satisfied satisfied average dissatisfied

INTERPRETATION: Majority of the respondents are satisfied with the support from
human resource department. 18% of the respondents are dissatisfied. So it is understood
that the performance of human resource department is quite good for labor turnover

TESTING OF HYPOTHESIS

H0: Training programs has no significant association with performance level of

employees.

H1: Training programs has significant association with performance level of employees.

For testing the independence of two attributes we apply ᵡ2-test.

χ2 = Ʃ (O-E) 2/ E

Where, O = Observed Frequency

E = Expected Frequency

Observed frequency

55
 IF INFLUENCE OF TRAINING PROGRAMS ON EMPLOYEES
TOTAL
RESPONDEN PERFORMANCE LEVEL

T IS
STRONGL
DISAGRE STRONGLY
RECEIVING
Y AGREE NEUTRAL
E DISAGREE
TRAINING
AGREE
PROGRAM
YES 38 27 8 6 0 79
NO 8 5 6 2 0 21
TOTAL 41 27 9 3 0 100

CHAPTER 5

FINDINGS CONCLUSION SUGGESTIONS

56
 FINDINGS

1. More responses were given properly by the individuals who have age between
25-45.
2. Female staffs are placed in the hospital than male staffs.
3. Educational qualification and experience are the main factors on which
candidate is assessed for the job. It may help the organization to choose the
right person for the right job.
4. Doctors and Nurses were satisfied with their remuneration than other staffs.
5. 20% of respondents were having experience of more than 30 years.
6. Employee referrals is the common method to recruiting fresh employees to the
hospital
7. Personal interview is the mostly used selection method.
8. Most of staffs are recruited on the part of their experiences.
9. 47.5% of respondents are satisfied with recruitment and selection practices in
the hospital

57
10. 73.75% of the respondents receive training facilities and 50% of the
respondents agree that training programs helps to boost the performance of
employees.
11. On the job training methods are used more than off the job training methods.
12. More of staffs were trained under internship training
13. Case study is the appropriate method to trains the doctors and other specialized
parties also.
14. Hospital checks only employees output as the measure of training
15. Forced choice method is not better to Co-Operative hospitals than
psychological appraisal and check list also
16. 66.25% receive salary increment after performance appraisal. Poor salary
increment is one of the reasons for labor turnover in the hospital
17. Quality of work & job knowledge are the mostly used criteria for performance
appraisal.
18. Out of 100% candidates only 25% percentage having Non financial incentives
19. Bonus and allowances are the most common financial incentives provided by
the hospital
20. Participation and Recognition are the most common Non financial incentives
21. The major reason for employee turn over is the other vacancies available
within India
22. 35% are satisfied with support from human resource department.
23. Testing of hypothesis proved that training programs provided has significant
association with performance level of employees.

58
 CONCLUSION

In EMS Memorial Co-operative Hospital, human resources management procedures are

generally good. There are a number of areas in which policymakers and co-operational
hospital administration are immediately concerned. Policies to handle employee
dissatisfaction concerns need to be addressed by taking a professional approach to the
administration of human resources. The study found that the present human resources
practises are favourable for providing stakeholders with quality health care, but also
identify the right human resources departments for maintaining their growth. This
research advises that the complete person be taken into account when he or she trains and
motivates them to make a positive shift in the attitudes of both management and workers
and to lead to a good working culture at co-operating hospitals. "The health is the
wealth..." Let everyone concerned remember;

59
 SUGGESTIONS

1. Recruitment of employees should be done whenever vacancies arises.

2. The hospitals should try more to match the compensation and expectation of
employees and give incentives and fringe benefits
3. Innovative performance appraisal standards can be adopt, Salary increment is to
be done after performance appraisal .
4. Training programs can be organized for all the employees for increasing their
performance level.
5. Labor turnover can be reduced by reducing employee grievances

60
BIBLIOGRAPHY

61
 BIBLIOGRAPHY
BOOK REFERENCE

• VenkataRatnam CS. Multinational Companies in India. The International Journal

of Human Resource Management 2005; 9(4): 567-589.
• Saif NI, Sartawi KS. Relationship between Human Resource Management
Practices and Perceived Performance of Employees in Jordanian Hospital,
European Journal of Business and Management 2013; 5(22): 129-136.

• Wamuuru G, Jamleck DM. Human Resource Management Practices,

EmployeeBehavioral Outcomes and Organizational Performance in Public
Service: A CriticalLiterature Review. Management and Economic Journal 2016;
203-219.

• Wendell L. French, Human Resource Management, Fourth Edition, All India

Publishers and Distributors, Chennai-84, p.333.

62
 • Edgar F, Geare A. HRM Practice and Employee Attitudes: Different Measures –
DifferentResult. Personal Review 2005; 34(5): 534-549.
• Wright PM, McMahan GC. Theoretical Perspectives for Strategic Human
Resource Management. Journal of Management 1992; 18(2): 295-320.
• Yafe SA. Assessing Job Satisfaction Level of Employees in a Tertiary Care
Hospital- A Tool for Talent Retention. Zenith International Journal of
Multidisciplinary Research 2011;1(8): 494-507.

WEBSITE REFERENCE

• http://www.scribd.com/
• http://www.wikipedia.com/
• http://www.encyclopedia.com/
• http://shodhganga.inflibnet.ac.in/

APPENDIX

Iam MUHAMMED ASLAM CK, a student of 4thsemester MBA in sambhram

accademy of management studies . As part of the curriculum, am doing a project on “ A
STUDY ON HUMAN RESOURCE MANAGEMENT PRACTICES IN CO-
OPERATIVE HOSPITALS WITH SPECIAL REFERENCE TO EMS
MEMORIAL HOSPITALS, PERAMBRA”. I request you to kindly spare a part of
your valuable time to fill up the questionnaire. This is purely for academic purpose and
data collected will be confidential

63
1 .Name:
2. Age :
Below 25 years 25-35 years

35-45 years Above 45 years

3.Gender:

Male Female

4. Educational qualification :

Matric Graduate Post graduate

Other

5. Designation at present:

64
 Doctor Nurse Manager

Accountant Clerk Sub staff

Others

6.Work experience:
Less than 10 years 10-20 years 20-30 years

More than 30 years

7. Which of the following recruitment methods is followed in your hospital?

Employee referrals Advertisement Recruitment consultants

Professional journals Other

8. Which of the following selection methods are adopted by your hospital?

Aptitude test Merit of qualifying exam Personal
Interview
Direct appointment Written test Others
9. On what factors, the candidate assessed fit for the job?
Educational qualification Experience References
10. Are you satisfied with the present recruitment & selection practices in the hospital?
Highly satisfied Satisfied Average
Dissatisfied
11. Do you avail training programs from this hospital?
Yes No
12. From the following training methods under which training method you have trained?
On the job training Off the job training Both
13. If you trained on the job training then from the following method which method you
had undergone?
Internship training Coaching Job rotation
Committee assignments Others

65
14. If you trained Off the job training then from the following method which method you
had undergone?
Case study Incident method Role play
In-basket method Business games Lectures
Conferences
15. How does your hospital assess the impact of training?
Performance Feedback Efficiency
Others
16. Which method of performance appraisal is implemented in your hospital?
Rating scales Checklist Forced Choice
Critical Incidents Method Field review Psychological
17. Do you receive any increment in your salary after performance appraisal?
Yes No
18. Which of the following criteria are used in your performance appraisal?
Quantity of work. Quality of work Job knowledge
Regularity of work Others
19 .Which type of incentives motivates you more?
Financial incentives Non financial incentives
20. Which are the financial incentives you avail from the hospital?
Bonus Allowances
Perquisites Others
21.Which are non financial incentives you avail from the hospital?
Recognition Participation Job enrichment
Job security Organizational climate Others
22.If yes, What are the reasons for labor turnover?
Better job prospects abroad Better job prospects within India
Marriage Lack of motivation Other
.
23. Are you satisfied with support from the Human Resource Department?
Highly satisfied Satisfied Average
Dissatisfied

66
 PROGRESS REPORT-1

Sl. No. Particulars

1 Name of the Student Muhammed Aslam CK

2 Registration Number
3 Name of College Guide
4 Name and Contact no of the Co-
Guide/External Guide (Corporate)
5 Title of the Dissertation
MB197074
Ms. Rema Narayanswamy
“A Study on Human Resource Management
Practices in Co-operative Hospitals With
Special Reference to EMS Memorial

67

6 Name and Address of the EMS Memorial Hospitals, Perambra
Company/Organization where Calicut, kerala, 673525
dissertation undertaken with Date
of starting Dissertation Date of starting Dissertation: July 1
7 Progress report: A brief note
reflecting, Number of meeting
with Guides, places visited,
libraries visited, books referred,
meeting with persons, activities
taken up, preparations done for
collection and analysis of data etc..
Date:
Signature of the Candidate
PROGRESS REPORT-2
Sl. No. Particulars
1 Name of the Student
2 Registration Number
3 Name of College Guide
4 Name and Contact no of the Co-
Guide/External Guide (Corporate)
5 Title of the Dissertation
68
Hospitals, Perambra”
· Contacted my guide more than 3 times
to get detailed instruction and
information regarding the project
report
· Referred Books and Online Journals
· Books:
· Websites visited:
www.wikipedia.com
· Completed Chapter 1&2
currently working on Chapter 3,4 and 5
Signature of the College Guide
Muhammed Aslam CK
MB197074
Ms. Rema Narayanswamy
“A Study on Human Resource Management
Practices in Co-operative Hospitals With
Special Reference to EMS Memorial
Hospitals, Perambra”
6 Name and Address of the EMS Memorial Hospitals, Perambra
Company/Organization where Calicut, kerala, 673525
dissertation undertaken with Date
of starting Dissertation Date of starting Dissertation: July 1
7 Progress report: A brief note · Contacted my guide more than 3 times
reflecting, Number of meeting to get detailed instruction and
with Guides, places visited, information regarding the project
libraries visited, books referred, report
meeting with persons, activities · Referred Books and Online Journals
taken up, preparations done for
collection and analysis of data etc.. · Books:
· Websites visited:

www.wikipedia.com
· Completed

Date:
Signature of the Candidate Signature of the College Guide

69
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74