Strategic Workforce Planning in Dutch
Healthcare organizations
Name:
Romy Marell
ANR:
981439
Address:
Arendhorst 45, 6043RR Roermond
Supervisor:
dr. M. Verhagen
2nd Reader:
dr. C. Freese
Project Period:
Jan-Jan
Project Theme:
HR Metrics
Index
1. Introduction ......................................................................................................................... 5 2. Theoretical framework ......................................................................................................... 9 2.1 Strategic Workforce Planning ....................................................................................................... 9 2.1.1 Strategic Workforce Planning process ........................................................................................ 10 2.2 Workforce segmentation ............................................................................................................ 13 2.3 Workforce segmentation implemented in the Strategic workforce planning process .................. 15 2.4 Contingency factors in the Healthcare sector .............................................................................. 16 2.4.1 External factors ........................................................................................................................... 17 2.4.2 Internal factors ............................................................................................................................ 20 3. Methodology ...................................................................................................................... 23 3.1 Research design .......................................................................................................................... 23 3.2 Research Sample ........................................................................................................................ 23 3.3 Instruments ................................................................................................................................ 24 3.3.1 Document analysis ...................................................................................................................... 24 3.3.2 Interviews ................................................................................................................................... 24 3.4 Procedure ................................................................................................................................... 25 3.5 Data Analysis .............................................................................................................................. 26 4. Results ................................................................................................................................ 29 4.1 Description of the cases .............................................................................................................. 29 4.2 Strategic workforce planning process ......................................................................................... 29 4.3 Workforce segmentation ............................................................................................................ 37 4.4 Workforce segmentation implemented in the Strategic workforce planning process .................. 39 4.5 Contextual factors ...................................................................................................................... 40 4.5.1 External factors ........................................................................................................................... 40 4.5.2 Internal factors ............................................................................................................................ 43 5. Conclusion .......................................................................................................................... 47 6. Discussion ........................................................................................................................... 51 6.1 Discussion The perceived need for implementing SWP .............................................................. 51 6.2 Limitations ................................................................................................................................. 54 6.3 Theoretical implications and future research .............................................................................. 55 6.4 Practical implications .................................................................................................................. 56 References ............................................................................................................................. 58 Appendix A – Interview Questions .......................................................................................... 63 Appendix B – Example Transcript ............................................................................................ 69 2 Abstract According to labor market predictions (AZW, 2013) labor shortages in the Dutch healthcare
sector will occur. Organizations need to determine their current personnel demands and their
future personnel needs. HR tools that can contribute are strategic workforce planning and
workforce segmentation implemented in strategic workforce planning. The goal of this research is
to investigate which contingency factors influence the strategic workforce planning process in the
Dutch healthcare sector and whether workforce segmentation is used in the strategic workforce
planning process.
In order to investigate these relationships semi structured interviews were held with seven Dutch
healthcare organizations. The interviews were aimed at gaining a deeper insight in the strategic
workforce planning process and the process of workforce segmentation, In addition, the
interviews tried to reveal which contingency factors have an influence on the strategic workforce
planning process. Eventually 21 interviews were conducted with Senior Managers, HR managers
and Line Managers in seven organizations.
It became apparent that only one healthcare organization implemented an actual strategic
workforce planning process and none of the organizations used workforce segmentation in the
strategic workforce planning process. Several organizations mentioned that they are currently
implementing strategic workforce planning and some of the organizations do not recognize the
necessity. Therefore, continuous research about these topics in the next few years will probably
provide a deeper understanding of these practices. In addition, the results show that four of the
contextual factors; available resources, collective bargaining agreements, segmentation of the
healthcare sector and size might have an influence on the strategic workforce planning process.
However, the organizations mentioned and research shows that the underpinning principle of
strategic workforce planning is universally applicable. Therefore, although research confirms
these propositions, future research should investigate the influence of these contextual factors in
practice.
Keywords: Strategic workforce planning, Workforce Segmentation, Contingency Theory, Best-fit
Approach, Dutch healthcare sector
3
4 1. Introduction
Since the economic crisis, the unemployment rate in the Dutch labor market has increased each
year (CPB, 2013). However, in last decade there is one sector that was characterized by an
increase in employment, namely the healthcare sector. In this sector, the total amount of
employment showed a growth of 385.000 jobs in the past ten years (CBS, 2011). In the nearby
future, nevertheless, the healthcare sector will have to deal with shortages of suitable personnel.
These future shortages in the healthcare sector are caused by the ageing of the Dutch workforce,
resulting in a higher outflow of skilled personnel. In addition, there is an increasing scarcity of
qualified personnel supply and fewer people will enter the labor market. Furthermore, research
indicates that the demand for personnel in the next few years will increase with minimal 140
thousand extra jobs (AZW, 2013). This all, will lead to a discrepancy between the increasing
demand for care and qualified personnel supply in the healthcare sector. Therefore, for healthcare
organizations it is important to make optimal use of the current personnel and retain
the personnel in the organization.
In this context, of future personnel shortages, organizations need to determine the current
workforce and the future personnel needs. A tool that can contribute is strategic workforce
planning, since it is a data driven process that maps current workforce demands and future
personnel needs (Giehl & Moss, 2009). In essence, “workforce planning is preparing, designing
and implementing of strategic policy in terms of inflow, through-flow and outflow of personnel”
(Evers & Verhoeven, 1999 p.15). Operationally this means, achieving the business objectives in
the most efficient way by getting the right people with the right skills, in the right job at the right
time (Anderson, 2004; Cotton, 2007).
Scientific literature identified that the basic of every strategic workforce planning model is
“closing the gap” between current demand and future supply of labor (Evers & Verhoeven, 1999;
Anderson, 2004; Cotton, 2007). During this gap analysis phase in the SWP model, workforce
segmentation can play an important role (Lavelle, 2007). Workforce segmentation is described as
a way in which organizations differentiate between roles and skill sets and to determine how
essential they are to meet business objectives (Lavelle, 2007).
5
Even though workforce segmentation is not often implemented in the SWP model, Lavelle
(2007) argues that segmentation is destined to play an important role in workforce planning. The
aim of SWP as mentioned earlier is putting the right people in the right job at the right time.
Workforce segmentation can contribute by identifying strategic positions, support positions and
eliminate jobs that do not add value (Huselid, Beatty & Becker, 2005). Segmentation provides
organizations insight in their entire workforce and creates an overview of which type of
employees organizations need to attract, retain and develop in order to achieve business objectives
(Evers & Verhoeven, 1999).
Although several researches argue that there are general success factors that determine
strategic workforce planning (Anderson, 2004; Cotton, 2007), Evers and Verhoeven (1999) state
that the strategic workforce planning process differs in every organization and that no one best
way is applicable. In addition, organizations are influenced by several internal and external factors
that might cause differentiation in the SWP process. This statement assumes a contingency-based
approach; which argues that organizations are influenced by contextual factors. Organizations
need to adjust to these factors in order to perform (Donaldson, 2001). Thus, this theory suggest
that it might be, that the applicability of a SWP model in the healthcare sector is different, due to
contextual factors, than in other sectors in the Dutch labor market. With regard to these
developments the following research question is formulated:
“Which contingency factors influence the strategic workforce planning process in the Dutch
healthcare sector and does workforce segmentation play a role in the strategic workforce
planning process?”
This paper contributes to the scientific research in this area in the following ways. First of
all, this study provides new insights about the possible contribution of workforce segmentation in
the strategic workforce planning process. Secondly, this study provides scientific insight about the
application of strategic workforce planning process in the Dutch healthcare sector and
provides insight in which contingency factors influence this process.
Organizations might benefit from these findings, because this study might provide them a
practical guideline for implementing the strategic workforce planning process and/or workforce
segmentation in the healthcare sector. Furthermore this study provides organizations with a more
6 planned and focused approach to attracting, developing and retaining employees, which will lead
to more organizational efficiency. Because SWP is a long-term oriented and ongoing process,
healthcare organizations will be able to anticipate on future labor shortages or surpluses. In
addition, new insights in which contingency factors influence the strategic workforce planning
process will lead to the development of more customized applications. In other words, the SWP
process can be better aligned with organizational needs in their specific context.
This paper will continue with the theoretical framework, methods, results and finally the
conclusion and discussion.
7
8 2. Theoretical framework
This part of the research discusses the central concepts, Strategic Workforce Planning, Workforce
Segmentation and the Contingency Factors, and investigates their relationship with each other.
2.1 Strategic Workforce Planning
In the literature about Strategic workforce planning, different definitions are used (Evers &
Verhoeven, 1999; Anderson, 2004: Freyens, 2010). In the early 90’s, workforce planning was
defined as the assessment of future human capital needs and determining and implementing
actions necessary to meet the required demands (Ripley, 1995). Since then, there has been a shift
from the purely technical aspects of workforce planning towards the inclusion of strategic
management, evaluation processes and turnover management (Idris and Eldrigde, 1998).
In the past decade, the definition of strategic workforce planning is further elaborated and
Cotton (2007) argues that nowadays most definitions include the same general elements. Firstly,
strategic workforce planning needs to be aligned with the business objectives of the organization.
Secondly, the identification of which people and what kind of skills are needed to achieve goals.
Thirdly, the human capital of the organization needs to be aligned with the business direction.
Lastly, the required human capital will be continuously available and the strategic workforce
planning process will be adapted when needed. However, there is one important issue that has to
be added, namely that SWP is not a static system but an ongoing process (IPMA, 2002). This is
essential because implementing strategic workforce planning and interpreting the results are
essential parts of the business operations. SWP is not effective when managers only use the
strategic workforce planning process at one moment in time (IPMA, 2002).
To have an overall definition of strategic workforce planning in this research that refers to
all elements described above, several definitions are combined which results in the following
definition:
Strategic workforce planning is an ongoing process of human capital planning, which is aligned
with the overall business strategy of the organization. It is a data driven process, which analyzes
the current workforce and identifies future workforce needs. Based on this information,
organizations are able to identify gaps and develop and implement gap-closing strategies in order
9
to achieve organizational missions, goals and objectives (Evers & Verhoeven, 1999; IPMA, 2002,
Cotton, 2007; Bechet, 2008).
2.1.1 Strategic Workforce Planning process
According to several researchers (Evers & Verhoeven, 1999; Choudhury, 2007; Giehl & Moss,
2009) there is no one best way of strategic workforce planning due to contextual factors that
influences this process. However several researchers state that every SWP process is based on the
same overall starting framework (Nkomo, 1988; Anderson, 2004; Cotton, 2007; Freyens, 2010).
In other words, the strategic workforce planning models developed over time are almost all
extensions of the basic workforce-planning model of Anderson (2004). This research will outline
the basic model of Anderson (2004) and, in addition, will include adaptations made by other
authors.
First of all, the workforce planning process begins by defining the organizations strategic
direction (Cotton, 2007). An inevitable part of defining the business strategy means identifying
the core strategic skills and competencies that are needed to achieved the business objectives
(Cotton, 2007; Nkomo, 1988; Young, 2006).
Secondly, a scan of the internal and external environment must be executed. Information
about technological, economic, sociocultural factors and the labor market should be collected and
analyzed in order to achieve alignment between the goals, policies, procedures or operations of
the workforce planning model and the external changes (Nkomo, 1988; Cotton, 2007). For
example the environmental changes (the ageing workforce, labor shortages) in the healthcare
sector have a major influence on the design of the workforce planning process. Besides an
external environmental analysis focus should also lie on analyzing the internal environment.
Factors that should be included are workforce trends (attraction and retention statistics, age and
distribution of the workforce), organizational structure, organizational culture and current levels
of performance (Cotton, 2007).
The third step in the strategic workforce planning process is a supply analysis, which
focuses on identifying and analyzing the current supply for labor in the organization based on
qualitative and quantitative data (Anderson, 2004; Cotton, 2007). On the one hand qualitative data
is important for mapping current skills and competencies of employees and eventually mapping
10 strengths and weaknesses of the workforce (Nkomo, 1988). On the other hand quantitative data is
necessary to conduct information and trends about developments in the workforce that will have
an influence on the organization when no action is taken (Anderson, 2004; Evers, 2011).
After the supply analysis, organizations need to identify the future workforce demands
through a demand analysis. This step provides an estimation of future personnel needs in terms of
required numbers of employees as well as future needed skills (Anderson, 2004; Cotton, 2007).
While identifying these workforce demands, organizations have to take in to account the overall
strategy of the organization, changing work boundaries and environmental factors influencing the
workforce (technology, labor market developments) (Anderson, 2004; Cotton, 2007).
Based on the two earlier phases, organizations should be able to match the current supply
with future needed demands (Anderson, 2004; Freyens, 2010). The gap analysis phase reveals the
differences between current labor supply and future labor demand. There are three different
situations that can occur: expected skill/labor shortages (demand exceeds supply), surpluses of
labor (supply exceeds demand) and that current demand and future supply are in balance
(Anderson, 2004). In this phase of closing the gap, emphasis must lie on both short-term solutions
as long-term strategies. HR practices that contribute to executing strategies are training and
development and compensation and benefits. (Cotton, 2007).
After developing a gap-closing strategy the final step of the strategic workforce planning
process is the implementation and evaluation of the developed strategy (Anderson, 2004). For
successfully implementing workforce strategies several aspects are critical such as leadership,
communication between workforce team members and other employees/managers and lastly
resources that facilitate the implementation phase (Cotton 2007). After implementation, the
strategic workforce process needs to be evaluated and revised were needed (Anderson, 2004).
Figure 1 shows the strategic workforce planning process as described in the above sections.
11
Evaluation
And ongoing
process
Define
strategic
direction
Implementati
on
External and
internal scan
Supply
analysis
Gap Analysis
Demand
Analysis
Figure 1: Strategic workforce planning process
Although almost 70 % of the costs made in the healthcare sector are personnel costs,
according to the Dutch research institute for healthcare NIVEL (2011), a strategic workforce
planning process, such a described above, is missing in many healthcare organizations. In addition,
with the ageing workforce coming up and the increasing workload in the healthcare sector, a SWP
process is now more important than ever. This is because the aim of SWP is to identify current
workforce demands, determine future personnel needs, execute a gap analysis and develop and
implement gap-closing strategies. Therefore, this study investigates to what extent healthcare
organizations have applied a strategic workforce planning process based on the earlier mentioned
SWP process steps. Therefore the following sub-question is raised:
“To what extent have Dutch Healthcare organizations implemented a strategic workforce
planning process?”
12 2.2 Workforce segmentation
Lavelle (2007) argues that workforce segmentation is destined to play an important role in the
workforce planning process. Workforce segmentation is defined as identifying different roles and
skill sets in order to determine how essential they are to meet business objectives and align with
the overall strategy of the organization (Lavelle, 2007). In addition, according to the resourcebased view of the firm, organizations consist, on the one hand out of core roles that create value
and on the other hand out of peripheral roles that are value supporters (Lavelle, 2007; Boxall &
Purcell, 2011). Furthermore, Lepak and Snell (1999) stated that segmentation between
employment groups asks for different employment relationships. Thus, different groups of
employees possess different skills, vary in their employment relationship and have different levels
of importance while achieving competitive advantage (Lepak & Snell, 2002; Huselid, Beatty &
Becker, 2005; Cascio & Boudreau, 2010). Several authors have developed different approaches of identifying and analyzing the
strategic positions in the workforce (Lepak & Snell, 2002; Huselid, Beatty & Becker, 2005;
Boudreau & Ramstad, 2007; Cascio & Boudreau, 2012). Huselid, Beatty and Becker (2005) made
a distinction between three categories, namely A-, B-, and C-Positions. A-Positions are the key
positions in an organization that have direct strategic impact. Positions that have indirect strategic
impact by supporting A-positions are defined as B-Positions. The last groups are the so-called Cpositions, these are needed in the organization but have little to no strategic impact. Boudreau and
Ramstad (2007) also differentiated between employees groups whereby they made a distinction
between pivotal roles in the organization, in other words the core employees, and the non-pivotal
roles. Pivotal roles are the ones where differences in performance affect the strategic success of
the organization the most (Cascio & Boudreau, 2012).
Lepak and Snell (1999, 2007) distinguished different employees groups by means of the
“HR architectural framework”, see figure 2. This architectural framework will be used in this
study because of its clarity and the extensive research that has been done on this model. Lepak
and Snell (1999) made a distinction between four types of employee groups, whereby the
distinction has been made on the one hand to the uniqueness of the human capital and on the other
hand to the strategic importance of human capital. Human capital in the first quadrant is both
13
unique and contributes to the strategic value of the organization and therefore these employees are
considered as the “core employees” (Lepak & Snell, 1999). Organizations should invest in these
employees in terms of training and development, participation and empowerment and
compensation and benefits, this is called a commitment-oriented HR system
Secondly, there are employee groups who have strategic value but their skills and
competencies are not unique for the labor market. Thus, these employees are important in terms of
achieving business objectives but have skills that are widely transferable in the sector. In this
quadrant the focus lies more on a productivity-based relationship. In addition, organizations
should not invest in training and developing these employees but should hire them and calculate
the possibility that they might leave. Thirdly, Lepak and Snell (1999; 2007) identified that there is
human capital that has low uniqueness and does not contribute to the strategic value of the
organization. This compliance based HR relationship implies that organizations should outsource
these employees or hire these employees through temporary work agencies. Employee groups that
have on the one hand high uniqueness, but on the other hand have low strategic value are part of
quadrant four. Lepak and Snell (1999) argue that this type of human capital needs to be managed
via a collaborative HR approach. In addition organizations need to engage in alliances or
partnerships with other organizations.
The model of Lepak and Snell (1999), see figure 2, provides a guideline for identifying
four types of employment. However, this will raise the question whether in practice healthcare
organizations identify strategic positions? And in which way is this process designed? Thus, the
following sub-question is raised:
“To what extent do healthcare organizations segment their workforce and if so, in which way is
this process designed?”
14 Figure 2: HR Architecture (Lepak and Snell, 1999)
2.3 Workforce segmentation implemented in the Strategic workforce planning process
The strategic workforce planning process provides insight in the current workforce and identifies
future workforce needs to meet business objectives. Thus, on the one hand this means executing a
supply analysis in which the current supply for labor is identified and analyzed based on
qualitative and quantitative data. On the other hand, future workforce demands needs to be
estimated in terms of headcount and future needed skills. Based on the supply and demand
analysis organizations have created an overview whereby the differences are revealed in terms of
labor shortages or labor surpluses (Evers & Verhoeven (1999); Anderson, 2004; Cotton, 2007).
Huselid, Beatty and Becker (2005) argue that especially in positions that have direct strategic
impact, having the right people in the right job is important, due to the fact that in these strategic
positions high performance variability will occur. In addition, this specific group is critical for
executing the strategy of the organization (Boxall & Purcell, 2010). Thus, when an organization is
going to implement or execute a strategic workforce planning process, it is important to lay
emphasis on the jobs that are core for the organization.
For this specific group of employees, who are unique and have high strategic value,
organizations rely on a commitment-oriented HR system (Lepak & Snell, 1999). There are
commitment-oriented HR practices that need to be taken into account while executing strategic
workforce planning. When there are insufficient potentials available for closing the gap, external
15
recruitment could be a solution (Collings & Mellahi, 2009). During this process of recruitment the
focus will lie on skills, knowledge and abilities that are currently not obtainable within the
organization (Ready and Conger, 2007). Moreover, organizations need to invest in extensive
recruitment and selection for these positions in order to successfully align with the strategy of the
organization (Lepak & Snell, 1999; 2002). Besides that, training of current employees will be
another solution for preparing current employees for future work demands and filling in the
strategic positions (Huselid, Beatty & Becker, 2005). Moreover, investing in the development of
the core employees of the organization enhance the opportunity of retaining these employees (Lee
& Bruvold, 2003). In addition, training and developing employees has a positive effect on
performance (Aguinis & Kraiger, 2009).
Concluding, the strategic workforce planning process can identify possible future labor
shortages in an early phase and it is a process whereby organizations can cope with this issue.
Furthermore, segmentation of the workforce can contribute to this process by identifying the
different positions and employees in the organization. When the strategic positions are revealed,
organizations need to lay emphasis on attracting, training and retaining employees in these
positions. However, almost no research has investigated the relationship between workforce
segmentation and strategic workforce planning. Thus, it is therefore important to investigate
whether healthcare organizations use workforce segmentation in the strategic workforce planning
process. This results in the following sub-question:
“To what extent do healthcare organizations use the process of workforce segmentation in
strategic workforce planning”?
2.4 Contingency factors in the Healthcare sector
The previous sections provide an outline about the strategic workforce planning process and gave
an overview of the concept workforce segmentation. However as earlier mentioned, there is a
discrepancy in the literature whether the SWP process is a best practice (Nkomo, 1988; Anderson,
2004; Cotton, 2007; Freyens, 2010) or whether there is no one best way of strategic workforce
planning (Evers & Verhoeven, 1999; Giehl & Moss, 2009; Boxal & Purcell, 2011). Although
16 researchers argue that the design and implementation of SWP depends on internal and external
contextual variables, no study investigated which contingency factors matter in the Dutch
Healthcare sector. The aim of this study is to explore which different contextual factors might
effect or influence the strategic workforce planning process in healthcare sector organizations. In
practice, this will lead to a more custom developed SWP process that aligns with the
organizational objectives of the specific organizations. Therefore the following sub-question has
been formulated:
“Which contextual factors influence the strategic workforce planning process in the healthcare
sector?”
The following section will provide an overview of different potential factors that, according to
research (Evers & Verhoeven, 1999; Paauwe, 2004; Datta, Guthrie, & Wright, 2005; Boxall &
Purcell, 2010), have an effect on the strategic workforce planning process in organizations.
However this list of contextual factors for the Dutch healthcare sector is not exhaustive and will
be complemented during the explorative stage of the research. In addition, both possible internal
and external contextual factors will be discussed in the upcoming section.
2.4.1 External factors
According to several researchers (DiMaggio & Powell, 1983; Paauwe, 2004; Boxall and Purcell
2010), there are multiple external contingency factors that have an influence on SHRM practices
and thus on strategic workforce planning. The factors that will be taken into account are part of
the institutionalized context. The factors are intensity of competition, segmentation in the
healthcare sector and collective bargaining agreements.
Institutionalized context
The external factor that will be discussed is the institutionalized context of the healthcare sector.
The Contextually Based Human Resource Theory (Paauwe, 2004) states that organizations not
only respond to institutional settings. Institutional mechanisms, such as legislation, the role of
trade unions and the role of government influence the design of SHRM policies and practices
(DiMaggio & Powell, 1983; Veld, 2012). Regarding the institutional mechanisms in the Dutch
Healthcare sector, the sector is characterized by a specific institutional setting, namely the
combination of market processes and government regulations (Veld, 2012). In addition the Dutch
17
healthcare sector consist out of different segments. These different segments are: academic
hospitals, other hospitals, GGZ, Disabled care, Nursing and home care, other care, well-being and
social services, youth care, childcare (AZW, 2013). The segments are among other things
characterized by different levels of competition and different collective bargaining agreements
(Evers & Verhoeven, 1999). In the following section three factors will be taken into account
namely, segmentation of the Healthcare sector, intensity of competition and collective bargaining
agreements
Segmentation of the Healthcare sector
According to Boxall and Purcell (2011) it is essential for organizations to adapt to the industry
context. However, industry is a broad concept that consists out of various levels in which
differences in strategic workforce planning processes occur. These various levels are: differences
between broad sectors, differences between industries within sectors and differences within
industries across strategic groups (Boxall & Purcell, 2011). The different segments in the Dutch
healthcare sector are: academic hospitals, other hospitals, GGZ, disabled care, nursing and home
care, other care, well-being and social services, youth care, childcare (AZW, 2013).
A labor market prediction from 2013 to 2017 of the healthcare sector showed major
differences between the different segments (AZW, 2013). On the one hand there are segments that
show a slight higher demand or the same demand of personnel needs in the future, such as
hospitals and academic hospitals. On the other hand the AZW (2013) indicates that segments such
as nursing and home care sector will have a future labor surplus. Moreover the nursing and home
care sector is characterized by a low to moderate skilled workforce, since is mostly consist out of
lower skilled nurses (AZW, 2013). While, the hospital sector consists out of a higher skilled
workforce with high and specialized skills (higher skilled nurses, doctors) (AZW, 2013). Thus,
this indicates that different sectors need to apply different strategic workforce planning strategies,
because it is easier to attract low/moderate skilled workforce in comparison to a higher skilled
workforce. Giehl and Moss (2009) argue that an organization which contains mostly lower skilled
employees, such as nursing and care home sector, talent is viewed as replaceable and focus is on
anticipating on turnover and acquire low-cost talent quickly. In other words, for the nursing and
home care sector there is less need to implement strategic workforce planning, since short-term
vacancy filling and anticipating on turnover should be sufficient. However, since the hospital
18 sector relies on a higher skilled workforce with high and specialized skills, there can be assumed
that more hospitals have implemented strategic workforce planning. This will lead to the
following proposition:
Proposition 1: “Labor market characteristics specific to different segments, might influence
whether organizations have implemented a strategic workforce planning process.
Intensity of competition
Within each segment in the healthcare sector, or in the whole healthcare sector, organizations
need to maintain their position in the competitive market (Boxall & Purcell, 2011). Competition in
the industry can be fierce or weak. A competitive industry is, in contrast to a less competitive
market characterized by striving for efficiency, effectiveness, flexibility, innovativeness and speed
(Paauwe, 2004). In terms of strategic workforce planning this suggests that in markets with a high
level of competition, attracting and retaining employees who have the right knowledge, skills and
abilities is essential to adapt to the competitive market (Boxall & Purcell, 2011).
Regarding to the Dutch healthcare sector there has been a shift made from a more supply
oriented system towards a more competitive market whereby the emphasis lies on more demand
an patient-oriented care (Veld, 2012). This shift is caused by Dutch policy, which is aimed at
more marketization of the Dutch healthcare sector, with the underlying assumption of increasing
the quality, the innovative capacity and a more client-oriented focus of this sector (Maarse, 2011).
Marketization of the healthcare sector implies more competition and therefore more focus on
attracting and retaining employees who have the right knowledge, skills and abilities to achieve
competitive advantage (Boxall & Purcell, 2011). Therefore a strategic workforce planning
strategy becomes more important in the Dutch healthcare sector. In addition, this raises the
question whether organizations acknowledge this and therefore implement strategic workforce
planning due to increased competition. This will lead to the following proposition:
Proposition 2: The level of competition might influence whether Dutch Healthcare organizations
have implemented a strategic workforce planning process.
19
Collective Bargaining Agreements
Another part of the institutional mechanism is the presence of the Collective Bargaining
Agreement (CBA), the Dutch healthcare sector consist out of different CBA’s for the different
segments. However, in all of these CBA’s different HR practices (wages, employee benefits,
equal treatment, diversity) are included and pre-determined (Veld, 2012). Therefore one CBA will
be discussed in more detail, namely the CBA for general hospitals.
The CBA for general hospitals specifically focuses on attracting and retaining employees
and furthermore new agreements were made on equal treatment of employees, irrespective of their
age. For example, the exception of night and weekend shifts increased to 59 years and employees
with a pensionable age are allowed to continue work after reaching this age. These regulations are
aimed at extending the amount of available human capital for preventing future labor shortages.
This implies that institutionalization affects the composition of the workforce, which inevitably
influences the strategic workforce planning process. Therefore the following proposition is
formulated:
Proposition 3: “Collective Bargaining Agreements influence the design and implementation of
strategic workforce planning process”.
2.4.2 Internal factors
Besides external contextual factors that might influence the design of the strategic workforce
planning process, research argues that there are several internal factors that affect the SHRM
policies and practices executed in organizations (Evers & Verhoeven, 1999; Cotton, 2007). After
a review of the literature, several factors have been selected, which are: size, structure of the
organization and available resources.
Size
The headcount differs among organizations and this has an influence on how organizations should
adapt to future workforce needs (Jackson & Schuler, 1995; Evers & Verhoeven, 1999). Jackson
and Schuler (1995), argue that large organizations rely less on temporary staff, use more
sophisticated staffing, have better training and development and have a more highly developed
internal labor markets. In addition, Choudhury (2007) showed in his study of strategic workforce
20 planning in small local governments that the size of the organization increases the more formal
role of demand analysis. Thus, in smaller organizations managers believe that via an informal
process, the future personnel demand can be identified. In larger organizations, there might be
more need of a formal strategic workforce planning process. This results in the following
proposition:
Proposition 4: “The size of an organization might influence whether Dutch Healthcare
organizations have implemented a strategic workforce planning process.
Structure of the organization
Several researchers argue that the structure of the organization will have an influence on the
strategic workforce planning process (Jackson & Schuler, 1995; Evers & Verhoeven, 1999). Evers
& Verhoeven (1999) use Mintzberg (1979) five different structural configurations of an
organization to describe possible differences in strategic workforce planning; simple structure,
machine bureaucracy, professional bureaucracy, divisionalized form and adhocracy.
According to Veld (2012), traditionally, most healthcare sector organizations were
structured via the professional bureaucracy configuration. In other words this means that similar
capacities of employees are grouped in one department. For example in hospitals surgeons are in
the surgery department and nurses are in the nursing department (Veld, 2012). In this
configuration SWP focuses on long-term demand analysis and retaining talent in the organization
(Evers & Verhoeven, 1999). In addition, this configuration is characterized by high levels of task
differentiation and specialization, whereby each department wants to optimize its level of
functioning, characterize a professional bureaucracy. However, this causes difficulties of
coordination between different departments (Vos, van Oostenbrugge, Limburg, van Merode, &
Groothuis, 2009).
Currently, healthcare organizations are shifting towards more process-oriented and a
customer-focused organization. In addition, this means that organizations need to be structured in
more functional way whereby boundaries are crossed between departments and employees need to
achieve common goals with employees from other departments (Veld, 2012). When shifting to a
structure with cross-functional teams organization need to map their current human capital. In
addition, they need to identify which skills, knowledge and abilities are needed in the cross21
functional teams and build a strategy of how to close this gap. Thus, this implies that healthcare
organizations that are shifting towards a more process-oriented and customer-focused
organization have implemented and used a more general process of strategic workforce planning.
Therefore, the following propositions is formulated:
Proposition 5: “Healthcare organizations which shifted towards more cross-functional teams are
more likely to have implemented a strategic workforce planning process in comparison to other
healthcare organizations.”
Available resources
Cotton (2007), argues that an important factor for successfully implementing the strategic
workforce planning process is having the right resources available that facilitate the process.
There are several aspects of available resources that contribute to having the appropriate level of
resources. Firstly, it is important to have a strong IT system whereby workforce data is available
for managers and supervisors who are involved in the daily workforce planning. Cotton (2007)
states that having enough financial resources is the second aspect of available resources, which
facilitate the process. The last aspect is that right amount of human capital needs to be available in
the HR departments. When HR employees do not have the right skills, abilities and knowledge,
successfully implementing the workforce planning strategy is impossible (Cotton, 2007).
Therefore the following proposition is formulated:
Proposition 6: “The availability of resources might influence whether organizations have
implemented a strategic workforce planning process.
22 3. Methodology
This part of the research explains how the main research question and the sub-question were
investigated. First of all the research design and sample is described, and finally data collecting
and the analysis will be discussed.
3.1 Research design
This study was designed as a qualitative research in order to provide a deeper insight in the
strategic workforce planning processes and use of workforce segmentation by Dutch healthcare
organizations. In addition, these semi-structured interviews may determine which contextual
factors have an influence on strategic workforce planning and workforce segmentation. Because
there is almost little to no research on SWP and workforce segmentation in combination with
contextual factors, a qualitative research design was chosen. The main method of data collection
was interviewing, with 21 respondents working in seven different organizations. Because the
entire workforce will be taken into account, the level of analysis was on organizational level. In
addition, this research was conducted by a cross-sectional research method, since it only gathers
data at one point in time (Ritchie & Lewis, 2003)
3.2 Research Sample
This study focuses on different types of organizations in the healthcare sector. The interviews
were conducted with 21 respondents working at seven different organizations. Respondents for
the interviews were contacted via personal network and social media, after which an e-mail about
the content of the research was sent. Interviews were held with HR Managers, Senior Managers
and Line Managers within Dutch healthcare sector organizations. Three participants in each
organization were interviewed to create a better overview and a more in-depth understanding
about the strategic workforce planning process, segmentation of the workforce and contextual
factors influencing the SWP process. The HR managers were interviewed because SWP is part of
the HR policy. In addition, the Senior Managers were interviewed because they have an overall
view of the organization and they have a lot of knowledge about the environment of the
organization. Finally, Line Managers were interviewed to determine whether SWP is actually
executed in the organization. The composition of the sample is included in table 1.
23
Organiza
tion
Disabled care
Nursing hom
e1
Nursing
home 2
Home care
Hospital 1
Hospital 2
Ambulance
Segment
Disabled care
Nursing
care and
care home
130
HR Advisor
Hospital
No Specific
segment
3000
HR Manager
Nursing care
and care
home
950
HR Manager
Hospital
Size
Responde
nt 1
Nursing care
and care
home
300
HR Advisor
3200
HR
Manager
200
HR Manager
Responde
nt 2
Project Manager
Senior
Manager
IT manager
(Planning)
Director
Senior
Manager
Responde
nt 3
Line Manager
Line Manager
Line
Manager
Team leader
Line
Manager
4500
HR
Business
Partner
HR
Business
Partner
Team
leader IC
Director
Line Manager
Table 1: Description of research sample
3.3 Instruments
In order to explore the process of strategic workforce planning in the Dutch healthcare sector, the
degree of segmentation in the workforce and which contingency factors influence this process,
several sub-questions were presented in the theoretical framework. These sub-questions were
studied with two methods, which will be discussed in the next section.
3.3.1 Document analysis
The first research method used in this study was document analysis. While examining the sub
research questions on the process strategic workforce planning and the contextual factors,
documents provided via the site of the organization or via a respondent are studied as well. The
documents are obtained from the seven different organizations and concerned the HR policy, the
overall strategy and annual reports of the organizations.
3.3.2 Interviews
The main method used in order in order to provide a more in-depth understanding about the
research topic and gather practical data from the respondents was interviewing. The data is
conducted via semi-structured face-to-face interviews, since this technique was more applicable
compared to structured interviews due to the explorative character of this research (Ritchie &
Lewis, 2003).
24 The interview started with a short introduction about the respondent and the specific
organization that he or she works for. Thereafter, the topic of strategic workforce planning was
addressed via general questions and question about the strategic workforce planning process as a
whole. The aim of these questions is to investigate whether strategic workforce planning is
defined different in organizations. And, in addition to identify whether the organization uses a
general strategic workforce planning model and if it corresponds with the general strategic
workforce planning model as defined in the theoretical framework (Nkomo, 1988; Anderson,
2004; Cotton, 2007; Freyens, 2010). Thus, questions for example referred to the alignment with
the business strategy, supply analysis of the current workforce, demand analysis of the future
workforce and gap identification and implementing strategies.
After these questions the topic of workforce segmentation was addressed. This topic
consisted out of three subcategories, with the aim to discover if healthcare organizations segment
their workforce and how this process is designed. Questions were asked about how workforce
segmentation is defined, in what way the workforce is segmented (uniqueness, strategic value,
performance) and the process of segmenting.
The last category is about the contextual factors that may influence the strategic workforce
planning process. This category consisted out of two subcategories internal and external
contextual factors. These two subcategories were further divided into the six contextual factors
that are chosen by extensive research (Evers & Verhoeven, 1999; Paauwe, 2004; Datta, Guthrie,
& Wright, 2005; Boxall & Purcell, 2010).
3.4 Procedure
The data for the research was collected during eight weeks, whereby the semi-structured
interviews are held face-to-face within the seven healthcare organizations. The duration of the
interviews was approximately 60 minutes. All interviews were executed in Dutch, since all
respondents were Dutch. The structure of the interview was formed in the following way, firstly a
short informal conversation, followed by mentioning confidentiality and anonymity of the
respondents and a brief explanation of the research. After the interview, the conversation was
transcribed, and an analysis of the data was executed. To secure the reliability of the research,
each interview was recorded in order to prevent a possible loss of information. In addition, each
25
interview was fully transcribed and coded. Lastly, a written report of the interview has been sent
to the respondent in order to receive verification about the content of the interview 3.5 Data Analysis
All of the data with regard to the questions asked to the respondents were coded and analyzed via
a qualitative content analysis method. Qualitative content analysis is a systematic method for
summarizing interview content into specific and meaningful categories according to the rules of
coding (Stealer, 2001). As a result, a coding scheme was developed in order to categorize the
responses of the interviewees into the right category. The first step was to identify the overarching
themes and thereafter label the data. Due to the fact that the interviews were conducted in a
structured manner, the next step was coding the data. The next step was to order the data in a way
that material with similar content is organized together and finally summarize the original data.
This all has been done via a matrix-based method.
First of all, the category strategic workforce planning was analyzed and interpreted. A
precondition for determining the degree of implementation is counting the steps outlined in the
theoretical framework (one to seven). A score of zero means that none of the strategic workforce
planning processes is implemented in the healthcare organization. In addition, a score of seven
means that all the steps are implemented in the organization. Subsequently, the organizations were
ranked from one to seven. The organization that is ranked as highest, thus number one has the
highest level of strategic workforce planning. Practically, this implies that healthcare
organizations have developed a strategic workforce planning process based on external
environment, the business strategy, current supply and future demands of the organization.
Organizations that are ranked in the middle, thus as fourth or fifth are executing three or four steps
of the workforce planning process. Lastly, the organization that is ranked as seventh has most
likely not implemented a strategic workforce planning model. Besides counting the steps it is
important to analyze whether the steps of SWP are integrated with each other. Because almost
none of the organizations have implemented a SWP process, it is hard to identify whether
healthcare organizations have integrated the SWP steps with each other. Therefore, counting the
steps will give an indication of the level of SWP.
26 Workforce segmentation is the second category that was coded and analyzed. Again a
matrix-based overview was created in order to analyze and interpreted the data. Firstly on the
vertical axis the organizations were ranked from a one to seven based on the earlier analysis about
strategic workforce planning. The horizontal axis consisted out of the different subcategories and
subdivisions of workforce segmentation (e.g. Function, Performance, Uniqueness). Subsequently,
an overview was created whereby analysis and interpretation has been done about if organizations
segment their workforce and how this process is designed. Finally, the matrix provides an
overview, whether workforce segmentation is applied more in organizations with a high degree of
SWP implementation than organizations with a low degree of SWP.
The last category consists of the contextual factors in the healthcare sector. The contextual
factors were analyzed by creating a matrix-based overview of each contingency factor. On the
vertical axis the organizations were ranked based on the ranking in the strategic workforce
planning analysis. The horizontal axis consisted out of the specific contextual factors. In addition,
there was no general way of analyzing the contingency factors. For example, the contingency
factor size was analyzed in the following way: In the table, the organizations are grouped based on
size, allowing data interpretation. Thereafter, an overview was created of which contextual factors
influences the SWP process in specific the healthcare organizations according to respondents.
Based on this overview, the answers were interpreted and compared to each other.
The qualitative content analysis should provide an overview of the different strategic workforce
planning processes used in practice and should give insight segmenting the workforce in
organizations. In addition, the first two main categories should provide an in-depth understanding
whether organizations implement workforce segmentation in the strategic workforce process and
what the purpose is of this. Finally the last main category will provide enough information for
answering the last sub-question. Whereby subsequently when combining all analysis the main
research question can be answered. 27
28 4. Results
This section will provide an overview of the results gained from the qualitative analysis of the
interviews. The results are based on 21 interviews, whereby in this section evidence will be
showed via direct quotes from the participants. Firstly, a short description of all the organizations
will be given; thereafter each sub-question will be analyzed.
4.1 Description of the cases
The sample consists out of seven Dutch healthcare organizations and all organizations operate in
the non-profit sector. In the first organization, people that have a mental, physical or psychosocial
are the core business of the organization. In their 10 institutions they provide complete care for
disabled people. The organizations in this case will be referred to as “Disabled care”. The second
organization is provider of responsible and suitable ambulance care for every potential patient. In
the following sections the organization will be referred to as “Ambulance”. The third organization
is a large top clinical hospital with high ambitions. The organization is known for their
specialisms neurosurgery and radiosurgery. The organization will be further named “Hospital 1”.
The fourth organization is a hospital founded through a merger in 2001. Their mission is to deliver
accessible, efficient and safe basic and top clinical care of the highest quality. From now on the
organization will be called “hospital 2”. The fifth organization is a former nursing home for nuns.
Nowadays it is a small nursing and care home in which living and working from a Christian
perspective, stands central. The organization in this case will be referred to as “Nursing home 1”.
The sixth organization is also operating in the nursing and care home segment. Their core
business is housing with care, nursing and home care and home care in small scale care
environments. The organization will be further named “Nursing home 2”. The final organization
is a small home care organization that wants to deliver quality care to clients in an environment
where their client feels comfortable. In the following sections the organizations will be referred to
as “Home care”.
4.2 Strategic workforce planning process
In the first paragraph the first sub-question: “To what extent does the strategic workforce planning
process of healthcare organizations correspond with the general strategic workforce planning
29
process?” will be analyzed. To provide an answer on this sub-question, the level of strategic
workforce planning within an organization will be measured based on the characteristics
described in the theoretical framework. The characteristics that are used are: firstly the strategic
direction and link with strategy, secondly an internal and external scan, thirdly a supply analysis,
fourthly a demand analysis, fifth the gap analysis, sixth the actual action and lastly the evaluation
of SWP and SWP as an ongoing process phase. When organizations meet the characteristics of a
criteria 1 point is assigned. However, due to the fact the it is sometimes not clear whether
organization meet the full criteria for an entire phase, 0,5 points are assigned to organizations who
have implemented parts of the phase.
The first characteristic that will be analyzed is the strategic direction and the link between
workforce planning and the organizational strategy. One organization, Home care, mentioned that
due to the fact that they are small and relatively young they have not defined their strategic
direction. Hospital 1, Hospital 2, Nursing home 1 and Nursing home 2, Ambulance and Disabled
care indicated that they have determined the strategic direction of the organization. However,
almost no organization has aligned the strategy of the organization with SWP. Only Disabled care
and Ambulance stated clearly that their workforce planning process is in line with their strategy.
“The HR policy is in line with the strategy of the organization. The strategy says that we have to
prepare for budget cuts and that we have to switch to another target group. This means that the
requirements for personnel will change and in addition you have discover what is the new target
group and what kind of competencies do you need. “This means that you have to link your
strategy with strategic workforce planning” (Senior Manager, Disabled care).
The internal and external scan of the environment is the second characteristic that is
analyzed. Hospital 2 and Nursing home 2 argue that you have to take in to account the
environment and you have to assess the value of environmental changes. “We do look at the
environment and external factors, however it is hard to assess the value of it. We take it into
account and take it seriously, but I have to keep in mind that in the past decade the environmental
predictions were not right” (HR Manager, Nursing home 2). Home care and Nursing home 1
mentioned that they take in to account the environment. However, according to these
organizations the labor market is loose and therefore they do not anticipate on the environment.
30 “We do look at the environment, however, at the moment we do not experience problems in terms
of recruiting personnel. Therefore, for our organization the environment is not extremely relevant”
(Senior Manager, Nursing home 1). Furthermore, Hospital 2, Nursing home 1, Nursing home 2
and Home care mention that they do look at the environment but do not actively cope with it.
However on the contrary, Disabled care, Ambulance and Hospital 1 mentioned that in terms of
SWP anticipating on the environment is important. “You have to make sure that you can
anticipate on the environment in terms of your personnel”(HR Manager, Ambulance). Thus, these
organizations take into account the environment and possible changes and they cope with these
changes. “ We made a scenario based on four different angles; the developments in the healthcare
sector, the financial scenario, the internal and external labor market and the strategy of the
organization. Based on this scenario we have insight in possible changes and we can coop with
these changes.” (HR Manager, Disabled care). Overall, every organization and all of the
respondents explained that it is important to take into account the environment and the changes in
the healthcare sector.
Supply analysis is the next characteristic that is studied. This third step in the SWP process
is partially executed by all organizations. All healthcare organizations mention that they know the
inflow, through flow and outflow of the whole organization “We strongly monitor on the inflow,
through flow and outflow of the entire workforce. Furthermore each Line Manager is responsible
for his or her department. Each year the manager develops a policy for their department. This
plan also includes the determined guidelines for the workforce and possible changes in the
workforce. This will be monitored and will be discussed during the monthly meeting” (HR
Business Partner, Hospital 2). Disabled care, Ambulance and Hospital 1 are going even one step
further and have performed a people review whereby they mapped the competencies and skills of
the workforce and identified the stars of the organization and the under performers “We have a
good overview of the inflow, through flow and outflow of all people in de upcoming five years. In
addition, a half year ago we did a people review. Who are the talented people in the organization
and who are not? We want to make a distinction between talents and underperformers. We want
to encourage people to develop themselves through training” (HR Manager, Ambulance).
31
Identifying the future needed demand of the workforce is the fourth step in the SWP
process. Not all organizations that have met the criteria for the supply analysis phase have
executed a demand analysis. Hospital 2, Nursing home 2 mentioned the uncertainty in the
healthcare sector as a reason for not executing a demand analysis “The question is whether this is
possible for this kind of organization. It is a systematic approach, while you can question if you
can forecast and plan everything. A hospital is an extremely complex organization with various
stakeholders who influence the development of a hospital (politics, health insurance companies,
the law). Thus, it is very complicated to predict how does the organization look like in two years
and what kind of demand of employees there will be” (HR Business Partner 1, Hospital 2).
However, in contrast Disabled care and Ambulance mentioned that the reason they executed an
entire SWP process including a demand analysis was due to the uncertain environment “We
implemented SWP because in the sectors we operate there are many environmental changes that
we need to adapt to (..). You almost know for sure this has consequences for your personnel
formation. In addition this means that employees will need other competencies. And you can wait
until it happens to you and then react. Or you can anticipate and that is de goal of strategic
workforce planning” (HR Manager, Disabled care).
The fifth step in the SWP process is the gap analysis. For almost all organizations this is
an inevitable step due to economic crisis en the changes in the healthcare sector. However since
almost all organizations do not have implemented an actual SWP process (only Disabled care),
they lay emphasis on the quantitative part of workforce planning. Nursing home 1, Disabled care,
Nursing home 2 and Hospital 1 mention that they have to deal with labor surpluses “I am worried
about how do I get to keep my personnel. The personnel wants to stay here but due to new
government policies we have less clients and this causes labor surpluses” (Line Manager,
Nursing home 1). Besides a quantitative gap, Hospital 2, Disabled care and Ambulance mentioned
that there is a gap between currently available skills en competencies of employees and future
needed skills. “In the Healthcare sector there will be a shift towards more HBO level nurses
instead of MBO level Nurses. This means that in the future I expect that there is going to be
shortages of HBO educated nurses and on the other side surpluses of MBO level nurses. This
transition phase that will be our biggest challenge” (HR Business Partner 2, Hospital 2)
32 The next step is developing an action plan and implementation of the action plan. One
solution mentioned by Hospital 1, Hospital 2, Disabled care, Nursing home 1 and Nursing home 2
is creating more flexibility. This can be done in the organization it self by working in different
departments. “Due to governmental measures, my department needs less personnel. It is important
to create flexibility and work together with other teams within the organization. This means that
someone has to work in another team and in that way can keep his or her job. However at the
moment, employees still only work in their own team” (Nursing home 1, Line Manager). However
all these organization mention creating flexibility as a possible solution, only Hospital 1 and
Disabled care are currently implementing an action plan which provides more flexibility. “When I
first arrived here as manager my department consisted out of sub-departments that did not
cooperated at all. If one sub-department had a labor surplus and the other one had shortages it
was not discussable to help-out in the sub-department with shortages. This is such an economic
loss. Thus, I decided to let people work on both sub-departments and created organizational
efficiency” (Line Manager, Hospital 1). One other way that was mentioned by Ambulance is
creating a network organization whereby people are working in two different organizations. “My
vision is to create an organization with more “Ketenaanstellingen1” and create an organization
whereby I can place employees. “Ketenaanstellingen” will create more dual-jobs and thus the
organization becomes more flexible” (Director, Ambulance). Besides the organizations that have
an action plan or some form of an action plan, Nursing home 2 and Home care do not have any
form of an action plan. In the case of Nursing home 2 there was a discrepancy in answers between
the respondents. On the one hand the HR Manager stated that they actually are busy with
implementing SWP, executing a gap Analysis and subsequently developing an action plan. On the
other hand the Line Manager did not mention any of the aspects of SWP and the IT Manager
(planner) even stated that they only just plan personnel in terms of quantity.
The last step in the SWP process that will be analyzed is the evaluation of SWP and SWP
as an ongoing process phase. Almost no organization evaluated the strategic workforce planning
process as a whole. The underlying reason for this is that most organizations do not have an actual
1
“Ketenaanstellingen”: care provided by different health professionals and costumed to a patient with specific needs. 33
SWP process implemented but just executed several steps of the SWP process. The one
organization that actually had implemented SWP mentioned that evaluation of SWP and SWP as
an ongoing process was an important aspect of the whole process. “We have to secure the
strategic workforce planning process, this means that we are going to revise the process on a
yearly basis and change action plans when needed” (HR Manager, Disabled care). Furthermore
four organizations, Disabled care, Ambulance Hospital 1 and hospital 2 mentioned that they take
into account workforce planning on the long run (3 to 5 years) and adapt when necessary. “We
use a timeframe of three to five years regarding workforce planning and we adapt when needed”
(HR Manager, Ambulance).
After evaluating every step it is important to take in to account whether the steps are
integrated with each other. Because almost no organization implemented SWP it is hard to
determine which organizations have integrated the SWP of SWP with each other. Disabled care is
the only organization that developed a SWP process and integrated all the steps in the process
with each other. “They are in fact logical steps that are put in a systematic way and are integrated
with each other. In this way you can control a very complicated process” (HR manager, Disabled
care). For the rest of the organizations there can be concluded that the amount of steps is an
indication for the degree of implementation.
Based on the analysis there can be concluded that each organization execute several steps
of the SWP process. Remarkably, only Disabled care mentioned during the interviews that they
had implemented an actual SWP process. In addition, the other organizations mentioned that there
was not a general process for the whole organizations but only some of the characteristics of SWP
were implemented in the whole organization or in several departments. As seen in table 2 only
Disabled care meets the criteria of the SWP process as a whole. The respondents of Disabled care
mentioned that they made a transition from workforce planning to strategic workforce planning.
In addition, only one other organization, Ambulance, scores relatively high on the level of
implementation of SWP and is second in the ranking. Hospital 1 scores 5 points and is third in the
ranking, fourth is Hospital 2 with 3,5 points. Fifth is Nursing home 1 with 3.5 points, Nursing
home 2 is has a sixth place in the ranking and lastly Home care with only one point. A complete
can be seen in table 2.
34 Disabled care
Ambulance
Hospital 1
Hospital 2
Nursing
Home 1
Nursing
Home 2
Home care
Strategic
direction &
link with
strategy (SWP
1.1)
1
1
0,5
0,5
0,5
External &
internal
scan
(SWP 1.2)
Supply
analysis
(SWP 1.3)
Demand
analysis
(SWP 1.4)
Gap
analysis
(SWP 1.5)
Action
(SWP
1.6)
Evaluation
& ongoing
process
(SWP 1.7)
Total
1
1
1
0,5
0,5
1
1
1
0,5
0,5
1
1
1
0,5
0,5
1
1
0,5
0,5
0,5
1
0,5
0,5
0,5
0,5
1
0,5
0,5
0,5
0
7
6
5
3,5
3
0,5
0,5
0,5
0
0
0
0
1,5
0
0,5
0,5
0
0
0
0
1
Table 2: Strategic workforce planning
Overall Disabled care, the highest ranked organization, distinguished itself from the six
other organizations because it actually implements a SWP process. In addition the organization
not only focuses on the quantitative aspects of workforce planning but also lays emphasize on the
quantitative aspects of strategic workforce planning. Furthermore it was the only organization that
actually made an action plan and took action.
Best Practice case – Disabled Care
Because Disabled care is the only organization that implemented a SWP process; it is interesting
to outline the motives why they implemented SWP and to describe their SWP process as a best
practice. Information of the motives and the SWP process of Disabled care are gathered through
interviews and document analysis. One of the main motives to implement SWP according to
Disabled care is that SWP is an instrument that provides an answer to, how many and which
employees are needed in the organization. In addition, it provides an answer to how Disabled care
can anticipate on the variations between the demand for care and the cost reductions that the
organizations have to deal with. Besides the main motives, the organization wants to achieve
several goals while implementing SWP. The goals are: learning experience, more insights in the
gap between current personnel and future personnel needs, designing a strategic policy in which
the inflow, through-flow and outflow of personnel can be aligned with future organizational needs
(recruitment, selection, training, flexibility), Workforce in terms of numbers, quality, cost and
flexibility meets the future needs and prevent that the organization can not sufficiently achieve the
35
planned objectives and activities.
After formulating the motives and goals of the tool SWP, Disabled care started
implementing SWP. While implementing SWP, Disabled care received support from the
organization “Zorg aan Zet”; an organization that actively supports organizations while they
implement SWP. The first step was composing a multidisciplinary project group (Financial
manager, HR manager, Line Manager, Directors and intern and external project leaders) and
formulating a project plan. The second step is the HR-Quickscan, in this step a “photo” is taken of
the current personnel formation and in addition the gathered data was analyzed. In the third step
possible scenarios of the organization in the future were linked to the future needed workforce.
Different aspects were taken into account for creating these scenarios, the scenario’s that were
included are: healthcare related scenarios, financial scenarios, personnel scenarios (including the
labor market) and the strategic direction of the organization. Because Disabled care consists of
multiple work foundations, three scenario’s (worst, middle and best case) are developed for every
work foundation The fourth step is the gap analysis phase (for every work foundation), in which a
comparison is made between current and future workforce according to quality, quantity, costs
and flexibility (employment relations). Finally HR policy priorities are formulated, these will
contribute to the achievement of the desired and required target information. This process will be
repeated every year.
Implementing SWP has led to several important results for Disabled care. For Disabled
care the advantage of this structured approach is that the organization can anticipate on the future
predictions of specific personnel shortages or surpluses and can undertake action in a timely
manner. In this way Disabled care can prevent a crisis. In addition, implementing SWP has
resulted in an organization wide personnel-planning system. In other words, personnel surpluses
in one work foundation can be prevented by transferring employees to a work foundation with
personnel shortages and this creates more flexibility for the organization. Finally, SWP gave
Disabled care insight into the amount of different functions in the organization. It turned out that
Disabled care had more than six hundred different functions in the organization. SWP has helped
Disabled care to reduce this to eighty different functions spread over a limited number of job
36 families. This also resulted in better recruitment and selection and training and development
policies.
4.3 Workforce segmentation
Now that there has been determined to what extent healthcare organizations implement strategic
workforce planning, the analysis will continue with workforce segmentation. This will be done on
several aspects, firstly there will be examined whether organizations made a distinction based on
function. After that segmentation based on performance will be take in to account and finally
segmentation based on strategic value will be taken into account.
Firstly, all organizations mention that they segment their workforce based on the job
functions in the organization. In all organizations the main characteristic of this segmentation is
difference in salary between functions. Furthermore, Nursing home 1, Hospital 1 and Hospital 2
mentioned that this segmentation is also characterized by giving more attention towards function
and employees whose jobs are scarcer. “It is hard to attract nurses for the elderly care (MBO
level 4). We pay extra attention to these employees. We have chosen to involve the elderly care
nurses in the total education program. This means that the elderly care nurses are going to teach
the care employees (MBO level 2 or 3) new nursing techniques. The nurses went to school to get a
training of becoming a trainer and they really liked it” (Senior Manager, Nursing home 1).
Secondly, segmentation based on performance will be taken in to account. Almost all HR
Managers and HR advisors of the seven healthcare organizations (except Home care) stated that
on organizational level they do not segment their workforce based on the characteristic
performance. The main reason for not segmenting their workforce on organizational level is that
they do not have insight in the qualities and competencies of all employees. However, the linemanagers of Ambulance, Disabled care and Hospital 1 and the HR-advisor of Home care mention
that they do have insight in the capabilities and qualities of their employees in their team “Every
team manager knows exactly how each individual employee of his or her department functions”
(Line Manager, Ambulance). The managers of Ambulance, Home Care, and Hospital 1 state that
due to the fact that they know their people they make a distinction between groups of employees
based on performance. In these organizations segmentation do finds place on team level “Yes, we
do make a distinction between different groups of employees. For example in every team we have
37
a health coordinator. Some people out perform others and they will receive extra attention in
terms of career opportunities and receive a bonus on top of their monthly salary” (Home care,
HR advisor). On the question how managers know which employees perform better than other
employees organizations gave two types of answers. On the one hand Home care and Hospital 1
do not have an objective performance system and stated “you just know” and that it is “gut
feeling”. Thus this implies that there is no objective performance system. On the other hand
Ambulance does have a performance measurement system whereby employees annually will be
reviewed “We developed a dashboard and a review form based on our core competencies.
Employees are rated via the ‘traffic light’ method. When employees have many green lights, you
can say oh this is a well performing employee. When there are many orange or red lights, this is a
sign that employees need to develop some competencies or skills” (Director, Ambulance).
Besides making a distinction between employees based on performance, the respondents
were asked whether they segment their workforce according to strategic value. Only the HR
manager of Hospital 1 mentioned that regarding workforce planning they pay extra attention to
those positions that are aligned with the strategy of the organizations. In addition, this hospital is
specialized in two medical areas and thus they pay some extra attention to the workforce.
Important focus points of our organization are trauma and neurosurgery (..). Of course there are
huge demands in terms of education and training for these employees. In addition you need to
have a lot of well-educated and trained personnel for the department trauma. Thus, you can say
that some extra attention is given this part of the workforce” (HR manager, Hospital 1). The other
organizations mentioned that they do not segment their workforce according to strategic value
“We do not have a model for distinguishing different strategic groups and talents who get more
attention and participate in a development track. This is very difficult to implement due to the fact
that differentiating between employees is a taboo in the healthcare sector (HR Business Partner 1,
Hospital 2)”.
When combining the three different aspects of segmentation, the analysis shows that all
organizations lay the most emphasize on the scarcity of employees. In addition some pay attention
to the performance and only one organization mentioned segmentation based on strategic value.
Furthermore, one other main result is that the analysis shows that on organizational level most
organizations do not segment between employees. Segmentation often takes place on
38 department level and is based on performance or scarcity. Although this analysis shows that
workforce segmentation in the healthcare sector is limited, Nursing home 1, Nursing home 2 and
Hospital 2 mention that it is something that needs to be on the agenda. “No, we do not segment
our workforce, because we do not have enough insight in the capabilities of employees. However
this year, we laid the infrastructure for the future to map which employees and which positions
are important for the organization” (HR Business Partner 2, Hospital 2).
4.4 Workforce segmentation implemented in the Strategic workforce planning process
In the following paragraph the purpose of implementing workforce segmentation in the strategic
workforce planning process will be discussed. This section will be analyzed based on several
aspects of workforce segmentation; function, performance, strategic value.
Regarding workforce planning only Nursing home 2 mentioned that they segment their
workforce based on function. More specially, managers of these organizations stated that
regarding workforce planning attention needs to be paid to the “direct” employees who are
working with the client. “Workforce planning is most important for the primary process,
healthcare, because most of our employees work there and it is pivotal for our organization” (HR
Manager, Nursing home 2). Besides paying extra attention to the “direct” employees of the
workforce only Hospital 2 mentioned that workforce planning is more important for function in
which they expect labor shortages or these employees are scarcer. This means that when functions
are scarce the organizations pay more attention to selection and recruitment and training and
development. “Workforce planning is important for every function. However, when employees for
a function are more scarce, this will be come more a priority and you will pay more attention to it”
(HR Business Partner 1, Hospital 2). The other organizations did not mention explicitly that they
segment their workforce based on function. However, all organizations mentioned that in terms of
workforce planning it is essential to have enough employees of each function. This suggests that it
is necessary to segment the workforce based on function.
Regarding segmentation based on performance in combination with strategic workforce
planning none of the organizations stated that segmenting based on performance has an influence
on the workforce planning process. Hospital 2, Nursing home 2 gave as main reason that they do
not have insight into the competencies and performance of employees. “On organizational level
39
we do not have systems for rating performance and the competencies of employees. Personally I
think that this is impossible for 4500 employees” (HR Business Partner 1, Hospital 2). The Line
Managers of the other organizations mentioned that all employees are considered to be
functioning on a minimal level “Everybody in this department is the same and has the same level
of education and thus we expect a minimal level of performance. Therefore we do not make a
distinction in terms of workforce planning” (Line Manager, Hospital 2). Thus, this implies that
performance is not taken into account while executing strategic workforce planning.
Lastly, the analysis of segmentation of the workforce based on strategic value showed that
only Hospital 1 mentioned that they segment their workforce based on strategic value. However
this organization argued that, regarding strategic workforce planning, they do not segment their
workforce based on strategic value. Therefore, there can be concluded that none of the
organizations segment their workforce based on performance while executing strategic workforce
planning.
In conclusion, the data show that, besides function, almost none of the organizations
segment their workforce for (strategic) workforce planning. The main reason for this is because
none of the organizations has a model for workforce segmentation. In addition, only one
organization has implemented strategic workforce planning as a process.
4.5 Contextual factors
The last section will analyze which contextual factors influence the strategic workforce planning
process in the healthcare sector. To provide an answer, the six contextual factors that are
described in the theoretical framework will be discussed one by one. Besides these contextual
factors, other possible contextual factors that the respondents mentioned will be outlined as well.
4.5.1 External factors
Segmentation of the healthcare sector
The first contextual factor that possibly could have an influence on the SWP process is the
segment in which the healthcare organization operates. According to Research program ‘labor
market health and social care’ (AZW, 2013), the healthcare sector consists out of eight different
40 segments. The seven participating organizations can be classified in four of the segments. Firstly,
Disabled care is classified in the Disabled care segment. Secondly, Nursing Home 1, Nursing
Home 2 and Home Care are part of the Nursing care and home care segment. Thirdly, Hospital 1
and Hospital 2 are classified in the Hospital segment. Lastly, since it is not obvious in which
segment Ambulance is operating, Ambulance is classified in the other care segment. Proposition
one proposed that segmentation might influence whether organizations have implemented a
strategic workforce planning process. In the theoretical framework only the nursing care and
home care and the hospital sector were taken into account. Because Ambulance and Disabled care
are classified in the other care segment and Disabled care segment these segments will also be
taken into account. Table 4 shows that organizations operating in the Nursing and home Care
segment all have a low ranking on SWP. In comparison, the two hospitals are ranked in third and
fourth place. This means that both hospitals have implemented more steps of strategic workforce
planning than the Nursing and home care segment. In addition, the organizations in the Disabled
care sector and the other care sector are ranked as highest in the strategic workforce planning
process. Based on this data it can be concluded that, there is some evidence that segmentation
might have an influence whether organizations have implemented a strategic workforce planning
process and therefore proposition 1 is confirmed.
Organization
Sector
Ranking in
Disabled
Nursing
Nursing
Care
home 1
home 2
Disabled
Nursing care
care
1
Home care
Hospital 1
Hospital 2
Ambulance
Nursing care
Nursing care
Hospital
Hospital
Other
and care
and care
and care
home
home
home
5
6
7
3
4
2
terms of SWP
Table 3: Segmentation of the healthcare sector
Intensity of competition
Most of the organizations mentioned that nowadays, the healthcare market shifted towards more
competition “Currently there are many care homes, we have many competitors in the healthcare
sector” (HR Manager, Disabled care). Most organizations operate in a market with some form of
41
competition. Disabled care, Nursing home 2 and Home care stated that competition in their sector
is high. The main reason for this is that there are many competitors active in their region. Hospital
1 and 2 stated that in in general the competition in their sector is moderate. This is mainly because
often people choose the hospital closest to their home, only in some expertise’s people
deliberately choose a specific hospital. The two organizations, Ambulance and Nursing home 1,
which stated that they do not experience competition mentioned that this is due to special
circumstances; they are both operating in a niche market. Even though, Nursing home 2 and
Home care mention that they experience a high level of competition, they have the lowest ranking
in the SWP process. But Nursing home 2 together with the all the other organizations argued that
SWP needs to be put on the strategic agenda due to the increased competition. In addition, the
only organization that implemented an actual SWP process, Disabled care, mentioned increased
competition as one the reasons for shifting towards SWP. Due to the fact that almost none of the
organizations has implemented SWP proposition two is rejected. Although, this proposition is
rejected many organizations mentioned that organizations are becoming more aware of the
necessity of a SWP process due to increased competition.
Organization
Disabled
Nursing
Home
Hospital 1
Hospital 2
Ambulance
care
home 2
care
Competition
High
High
High
Moderate
Moderate
Low
Ranking in
1
6
7
3
4
2
Nursing
home 1
Low
5
terms of SWP
Table 4: Intensity of competition
Collective bargaining agreements
The third contextual factor that will be analyzed is the influence of collective bargaining
agreements on strategic workforce planning. Every organization stated that collective bargaining
agreements have an impact on workforce planning. “The collective bargaining agreement has a
major impact on workforce planning. We are affiliated with a standard agreement which means
that we can not deviate from the standard collective bargaining agreement”(Line Manager,
Ambulance). In addition all organizations mentioned that the bargaining agreement has negative
42 consequences for workforce planning in terms of flexibility. “At the moment we can not hire
employees with a 0-hours contract. You have to hire people as a temporary employee and
therefore you become less flexible” (Line Manager, Nursing home 1). Regarding long-term
workforce planning, almost every organization stated that due to collective bargaining agreements
the organization becomes less flexible. This is due to the fact that one the hand in the healthcare
sector fixed contracts is the norm. “The basic principle of the collective bargaining agreement is
that employees have a fixed contract. However these days this is almost impossible because it is
hard to forecast what is going to happen next year in the healthcare sector regarding
employees”(HR Manager, Nursing home 2). On the other hand due to ‘social plans’ it is difficult
to fire employees “We had a horrible social plan which made it almost impossible to fire
somebody” (Line Manager, Hospital 2). These examples of rules in the collective bargaining
agreements and all the other rules which have to be taken into account, makes (strategic)
workforce planning for organizations complex. Therefore, it can be concluded that collective
bargaining agreements have an influence on strategic workforce planning and thus proposition 3 is
confirmed.
4.5.2 Internal factors
Size and Structure
This section provides an answer to the fourth and fifth propositions about whether size and
structure have an influence on the degree of strategic workforce planning. Table 5 shows the level
of SWP, the size and the structure of the organizations. The organizations are categorized from
largest to smallest organizations in terms of personnel. Below the size of the organization the
ranking in terms of SWP is showed. The largest organization is ranked as fourth while the
smallest organization is ranked on the last place. As seen in Table 5, the three largest
organizations are ranked in the top four. Only one small organization, Ambulance, is ranked high
regarding the strategic workforce planning process. This implies that there is a tendency that the
size of the organization might influence whether organizations have implemented SWP or not.
Therefore, proposition four is confirmed.
Besides size, this study analyzes whether the structure of the organization has an influence
on strategic workforce planning. The proposition stated that organizations that shifted towards a
43
more customer-oriented structure are more likely to implement SWP. The structure of each
organization has been analyzed via documents available on the site of the organization. The
structure had been determined via the organogram available on the site of the organization. In
addition, several questions had been asked during the interviews about the structure of the
organizations. The analysis shows that the four largest organizations have a divisional structure
and the three smaller organizations have a functional structure. Although none of the
organizations made a transition towards a more customer oriented structure, the interviews give
some evidence that this might change in the near future. “Currently, in the Dutch healthcare
sector several organizations made a shift towards a more customer focused organizations and the
trend is that more healthcare organizations will follow. This will have consequences for
workforce planning. This means, that the competencies that an employee needs to have to function
are changing and there employees need training to close this gap” (HR Business Partner 2,
Hospital 2). Furthermore, ambulance mentioned the importance of customers and that
competencies need to be aligned with the customer demands. Thus, although proposition five is
not confirmed these changes towards a more customer-focused organizations might be an
incentive for organizations to apply SWP. In addition, because there is hardly any variety between
the structures of the organizations it is not possible to draw a conclusion whether there is a
tendency that structure influences the degree of implementation of SWP
Organization
Hospital 2
Hospital 1
Disabled
Nursing
Nursing
Care
Home 2
Home 1
Ambulance
Home care
Size
4500
3200
3000
950
300
200
130
Structure
Divisional
Divisional
Divisional
Divisional
Functional
Functional
Functional
Ranking in
4
3
1
6
5
2
7
terms of SWP
Table 5: Size and Structure
Available resources
In this section the last contingency factor, available resources, will be analyzed. Proposition 6
proposed that the availability of resources might influence whether organizations have
44 implemented a strategic workforce planning process. For the analysis, available resources will be
taken into account according to three aspects namely, IT Systems, financial resources and human
capital within the HR department. First of all, every organization, except Nursing home 2,
mentioned that a useful IT system is important for workforce planning. Disabled care, the only
organization that actually implemented SWP, argued that IT plays a role in SWP. “You need a
calculation tool, because otherwise you can not implement strategic workforce planning. However
you need to take into account that an IT system is only a tool” (HR Manager, Disabled care).
Secondly, financial resources will be taken into account. Ambulance, Hospital 2, Disabled
care and Nursing home 1 stated that workforce planning depends on the available financial
resources. “Financial resources are important for workforce planning in terms of career
development and training” (HR Manager, Nursing home 1). Furthermore Disabled Care
mentioned that the process of changing from workforce planning tot strategic workforce planning
costs money in terms of an internal and external consultant. “We had one full time internal
consultant and one external consultant for implementing SWP” (Senior Manager, Disabled care).
Of the three other organizations, Home Care, Hospital 1, did not mention financial resources as an
aspect in strategic workforce planning. The last organization, Nursing home 1, argued that
financial resources does not play a role in SWP because it is not expensive.
Finally, human capital as a resource will be analyzed. On the question which resources
play an important aspect in strategic workforce planning Disabled care, Ambulance, Hospital 1,
Hospital 2, Nursing home 2 mentioned role of human capital of the HR department. The five
organizations confirmed that in order to implement SWP the overall capacity in the HR
department is important. For example, Nursing home 2 mentioned that due to the fact that they
only have one HR employee it is impossible to implement something a SWP, since it is an
enormous process. In addition, Disabled care assigned a project manager for implementing SWP,
due to the fact that the implementation is a time demanding process. Therefore, there can be
assumed that the availability of human capital in the HR department is a pre condition for
implementing SWP.
45
In conclusion, these results imply that the availability of IT systems, financial resources
and human capital play a role in the degree of implementing SWP. This can be concluded due to
the fact that five organizations mentioned that IT is a tool that supports the strategic workforce
planning process. Furthermore the two highest ranked organizations (Disabled care and
Ambulance), together with Hospital 2 and Nursing home 2 argue that financial resources have an
influence in successfully implementing SWP. And lastly, five organizations mentioned that the
human capital in the HR department is essential for implementing strategic workforce planning.
Thus, combining the data of these three aspects, proposition 6 can be confirmed.
4.5.4 Other Contingency factors
Besides analyzing the six-abovementioned contingency factors the aim of this research was to find
other factors that possible could have an influence on strategic workforce planning. There is only
one factor that is repeatedly mentioned by several organizations that possibly could have an
influence on strategic workforce planning. Nursing home 1, Disabled care and Hospital 2 argued
that demographical factors could have an influence on SWP. “Everything depends on what
influences the demand for personnel. This depends on which care do the patients need and the
need for care in the region. Demographical factors influence this. How does the population of the
city looks like, what kind of diseases are there and what do we need to offer in the next few years”
(HR Business Partner 1, Hospital 2). This implies that when for example the demographical
characteristics of region A differ from region B this has an influence on SWP. Although several
respondents mention this as a contingency factor, there research does have right data to investigate
this statement.
46 5. Conclusion
The aim of this research was to answer the main research question: “Which contingency factors
influence the strategic workforce planning process in the Dutch healthcare sector and does
workforce segmentation play a role in the strategic workforce planning process?” To answer this
question several sub-questions and propositions are formulated. This section will firstly discuss
the first sub-question about strategic workforce planning extensively since this sub-question led to
the most important results. Thereafter the concepts workforce segmentation and contingency
factors will be discussed.
Strategic workforce planning: In order to identify how the strategic workforce planning
process is implemented in the healthcare sector, respondents were asked about the dimensions of
the SWP process. Based on these questions the healthcare organizations were ranked from one to
seven based on the level of SWP. Based on the analysis only one organization has implemented a
strategic workforce planning process. Of the other six organizations two meet most of the
characteristics of SWP, while four organizations meet a few to almost no criteria of SWP.
Regarding the seven steps of SWP, the analysis shows that most organizations implemented (to
some extent) the first four steps of SWP. In addition, almost none of the organizations
implemented (to some extent) the last three steps of SWP. This means that every step (table 2) of
the implementation of SWP is less likely to be implemented by organizations. Due to the fact that
almost no organization has implemented SWP, it is difficult to determine how the strategic
workforce planning process is designed in the healthcare sector. In general, regarding the first
sub-question, the overall conclusion is that only one organization meets all the characteristics of
SWP and that the other six organizations meet some of the criteria.
Workforce segmentation: The second sub-question is related to the level of segmenting
the workforce and how this process is designed. In general there was found that none of the
organizations used a specific process for workforce segmentation. However, all organizations
stated that they segmented their workforce based on job functions causing differences in salary
between the different functions. In addition, another result of this study is that some organizations
segment their workforce based on performance. However, in these healthcare organizations
segmentation based on performance does not occur on organizational level but on the level of the
47
Line Manager. Lastly, based on the analysis only healthcare organization segment their workforce
based on strategic value.
Workforce segmentation implemented in SWP: The purpose of the third sub-question is
to investigate to what extent organizations use the process of workforce segmentation in strategic
workforce planning. This study showed that organizations segment their workforce based on
function and gave more attention to some of the functions in the SWP process. Furthermore, the
analysis showed that none of the organizations segment their workforce based on performance or
strategic value in the strategic workforce planning process. In general, it can be concluded that
some organizations implemented segmentation based on function in the SWP process, but that
none of the organizations used segmentation based on performance or strategic value in the SWP
process.
Contingency factors: In order to determine which contingency factors have an influence
on the strategic workforce planning, six propositions were proposed. Of the six studied
contingency factors, available resources, collective bargaining agreements, size and segmentation
of the healthcare sector have an influence on the SWP process. The analysis shows that
availability of resources is necessary (financial, IT, Human capital) otherwise it is impossible to
execute a SWP process. Furthermore, the analysis shows that organizations have to follow the
rules of collective bargaining agreements, which confines them to the framework shaped by the
CBA’s. The influence of contingency factor size is confirmed because the three largest
organizations are ranked in the top for of SWP. The final contingency factor that has an influence
is the factor segmentation of healthcare sector. In the case of segmentation of the healthcare sector,
the organizations in the hospital segment are higher ranked than the organizations in the nursing
and care home sector. In addition, the two organizations in the other segments are ranked as
highest, which assumes that segmentation in the healthcare sector might have an influence
whether organizations have implemented a strategic workforce planning process. The influence of
the contingency factor structure is rejected because there is hardly any variety between the
structures of the organization. Which makes it impossible to draw a conclusion. Finally, this study
has found that although organizations mentioned that due to increased competition it is inevitable
to implement SWP, however currently the results do not completely confirm this statement.
48 In general, currently most healthcare organizations do not have implemented strategic
workforce planning. Most organizations only implemented several steps of the strategic workforce
planning process. Furthermore this study shows that workforce segmentation in terms of
performance and uniqueness does not play a role in the strategic workforce planning process.
Finally, several contingency factors, such as available resources, collective bargaining agreements,
intensity of competition and segmentation have an influence on the SWP process.
49
50 6. Discussion
6.1 Discussion
The perceived need for implementing SWP
In the introduction, the reason for executing this research about strategic workforce planning was
mentioned, namely the future expected labor shortages in the healthcare sector. According to
several statistics (CBS, 2011; AZW, 2011; CPB, 2014), the healthcare sector will have to deal
with shortages of suitable personnel caused by a higher demand for personnel and ageing of the
Dutch workforce. In general, these issues will lead to a discrepancy between the supply and
demand of suitable personnel. Healthcare organizations will feel the need to find a solution for
this future problem. Strategic workforce planning could be an important tool for solving this
problem since its aim to achieve business objectives in the most efficient way by having the right
personnel with the right skills, in the right job (Evers & Verhoeven, 1999).
Remarkably none of the respondents argued that labor shortages are currently an issue in
the Dutch healthcare sector. The organizations stated that the labor market predictions of five
years ago turned out to be wrong. Due to the current economic situation and the uncertainty in the
labor market employees do not switch their jobs and this might be an explanation why the
turnover percentage in healthcare organizations is extremely low. When the turnover percentage is
extremely low this eventually will lead to labor surpluses in some healthcare functions. Research
stated that SWP is also an excellent tool for dealing with surpluses of labor or when the demand
and supply are in balance (Anderson, 2004). But, why is it that only few organizations have
implemented SWP?
Organizations argued that due to unpredicted changes (governmental measures, economic
crisis) organizations are skeptic and reluctant in identifying future needed personnel. In addition,
since they have enough qualified personnel and people do not switch jobs; they do not feel the
necessity for implementing strategic workforce planning. Furthermore the respondents stated that,
since there is no labor market scarcity, organizations are not afraid that they cannot recruit the
right employees. This implies that organizations do not feel the perceived need to implement
strategic workforce planning in times of labor surplus in the organization and no labor market
51
scarcity. In addition, many management articles confirm this argument because they only cause
they mention for implementing strategic workforce planning is labor shortages. Therefore,
although theory suggests that strategic workforce planning is a tool for as well surpluses,
shortages and a balance of personnel, it is questionable whether this is true in practice.
Implementing SWP and Workforce segmentation
One other explanation of why almost none of the healthcare organizations has implemented a
strategic workforce planning process and/or implemented a workforce segmentation process
might be that these processes are relatively new and arising HR practices. Based on this research it
can be concluded that, only one organization has implemented a SWP process and that none of
organizations implemented a workforce segmentation process. In addition, the past five years
several environmental changes have influenced the organizations. Due to all these environmental
influences, almost all organizations recognize the importance of SWP and workforce
segmentation; however they have not adopted it yet. This implies that strategic workforce
planning and workforce segmentation are in an early adoption stage.
This is in line with several researches about adopting new HR practices (Boon, Paauwe &
Boselie, 2009; Paauwe, 2004; Mirvis, 1997). Mirvis (1997) argued that organizations that adopt
new HR practices or policies are classified in four groups. First, HR leaders are the organizations
that are first to implement a new developed HR innovation. They are characterized by the
combination of downsizing with restructuring the organizations, employee involvement programs
and the have trained and redeployed twice as much employees than the other three groups (Mirvis,
1997). Second, fast followers organizations adopt the practices before the rest of the competition
to achieve competitive advantage. Third, slow followers are organizations that adopt the
‘innovation’ when it is widely known and implemented. Lastly, laggards only implement the
practices when it is proven to be beneficial in other organizations.
For example, regarding the seven organization that participated in this study, Disabled care
was the only one who implemented an actual SWP process. The interviewees mentioned that they
had to train and redeploy two third of the complete organization and employee involvement plays
a major role in the organization. This implies that Disabled care meets most of the characteristics
of being an HR leader. Moreover, the overall reason for Disabled care to implement SWP is
52 because they had to downsize and restructure the organization. However, when using
organizations could anticipate on a possible reorganization. When organizations map their current
demand and future supply, they know whether they have enough qualified personnel in the long
run (Evers & Verhoeven, 1999). This analysis shows organizations if they need to take action and
therefore could anticipate on reorganizations. Thus, future reorganizations could be a possible
incentive for organizations to implement SWP.
The above-mentioned distinction between different groups and the example of Disabled
care implies that workforce segmentation and strategic workforce planning are in the early
adopting stage. In addition, almost all of the six other organizations argued that they need to react
and start implementing SWP or/and workforce segmentation. Thus, this implies that in a couple of
years the practices, workforce segmentation and strategic workforce planning are more used
practices in healthcare organizations.
Strategic workforce planning: Combining best fit and best practice.
This study tries to explore if and which contingency factors have an influence on strategic
workforce planning. Contingency theory assumes that there is no one best way of strategic
workforce planning, but that organizations need to adapt to several contextual factors in order to
perform (Donaldson, 2011). The results of the analysis shows that of the six investigated
contextual factors, four propositions were confirmed and two were not confirmed. The contextual
factors collective bargaining agreements, segmentation of the healthcare sector, size and available
resources have, as proposed, an influence on strategic workforce planning. In addition, intensity of
competition and structure of an organization were not confirmed. Although this study, in general,
confirms that context matters and that SWP can be successful when there is a fit between the
internal and external environment, it is questionable whether the context has a major influence on
the design of strategic workforce planning.
Several respondents confirmed that strategic workforce planning consists out of the same
general steps. In addition, the interviewees mentioned that aspects like the right people, creating
insight in the workforce, scenario planning and aligning with the business strategy, are important
for a successful workforce planning process. This implies that there are several best practices that
are applicable in every organization. Boxall and Purcell (2011) made a distinction between the
53
best practice and the best fit approach. On the one hand the surface level of HR practices is
heavily influenced by contextual factors and therefore these practices and policies are firm
specific and relate to the concept of best fit. On the other hand the underpinning level is
characterized by those HR policies and practices that are generic and are universal applicability,
which is in line with the best practice method (Boxall & Purcell, 2003).
Regarding strategic workforce planning, this study shows that the contextual factors
collective bargaining agreements, intensity of competition, size and available resources have an
influence on design and the way of executing strategic workforce planning. Although, this study
shows that there are differences among organizations regarding strategic workforce planning the
underpinning principle of SWP is universal applicable. Organization confirm that the
underpinning principle is achieving business objectives in an efficient way by getting the people
right with the skills in the right job at the right time (Anderson, 2004; Cotton, 2007; Evers &
Verhoeven, 1999). Thus, this implies that, although there are differences by contextual factors, the
general principle of strategic workforce planning is guided by universalistic principles.
6.2 Limitations
Since this is an explorative study and there is limited availability of empirical studies of strategic
workforce planning in healthcare organizations, it is important to take in to account limitations so
that they could be avoided in the future.
The research has been conducted in the healthcare sector, in different segments. The seven
organizations were selected randomly. The healthcare organizations were selected on the fact that
they had indicated that they had some experience in strategic workforce planning, which implies
that the overall picture of SWP is even bleaker in the Healthcare sector. Unfortunately, only one
healthcare organization had actually implemented a strategic workforce planning process. Due to
the fact that the interview questions on SWP are based on the theoretical framework, it may have
been that not all information regarding SWP has been mentioned by the other six organizations.
Therefore it was difficult to get insight into whether, and to what extent, the other organizations
use strategic workforce planning. In general, this resulted in a difficulty in discovering and
identifying how the SWP process is designed in the healthcare sector.
54 One other limitation regarding strategic workforce planning is that this study tried to
examine if and how SWP is implemented in the Dutch healthcare sector. Almost none of the
organizations implemented an actual SWP process on organizational level and enormous
differences between departments in organization arose. In addition each organization executed the
steps of the SWP process on their own way. Which mostly led to seven different ways of
executing one step. This led to difficulties in making an objective ranking about the current
strategic workforce planning process in one of the seven healthcare organizations. In addition,
eventually this made it difficult to examine how the strategic workforce planning process looks
like in the healthcare sector.
Although there are some limitations about this research set up, the use of several
interviews in one organization is one of the strengths of this research. Interviews were held with a
HR Manager, Senior Manager and a Line Manager, which resulted in different points of view and
the ability to gain data from several levels in the organizations. Executing several interviews in
one organization will increase the validity and the reliability in the research. In addition, gaining
data from not only the higher levels in the organizations (HR Manager and Senior Manager),
makes is possible to discover whether intended HR practices are actually executed by Line
Managers. However, there is one limitation, discrepancy in the answers of the respondents. While
executing the interviews, respondents of the same organization gave different answers on the
same questions, which sometimes resulted in difficulties to make one clear analysis.
6.3 Theoretical implications and future research
One of the theoretical implications and suggestions future research is to select a greater research
sample. The current research sample is too small to explore whether different segments, size,
structure, intensity of competition have an influence on the strategic workforce planning process.
The developed propositions should be tested again in a larger research sample to explore whether
the six contextual factors have an influence on SWP. In addition, future research should select
organizations that have developed a model for workforce segmentation. This should provide an
answer on the sub-research questions about workforce segmentation and should provide more
insight in what the purpose of workforce segmentation in strategic workforce planning is. In
addition since several respondents mentioned that demographical factors could possible influence
55
SWP, future research should also investigate the demographical characteristics of an organization
and its environment.
One other is implication is that almost none of the organizations implemented strategic
workforce planning. However some organizations mentioned that they are in the beginning or in
the middle of implementing an SWP process. Therefore, it is recommended to execute this
research again in about two years. Then, most of the organizations will have implemented SWP
and executed the process. This implies that if the same research is executed in two years, major
differences in results will probably occur. Which implies that it is likely that more organizations
will participate in the research, since more healthcare organizations will have implemented an
SWP process. The greatest difference and advantage of this further research, is that the research
will show more insight into the actual SWP process in the healthcare sector and better
comparisons can be made.
The final theoretical implication is the theoretical framework of Lepak and Snell (1999)
about workforce segmentation. The model of Lepak and Snell (1999) makes a distinction between
four types of employees groups through uniqueness of the human capital and the strategic value of
the human capital. According to this research almost none the organizations segmented their
workforce based on these two aspects. But, organizations rather mentioned function classification
as an aspect of workforce segmentation. This raises the question whether the model of Lepak and
Snell (1999) is exhaustive, or that function classification needs to be included in the model.
Therefore, future research should investigate and test the model of Lepak and Snell (1999).
6.4 Practical implications
Although all organizations have some insight in the current inflow, through flow and outflow of
personnel, only one organization has analyzed the current workforce, identified future personnel
needs (quantitative and qualitative), identify the gap and developed an action plan. Due to the fact
the almost none of the organizations use the strategic workforce planning process and none of the
organizations use workforce segmentation, this study has few practical recommendations for HR
Managers.
First of all, the only organization that implemented SWP, mentioned that it is of great
importance to have support and commitment from the important stakeholders. In practice, this
56 means that before implementing SWP on organizational level, support of the board of directors is
needed. This can be obtained by showing them the added value of SWP in terms of improved
efficiency and revenues. Furthermore, cooperation between HR Managers, Senior Managers and
line management is needed to successfully implement SWP. The HR department should facilitate
and act supportive instead of leading. In addition, SWP is a process that is executed by line
management and therefore focus and responsibility should mostly lie by the line management.
Secondly, Healthcare organizations have to shift their focus from only the short-term
towards a more long-term view and acknowledge the long-term strategic challenges for the
healthcare sector. Due to the fact that currently the healthcare sector has to deal with major
environmental changes and governmental measures, almost all healthcare organizations have to
deal with reorganizations and in some cases layoffs. Strategic workforce planning is a helpful tool
for organizations that have to deal with reorganization since it can contribute by identifying
personnel needs, future demands and the gap. In addition, anticipating on the future situation can
even prevent layoffs. It is therefore important that healthcare organizations that are reorganizing,
consider strategic workforce planning, in order to get the right people, with the right skills in the
right place.
Lastly, it is recommended that the HR department in an organization needs to facilitate this
transition, by providing a general tool or standard SWP process that helps the different
departments or care homes in healthcare organizations. This means that HR needs to take a
facilitating role whereby they support line management in managing the transition. In addition,
HR should focus on helping the departments or different care homes in understanding and
applying the underlying idea of strategic workforce planning. In this way, Line Managers can
explain the idea to the employees in an optimal way and it is less likely that resistance to change
will occur.
57
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62 Appendix A – Interview Questions
Interview HR Manager
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Kunt u me iets vertellen over u als persoon en uw huidige positie in de organisatie?
Strategic workforce planning
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Waar liggen de voornaamste accenten/speerpunten op het gebied van HR?
Wat doen jullie als organisatie aan personeelsplanning?
Op welke manier hebben jullie inzicht in de instroom, doorstroom en uitstroom van
personeel?
Hoe zit het dit (personeelsplanning) proces eruit? En wie is betrokken bij dit proces?
Zijn er bepaalde bottlenecks in dit personeelsplanning proces?
Welke vormen van personeelsplanning kennen jullie?
Maken jullie gebruik van vlootschouw ‘s, zo ja op welk niveau (per afdeling?)
Hoe heeft de organisatie kennis opgedaan met betrekking tot het ontwikkelen van een
personeelsplanning proces? (intern benchmarking, professionele netwerken) Speelt het
overheidsbeleid hier ook een rol in?
Welke werknemers data gebruiken jullie wanneer je je huidige personeelsbestand wilt
definiëren? kwalitatief (competenties & skills) of kwantitatief (Personeelstrends)?
Maakt u ook personeelsvoorspellingen en zo ja, is dit aan de hand van kwalitatieve of
kwantitatieve data?
Hebben jullie het toekomstige top personeel al in huis, zo nee hoe gaan jullie hiervoor
zorgen? (op welke manier?)
Welke technieken worden gebruikt om personeelsvraag en uiteindelijk tekorten en
overschotten te identificeren?
Spelen functioneringsgesprekken met het personeel een rol in personeelsplanning?
Kijken jullie ook naar externe factoren/trends (Technology, arbeidsmarkt, economisch)
wanneer personeelsvraag wordt geïdentificeerd, en zo ja welke factoren spelen hier een
rol?
Wat voor tijdshorizon gebruiken jullie met betrekking tot personeelsplanning?
Is het personeelsplanning proces in lijn met de strategie van de organisatie en zo ja op
welke manier?
Wat zijn de volgende stappen met betrekking tot personeelsplanning, waar willen jullie
naar toe?
Wat zijn jullie best practices geweest met betrekking tot personeelsplanning (Wat heeft
goed gewerkt)?
Workforce segmentation
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Maken jullie onderscheid tussen verschillende groepen personeel, zo ja waarom?
Hoe zijn deze groepen personeel ingedeeld?
63
Strategisch personeelsplanning
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is personeelsplanning van even groot belang voor alle functies?
Is het proces van personeelsplanning voor iedere werknemer het hetzelfde? (extra aandacht
aan groep werknemers en zo ja waarom?)
Welke kenmerken hebben hier een invloed op? ( Performance, opleidingsniveau, cruciale
kennis, strategisch belang van de functie)
Contingency factoren (Contextuele factoren)
Institutionele mechanisme
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In welke mate heeft de wetgeving invloed op personeelsplanning (Pensioenen, contracten,
flexibel werk)?
Welke invloeden hebben deze factoren op de aard en samenstelling van het
personeelsplanningsysteem?
Welke factoren werken begunstigend voor personeelsplanning en welke belemmerend?
Beschikbare middelen
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Wat voor middelen spelen een rol in het personeelsplanning proces? (Financieel, Mensen,
IT)
Is er een specifiek software programma gebruikt om personeelsplanning te implementeren
en te gebruiken.
Afsluitende vragen
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Zijn er nog andere factoren die van invloed zijn op het personeelsplanning proces?
Wat zijn de belangrijkste lessen geleerd met betrekking tot personeelsplanning?
64 Interview Senior Manager
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Kunt u me iets vertellen over u als persoon en uw huidige positie in de organisatie?
Strategic workforce planning
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Wat zijn de voornaamste werkzaamheden van de organisatie?
Waar zijn de voornaamste accenten/speerpunten van het HR beleid?
Wat doen jullie als organisatie aan personeelsplanning?
Hebben jullie inzicht in de instroom, doorstroom en uitstroom van personeel?
Welke vormen van personeelsplanning kennen jullie?
Wie is er betrokken bij dit proces?
Hoe heeft de organisatie kennis opgedaan met betrekking tot het ontwikkelen van een
personeelsplanning proces? (Intern, benchmarking, professionele netwerken)
Kijken jullie ook naar externe factoren/trends (Technology, arbeidsmarkt, economisch)
wanneer personeelsvraag wordt geïdentificeerd, en zo ja welke factoren spelen hier een
rol? Speelt het overheidsbeleid hier ook een rol in?
Hoe wordt er ingespeeld op de vergrijzing? En het wegvloeien van kennis?
Welke werknemers data gebruiken jullie wanneer je je huidige personeelsbestand wilt
definiëren? kwalitatief (competenties & skills) of kwantitatief (Personeelstrends)?
Maakt u ook personeelsvoorspellingen en zo ja, is dit aan de hand van kwalitatieve of
kwantitatieve data?
Hebben jullie het toekomstige top personeel al in huis, zo nee hoe gaan jullie hiervoor
zorgen? (op welke manier?)
Wat voor tijdshorizon gebruiken jullie met betrekking tot personeelsplanning?
Is het personeelsplanning proces in lijn met de strategie van de organisatie en zo ja hoe?
Is het personeelsplanning proces geïntegreerd met de al gehele strategie van de organisatie,
zo ja op welke manier?
Wat zijn de volgende stappen met betrekking tot personeelsplanning, waar willen jullie
naar toe? En wat zijn bottlenecks?
Wat zijn jullie best practices geweest met betrekking tot strategisch personeel planning
(Wat heeft goed gewerkt)?
Workforce segmentation
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Hoe ziet jullie personeelsbestand eruit (geschoolde of ongeschoolde werknemers)
Maken jullie onderscheid tussen verschillende groepen personeel, zo ja waarom?
Hoe zijn deze groepen personeel ingedeeld?
Wat is van belang wanneer dit onderscheid tussen verschillende groepen personeel wordt
gemaakt? Welke factoren spelen hier een rol? (Uniqueness, prestatie, strategische waarde).
Wat zijn de voordelen van onderscheid maken tussen verschillende groepen in de
organisatie (workforce seg mentatie)
Waarom segmenteren jullie jullie personeelsbestand?/ Waarom maken jullie onderscheid
tussen verschillende groepen?
Wat zijn de voordelen van workforce segmentatie in de organisatie?
65
Contingency factoren
Afzetmarkt
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Opereert de organisatie in een markt met veel concurrentie?
Is de vraag naar producten stabiel of dynamisch?
Is de vraag naar producten voorspelbaar? Hoe wordt dit voorspelt?
Branche
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Hoe zou u de relaties in de branche omschrijven? (samenwerking, relaties).
Wat zijn de belangrijkste trends met betrekking tot personeel in de sector (Ziekenhuis,
verpleging & verzorging sector)?
Structuur/Grootte
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Is de besluitvorming in de organisatie gecentraliseerd of gedecentraliseerd met betrekking
tot het niveau waar de besluiten worden genomen in de organisatie?
Is besluitvorming formeel of informeel?
Is het werk kapitaal of arbeidsintensief?
Zijn deze factoren in de loop van de jaren veranderd of gaat dit in de nabije toekomst
veranderen?
Afsluitende vragen
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Zijn er nog andere factoren die van invloed zijn op het personeelsplanning proces?
Wat zijn de belangrijkste lessen geleerd met betrekking tot personeelsplanning?
66 Interview Line manager
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Kun u me iets vertellen over u als persoon en uw huidige positie in de organisatie?
Strategic Workforce Planning
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Wat zijn de voornaamste werkzaamheden van de organisatie?
Wat zijn de belangrijkste werkzaamheden van de afdeling?
In welke mate heeft u binnen uw afdeling te maken met het vastgesteld HR-beleid van de
organisatie?
In hoeverre heeft u inzicht in de instroom, doorstroom en uitstroom van het personeel van
uw afdeling?
Maken jullie gebruik van een vlootschouw?
Welke werknemers data gebruikt u wanneer uw het huidige personeelsbestand van uw
afdeling in kaart wilt brengen? kwalitatief of kwantitatief?
Bent u als afdelingsmanager ook betrokken bij personeelsvoorspellingen van uw afdeling?
Hoe wordt er ingespeeld op de vergrijzing en het wegvloeien van kennis binnen uw
afdeling?
Hebben jullie op de afdeling het toekomst personeel al in huis? Zo, nee hoe gaan jullie hier
voor zorgen?
Spelen functioneringsgesprekken in rol in het bepalen van talent binnen uw afdeling?
Worden er bepaalde technieken gebruikt om overschotten en/of mogelijke tekorten binnen
de afdeling in kaart te brengen?
Welke vormen van personeelsplanning kennen jullie?
Wat voor tijdshorizon wordt hiervoor gebruikt?
Welke systemen worden gebruikt voor personeelsplanning? Is dit structureel vastgelegd?
Heeft uw organisatie een onderliggend personeelsplanning proces, zo ja heeft u hier als
lijn manager mee te maken?
Hoe ziet volgens u het personeelsplanning proces eruit en wie is er betrokken bij dit
proces?
Wat zijn volgens u de leerpunten met betrekking tot personeelsplanning en wat zijn de best
practices (wat heeft goed gewerkt)?
Workforce segmentation
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hoe ziet het personeelsbestand van uw afdeling eruit?
Wordt er binnen uw afdeling onderscheid gemaakt tussen verschillende groepen personeel,
zo ja waar is dit onderscheid op gebaseerd?
Wat is volgens u het voordeel van onderscheid maken tussen verschillende groepen
personeel in de organisatie/afdeling?
Is het personeelsplanningsproces voor iedere werknemers op uw afdeling hetzelfde, of
wordt hier in onderscheid tussen gemaakt.
Zo ja, waarop is dit onderscheid gebaseerd?
67
Contingency factoren
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Opereert uw organisatie in een markt met veel concurrentie?
In hoeverre heeft de wetgeving invloed op uw direct personeel en personeelsplanning
(Pensioenen, contracten, flexibel werk)
Hoe zou u de relaties in uw branche omschrijven?
Is de besluitvorming in de organisatie gecentraliseerd of gedecentraliseerd met betrekking
tot het niveau waar de besluiten worden genomen in de organisatie?
Is besluitvorming formeel of informeel?
Wat voor middelen spelen er volgens u een rol in het personeelsplanning proces? (Denk
aan: IT, Financieel, Mens)
Welke factoren van buitenaf hebben volgens u een invloed op het personeelsplanning
proces?
Afsluitende vraag
-­‐
Wat zijn volgens u de belangrijkste lessen geleerd met betrekking tot personeelsplanning
en waar ziet u nog verbeterpunten?
68 Appendix B – Example Transcript
HR Manager Hospital 2
Strategic workforce planning
-­‐
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Waar liggen de voornaamste accenten/speerpunten op het gebied van HR?
Ligt op het ontwikkelen en door ontwikkelen van vakmanschap omdat we toch zien dat dit
de kern is van de strategische bijdrage die medewerkers. Het allerbelangrijkste in steek die
wij als organisatie kiezen om de kwaliteit te verhogen. Tweede is resultaatgerichtheid en
de derde is dan medewerkers in staat zijn om de verbinding te leggen en dat wordt steeds
belangrijkers. Verbinding leggen met collega’s en met de patiënt, dat wordt steeds
belangrijker maar ook met de buitenwereld. De gezondheidszorg wordt steeds meer een
netwerkorganisatie als je slimmer wilt gaan werken dan moet je ook de verbinding gaan
zoeken en niet alleen maar doen wat je altijd gewend bent om te doen
Wat doen jullie als organisatie aan personeelsplanning?
We hebben niet een heel uitgewerkt systeem voor SPP, wat we wel doen is dat we heel
nauwkeurig bijhouden wat de in, uit en doorstroom cijfers zijn en daar hebben we ook
instrumenten voor ontwikkelt waar managers online allerlei ken en stuurgetallen kunnen
inzien. Als het gaat over de planning dan is het nu vrij korte termijn planning. We hebben
het meer over roosteren dan over plannen. Er wordt natuurlijk ook wel vooruit gekeken en
wordt gekeken naar begrotingen van het volgend jaar. Wat dat dan betekent voor eventuele
uitbereiding en krimp en daar wordt dan op geacteerd, we hebben tot nu toe nog geen
systeem organisatie breed voor personeelsplanning we zijn er wel mee bezig om dit in de
toekomst te implementeren.
Op welke manier hebben jullie inzicht in de instroom, doorstroom en uitstroom van
personeel?
Zie vorige vraag
Hoe zit het met de opvolging, Trainees, Talenten?
Hoe vang je een grotere krimp op?
Dit gebeurt meestal via reorganisatie, dat is een besluit dat op een gegeven moment
genomen wordt, dit heeft gevolgen voor medewerkers dat ze op zoek moeten gaan naar
een nieuwe functie. Het liefst binnen ziekenhuis 2 en als dat niet lukt buiten ziekenhuis 2.
Dit is nog al een schoksgewijze verandering die ook mensen in een situatie brengt waarin
ze gedwongen opzoek moeten gaan naar iets anders. Wat wij eigenlijk nu proberen is
eigenlijk dit zoveel mogelijk te gaan voorspellen zodat er geen reorganisatie meer hoeft
plaats te vinden om de krimp te bereiken. Dit vraagt nog wel een heleboel werk, dit
betekent dat we veel beter in kaart moeten brengen wat er op ons afkomt en ons
personeelsbestand veel beter in kaart moeten brengen. In welke mate het
personeelsbestand vergrijst en gaat verlopen en hoe we dat op tijd kunnen opvangen met
nieuwe instroom en opleiding.
Talenten binnen de organisatie, brengen jullie dat in kaart?
Natuurlijk worden die wel herkent en daar hebben we nu een nieuwe systematiek voor,
PVB cyclus. Plannen voortgang beoordelen cyclus. Dat betekent dat we medewerkers
69
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-­‐
-­‐
kunnen beoordelen op hun prestaties en daarmee dus ook talent herkennen. Ook hiervoor
geldt op afdelingsniveau worden talenten herkent, gecoacht en gestimuleerd. Er wordt ook
wel individueel en op casus niveau aan opvolgingsplanning gedaan. Bijvoorbeeld als we
weten dat een leidinggevende weggaat en we hebben een talent op het vizier en zullen we
die zeker polsen voor opvolging. Maar dit is geen organisatie brede systematiek waarin we
kunnen voorspellen dat zoveel leidinggevende gaan vertrekken en dat we zon behoefte
hebben aan vervangen en dat we op basis daarvan een klas opleiden van talenten.
Op welke termijn zal dat nieuwere systeem komen?
Dit jaar mee aan de slag, ik denk dat dit een stapsgewijze ontwikkeling is en dat je niet
moeten verwachten dat dit er binnen twee jaar echt helemaal staat. De vraag of of dit wel
überhaupt mogelijk is in zo’n soort organisatie. Het is toch vrij systemische benadering
terwijl je je kunt afvragen of het wel zo werkt dat je dus alles kan voorspellen en plannen.
Een ziekenhuis is een organisatie met een hele complexe dynamiek met allerlei belangen
en spelers die invloed uitoefenen hoe een ziekenhuis zich ontwikkelt, politiek,
zorgverzekeraars, wetgeving noem maar op. Dus het is ook heel lastig te voorspellen hoe
wij er over 2 jaar uitzien en wat voor vraag naar personeel er dan is.
Welke vormen van personeelsplanning kennen jullie?
Wat we wel doen bijvoorbeeld, heel gestructureerd verpleegkundige opleiden en daarmee
samenwerken met ROCs en hogescholen en op die manier werk je natuurlijk wel aan
personeelsplanning omdat je jaarlijkse eerstejaars als instroom hebt. Tweede en derdejaars
als doorstroom en een uitstroom van de pas afgestudeerden verpleegkundigen. We weten
wat er in die stroom zit van verpleegkundigen die we aan het opleiden zijn en hoeveel er
uiteindelijk afgestudeerd zijn en wat we daar mee willen gaan doen als ze uiteindelijk
afgestudeerd zijn. Dat is meer per functiegroep. Dit geldt bijvoorbeeld ook voor de
laboranten en de radiologie medewerkers die leiden we ook allemaal zelf op. Daar vindt op
afdelingsniveau wel een planning plaats.
! Lijnmanagement is verantwoordelijk om dit te initiëren, wij kunnen vanuit P&O kennis
aanleveren hoe ze dat beter kunnen voorspellen en ze daarin begeleiden maar voor die hele
specifieke functies is dit vooral iets van de lijn.
Hoe heeft de organisatie kennis opgedaan met betrekking tot het ontwikkelen van een
personeelsplanning proces? (intern benchmarking, professionele netwerken)?
Je lees heel veel erover in vakliteratuur, we gaan ook geregeld naar allerlei congressen en
symposia bijvoorbeeld van de universiteit van Tilburg (PMC). PMC heeft onlangs een
seminar georganiseerd over SPP. En in mijn vorige werk heb ik hierover ook ervaring over
opgedaan en zelf een SPP proces opgezet bij een aantal bedrijven en die kennis neem ik
ook van daaruit mee. Maar dat maakt het nog niet zo eenvoudig in een grote organisatie te
implementeren.
Welke werknemers data gebruiken jullie wanneer je je huidige personeelsbestand
wilt definiëren? kwalitatief (competenties & skills) of kwantitatief
(Personeelstrends)?
We weten natuurlijk heel goed wie er bij ons in dienst zijn, we hebben daar allerlei data
over beschikbaar en die gegevens zijn er wel en goed toegankelijk alleen we hebben ze
nog niet verwerkt in een planningstool. Als je dat zou doen zou je natuurlijk vooral kijken
zaken als aantal FTE dat iemand werkt, leeftijd, functieniveau, type functie waarin iemand
werkt en dat zou je dan vervolgens later kunnen uitbreiden ambities voor loopbaan en
ontwikkelpotentieel.
70 -­‐
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Competenties en vaardigheden: Dit gebeurt op de werkvloer wel, maar dit hebben we niet
in systemen gegoten en dit lijkt me ook lastig om dit voor 4500 werknemers te definiëren.
Het lijkt me beter om dit per afdeling te vast te stellen door bijvoorbeeld een vlootschouw
of een potentieel beoordeling samen met de lijnmanager. We hebben ook wel eens
nagedacht over een intranet instrument waarbij medewerkers het zelf kunnen aangeven
waar hun talenten liggen en waar hun ontwikkelpunten liggen om op deze manier een
soort marktplaats te maken, maar dit laat nog wel even op zich wachten. Ideeën zijn er
genoeg, maar het meer de uitvoering en dat heeft dit toch weer niet de hoofd prioriteit.
Maakt u ook personeelsvoorspellingen en zo ja, is dit aan de hand van kwalitatieve of
kwantitatieve data?
Dit is al beantwoord. Wat we ook doen is dat we kijken naar de toekomst in een meer
globale zin. We gaan over een jaar of 4/5 over naar een nieuwbouw situatie waarin we op
onze andere locatie de molengracht enorm gaan uitbreiden en verbouwen en locatie
Langedijk gaan sluiten. Dit betekent dat we op een heleboel vlakken de werkprocessen
moeten aanpassen en de manier waarop we georganiseerd zijn de formatie en dan
gebruiken we als een soort ankerpunt om vooruit te kijken. Dus ook allerlei projecten te
doen om te kijken hoe zouden we nu anders kunnen werken en wat betekent dat
vervolgens voor de vraag naar personeel, we zijn er wel mee bezig. Alleen dit is pas in de
hoofdlijnen doorgerekend wat dat gaat vragen. Wat het in ieder geval duidelijk maakt is
dat we op heel veel vlakken met minder mensen moeten gaan werken
Hoe gaan jullie daar op in spelen?
Zoveel mogelijk door middel van natuurlijk verloop en kritisch te kijken of het echt nodig
is om iemand te vervangen. Daarnaast daar waar nodig is bijsturen door middel van
reorganisaties. Of stimuleren dat mensen zich op een andere manier ontwikkelen en ander
werk gaan doen waar wel vraag naar is.
Hebben jullie het toekomstige top personeel al in huis, zo nee hoe gaan jullie hiervoor
zorgen? (op welke manier?)
We denken dat we ze in huis hebben maar we weten niet precies wie we nou precies in de
toekomst nodig hebben. Het is een beetje dubbel aan de ene kant denk ik dat we niet in de
situatie zitten van arbeidsmarkt schaarste dus we hoeven niet alles op alles zetten om
talenten uit de arbeidsmarkt te plukken. Het is eerder andersom hoe kunnen we afscheid
nemen van bepaalde mensen. Aan de andere kant weet je ook dat je altijd toppers nodig
hebt
dus
daar
zal
je
altijd
naar
moeten
blijven
zoeken.
Op welke manier zoeken jullie daar naar?
Dat gaat dus ook weer via de lijn, dat is vaak op individuele casus gebaseerd. Iemand gaat
weg of er ontstaat een vacature en dan gaan we natuurlijk selecteren wie er best bij het
toekomstig profiel past. Maar we hebben niet een voorspellend systeem dat we nu weten
dat we in 2017, 30 bepaalde professionals nodig hebben en dat we die nu al gaan opleiden.
Wat doen jullie aan talentmanagent?
We doen veel aan opleiding, medewerkers kunnen zich op allerlei manier ontwikkelen en
dat wordt dan met de medewerker besproken. Dat kan bijvoorbeeld een opleiding zijn
management in de zorg als bijvoorbeeld iemand leidinggevende capaciteiten heeft. Maar
dat kan ook een inhoudelijk opleiding zijn of een specialisatie, dat we verpleegkundige zo
goed vinden dat we denken dat die ook gespecialiseerd verpleegkundige kan worden en
dat we dan ook een specialistische opleiding kunnen regelen ! allemaal in samenspraak
71
-­‐
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-­‐
met de lijn. Het is vooral het een lijn a gelegenheid, er zit nog niet heel veel sturing in
vanuit HR. Het is ook maar de vraag of dit wenselijk is voor de situatie.
Welke technieken worden gebruikt om personeelsvraag en uiteindelijk tekorten en
overschotten te identificeren?
We weten natuurlijk hoe onze formatie eruit en of de hoofdlijnen hoe die zich gaat
ontwikkelen. We weten aan de hand van de begroting voor het komende jaar en de
taakstelling die daar opgelegd wordt hoe die vraag eruit gaat zien en dat betekent dus ook
dat duidelijk wordt wat dat voor de formatie betekent. Dit is vaak op een wat kortere
termijn (1 of 2 jaar).
Spelen functioneringsgesprekken met het personeel een rol in personeelsplanning?
Ja ! talenten
Kijken jullie ook naar externe factoren/trends (Technology, arbeidsmarkt, economisch)
wanneer personeelsvraag wordt geïdentificeerd, en zo ja welke factoren spelen hier een
rol?
Ja, voorbeeld daarvan is dat landelijk wordt nagedacht over een beroepsprofiel van een
verpleegkundige dat is iets wat heel Nederland een beetje over nadenkt. Is dit nu een HBO
of MBO functie, nu door beide afstudeerrichtingen ingevuld. Zo’n ontwikkeling speelt ook
hier door in de toekomst planning. Wat voor soort verpleegkundige willen wij in de
toekomst hebben en hoe ziet dat functiehuis eruit en hoe ziet de bemensing van zo’n
afdeling eruit als je bijvoorbeeld naar het nieuwe profiel toegaat. Welke vorm van
arbeidsdeling ga je dan toepassen. Maar ook met toenemende inspectie eisen en
kwaliteitseisen die worden opgelegd dat betekent ook iets voor onze eigen medewerkers
en kwaliteit. We spelen hier op in door opleiding, protocollen, assessments op capaciteiten
en heel gericht worden bijgeschoold waar de gaten vallen. Dat zijn wel hele gerichte
interventies.
Wat
voor
invloed
heeft
het
overheidsbeleid
erop?
Heeft er effect op maar welk effect is lastig te beantwoorden. De overheid vraagt aan de
ene kant dat ziekenhuizen zich als marktpartijen gaan gedragen dat betekent dus ook dat
we steeds meer moeten bewust worden van onze marktpositie en van het feit dat patiënten
een keuze maken om wel of niet hier te komen. Dit betekent vervolgens dat we ook
moeten zorgen dat we de beste keuze voor de patiënt zijn. Die beste keuze worden we
alleen maar als onze medewerkers zich als een echte professional gedragen. Dat heeft wel
degelijk invloed het is een hele reeks van redeneringen die daar toe leidt. Het anders is het
hele verhaal van spreiding en concentratie van zorg van ziekenhuizen moet nou ieder
ziekenhuis alle specialisme in huis hebben of moeten ziekenhuizen zich richten op een
paar dingen waar ze heel goed in zijn en de rest laten vallen. Voor sommige heb je een
regionale functie, het is niet handig als je voor een KNO arts helemaal naar Eindhoven
moeten maar voor andere dingen die heel bijzonder zijn en niet vaak voorkomen,
bijvoorbeeld verwijdering van je blaas of oncologische operatie, daarvoor is het helemaal
niet zo gek om naar Rotterdam of Utrecht te rijden. Dat soort keuzes van de overheid en
zorgverzekeraars zullen wij gaan zorgen voor drastische veranderingen in hoe wij
georganiseerd zijn.
Hebben daar al drastische veranderingen in plaatsgevonden?
Nee, dit is eigenlijk nog niet. Iedereen praat erover en we zien het op ons afkomen. Er
wordt een strategisch profiel opgesteld, voor ziekenhuis 2
72 -­‐
-­‐
-­‐
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is dit Hart en Vaten en oncologie Vrouw en Kind. Daarnaast gezond ouder worden en
daar organiseren we ons ook op. We blijven tegelijkertijd al die andere dingen doen
(Oogartsen, reumatologen, plastische chirugie). Dit betekent dat we op een kruispunt
staan, we weten dat we ons moeten specialiseren en aan de andere kant moeten we ook die
basiszorg aanbieden.
Wat voor tijdshorizon gebruiken jullie met betrekking tot personeelsplanning?
1 a 2 jaar
Is het personeelsplanning proces in lijn met de strategie van de organisatie en zo ja op
welke manier?
Ja, heel globaal gezegd denk ik dat dat wel zo is. Omdat de strategie van de organisatie wel
op het netvlies staat en bij de selectie van nieuwe medewerkers houden we daar wel
rekening mee. Maar nogmaals we hebben daar geen prachtig systeem voor waar we
kunnen voorspellen wat er in de komende jaren gaan gebeuren en wat dat voor de vraag
naar personeel betekent.
Wat zijn de volgende stappen met betrekking tot personeelsplanning, waar willen jullie
naar toe?
Wat wij nu gaan doen is dat we niet organisatie breed als een heel groot project gaan
opzetten personeelsplanning. Wat we gaan doen is dat we per zorgkern, grote afdeling is
maar eens gaan beginnen met gesprekken met het management en het teammanagement
over welke veranderingen zie je nou de komende jaren nu op je afkomen? Welke keuzes
maken jullie? Wat betekent dit voor hoe je georganiseerd bent en welke taken je gaat
uitvoeren en wat betekent dit voor de vraag naar personeel die je hebt. Daar zetten we
tegenover hoe gaat het personeels zich nou autonoom ontwikkelen (pensioen en andere
dingen weg). Dat bij elkaar dat bepaald de vraag naar personeel en de behoefte om die te
vervangen of juist te laten krimpen. Dit willen we gewoon per afdeling doen en op de
achtergrond een database aanleggen waar we al die gegevens bij elkaar op tellen. Maar
niet als een enorm project van bovenaf. Waar het ook omgaat is dat personeelsplanning is
vaak enorm gebaseerd op aannames en dan reken je dat allemaal door en dan denk je de
waarheid te hebben gevonden en allerlei acties te kunnen uitzetten maar in het begin van
het traject zijn zoveel scenario’s bedacht en aannames gedaan. Die je uiteindelijk net zo
goed waar als niet waar kunnen zijn dit bied schijnzekerheid. Ik denk dat het daarom
handiger is om bij de basis te beginnen om vooral met teams en afdelingen te kijken waar
ga je nou naar toe en wat betekent dat en dat later bij elkaar op te tellen in plaats van op de
grote lijnen te beginnen.
Wat zijn jullie best practices geweest met betrekking tot personeelsplanning
(Wat heeft goed gewerkt)?
Wat ik in het verleden heb gemerkt is dat het grootste belang is dat je de lijn erin betrekt
en dat wil ik hier ook gaan doen als we daar mee gaan beginnen. Je moet het niet iets
maken van de directie of van P&O. Uiteindelijk die je het niet om een beeld te krijgen
maar om interventies te plannen. Om te gaan werven of om te gaan ontwikkelen of te laten
uitstromen daar gaat het uiteindelijk om. Die actie kun je alleen maar doen als de lijn snapt
waarom dat nodig is. Daar draait het uiteindelijk om.
Workforce segmentation
73
-­‐
-­‐
Maken jullie onderscheid tussen verschillende groepen personeel, zo ja waarom?
In beginsel maken wij geen onderscheid tussen groepen. We zijn nogal een organisatie die
uitgaat van dat iedereen dezelfde rechten en plichten heeft. Het denken langs te lijn van de
cao is erg belangrijk. Daarbinnen zijn er natuurlijk wel verschillen. Verschillende
leeftijdsgroepen ga je natuurlijk anders mee om, met betrekking tot ontwikkel
mogelijkheden en inzetten van diensten. We hebben daar niet een model voor met groepen
talenten die we speciale programma’s laten ondergaan en dat is ook vrij lastig. Omdat het
denken langs de cao lijn van iedereen wel erg bepalend is. Ook als het gaat om bijzondere
beloningen voor prestaties dan is dat eigenlijk een taboe in de gezondheidszorg.
Hoe zijn deze groepen personeel ingedeeld?
Zijn er niet
Strategisch personeelsplanning
-­‐
is personeelsplanning van even groot belang voor alle functies?
Ik denk uiteindelijk dat het voor alle functies van belang is, natuurlijk zijn er functies die
schaarser zijn dan andere en daar ga je dan eerder aan denken. We zijn een aantal jaar
geleden begonnen met een samenwerkingsvorm tussen allerlei ziekenhuizen in ZuidNederland Convenant arbeidsmarkt. Waarin we op macroniveau voorspelling hebben
gedaan naar de toekomstige vraag naar IC verpleegkundige, OK assistenten, CCU
verpleegkundige, Spoedeisend hulp verpleegkundigen. Specifieke groepen die een aantal
jaar geleden heel schaars waren. Toen is er met de ziekenhuizen in het convenant
afgesproken om gezamenlijk een bepaalde opleidingsinspanning te leveren waarbij naar
rato die verdeeld is over de ziekenhuizen. En verder is er door de raden van bestuur
afspraken gemaakt over het aantal mensen dat je opleid. In die zin zijn er wel voor
specifieke groepen wel maatregelen getroffen. Die zijn ook in samenwerking met de
andere ziekenhuizen, met het oogpunt het niet kan zijn dat het ene ziekenhuis veel
investeert en dat ze vervolgens weggehaald worden door een ander ziekenhuis. Er zijn ook
afspraken gemaakt aan het strikt houden aan de cao en strikte bepaling van Loon waar
geen concurrentie op mag plaatsvinden.
Onderlinge concurrentie?
Arbeidsmarkt, nauwelijks. Dit komt door de mensen die werken in de gezondheidszorg.
Deze mensen werken graag dicht bij huis en zouden misschien wel ooit ergens anders
willen werken maar kiezen vanuit praktische overwegingen daar toch niet voor. Ik zie het
wel dat als we nieuwe medewerkers hebben die instromen bij ons dat ze vaak van andere
ziekenhuizen komen. Er vindt wel wat verschuiving plaats maar echte concurrentie op de
arbeidsmarkt plaats vind niet plaats.
Concurrentie op de afzetmarkt?
Vind ik heel moeilijk te beantwoorden omdat ik niet zo goed zicht op heb. Maar dat is wel
de indruk die ik heb, dat een deel van de patiënten als wat planbare zorg is. Bijvoorbeeld
ik ga over 3 weken naar het ziekenhuis om een staaroperatie te doen of nieuwe knie erin te
laten zetten. Dat soort zorg vind wat meer concurrentie op plaats en vind meer de
marktwerking plaats. Je kan dit heel goed vergelijken, wat zijn nu de resultaten de
herstelkansen. Mensen zijn er vrij bewust mee bezig en zorgverzekeraars bieden daar
steeds meer informatie voor. Patiënten gaan zich op dat vlak wat meer als consumenten
gedragen. Alles wat acuut is daar is helemaal geen marktwerking voor, zo snel mogelijk
74 naar het ziekenhuis. Heel veel andere basiszorg is toch ook wel dat mensen daar voor
kiezen om dat in het ziekenhuis van hun stad terecht willen, omdat de huisarts dat gewoon
adviseert of voorschrijft. Ik denk dat het wel meevalt met de marktwerking tot nu toe ik
denk wel dat het sterker gaat worden en ik dat het ook gaat plaatsvinden voor hele
specifieke ingrepen. Als je je moeten laten opereren aan iets wat heel ernstig is dan gaan
patiënten toch goed vergelijken en informeren waar nu de beste zorg geleverd kan worden.
Patiënten uit Limburg komen hier naar toe voor een hartoperatie. Waar verder heel veel
concurrentie toeneemt is op de inkoopmarkt. Dat betekent dat zorgverzekeraars veel
sterker gaan onderhandelen over tarieven op de gezonheidsmarkt. De tarieven worden ook
vrijer voor onderhandelingen, waar ze vroeger werden vastgesteld door rijksoverheid. Ook
voor ziekenhuizen ontstaan er keuzes, willen wij dit nog wel tegen dat tarief aanbieden aan
zorgverzekeraars.
Heeft dit gevolgen gehad?
Nog geen dramatische gevolgen in de zin dat we nog geen behandelingen hebben moeten
stop zetten. Maar we kunnen nu maar een bepaald aantal patiënten behandelen omdat er
anders geen budget meer voor is. We moeten er dan op dat moment moeten stoppen.
Contingency factoren (Contextuele factoren)
Institutionele mechanisme
-­‐
-­‐
In welke mate heeft de wetgeving invloed op personeelsplanning (Pensioenen,
contracten, flexibel werk)?
Medewerkers hebben een contract voor onbepaalde tijd, dat is het uitgangspunt in de cao.
Dat is in de huidige tijd bijna onmogelijk omdat we gewoon heel slecht kunnen
voorspellen wat er volgend jaar op ons afkomt. Die wendbaarheid voor de organisatie
moeten we creëren. Aan de ene kant willen we ons heel graag aan de cao houden en dus
die contracten van onbepaalde tijd bieden. Aan de andere kant waar we argumenten
hebben om daar van af te wijken, bijvoorbeeld omdat we niet weten hoe begroting van een
afdeling er volgend jaar eruit ziet. Dan maken we een passende aanpassing, contract voor
bepaalde tijd. En dan kijken we volgend jaar of daar nog plaats voor is. Het gaat dus niet
om beoordelen van mensen op langere periode dat is niet toegestaan. Je kan niet zeggen je
krijgt een jaarcontract en bij goed functioneren krijg je een OT. BT kan alleen als je niet
weet of als er volgend jaar nog genoeg vraag is naar die functie. Jaarcontracten gebeuren
wel, maar dit kan niet als standaard gehanteerd worden. Het gebeurd wel als de formatie
onduidelijk is. Ik sluit het niet uit dat sommige leidinggevende het wel gebruiken om eerst
te
beoordelen
en
dan
toch
te
besluiten
om
te
verlengen.
Daarnaast zijn er natuurlijk allerlei andere vormen die tegemoet komen om de
flexibiliseren, Min max contracten. Waarbij je een contract afsluit voor minimaal aantal
uren die je sowieso kan werken en daar boven op een aantal uren die je kan werken waar
nodig is maar waar je geen recht op hebt. 0-uren contracten komen steeds minder voor, en
met het sociaal akkoord zijn deze vanaf de zomer verboden geworden en proberen dit nu
zoveel
mogelijk
af
te
bouwen.
In de cao wordt ook geprobeerd om mensen op onregelmatige basis te laten werken, maar
hier zitten vaak financieel toeslagen aan vast die niet aantrekkelijk zijn voor ziekenhuis 2.
Welke factoren werken begunstigend voor personeelsplanning en welke belemmerend?
75
Aan de ene kant is die cao een gedrocht want het is een enorm boekwerk met regels waar
iedereen zich aan moet houden. Heel veel artikelen uit de cao hebben een standaard
karakter en je bent verplicht om deze na te leven. Aan de andere kant biedt de cao heel
veel duidelijkheid aan medewerkers. Het is ook makkelijker uit te leggen dat je niet
afwijkt van de regels dan dat je uitlegt waarom je afwijkt van de regels. Er zitten ook
allerlei elementen in de cao die gemoderniseerd zouden kunnen worden. Dan denk ik
bijvoorbeeld aan toeslagen die staan op onregelmatigheid, of rechten op wachtgeld voor
hele lange periode als van een medewerker afscheid genomen moet worden. Het is wel erg
beschermend voor een medewerker terwijl de situatie voor ziekenhuizen op dit moment is
dat ze ontzettend goed naar de portemonnee moeten kijken om de validiteit van de zorg te
kunnen handhaven. Arbeidsvoorwaarden zijn heel erg geschreven op de hand van de
medewerker en hierdoor wordt het lastig om te concurreren en te kunnen meebewegen met
strategische verandering.
Beschikbare middelen
-­‐
Wat voor middelen spelen een rol in het personeelsplanning proces? (Financieel,
Mensen, IT)
Om personeelsplanning te kunnen realiseren, aan de ene kant kennis en die is wel
beschikbaar. We kunnen die ook halen uit andere organisaties. Ook is een systeem handig,
er zijn allerlei aanbieders die een stevige prijs hanteren. Ik denk dat het uiteindelijk niet in
de systemen zit, goede personeelsplanning niet een kwestie is van een goed systeem
aanschaffen maar dat het veel meer is dat het je lukt om het proces te organiseren binnen je
organisatie. Je moet tijd vrij maken en dat je het onderwerp op de agenda weet te krijgen
en dat je het lukt om daar heel gericht aandacht aan weet te geven in alle wirwar van
prioriteiten. Ik denk dat dat het allerbelangrijkst is. Zowel vanuit HR als vanuit het
lijnmanagement om daar samen mee aan de slag te gaan. En dan doen die systemen niet
echt iets en kan je het ook in het Excel bestand te zetten.
Overige contingency factoren
-­‐
Zijn er nog andere factoren die van invloed zijn op het personeelsplanning proces?
Eigenlijk gaat het over alles wat de vraag naar personeel beïnvloed. Dan hebben we het in
eerste instantie die vraag die de patiënten aan ons stelt en de behoefte aan zorg die er in
onze regio ligt. Dit wordt beïnvloed door de demografie, hoe zie de bevolking van Breda
en omstreken eruit, wat voor soort aandoeningen zijn er nou de komende jaren waar we als
ziekenhuis zorg aan moeten aanbieden. Dat is eigenlijk de kern van de zaak. De patiënt
heeft een bepaalde zorgvraag en daar moeten wij op inspelen met capaciteit en kwaliteit.
Daarnaast spelen allerlei juridische, commerciële en strategische belangen mee. Maar
uiteindelijk gaat het erom wat gaan onze patiënten nou doen en als we daar een beeld van
hebben dan kunnen we ook veel beter monitoren wat voor personeel we nou in de
toekomst
nodig
hebben.
Daar zijn we mee bezig en daar hebben we ook analyse, maar dat bieden vooral scenario’s.
Dat zijn waarschijnlijkheden en geen zekerheden maar dat beeld wordt wel af en toe
opgemaakt op basis van leeftijdsopbouw en residentie van aandoeningen.
76 Afsluitende vraag
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Wat zijn de belangrijkste lessen geleerd met betrekking tot personeelsplanning?
Het is een ontzettend mooi onderwerp, het is strategisch en heel veel over geschreven en in
alle media gehyped. Ik vraag me af hoeveel organisatie nu werkelijk succesvol een
werkend proces van hebben gemaakt. Ik ken wel wat voorbeeld maar het zijn iedere keer
dezelfde voorbeelden die je hoort, Shell Rabobank. Hoeveel organisaties zijn nu werkelijk
instaat iets goed te doen en het goed te houden. Het moet niet als een project neergezet
worden maar iets wat normaal is om te doen als lijnmanager. Je moet er tijd voor
vrijmaken. Er wordt heel veel geplugd vanuit consultancy en IT, maar uiteindelijk draait
het daar niet om. Het draait erom gaan we het doen? Maken we hier tijd voor vrij?
SPP is relevant, maar dat het enorm wordt aangedikt vanuit commerciële motieven en het
beantwoord vooral aan de behoefte van veiligheid en zekerheid. Je hebt het gevoel in
control te zijn, alleen die planning is vaak gebaseerd op aanname en zekerheid. Precies
uitrekenen is vaak toch wel flauwekul. Het is goed om te doen en in gesprek te blijven met
de lijn erover.
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