By Author
  By Title
  By Keywords

February-B 2021, Volume 71, Issue 2

Narrative Review

Linkage between performance of healthcare professionals and management practices in health care organizations

Munaza Bibi  ( Bahria University, Karachi Campus, Pakistan. )


The performance of healthcare professionals is now becoming a great apprehension for health care organizations to deliver quality services. Therefore, organizations are considering management practices to effectively manage their human resource, as they are an essential resource to deliver services through their performance. The objective of the current paper was to describe the link between management practices and performance of healthcare professionals in healthcare setup. In addition, based on the review, it has been found that recruitment & selection, training & development, performance appraisal along with compensation, practices of health and safety, as well as, flexible working hours play a crucial role in the enhancement of employee performance, whereas ineffective execution of these practices has a negative influence on the performance of healthcare professionals. Thus, the management of the health care segment should focus on the timely and fair implementation of the above-mentioned management practices in order to improve the performance of their employed personnel.

Keywords: Performance, Healthcare Professionals, Management, Practices.





Performance of healthcare professionals is an imperative aspect of concern for healthcare organizations nowadays due to increased competition as thousands of individuals have been employed in this sector (e.g., doctors, nurses, paramedical, and supplementary supporting staff).1,2 Due to the changing environment, health care organizations are also facing competition to provide quality services to patients while they have been focused to hire competent human resources as their performance can help an organization to gain a competitive edge over others.1 For the attainment of this purpose organizations are now investing in implementing a set of management practices because it will serve as the catalytic agent to persuade the individual performance.3

The management of personnel through employing various practices is sprouting as a true challenge for the health care segment.4 Though numerous studies viewed the importance of management practices for employee performance in other sectors yet how the implementation of management practices affects the performance of healthcare professionals has not been specified. Therefore, the existing narrative review was deliberate to comprehend the influence of management practices on the performance of healthcare professionals using the existing literature. Thus, the prime objective of this study was to sightsee a link between management practices and the performance of healthcare professionals to deliver quality services. However, this objective was outlined by means of the research question i.e., whether healthcare professionals perform better when healthcare organization executes management practices? Therefore, the pertinent articles reporting on management practices and performance of healthcare professionals were included in order to support the study objective. Therefore, this study provides an inclusive examination of existing literature regarding management practices i.e., recruitment & selection, training & development, performance appraisal, compensation, practices of health and safety, and flexible working hours that affect the performance of healthcare professionals.


Management Practices and Healthcare Professionals Performance


Nowadays, healthcare organizations particularly focusing on the delivery of quality services to patients through the performance of their employed workers by developing a system of management practices which embrace recruitment, training as well as development, performance appraisal, timely administration of compensation, safety & health, and working hours to meet the organizational goals via delivery of quality healthcare services to patients.5,6  The next section has highlighted the linkage between management practices and the performance of health care professionals. So, the practices considered in the current review are recruitment and selection, training and development, performance appraisal, compensation, health and safety as well as flexible working hours.


Recruitment & Selection and Performance of Healthcare Professionals


The first aspect in the management of the human resource is recruitment and selection because it helps the organization to hire the best individuals,7 which eventually result in augmentation of performance at both levels; individual and organizational. In fact, the bias decisions of management made in the process of hiring affect the performance positively or negatively. Accordingly, as per the current literature, due to the presence of preferential treatment during hiring & selection in the organization,8 can eventually result in the prevalence of negative perception among employees which in turn affects their performance unfavorably. On the other side, when the process is implemented fairly result in better performance as several studies unveiled that a noteworthy relationship exists between the recruitment & selection process and performance of health care staff.9,10


Training & Development and Performance of Healthcare Professionals


For a healthcare organization, training and development of professionals are the main tools for enhancement of their knowledge and skills which fallouts in better employee's attitudes, behavior, and performance.11,12 The researcher proclaimed that the implementation of training and development practices according to the need of an individual can meaningfully affect the performance of health care professionals.13,14 So, the training & development of staff in due course result in enhancement of employee retention, staff morale, job competency to perform the task more confidently and efficiently; in the end, a patient feels satisfied because of the positive attitude of healthcare professionals.15 Therefore, training and development is considered as an important management practice to improve the knowledge, skills and capabilities of human resources for the current as well as anticipated task at workplace that result in better performance of human resources.


Performance Appraisal and Performance of Healthcare Professionals


An appraisal is often named as individual performance review an essential factor to identify the gaps in individual performance.16 In the parallel vein, presence of biases in terms of identifying gaps in the performance of human resources is also specified in the extant literature that the appraisal process must be free of bias,17 because if the employee perceives that the assessment process is negative or based on preferential basis rather on performance criteria eventually result in decreasing trust on the appraisal system,18,19 which in turn affect their performance ahead whereas when an employee perceives the assessment process positively, eventually result in higher performance. So, conducting the performance appraisal process without having any bias is an important apprehension for an organization because it is linked with creating either positive and negative perception among employees.


Compensation and Performance of Healthcare Professionals


Compensation is viewed as an output individual receives for the results of their input is affecting the individual performance in the health care segment.20 Consistently, the scholars pointed out when a health care organization compensates its staff (clinical and non-clinical) efficiently,21 it fallouts into a better quality of care and performance.22-24 On the other pointer, a negative association also exists between compensation and performance as per the outcome of the study,25 because dissatisfaction with compensation would reduce the performance of employees along with the increasing complaint and causing them to call for work strike.26 Accordingly, the ineffective execution of compensation can result in affecting the performance of human resources adversely.


Health & Safety and Performance of Healthcare Professionals


The provision of a safe and healthy environment for healthcare professionals is one of the most important areas of emphasis for organizations particularly healthcare setup. As they are confronted with factors that cause hazards to the health and safety of healthcare professionals include occupational diseases due to exposure to blood and body fluids,27 sterilants (chemicals), drugs, latex (material that causes allergies), and radiation.28 As a result, of the presence of the above-mentioned hazards, the health professionals are more susceptible to health and safety hazards,29 which in turn affect their performance negatively. On the opposing quarrel, effective implementation of health and safety practices in healthcare setup was found to produce positive outcomes such as enhancement of productivity and performance of healthcare professionals.30,31 


Flexible Working Hours and Performance of Health Care Professionals


In health care set up flexible working hours are an imperative area to contemplate because of the nature of the long working hours as it can create disturbance in healthcare professional's family life,32 which in turn affects their performance. Similarly, investigators in their study unveiled that health care professionals who worked for 12-hours provided lesser quality of care to the patient as compared to those who performed their tasks for 8-hours.33 Moreover, the fallouts of studies indicate that the practices of flexible working hours affect positively the performance of health care professionals.34,35 Subsequently, it is important for the health care organization to offer flexible work schedules for better performance of healthcare professionals.

However, mixed indications found in the literature regarding management practices as researchers have viewed that management practices affect the healthcare professional's performance positively just because of fair implementation of practices while on the adjacent side other investigators have seen that management practices affect healthcare professional's performance negatively. The reason behind negative affect is the presence of preferential treatment during the hiring & selection and performance appraisal process along with lack of training and development programs for healthcare professionals to deal with anticipated changes and inapt compensations for their input along with that the absence of flexible work hours and inaccessibility to health and safety environment. Accordingly, few suggestions that healthcare organizations could adopt perhaps result in improvement of healthcare professional's performance include merit-based recruitment & selection process, proper training & development programs according to needs of an individual to deal with changes, performance appraisal must be based on standards rather than on preferential basis along with timely execution of compensation. In addition, the organization must take protective & prevention measures for the better health and safety of healthcare professionals. Moreover, flexible schedules must be provided to a professional working in healthcare setup to augment their performance. Thus, a healthcare organization can increase the performance of healthcare professionals by executing impartial management practices. Therefore, implementation of management practices can affect the performance of human resources positively as well as negatively depending on how an employee perceives the whole process. While it is important to comprehend how these practices are executed in developing countries like Pakistan by collecting data from both managers as well as employees as limited empirical evidence exists how managers and employees perceive the implementation of management practices in healthcare setup.




Management practices is an important area for the healthcare organization. Several management practices prompt performance among healthcare professionals, including recruitment & selection, training & development, performance appraisal along with compensation, practices of health and safety as well as flexible working hours as these practices can help an organization to improve the performance of their employees. Besides, the review discovered that the ineffective execution of management practices has negative influence whereas the effective execution of practices has a substantially positive effect on the performance of healthcare professionals. In general, increased responsiveness to implement proper management practices by health care organizations has now become an essential aspect and it is possible by developing strategies to manage the employees of this sector because their performance is linked with the health of patients.


Disclaimer: None to declare.

Conflict of Interest: None to declare.

Source of Funding: None to declare.




1.      Chuang E, Dill J, Morgan JC, Konrad TR. A Configurational Approach to the Relationship between High-Performance Work Practices and Frontline Health Care Worker Outcomes. Health Serv Res. 2012; 47:1460-81.

2.      Nica E. The Importance of Human Resources Management to the Health Care System. Eco Manag Fina Markets. 2013; 8:166-71.

3.      Pillai MM, Senthilraj DO, Swaminathan.S D. Role of Human Resources Management in Healthcare Organizations: A Review. Int J Health Sci Res. 2019; 9:228-35.

4.      Ganapathy S, Ashokkumar M. A Study On Human Resource Management Practices (Hrm) And Job Satisfaction Of Employees Of Paramedics In Private Hospitals. Int J Manag Res Rev. 2017; 7:584-95.

5.      Mujeeb LM. Importance of best Human Resource Management Practices and the need for a Human Resource Information System (HRIS) for the Public Health Sector in Sri Lanka. Srilanka J Bio Med Informatic. 2013; 3:55-62.

6.      Pradhan P, Muraleedharan VR, Kamalnabhan TJ, Thulasiraj RD. Healthcare Human Resource For Ensuring Patient Focused Care. Hum Res Manag. 2015; XIX:20-25.

7.      Stanujkic D, Djordjevic B, Karabasevic D. Selection Of Candidates In The Process Of Recruitment And Selection Of Personnel Based On The Swara And Aras Methods. Quaestus Multidisciplinary Res J. 2015; 7:53-62.

8.      Kumar P, Khan AM. Human Resource Management In Primary Health Care System. Health and Population: Perspect Issues. 2013; 36:66-76.

9.      Makhamara FH, Waiganjo DEW, Kwasira DJ. Influence Of Strategic Recruitment And Selection On Employee Performance In The Health Sector In Kenya. Strateg J Bus Change Mang. 2016; 3:347-61.

10.    Tripathi R, Srivastava A. Recruitment and Selection Process in Healthcare Industry in India. Amity J Healthcare Manag. 2017; 2:36-49.

11.    Kiweewa SB, Asiimwe SB. Does training influence employee performance in regulatory organizations in Uganda: Empirical evidence from UCC. Merit Res J Bus Manag. 2014; 2:21-9.

12.    Siddique MU, Rehman A, Jafri SA. The Impact of Training and Development on Employee’s Performance on Private and Public Hospitals in Lahore, Pakistan. Med Forum. 2015; 26:47-51.

13.    Fatema N. Stimulation of Efficient Employee Performance through Human Resource Management Practices: A Study on the Healthcare Sector of Bangladesh. Int J Bus Soc Res. 2018; 08:01-18.

14.    Madhawa D, Premashantha LJ, Fernando K, Mullekanda A, Atapattu A. Impact Of Employees’ Training On Their Work Performance; With Reference To Abc Pvt. Hospital In Sri Lanka SS Wanigasingha. J Bus Manag. 2018:40-7.

15.    Gesme DH, Towle EL, Wiseman M. Essentials of staff development and why you should care. J Oncol Pract. 2010; 6:104-6.

16.    Dharmadhikari DSP, Bampoori M. Study of employee performance appraisal methods in hospitals. Int J Acad Res Dev. 2018; 3:1149-53.

17.    Fernandes CA. Impact of organizational justice in an expatriate work environment. Manag Res News. 2006; 2:56-63.

18.    Abubakr MT. Links between justice, satisfaction and performance in the workplace: A survey in the UAE and Arabic context. J Manag Dev. 2007; 26:294-311.

19.    Javidmehr M, Ebrahimpour M. Performance appraisal bias and errors: The influences and consequences. Int J Organizational Leadership. 2015; 4:286-302.

20.    Minor AC. Compensation as a Construct for Employee Motivation in Healthcare. Am J Manag. 2013; 13:108-11.

21.    Sewe S, Bula H, Oringo J. Compensation Management Practices and Quality of Health Care at Jaramogi Oginga Odinga Teaching and Referral Hospital. Am Sci Res J Engineer Technol Sci. 2018; 49:146-74.

22.    Dayanandan DR. Effects Of Compensation On The Job Performance Among Hospital Employees!! - A Meta Analysis. J Manag Sci. 2017; 7:1-27.

23.    Riaz Q, Ayaz K, Wain AM, Sajid M. Impact of HR Practices on Perceived Performance of Hospital Employees in Pakistan. J Eco Sustain Dev. 2012; 3:10-15.

24.    Abduljawad A, Al-Assaf AF. Incentives for better performance in health care. Sultan Qaboos Univ Med J. 2011;11:201-6.

25.    Duvie AN, Nwokediuko, Issadas Chinwendu. Direct Compensation Management As Correlate Of Teacher Task Performance. Eur J Edu Stud. 2017; 3:132-49.

26.    Pangarso A, Darmawan I, Kamil I. Compensation Effect On Police Hospital Employees Performance at Bandung, Indonesia. 6th Global Conference On Business & Social Sciences (GCBSS-2017). Thailand: 2017.

27.    Siegel JD, Rhinehart E, Jackson M, Chiarello L, Health Care Infection Control Practices Advisory Committee. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Am J Infect Control. 2007; 35:S65-164.

28.    Other Hazards. Occupational Safety and Health Administration: United States Department of Labor. [onlie] [cited 2020 Apr 23].Available from:URL: from

29.    Jivany N, Yakoob J, Bana S, Faisa A, Jawed H. Professional Practices Promoting Health of Healthcare Workers: Comparison of Public and Private Hospitals in Pakistan. Int J Hospital Res. 2016; 5:87-92.

30.    Gbadago P, Amedome SN, Honyenuga BQ. The Impact of Occupational Health and Safety Measures on Employee Performance at the South Tongu District Hospital. Global J Med Res. 2017;17:13-9.

31.    Kaynak R, Toklu A, Elçi M, Toklu I. Effects of Occupational Health and Safety Practices on Organizational Commitment, Work Alienation, and Job Performance: Using the PLS-SEM Approach. Int J Bus  Manag. 2016; 11:146-66.

32.    Drouin R, Potter M. Flexible scheduling: Exploring the benefits and the limitations. Am J Nurs. 2005; 105:72E-F.

33.    Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM. Sleep, Sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int. 2012; 29:211-9.

34.    John F, Alex B. Working time flexibility and productivity in Britain Theory and evidence: Nat Inst Eco Soc Res. 2011.

35.    Osisioma H, Nzewi H, Ifechi I. Flexible Working Hours And Employee Performance In Selected Hospitals In Awka Metropolis, Anambra State, Nigeria. Int J Hum Res Manag Res. 2015; 5:1-10.


Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: