Monday, August 3, 2009
Sunday, August 2, 2009
Sunday, July 26, 2009
Saturday, July 25, 2009
Sunday, June 14, 2009
Monday, June 8, 2009
Tuesday, June 2, 2009
Saturday, May 30, 2009
Tuesday, May 26, 2009
Monday, May 18, 2009
Sunday, May 17, 2009
Monday, May 11, 2009
Sunday, May 10, 2009
Friday, May 8, 2009
Thursday, May 7, 2009
Tuesday, May 5, 2009
Monday, May 4, 2009
Tuesday, April 28, 2009
Saturday, April 25, 2009
Thursday, April 23, 2009
How to improve communication between doctors and patients -- Charles et al. 320 (7244): 1220 -- BMJ
How to improve communication between doctors and patients -- Charles et al. 320 (7244): 1220 -- BMJ: "BMJ 2000;320:1220-1221 ( 6 May )
BMJ 2000;320:1220-1221 ( 6 May )
Editorials
How to improve communication between doctors and patients
Learning more about the decision making context is important
General practice p 1246
Communication difficulties between doctors and patients have been looked at by researchers from several disciplines who have tried to explore why these occur. Mishler, for example, has argued that doctors and patients talk to each other with different voices.1 The voice of medicine is characterised by medical terminology, objective descriptions of physical symptoms, and the classification of these within a reductionist biomedical model.1 The voice of patients, on the other hand, is characterised by non-technical discourse about the subjective experience of illness within the context of social relationships and the patient's everyday world. Typically, doctors have more power than patients to structure the nature of the interaction between them. As a consequence, patients may feel that their voice is overridden, silenced, or stripped of personal meaning and social context. To improve communications between doctors and patients we need also to understand the nature of the decision making that is taking place in the consultation.
Two recent papers in the BMJ, one of them published this week (p 1246), focus on the type and frequency of communication misunderstandings experienced by general practitioners and their patients in 20 English general practices. 2 3 The prevalence of these misunderstandings among presumably well intentioned doctors and their patients is alarming, particularly given their effects on subsequent patient behaviour.
In their first paper the authors presented findings about communication misunderstandings associated with prescribing decisions.2 Fourteen categories of misunderstandings between doctors and patients were identified, each of which had potential or actual adverse consequences for medicine taking. All were associated with a lack of patient participation in decision making in terms of voicing expectations or preferences or voicing responses to their doctor's actions.
In this week's paper the authors explore the agendas that patients bring for discussion with their doctor at a forthcoming consultation; those aspects of patients' agendas that they actually voiced in the consultation; and the effects of unvoiced agendas on patients' subsequent behaviour.3 Most patients did not voice all their agenda items, though it is important to note that these items were generated during a qualitative interview, which is longer and more open ended than a normal consultation. Unvoiced agenda items led to specific problems such as unwanted prescriptions and non-adherence.
The authors recommend that efforts should be made to improve communication between doctors and patients in the treatment decision making process, and they are developing educational interventions targeted at doctors to address these issues. Patient focused interventions, although not mentioned, are also likely to help patients voice their agendas. A potential limitation of the research is that it is not clear how many of the consultations studied represented repeat visits to a doctor with whom the patients had a continuing relationship. This is important because unspoken agendas may have been covered in an earlier visit (and indeed could still be voiced in a later one).
Nevertheless, these findings indicate that treatment decision making in the medical encounter is a complex and dynamic process, the course of which is not predictable in advance because no two encounters are exactly the same. Doctors are being urged to practise shared treatment decision making with their patients, and clearly unspoken patient agendas pose barriers to this goal.
It is now recognised that there are several distinct approaches to treatment decision making that doctors can use with their patientsthe paternalistic, the shared, and the informed (or consumerist) approach. Each has different implications for the roles of doctors and patients in communicating information and for the type, amount, and flow of information between the two.4 Moreover, some approaches are more amenable than others to incorporating patients' voices and eliciting patients' agendas.
Doctors who adopt a paternalistic approach, for example, are unlikely to have much interest in discussing patient concerns expressed "in the voice of the life world."1 They are more likely to want short descriptions of physical symptoms that they can transform into diagnostic categories. In the "pure type" of this approach doctors can then make a treatment decision that they think is in their patients' best interest without having to explore each patient's values and concerns.
In the informed approach patients are accorded a more active role in both defining the problem for which they want help and in determining appropriate treatment. In the pure type of this approach the doctor's role is limited to providing relevant research information about treatment options and their benefits and risks so that the patient can make an informed decision.
Only in the shared approach do doctors commit themselves to an interactive relationship with patients in developing a treatment recommendation that is consistent with patient values and preferences.5 To enable this to happen, the doctor needs to create an open atmosphere in which patients can communicate all their agenda items. In this approach information exchange helps the doctor understand the patient and ensures that the patient is informed of treatment options and their risks and benefits. It also allows patients to assess whether they feel they can build a relationship of trust with their doctor.
Actual behaviour, of course, rarely corresponds to ideal types, and most doctor-patient encounters combine elements from different models.6 Moreover, the approach adopted at the beginning of an encounter may change as the doctor gains a better sense of whether the patient has a good understanding of the available treatments.
To develop effective interventions to promote better communication, it is useful to explore specific communication patterns within the broader context of the type of decision making process within which communication is embedded. For example, there may be a mismatch between the decision making approach that the doctor wants to use and patients' desire to voice their own agenda in their own words. Understanding the reasons why communication problems occur can help researchers develop interventions designed specifically to address potentially different types of communication issues. 7 8
Cathy Charles, associate professor.
Amiram Gafni, professor.
Tim Whelan, associate professor.
Centre for Health Economics and Policy Analysis and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8L 2X2
--------------------------------------------------------------------------------
1. Mishler EG. The discourse of medicine, dialectics of medical interviews. Norwood, New Jersey: Ablex Publishing Corporation, 1984.
2. Britten N, Stevenson FA, Barry CA, Barber N, Bradley CP. Misunderstandings in general practice prescribing decisions: qualitative study. BMJ 2000; 320: 484-488[Abstract/Free Full Text].
3. Barry C, Bradley C, Britten N, Stevenson F, Barber N. Patients' unvoiced agendas in general practice consultations: qualitative study. BMJ 2000; 320: 1246-1250[Abstract/Free Full Text].
4. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango) Soc Sci Med 1997; 44: 681-692.
5. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med 1999; 49: 651-661.
6. Charles C, Gafni A, Whelan T. What do we mean by partnership in making decisions about treatment? BMJ 1999; 319: 780-782[Free Full Text].
7. Gafni A, Charles C, Whelan T. The physician-patient encounter: the physician as a perfect agent for the patient versus the informed treatment decision-making model. Soc Sci Med 1998; 47: 347-354.
8. Whelan T, Gafni A, Charles C, Levine M. Lesson learned from the decision board: a unique and evolving decision aid. Health Expectations (in press).
BMJ 2000;320:1220-1221 ( 6 May )
Editorials
How to improve communication between doctors and patients
Learning more about the decision making context is important
General practice p 1246
Communication difficulties between doctors and patients have been looked at by researchers from several disciplines who have tried to explore why these occur. Mishler, for example, has argued that doctors and patients talk to each other with different voices.1 The voice of medicine is characterised by medical terminology, objective descriptions of physical symptoms, and the classification of these within a reductionist biomedical model.1 The voice of patients, on the other hand, is characterised by non-technical discourse about the subjective experience of illness within the context of social relationships and the patient's everyday world. Typically, doctors have more power than patients to structure the nature of the interaction between them. As a consequence, patients may feel that their voice is overridden, silenced, or stripped of personal meaning and social context. To improve communications between doctors and patients we need also to understand the nature of the decision making that is taking place in the consultation.
Two recent papers in the BMJ, one of them published this week (p 1246), focus on the type and frequency of communication misunderstandings experienced by general practitioners and their patients in 20 English general practices. 2 3 The prevalence of these misunderstandings among presumably well intentioned doctors and their patients is alarming, particularly given their effects on subsequent patient behaviour.
In their first paper the authors presented findings about communication misunderstandings associated with prescribing decisions.2 Fourteen categories of misunderstandings between doctors and patients were identified, each of which had potential or actual adverse consequences for medicine taking. All were associated with a lack of patient participation in decision making in terms of voicing expectations or preferences or voicing responses to their doctor's actions.
In this week's paper the authors explore the agendas that patients bring for discussion with their doctor at a forthcoming consultation; those aspects of patients' agendas that they actually voiced in the consultation; and the effects of unvoiced agendas on patients' subsequent behaviour.3 Most patients did not voice all their agenda items, though it is important to note that these items were generated during a qualitative interview, which is longer and more open ended than a normal consultation. Unvoiced agenda items led to specific problems such as unwanted prescriptions and non-adherence.
The authors recommend that efforts should be made to improve communication between doctors and patients in the treatment decision making process, and they are developing educational interventions targeted at doctors to address these issues. Patient focused interventions, although not mentioned, are also likely to help patients voice their agendas. A potential limitation of the research is that it is not clear how many of the consultations studied represented repeat visits to a doctor with whom the patients had a continuing relationship. This is important because unspoken agendas may have been covered in an earlier visit (and indeed could still be voiced in a later one).
Nevertheless, these findings indicate that treatment decision making in the medical encounter is a complex and dynamic process, the course of which is not predictable in advance because no two encounters are exactly the same. Doctors are being urged to practise shared treatment decision making with their patients, and clearly unspoken patient agendas pose barriers to this goal.
It is now recognised that there are several distinct approaches to treatment decision making that doctors can use with their patientsthe paternalistic, the shared, and the informed (or consumerist) approach. Each has different implications for the roles of doctors and patients in communicating information and for the type, amount, and flow of information between the two.4 Moreover, some approaches are more amenable than others to incorporating patients' voices and eliciting patients' agendas.
Doctors who adopt a paternalistic approach, for example, are unlikely to have much interest in discussing patient concerns expressed "in the voice of the life world."1 They are more likely to want short descriptions of physical symptoms that they can transform into diagnostic categories. In the "pure type" of this approach doctors can then make a treatment decision that they think is in their patients' best interest without having to explore each patient's values and concerns.
In the informed approach patients are accorded a more active role in both defining the problem for which they want help and in determining appropriate treatment. In the pure type of this approach the doctor's role is limited to providing relevant research information about treatment options and their benefits and risks so that the patient can make an informed decision.
Only in the shared approach do doctors commit themselves to an interactive relationship with patients in developing a treatment recommendation that is consistent with patient values and preferences.5 To enable this to happen, the doctor needs to create an open atmosphere in which patients can communicate all their agenda items. In this approach information exchange helps the doctor understand the patient and ensures that the patient is informed of treatment options and their risks and benefits. It also allows patients to assess whether they feel they can build a relationship of trust with their doctor.
Actual behaviour, of course, rarely corresponds to ideal types, and most doctor-patient encounters combine elements from different models.6 Moreover, the approach adopted at the beginning of an encounter may change as the doctor gains a better sense of whether the patient has a good understanding of the available treatments.
To develop effective interventions to promote better communication, it is useful to explore specific communication patterns within the broader context of the type of decision making process within which communication is embedded. For example, there may be a mismatch between the decision making approach that the doctor wants to use and patients' desire to voice their own agenda in their own words. Understanding the reasons why communication problems occur can help researchers develop interventions designed specifically to address potentially different types of communication issues. 7 8
Cathy Charles, associate professor.
Amiram Gafni, professor.
Tim Whelan, associate professor.
Centre for Health Economics and Policy Analysis and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8L 2X2
--------------------------------------------------------------------------------
1. Mishler EG. The discourse of medicine, dialectics of medical interviews. Norwood, New Jersey: Ablex Publishing Corporation, 1984.
2. Britten N, Stevenson FA, Barry CA, Barber N, Bradley CP. Misunderstandings in general practice prescribing decisions: qualitative study. BMJ 2000; 320: 484-488[Abstract/Free Full Text].
3. Barry C, Bradley C, Britten N, Stevenson F, Barber N. Patients' unvoiced agendas in general practice consultations: qualitative study. BMJ 2000; 320: 1246-1250[Abstract/Free Full Text].
4. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango) Soc Sci Med 1997; 44: 681-692.
5. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med 1999; 49: 651-661.
6. Charles C, Gafni A, Whelan T. What do we mean by partnership in making decisions about treatment? BMJ 1999; 319: 780-782[Free Full Text].
7. Gafni A, Charles C, Whelan T. The physician-patient encounter: the physician as a perfect agent for the patient versus the informed treatment decision-making model. Soc Sci Med 1998; 47: 347-354.
8. Whelan T, Gafni A, Charles C, Levine M. Lesson learned from the decision board: a unique and evolving decision aid. Health Expectations (in press).
Sunday, April 19, 2009
Thursday, April 16, 2009
Wednesday, April 15, 2009
Wednesday, March 18, 2009
Tuesday, March 17, 2009
Sunday, March 15, 2009
Saturday, March 14, 2009
The Nation's Health Care System - The Components Of The Health Care System
The health care system consists of all personal medical care services—prevention, diagnosis, treatment, and rehabilitation (services to restore function and independence)—plus the institutions and personnel that provide these services and the government, public, and private organizations and agencies that finance service delivery.
The health care system may be viewed as a complex made up of three interrelated components: people in need of health care services, called health care consumers; people who deliver health care services—the professionals and practitioners called health care providers; and the systematic arrangements for delivering health care—the public and private agencies that organize, plan, regulate, finance, and coordinate services—called the institutions or organizations of the health care system. The institutional component includes hospitals, clinics, and home-health agencies; the insurance companies and programs that pay for services like Blue Cross/Blue Shield, managed-care plans such as health maintenance organizations (HMOs), and preferred provider organizations (PPOs); and entitlement programs like Medicare and Medicaid (federal and state government public assistance programs). Other institutions are the professional schools that train students for careers in medical, public health, dental, and allied health professions, such as nursing. Also included are agencies and associations that research and monitor the quality of health care services; license and accreditation providers and institutions; local, state, and national professional societies; and the companies that produce medical technology, equipment, and pharmaceuticals.
Much of the interaction among the three components of the health care system occurs directly between individual health care consumers and providers. Other interactions are indirect and impersonal such as immunization programs or screening to detect disease, performed by public health agencies for whole populations. All health care delivery does, however, depend on interactions among all three components. The ability to benefit from health care depends on an individual's or group's ability to gain entry to the health care system. The process of gaining entry to the health care system is referred to as access, and many factors can affect access to health care. This chapter provides an overview of how Americans access the health care system.
The health care system consists of all personal medical care services—prevention, diagnosis, treatment, and rehabilitation (services to restore function and independence)—plus the institutions and personnel that provide these services and the government, public, and private organizations and agencies that finance service delivery.
The health care system may be viewed as a complex made up of three interrelated components: people in need of health care services, called health care consumers; people who deliver health care services—the professionals and practitioners called health care providers; and the systematic arrangements for delivering health care—the public and private agencies that organize, plan, regulate, finance, and coordinate services—called the institutions or organizations of the health care system. The institutional component includes hospitals, clinics, and home-health agencies; the insurance companies and programs that pay for services like Blue Cross/Blue Shield, managed-care plans such as health maintenance organizations (HMOs), and preferred provider organizations (PPOs); and entitlement programs like Medicare and Medicaid (federal and state government public assistance programs). Other institutions are the professional schools that train students for careers in medical, public health, dental, and allied health professions, such as nursing. Also included are agencies and associations that research and monitor the quality of health care services; license and accreditation providers and institutions; local, state, and national professional societies; and the companies that produce medical technology, equipment, and pharmaceuticals.
Much of the interaction among the three components of the health care system occurs directly between individual health care consumers and providers. Other interactions are indirect and impersonal such as immunization programs or screening to detect disease, performed by public health agencies for whole populations. All health care delivery does, however, depend on interactions among all three components. The ability to benefit from health care depends on an individual's or group's ability to gain entry to the health care system. The process of gaining entry to the health care system is referred to as access, and many factors can affect access to health care. This chapter provides an overview of how Americans access the health care system.
Thursday, February 5, 2009
Human resource management
Human resource management
Human resource management (HRM) is the strategic and coherent approach to the management of an organisation's most valued assets - the people working there who individually and collectively contribute to the achievement of the objectives of the business. The terms "human resource management" and "human resources" (HR) have largely replaced the term "personnel management" as a description of the processes involved in managing people in organizations.
Contents
1 Features
2 Academic theory
2.1 Critical Academic Theory
3 Business practice
4 Careers
5 Professional organizations
6 See also
7 References
Features
Its features include:
Organizational management
Personnel administration
Personnel management
Manpower management
Industrial management
But these traditional expressions are becoming less common for the theoretical discipline. Sometimes even industrial relations and employee relations are confusingly listed as synonyms, although these normally refer to the relationship between management and workers and the behaviour of workers in companies.
The theoretical discipline is based primarily on the assumption that employees are individuals with varying goals and needs, and as such should not be thought of as basic business resources, such as trucks and filing cabinets. The field takes a positive view of workers, assuming that virtually all wish to contribute to the enterprise productively, and that the main obstacles to their endeavours are lack of knowledge, insufficient training, and failures of process.
HRM is seen by practitioners in the field as a more innovative view of workplace management than the traditional approach. Its techniques force the managers of an enterprise to express their goals with specificity so that they can be understood and undertaken by the workforce, and to provide the resources needed for them to successfully accomplish their assignments. As such, HRM techniques, when properly practiced, are expressive of the goals and operating practices of the enterprise overall. HRM is also seen by many to have a key role in risk reduction within organisations.
Synonyms such as personnel management are often used in a more restricted sense to describe activities that are necessary in the recruiting of a workforce, providing its members with payroll and benefits, and administrating their work-life needs. So if we move to actual definitions, Torrington and Hall (1987) define personnel management as being:
“a series of activities which: first enable working people and their employing organisations to agree about the objectives and nature of their working relationship and, secondly, ensures that the agreement is fulfilled" (p. 49).
While Miller (1987) suggests that HRM relates to:
".......those decisions and actions which concern the management of employees at all levels in the business and which are related to the implementation of strategies directed towards creating and sustaining competitive advantage" (p. 352).
Academic theory
The goal of human resource management is to help an organization to meet strategic goals by attracting, and maintaining employees and also to manage them effectively. The key word here perhaps is "fit", i.e. a HRM approach seeks to ensure a fit between the management of an organization's employees, and the overall strategic direction of the company (Miller, 1989).
The basic premise of the academic theory of HRM is that humans are not machines, therefore we need to have an interdisciplinary examination of people in the workplace. Fields such as psychology, industrial engineering, industrial, Legal/Paralegal Studies and organizational psychology, industrial relations, sociology, and critical theories: postmodernism, post-structuralism play a major role. Many colleges and universities offer bachelor and master degrees in Human Resources Management.
One widely used scheme to describe the role of HRM, developed by Dave Ulrich, defines 4 fields for the HRM function:[6]
Strategic business partner
Change management
Employee champion
Administration
However, many HR functions these days struggle to get beyond the roles of administration and employee champion, and are seen rather as reactive than strategically proactive partners for the top management. In addition, HR organizations also have the difficulty in proving how their activities and processes add value to the company. Only in the recent years HR scholars and HR professionals are focusing to develop models that can measure if HR adds value.[7]
Critical Academic Theory
Postmodernism plays an important part in Academic Theory and particularly in Critical Theory. Indeed Karen Legge in 'Human Resource Management: Rhetorics and Realities' poses the debate of whether HRM is a modernist project or a postmodern discourse (Legge 2004). In many ways, critically or not, many writers contend that HRM itself is an attempt to move away from the modernist traditions of personnel (man as machine) towards a postmodernist view of HRM (man as individuals). Critiques include the notion that because 'Human' is the subject we should recognize that people are complex and that it is only through various discourses that we understand the world. Man is not Machine, no matter what attempts are made to change it i.e. Fordism / Taylorism, McDonaldisation (Modernism).
Critical Theory also questions whether HRM is the pursuit of "attitudinal shaping" (Wilkinson 1998), particularly when considering empowerment, or perhaps more precisely pseudo-empowerment - as the critical perspective notes. Many critics note the move away from Man as Machine is often in many ways, more a Linguistic (discursive) move away than a real attempt to recognise the Human in Human Resource Management.
Critical Theory, in particular postmodernism (poststructualism), recognises that because the subject is people in the workplace, the subject is a complex one, and therefore simplistic notions of 'the best way' or a unitary perspectives on the subject are too simplistic. It also considers the complex subject of power, power games, and office politics. Power in the workplace is a vast and complex subject that cannot be easily defined. This leaves many critics to suggest that Management 'Gurus', consultants, 'best practice' and HR models are often overly simplistic, but in order to sell an idea, they are simplified, and often lead Management as a whole to fall into the trap of oversimplifying the relationship.
Business practice
Human resources management comprises several processes. Together they are supposed to achieve the above mentioned goal. These processes can be performed in an HR department, but some tasks can also be outsourced or performed by line-managers or other departments.
Workforce planning
Recruitment (sometimes separated into attraction and selection)
Induction and Orientation
Skills management
Training and development
Personnel administration
Compensation in wage or salary
Time management
Travel management (sometimes assigned to accounting rather than HRM)
Payroll (sometimes assigned to accounting rather than HRM)
Employee benefits administration
Personnel cost planning
Performance appraisal
Careers
The sort of careers available in HRM are varied. There are generalist HRM jobs such as human resource assistant. There are careers involved with employment, recruitment and placement and these are usually conducted by interviewers, EEO (Equal Employment Opportunity) specialists or college recruiters. Training and development specialism is often conducted by trainers and orientation specialists. Compensation and benefits tasks are handled by compensation analysts, salary administrators, and benefits administrators.
Professional organizations
Professional organizations in HRM include the Society for Human Resource Management, the Australian Human Resources Institute (AHRI), the Chartered Institute of Personnel and Development (CIPD), the International Public Management Association for HR (IPMA-HR), Management Association of Nepal MAN and the International Personnel Management Association of Canada (IPMA-Canada).
Human resource management (HRM) is the strategic and coherent approach to the management of an organisation's most valued assets - the people working there who individually and collectively contribute to the achievement of the objectives of the business. The terms "human resource management" and "human resources" (HR) have largely replaced the term "personnel management" as a description of the processes involved in managing people in organizations.
Contents
1 Features
2 Academic theory
2.1 Critical Academic Theory
3 Business practice
4 Careers
5 Professional organizations
6 See also
7 References
Features
Its features include:
Organizational management
Personnel administration
Personnel management
Manpower management
Industrial management
But these traditional expressions are becoming less common for the theoretical discipline. Sometimes even industrial relations and employee relations are confusingly listed as synonyms, although these normally refer to the relationship between management and workers and the behaviour of workers in companies.
The theoretical discipline is based primarily on the assumption that employees are individuals with varying goals and needs, and as such should not be thought of as basic business resources, such as trucks and filing cabinets. The field takes a positive view of workers, assuming that virtually all wish to contribute to the enterprise productively, and that the main obstacles to their endeavours are lack of knowledge, insufficient training, and failures of process.
HRM is seen by practitioners in the field as a more innovative view of workplace management than the traditional approach. Its techniques force the managers of an enterprise to express their goals with specificity so that they can be understood and undertaken by the workforce, and to provide the resources needed for them to successfully accomplish their assignments. As such, HRM techniques, when properly practiced, are expressive of the goals and operating practices of the enterprise overall. HRM is also seen by many to have a key role in risk reduction within organisations.
Synonyms such as personnel management are often used in a more restricted sense to describe activities that are necessary in the recruiting of a workforce, providing its members with payroll and benefits, and administrating their work-life needs. So if we move to actual definitions, Torrington and Hall (1987) define personnel management as being:
“a series of activities which: first enable working people and their employing organisations to agree about the objectives and nature of their working relationship and, secondly, ensures that the agreement is fulfilled" (p. 49).
While Miller (1987) suggests that HRM relates to:
".......those decisions and actions which concern the management of employees at all levels in the business and which are related to the implementation of strategies directed towards creating and sustaining competitive advantage" (p. 352).
Academic theory
The goal of human resource management is to help an organization to meet strategic goals by attracting, and maintaining employees and also to manage them effectively. The key word here perhaps is "fit", i.e. a HRM approach seeks to ensure a fit between the management of an organization's employees, and the overall strategic direction of the company (Miller, 1989).
The basic premise of the academic theory of HRM is that humans are not machines, therefore we need to have an interdisciplinary examination of people in the workplace. Fields such as psychology, industrial engineering, industrial, Legal/Paralegal Studies and organizational psychology, industrial relations, sociology, and critical theories: postmodernism, post-structuralism play a major role. Many colleges and universities offer bachelor and master degrees in Human Resources Management.
One widely used scheme to describe the role of HRM, developed by Dave Ulrich, defines 4 fields for the HRM function:[6]
Strategic business partner
Change management
Employee champion
Administration
However, many HR functions these days struggle to get beyond the roles of administration and employee champion, and are seen rather as reactive than strategically proactive partners for the top management. In addition, HR organizations also have the difficulty in proving how their activities and processes add value to the company. Only in the recent years HR scholars and HR professionals are focusing to develop models that can measure if HR adds value.[7]
Critical Academic Theory
Postmodernism plays an important part in Academic Theory and particularly in Critical Theory. Indeed Karen Legge in 'Human Resource Management: Rhetorics and Realities' poses the debate of whether HRM is a modernist project or a postmodern discourse (Legge 2004). In many ways, critically or not, many writers contend that HRM itself is an attempt to move away from the modernist traditions of personnel (man as machine) towards a postmodernist view of HRM (man as individuals). Critiques include the notion that because 'Human' is the subject we should recognize that people are complex and that it is only through various discourses that we understand the world. Man is not Machine, no matter what attempts are made to change it i.e. Fordism / Taylorism, McDonaldisation (Modernism).
Critical Theory also questions whether HRM is the pursuit of "attitudinal shaping" (Wilkinson 1998), particularly when considering empowerment, or perhaps more precisely pseudo-empowerment - as the critical perspective notes. Many critics note the move away from Man as Machine is often in many ways, more a Linguistic (discursive) move away than a real attempt to recognise the Human in Human Resource Management.
Critical Theory, in particular postmodernism (poststructualism), recognises that because the subject is people in the workplace, the subject is a complex one, and therefore simplistic notions of 'the best way' or a unitary perspectives on the subject are too simplistic. It also considers the complex subject of power, power games, and office politics. Power in the workplace is a vast and complex subject that cannot be easily defined. This leaves many critics to suggest that Management 'Gurus', consultants, 'best practice' and HR models are often overly simplistic, but in order to sell an idea, they are simplified, and often lead Management as a whole to fall into the trap of oversimplifying the relationship.
Business practice
Human resources management comprises several processes. Together they are supposed to achieve the above mentioned goal. These processes can be performed in an HR department, but some tasks can also be outsourced or performed by line-managers or other departments.
Workforce planning
Recruitment (sometimes separated into attraction and selection)
Induction and Orientation
Skills management
Training and development
Personnel administration
Compensation in wage or salary
Time management
Travel management (sometimes assigned to accounting rather than HRM)
Payroll (sometimes assigned to accounting rather than HRM)
Employee benefits administration
Personnel cost planning
Performance appraisal
Careers
The sort of careers available in HRM are varied. There are generalist HRM jobs such as human resource assistant. There are careers involved with employment, recruitment and placement and these are usually conducted by interviewers, EEO (Equal Employment Opportunity) specialists or college recruiters. Training and development specialism is often conducted by trainers and orientation specialists. Compensation and benefits tasks are handled by compensation analysts, salary administrators, and benefits administrators.
Professional organizations
Professional organizations in HRM include the Society for Human Resource Management, the Australian Human Resources Institute (AHRI), the Chartered Institute of Personnel and Development (CIPD), the International Public Management Association for HR (IPMA-HR), Management Association of Nepal MAN and the International Personnel Management Association of Canada (IPMA-Canada).
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