Academy of Management Annual Meeting Proceedings

Over the last two decades there has been global debate about the future of healthcare systems and uncertainty in regard to how health reform should be undertaken. In many countries healthcare reform has concentrated on structural change, cost containment, the introduction of market mechanisms and consumer choice. Despite efforts from policy makers, politicians and communities, healthcare systems are substantially unaltered. In this paper we argue that research and developments in business and human resource management (HRM) have not been transferred to the healthcare sector, despite the widely held belief that “management matters” in delivering quality healthcare outcomes. The key lesson from the HRM literature is that investing in developing and maintaining effective HRM builds a well-motivated and appropriately skilled workforce that makes significant and measurable positive contributions to organizational performance. In the same way, the approach taken to manage human resources in healthcare could be a facilitator (or major constraint) to achieving the objectives of health sector reform. We draw on HRM control theory to examine current practice in hospitals because research consistently suggests that the health sector adopts a control orientation to people management and there is a need to understand existing practice before recommendations for change can be made. We employ multilevel and grounded theory approach to explicate the complexities of the various forms of control and HRM climate. Our findings reveal major themes elucidating not only the forms of control adopted in hospitals but the specific conditions under which these controls are used. Results also highlight how forms of control employed in hospitals influence the climate and strength of the HRM system and perceptions of HRM professionals. This study provides important implications for healthcare managers, policy makers, HRM professionals, researchers and those responsible for change management in the health secto