Human Resource Management Issues of Home Care Services


Health care is an expensive affair that often requires the cooperation of various players to guarantee equitable accessibility to quality care. Hence, organizations in the healthcare sector have financial constraints that may emerge from the increased healthcare costs. This paper focuses on various issues that influence home care services in Quebec, including HRM issues that hinder home care services from achieving their optimal performance. CSSS JR is deployed as the case in point.

Home Care Services in Quebec

Home care services in Quebec face a context that requires total transformation to increase employee productivity, reduce the cost of operation of home care organizations, and/or ensure the integration of technology as a means of ensuring effectiveness and efficacy. From the case study that involves CSSS JR, nurses spend excessive amount of time in clerical works, which do not necessarily translate into higher occupation in delivering care to the patients. The procedure taken to collect patients’ health information, including its processing at CSSS JR, calls for the integration of patients’ information management to increase not only speed of accessing medical records but also the processing of patients’ information. Although CSSS JR scores highly in the use of EMRs, integration of healthcare systems is absent. Hence, other home care organizations do not only depict the absence of integrated healthcare systems but also have low adoption of EMRs.

Quebec home care services encounter situations that are characterized by escalations of operations costs without the necessary increment in the number of clientele. Hence, revenue collected is also low. With the hefty budget to fund due to the increasing number of people who require care to cope with chronic ailments (HEC Montreal 11), Quebec home care anticipates hard financial challenges ahead. Indeed, “from 2005-2006 to the end of the fiscal year 2009-2010, the amount of expenditures on home support services rose from $7.9 M to $10.1 M, which represents an annual average increase of 6.3%” (HEC Montreal 11). Therefore, a major interrogative is on how Quebec home care services can deal with the increasing costs while providing the much-needed optimal quality care. The overall context surrounding home care services in Quebec requires total transformation.

Health care authorities in Quebec must prioritize this sector in the short term. One of the fundamental human rights is the right to have access to good health care. To help in the realization of this universal human right, authorities establish various programs and public health campaigns to ensure that people recognize the need for remaining risk-free from preventable and curable ailments. In case of chronic ailments, various authorities across the globe develop programs for helping people to manage the conditions. Quebec’s people deserve quality and reliable care. Thus, its authorities have a noble role to ensure that problems that ail the sector are resolved to eliminate any risks on people’s health and lives that may escalate due to the existence of non-performing home care sector.

One of the major mandates of any government is to put in place a means of identifying incidents that are likely to pose health threats to its citizens and then responding appropriately to such threats in an attempt to ensure that a nation collectively remains healthy. To this extent, the government establishes various institutions charged with the responsibilities of delivering quality care to all people. Quebec has established an elaborate health and social services system with the government operating as its principal insurer and administrator of various services (Gouvernement du Québec 5). The primary objective of the system is to ensure equitable accessibility to quality care. Consistent with this objective, authorities in Quebec cannot shun from prioritizing the homecare sector if they must remain committed to the statutory mandate of ensuring accessibility and equity in healthcare among its citizenry. To achieve this goal, a resolution of challenges that ail the sector is necessary.


CSSS JR is facing operational challenges. The case study identifies these challenges in the service organization, finance, and human resource areas. Therefore, if the three challenges are resolved, then CSSS JR will have good long-term performance. However, is this the case, or more challenges will emerge in other areas? In determining whether the three challenges can significantly resolve the situation at CSSS JR, the principle of root cause becomes significant. Jing asserts that any attempts to dig for root causes of problems or an event yield endless chains of events and causations (473). However, such endless list of events and causations are not helpful to diagnose the challenges that influence the CSSS JR. Consequently, it is necessary to establish a point “where to stop drilling down and conclude having reached a root cause” (Jing 474). The author further suggests that it is necessary to focus on the causes of organizations’ problems, especially issues that have high frequency coupled with high leverage, but occur within the sphere of control. Service organization, finance, and human resource are within this range.

The three problems have their actual and anticipated consequences. Human resource problems have actual consequences of increasing complexities of task redistribution and personnel shortage. A shortage in personnel translates into high overtime together with seeking services of employment agencies that are outside CSSS JR. With these actual problems, more challenges are anticipated. For example, CSSS JR employs nurses. For nurses, scholarly research in recruitment identifies several factors that may influence nurses to accept nursing jobs within different healthcare care organizations coupled with factors that influence their decisions to stay on the job they have accepted. For instance, Jones claims that recruitment and subsequent retention of the nurses are influenced by factors such as salary, reputation of the health facility or home care, nature and the status of unions, and more importantly, the autonomy of work (43). CSSS JR has inflexible work time structures and bureaucratic systems, which create difficulties in the redistribution of tasks (HEC Montreal 7). From Jones’ arguments, CSSS JR anticipates problems of nurse turnover or even failure to accept jobs at the organization in case a decision is made to recruit more employees to reduce dependency on external employment agencies to augment employee shortage (43).

The organization of home care services has the actual problem of declining performance over time (HEC Montreal 8). This situation implies reduced activity volumes, productivity, and dwindling accessibility. The ultimate anticipated consequence is long waiting lists and sub-optimal utilization of time by employees when it comes to offering the actual care. Rather, time is wasted in travelling between client’s homes, doing clerical works, and/or executing administrative tasks. This situation translates into loss of 28,000 working hours (HEC Montreal 9).

The demand for home support services and home care is increasing with time as demographic changes for the clientele of CSSS JR occur. However, the organization’s funds are constrained, especially considering that costs increase without a corresponding increase in clientele number. The actual and anticipated consequence for this case is the reduction of the capability of the CSSS RJ to continue providing the much-needed care, especially for persons with chronic ailments. The IT department is not void of challenges. Although CSSS JR has EMRs, clinical process or even clinical information systems have not been integrated. This gap has the actual and anticipated consequence of poor support together with decreasing care continuity. Home care employees still do not possess computerized tools suited to their unique needs. Therefore, significant time is wasted in the manual feeding of data

My healthcare organization faces problems that are similar to those of CSSS JR, especially in human resource organizations and management. My organization has challenges in retaining nurses. Nurses claim that they are overworked. Due to burnout, they are only left with the option of seeking employment elsewhere (Genevieve and Cheˆnevert 710). Similar to CSSS JR, this situation has cost implications on the organization, as it becomes financially constrained due to the financial resources allocated in recruiting nursing staff. Indeed, Jones approximates that it requires about $62,100 to replace an existing registered nurse within a health facility (45). This figure is an immense cost, especially by noting that a turnover of a single nurse creates a vacuum in terms of workload, which must be taken up by other nurses. From the perspective of human resource management, increasing the workload implies that nurses who are left are likely to get lowly motivated due to the increased workload, which they consider unfair. DiMeglio and Piatek find a single turnover as having the capacity to translate into multiple turnovers. The only most practical way to deal with this self-replicating problem is to seek mechanisms for employee retention (115).

Main Causes associated with the Problems

Jing suggests that problems may be reduced into a sequence of infinite events and their causes (473). However, for purposes of discussion in this section, an assumption is made that the problems that influence operations at CSSS JR can be wholly explained by their causes so that the organization can obtain the best leverage that is analogous to its Return on Investment (ROI) if the causes are addressed. Human resource problems are caused by poor human resource management policies. This challenge is manifested by the increasing complexities of task redistribution and personnel shortage. Shortages may arise from turnover due to overworked employees as evidenced by the high overtime. Therefore, seeking services of employment agencies external to CSSS JR becomes inevitable. Here, a series of events and their causations is encountered. However, by changing the human resource management policies at the company, many of these problems can be resolved. Hence, the current policies may be considered causes associated with human resource at CSSS RJ.

Financial problems are associated with the primary causes of increasing the cost of home care services at CSSS JR. High costs are attributed to the increasing number of people with chronic diseases, which require care and the rising expenses that are inconsistent with the clientele. High costs may also be attributed to inefficiency of the organization’s employees, especially upon noting the high amount of time wasted in conducting clerical works. Now, the IT problem reveals the financial problems arising from the time wasted in clerical works. With an integrated system for managing home care services coupled with the adaptation of IT systems to the needs of employees, time saving is acquired to increase employee productivity and efficiency increases.

Human Resource Problems at CSSS JR

Low Productivity

CSSS JR faces the problem of low productivity of employees. Large overtimes have failed to yield productivity as evidenced by many teams that do not achieve their volumes of target activities. This case underlines the HR problems in terms of its strategies for increasing employee productivity. Indeed, the HRM needs to understand that working for long hours at the expense of employees’ personal life may not necessarily translate into organizational effectiveness or create differences in terms of increasing productivity. To resolve the problem, the HR needs to adopt the flextime approach, eliminate bureaucratic structures to ensure open communication, incorporate new technologies, reward and motivate employees, and/or ensure good work management while avoiding micromanagement.

Employee Shortage

Shortage of employees may be explained by various factors such as poor retention policies or insufficient recruitment. In some situations, employees may be sufficient to perform a given task. However, due to low productivity, an organization perceives its workforce as inadequate. The solution to the problem depends on the identified cause. For example, poor employee retention requires the creation of retention programs depending on the cause of turnover. For instance, dissatisfied highly qualified employees may have their retention fostered by delegation of responsibility and participation in decision-making processes through the development of democratic organizational culture as opposed to bureaucratic or autocratic culture.

Poor Work-Life Balance (WLB)

Employees at CSSS JR have long overtimes. This situation has an impact on WLB. In this regard, satisfaction of employees through WLB is essential. Without the creation and maintenance of WLB programs, organizations are exposed to the risk of employee conflicts. The conflict entails family roles and interference with work life, a situation that creates challenges or tensions among employees. Such conflicts create incompatibilities between the employees’ individual life and family life and work pressures. Personal conflicts related to WLB challenges within an organization create organizational and workforce psychological distress. To deal with the challenge, CSSS JR can implement flexible work arrangements.

Training and Development

CSSS JR needs innovation in areas of IT. It also needs to employ people who can easily adapt to the changing technologies. Indeed, through increasing its innovative capacity, the organization can develop applications for quick collection of data with little or no human inputs. Thus, home care personnel will have adequate time to provide care directly to the clients, rather than wasting time in clerical works and manual data entry. This task is possible through HRM investments in training and development of employees. Training and development help to provide a new set of skills and knowledge to enhance innovation and employee creativity.

Although the goal of CSSS JR focuses on increasing productivity and profitability through cost reduction, literature on training and development, as a function of human resource, reveals that the endeavor is important for various reasons. For example, Ruppe asserts, “employees with upgraded skills and equipped to deal with the changing demands of the workplace have higher morale, career satisfaction, creativity, and motivation” (38). Such employees have increased productivity coupled with higher responsiveness in terms of meeting organizational objectives. Hence, the issue of training and development is critical in addressing problems that CSSS JR faces now and in the future.


Home care organizations play an essential role of providing services to patients within their homes. In such organizations, HRM approaches are indispensable. In some situations, especially in case of an organization that operates in the home care sector, human resource issues emerge in terms of ensuring retention by establishing work structures that guarantee workforce satisfaction. The paper has discussed these issues with the view of providing their possible solutions as they apply in CSSS JR.


DiMeglio, Padula, and Charles Piatek. “Group cohesion and nurse satisfaction: Examination of a team building approach.” Journal of Nursing Administration 35.3(2010): 110-120. Print.

Genevieve, Jourdain, and Denis Cheˆnevert. “Job demands–resources, burnout and intention to leave the nursing profession: A questionnaire survey.” International Journal of Nursing Studies 4.7(2010): 709–722. Print.

Gouvernement du Québec. The Québec Health and Social Services System, Québec: Gouvernement du Québec, 2008.

HEC Montreal. (2012). Organization, Change Management, Human Resources and Information Technology. London: Routledge.

Jing, Gary. “Digging for the Root Cause.” ASQ Six Sigma Forum Magazine 7.3(2008): 473-479. Print.

Jones, Bethel. “The Costs of Nurse Turnover.” Journal of Nursing Administration 35.1(2009): 41-49. Print.

Ruppe, Leonard. “Tools and Dialogue Set the Stage for Talent management At Johnsmanville.” Journal of Organizational Excellence 2.1(2006): 37-48. Print.

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