Sustainable Human Resource Management in the Hospital Sector: A Review of Literature

Abstract

The field of personal management has undergone a significant change in the past decade. During the initial phases of sustainable practices—organisations seem to be responsible towards their society and environment along with a focus on financial profits. Building on sustainable management theory, ‘sustainable human resource management’ concept receives significant interest from management, academicians and scholars. Studies related to this area are limited and are still emerging in the developing country context. In this article, the literature review suggests that sustainability could be the driver of the hospital sector in the system. Sustainability in the hospital sector through sustainable human resource management practices is necessary to build and adapt a concrete sustainable practices structure. The various service sectors are focusing on embedding environmental sustainability and lesser focus has been given to the other three elements of sustainability that is the strategic, social and humanistic approach. The present article approaches headed for the full range implementation of sustainable human resource management practices in the hospital sector. In light of this, we proposed a model (SHRM—layout). We offer recommendations for the managing the hospital sector to implement these practices and influence others to maximise sustainable performance from the findings. The framework acts as a guide to organisations for incorporating sustainability practices in their management development plans.

Keywords

Sustainable human resource management systematic literature review hospital sector conceptual framework (SHRM layout)organisational performance

Introduction

From the past decade, the concept of SHRM has been gaining attention from academicians and practitioners. Globally, the issues that arise from the unsustainable activities of population call for sustainable management of resources. From the origination of ‘sustainable development’ concept in the year 1987, every organisation strives to carry sustainability in its management practices to achieve individual, socially, economically and environmentally acceptable outcomes (Molamohamadi, 2013). ‘Care for society’ has been focused by the business world, as they realised the importance of society and society’s contribution to establishing the business (Nath et al., 2019). Nevertheless, presently, there is a need to focus on SHRM (Kainzbauer & Rungruang, 2019) which, along with concentrating on societal aspects, focuses on the environmental, strategic and psychological aspects also (Mazur, 2015). The term sustainability has been used as synonym for ‘long term’, ‘durable’, ‘systematic’ and ‘sound’. SHRM is a major concern in front of us in order to make optimum utilisation of naturally available resources. Sustainability practices are regarded as ‘nice to have’ concept in the management of organisations.

The healthcare sector is one of India’s most extensive service sectors. Hospitals are one of the prominent institutions which are being responsible for delivering quality care to patients (Pinzone et al., 2016). They are required to apprehend sustainable strategies in delivering quality healthcare services to fulfil the demands of increasing expectations of the general public (Marimuthu & Paulose, 2016), (Villajos et al., 2019). Presently, during the pandemic phase, we have undoubtedly realised the importance of the hospital sector and healthcare professionals in our economy. Nevertheless, in contrast to this, if we consider ‘warriors’, the healthcare professionals themselves face a fearful atmosphere—physically, socially and more specifically psychologically. Healthcare professionals face conflicts related to their duties and families, which cause psychological stress (Tan et al., 2020). Furthermore, these days the disposal of personal protective equipment is also a primary environmental concern that adds to the earlier environmental concerns such as the generation of a large amount of plastic waste, water wastages and unsustainable activities Cite (Hoeppe, 2014). There is a paradigm shift in the concept of sustainability. Environmental protection should be taken care of in the daily work (D’Adamo et al., 2020). Considering this, we proposed a framework (Figure 1) for SHRM practices which would be beneficial to the management of hospitals in all aspects- economically, socially, environmentally and psychologically (Onnis, 2019).

Figure 1.

SHRM—Layout.

Our review makes different contributions. First, through our literature review, we will discuss the interconnection among different relatable terms—human resource management, strategic human resource management, SHRM. Second, we explored a shift towards SHRM, different models constructed by earlier practitioners, benefits of adopting sustainable practices, and the need for bringing SHRM in the hospitals. From this current review of literature and the resulting sustainable strategies framework, we enrich to available literature related to sustainability by unfolding how SHRM is compatible with the hospital sector. Lastly, we offer directions for future research to inspire more systematic investigation evaluations of embedding sustainability practices at hospitals.

Literature Review

Conceptualisation of the Term ‘Sustainable Human Resource Management’

There is no one universally accepted definition for the concept SHRM. This concept has gained much importance in the last 2–3 decades. Every researcher tried to give a different direction to this term. So, the United Nation’s World Commission on Economic Development has fuelled the sustainability concept by the term ‘sustainable development’ in 1987. The definition given by the UN’s Commission is accepted widely. Sustainable development means the ‘use of available natural resources in such a way that it meets the needs of the present generation, along with this it does not compromise future generation’s ability to meet their needs’ (Macke & Genari, 2019). From this initial conceptualisation of the term sustainability, it is understood that sustainability should be viewed from all three pillars (economic, social and environment) simultaneously (De Stefano et al., 2017). In context to this, SHRM is the efficient, effective and innovative applications of human resources to achieve an organisation’s economic, social and environmental goals in ethical ways (Lopez-Cabrales & Valle-Cabrera, 2019). The same has been supported by introducing SHRM practices majorly for the welfare of the stakeholders—justice and equality, transparent HR practices, profitability, and employee well-being (Järlström et al., 2016).

SHRM is defined as ‘An extension of strategic HRM by facing the increasing dilemma of efficiency and (sustainable) investment in HRM initiative’ (Indiparambil, 2019). Moreover, sustainable HRM is seen as an extension of strategic HRM, and it presents a new way of people management with a focus on long-term human resource development, regeneration and renewal (Bush, 2018; Guerci, et al., 2014). SHRM is considered the management of people through practices such as work–life balance, personal autonomy in professional development, employability of workers (Pipoli, 2014). Additionally, SHRM practices examine safety and health, work stress, work–family conflict, job control, training and development (Jo, 2019). Sustainable HRM is ‘an open system, resource-dependent system, a system which increases employability, promoting social responsibility, ensuring harmonious work–life system’ (Arman, 2017; Stankevičiūtė & Savanevičienė, 2018). One of the studies (Khan, 2019) contributed that any organisation’s SHRM practices would naturally lead to more flexibility and higher performance. Sustainable HR refers to the ‘adoption of HRM strategies and practices that enable the achievement of financial, social and ecological goals’ (De Stefano et al., 2017; Ibrahim & Rahman, 2017). Taking this into consideration, De Prins introduced the sustainable approach under which the performance is measured on three levels: the individuals, the society and the organisation. In the later stages, researchers found that this definition had ignored the importance of employee perspective (De Prins et al., 2014; Mazur, 2015).

Sustainability is the future vision, which focuses upon a set of values, ethical and moral principles to guide our actions (Viedman, 1995). In 1994, John Elkington founded the triple-bottom-line concept, which describes the three bottom lines in the business—needs to be concerned about its impact on people and the planet—and not only finance and profits. There is tremendous research available in this area. Sustainable management practices are much needed for ensuring the sustainable performance of hospitals (Pellegrini et al., 2017). We found a research gap concerning the implementation of all the dimensions of SHRM. Second, there is a dearth of studies that discussed the use of sustainable practices in the hospitals of India (as depicted from Table 1). Third, the majority of the studies discussed waste management, environmentally friendly practices. Fourth, SHRM is built upon four dimensions (Mazur, 2015): triple bottom line approach—economic, social and environment, and psychological human resource management.

Table 1.

Application of Sustainability Practices in the Hospital Sector.

S. No.	Title of the Research Article	Authors	Research Area	Different Sustainable Practices Followed
1.	Sustainable hospital design for sustainable development	Dicle Aydın, Esra Yaldız and Suheyla Buyuksahin	Turkey	Sustainable architect (green building Long-life building design Efficient use of limited natural resources Use of renewable energy sources Reduction of waste Minimising health and safety risks Ensuring healthy indoor air quality To reduce environmental pollution
2.	Making hospitals healthier: How to improve sustainability in healthcare facilities	M. Buffoli, M. Gola, M. Rostagno, S. Capolongo, D. Nachiero	Old generation hospital Milan, New generation hospital, Lombardy	Sustainable Healthcare Tool: Humanisation Managerial waste Clinical waste Technological waste Comfort Distribution Material and resources Waste Care Saving with efficiency
3.	Environmental  sustainability in hospitals—A systematic review and research agenda	Forbes McGain and Chris Naylor	Review article	Hospital design Energy Water Travel Waste Staff behaviour
4.	Sustainability endeavors and sustainable development in Spanish public hospitals	Rocio Rodrigue, Carmen Otero-Neira, Göran Svensson	Spanish healthcare industry	Application of sustainability in  Spanish hospitals Selecting hospitals which run sustainability endeavours Qualitative analysis of past and present sustainability endeavours
5.	The efficiency of hospitals: Platform for sustainable healthcare system	Beata Gavurova, Kristina Kocisova	Slovakia healthcare system	Production efficiency of the hospitals Quality of service using patient-reported safety and satisfaction measures
6.	Sustainable hospitals? An Australian perspective	Dr Forbes McGain	Australia	Recycling Reusing Energy Involving everyone Hospital sustainability reporting
7.	Can sustainable hospitals help bend the healthcare cost curve?	Susan Kaplan, Blair Sadler, Kevin Little, Calvin Franz and Peter Orris	Review paper	Energy use reduction Waste reduction Reprocessing and reuse of single-use medical devices
8.	Sustainable hospitals: A socio-ecological approach	Ulli Weisz, Willi Haas, Jürgen M. Pelikan,  Hermann Schmied	Vienna	Economic efficiency Healthcare Health promotion Social compatibility Ecological compatibility Hospital Environment

Source: Compiled from review of literature by the authors.

This section of our research will present a comprehensive review of the published literature on the shift towards SHRM. Initially, human resource management refers to a process of managing people in the organisation in a structured manner. ‘HRM is a philosophy of people management based on the belief that human resources are uniquely important to sustained business success’ (Leontjeva, 2013). Later on, the earlier researchers threw light upon the two types of human resource management. First, ‘Hard’ human resource management refers to human resource management as a way of ‘managing employees’, not ‘people’. Therefore, it includes all the elements that emphasised employee development in the organisation. Second, in the ‘Soft HRM’, it is believed that the employees’ creativity, commitment and skills would add value (Rompa, 2011).

Human resource management refers to ‘managing people tactfully’ in the organisation. Strategic human resource management developed in the late 1970–1980s period. It is a way of managing people in an increasing, fast-changing and uncertain environment. Strategic HRM is an approach regarded as a people-centric approach, and it deploys all the functions of HRM like recruitment, staffing and payment which leads to the development of employees (Indiparambil, 2019; Lopez-Cabrales & Valle-Cabrera, 2019). In recent years, sustainability has become one of the primary objectives of every organisation to become agents of sustainable development. Incorporating corporate social responsibility in the organisation is the way of integrating well-being of employees, customers and society simultaneously (Celma et al., 2017; Pless et al., 2012) De Stefano et al. (2017) validated the relationship between human resource management and sustainability. The organisations which are considerate for care for the health and well-being of their members would enjoy good organisational outcomes (Cleveland et al., 2015). Incorporating sustainability is not only the single-hand responsibility of the white-collar professionals or senior management. It also becomes the responsibility of every individual belonging to this planet Earth. So, the sustainability behaviour of employees is segregated into two different categories—‘in role’ employee sustainability behaviour (the extent to which employees complete their tasks that are linked to sustainability) and ‘extra role’ sustainability behaviour (the extent to which employees initiate on their own to engage in sustainability) both together formulated to embrace sustainability (Pellegrini et al., 2018). Through mutual understanding, everyone would understand the expectations about sustainable activities (Docherty et al., 2009). Several terms are used to describe sustainability—human resource sustainability (Gollan, 2005), sustainable organisations (Wales, 2013), sustainable management of human resources (Ehnert et al., 2013; Ehnert, 2014; Strenitzerov, 2020).

Review Questions: Two specific questions are the focus of our review: 1.

How we can implement different dimensions of SHRM in the hospital sector?

What are the implications of the compatibility of SHRM in the hospital sector and organisational performance?

Research Methodology

In this review process, we followed a systematic literature review approach suggested by the various prominent authors (Materla et al., 2017; Mishra & Singh, 2021; Tawfik et al., 2019). This approach is immensely beneficial as it highlights the theories and models related to the study area. This current research work involves three steps, as depicted in Figure 2. First, initial research, second exclusion and inclusion criteria, and lastly, extensive review of the available literature.

Figure 2.

Source: Materla et al. (2017), Mishra and Singh (2021) and Tawfik et al. (2019).

Initial Search

The primary objective of this current research study is to identify and organise the available literature on the concept of SHRM. Taking this into consideration, we come up with 221 articles by searching on the Scopus database by typing keywords—sustainable AND human AND resource AND management or sustainable AND HRM.

Inclusion and Exclusion Criteria

We apply inclusion and exclusion criteria, including only the articles published in the English language, excluded conference papers and book chapters. The resulting research articles were 109 taking the recent years as timeframe so that our literature will provide relevant and up-to-date results. Each paper is subject to a thorough evaluation of the title, abstract using the inclusion and exclusion criteria in this systematic review process. During this process, almost 22 papers were excluded that were not meeting the objectives of our study.

Final Papers

Finally, we combined and arranged papers exploring the various dimensions of SHRM. To achieve the objectives, we presented the most suitable SHRM practices for the hospital industry, which is the significant contribution of this current research.

Findings

A Shift Towards Sustainable HRM

From the extensive review of literature, Table 2 shows the shift from human resource management to the SHRM in all the human resource management functions such as job design, recruitment, training and development, performance appraisal, work–life balance and leadership. In the initial phases of managing human resources, it basically refers to the management of human resources in the best possible manner that leads to the achievement of organisational goals (Westerman et al., 2020).

Table 2.

Paradigm Shift Towards Sustainable Human Resource Management.

S. No.	Factors	Human Resource Management	Strategic Human Resource  Management	Sustainable Human Resource Management
1.	Meaning	It is an approach to the management of the organisation’s most valuable assets, i.e., the people who are working collectively to contribute towards the achievement of its objectives (Armstrong, 2016)	It can be defined as the linking of human resources with strategic goals and objectives in order to improve nosiness performance and foster competitive advantage (Gannon et al., 2015)	It can be defined as the adoption of sustainable strategies and practices in all the human resource management functions (Ibrahim & Rahman, 2017)
2.	Job description	Matching expectations of the organisation with the qualification and experience of the candidate. Fit people to static jobs (Armstrong, 2016)	Job design must ensure flexibility, commitment, motivation and must provide employees with the autonomy to fully use their knowledge and skills (Cleveland et al., 2015)	It refers to meeting the expectations such as organisation’s environmental management system including setting standards (Kira et al., 2010)
3.	Recruitment, selection	Recruitment is regarded as a negative process and selection is regarded as positive process for the organisation (Armstrong, 2016)	Recruit and retain high-quality people with innovative skills, likely to deliver high level of customer service (Jepsen & Metcalf, 2017)	Accept applications from the people which are close to organisation, minimise unnecessary expenditure (Jepsen & Metcalf, 2017)
4.	Training and development	It is the art of increasing the skills of an employee for doing a particular job	It refers to the development of strategic capabilities and enhancing intellectual capital of the organisation (Cleveland et al., 2015)	Employees should be trained to rethink every aspect of the job in terms of sustainability—innovative ways to reduce wastages, increased efficiencies, increased harmony at workplace and building long-term relationships with respective organisations (Zaugg et al., 2001)
5.	Performance appraisal	Providing financial and non-financial rewards for the satisfaction of human resources (Podgorodnichenko et al., 2020)	It refers to an appraisal that link rewards to quality performance (Ehnert & Harry, 2012)	Performance appraisal linked to the economic aspect of sustainability and rewarding sustainable initiatives of the employees (Diaz-Carrion et al., 2020)
6.	Work–Life balance	It is a term used for the idea that you need time for both work and other aspects of life, whether those are family related or personal interests (Kalliath & Brough, 2008)	Work–life balance is the equilibrium between personal life and career work. In the employment practices are such that enable HRs to balance their work and personal obligations by itself (Haddon & Hede, 2009)	It is the minimisation of work-related stress and establishing a stable and sustainable way (Diaz-Carrion et al., 2020). It aims at ensuring well-being of employees and reducing stress at work (Mazur, 2015)
7.	Diversity management	It is the degree of heterogeneity among the team members on specifies demographic dimension which all in together contributes towards performance of the individuals and organisation (Mazur, 2015)	It is defined as voluntary activities in a company that serve to better involve employees coming from different backgrounds (Sukalova & Ceniga, 2020)	It refers to the organisational actions that aim to promote greater inclusion of employees from different backgrounds into an organisation’s structure through specific policies and procedures (Sukalova & Ceniga, 2020)

Models of Sustainable Human Resource Management

Through the extensive literature review, researchers found that many of the earlier researchers have explored various perspectives and models of SHRM depending upon the nature of the research. The purpose of exploring all these models is to establish a new model, i.e., SHRM layout for the hospital sector by considering the best possible practices in this area of research. Table 3 shows the different models constructed by earlier researchers from different perspectives.

Table 3.

Models Developed for Sustainable Human Resource Management.

S. No.	Name of the Model	Factors Depicted by the Models	Sub-factors	Findings	Authors
1.	Holistic human resource management model	Human resource outcomes Performance outcomes Social outcomes Financial outcomes	Engagement, competence, commitment, flexibility, skills, motivation Employee productivity, customer satisfaction, improved performance Social well-being, social responsibility, ethical practices, individual well-being Sales, profit, growth, market value and share, return on investment	Companies are required to include a unique approach, i.e. adapting to the principles of sustainability. The companies that are able to follow holistic HRM model are mutually beneficial to the company, stakeholders, environment and society as a whole	Leontjeva (2013)
2.	Refined integrated corporate sustainability model	Perseverance Resilience development Moderation Triple bottom line Brand equity	Preserve to improve process, products and services for stakeholders Anticipate and prepare for change Make a decision prudently Integrate social and environmental responsibility in operations Share operations internally and externally	Corporate leaders should ensure that their vision statement is brief, clear, stable, future oriented, inspiring and increases shareholder’s satisfaction	Kantabutra and Ketprapakorn (2020)
3.	Socially responsible human resource management (SR-HRM) indicator	Equal opportunities Objective and justice Empowerment Welfare of workers and Quality of employment	Gender, race and age Remuneration policy Engagement, satisfaction and retention Minimum salary, maternity/paternity leave	Sustainably is an umbrella that leads organisations to behave responsibly in all areas of the management which creates value for individuals, organisations and society	Diaz-Carrion  et al. (2020); Abdelmotaleb and Saha (2020)
4.	Sustainable human resource management	Facilitating Building Focusing	Employee participation Open communication Work roles Performance evaluation Employee strengths Performance facilitation Trust between employees and managers, sustainable work system Work–life balance Positive human or social outcomes Organisational economic outcomes)	This paper provides a new mode of administrating and managing employees of an organisation with the adoption of humanitarian approach	Indiparambil (2019)
5.	Sustainable human resource management structure	Economic dimensions Environmental dimension Social dimension	Remuneration, fringe benefits, employee protective expenses, social responsibility expenses outside the organisation Awareness of employees, protecting natural environment, avoiding environmental harm Basic human rights, health and safety, diversity management, social relations, HR selection, education and training, performance appraisal	The implementation of sustainable human resource management practices will make it more straightforward for the companies to have sustainable organisation form	Westerman  et al. (2020)
6.	CSR and sustainability	Human resource for CSR Sustainable HRM HR for community sustainability HR for ecosystem sustainability	Staffing, training, communication and development, compensation, organisational culture and values Employee’s welfare and well-being, Occupational health and safety, job security and responsible layoffs Philanthrophic, human rights, employees’ volunteering, community training and employability Sustainability practices across supply chain, labour standards and sustainability in business ecosystems	Finding of the study suggests that strategic HRM should converge into Sustainable HRM, with potential benefits for all stakeholders.	De Stefano  et al. (2017)
7.	ROC Model	Respect Openness Continuity	Talent, Employee Loyalty, health and well-being, employee participation Diversity management, Ageing workforce, work life balance Learning organisation, employability, workplace innovation	Sustainable HRM is more complementary perspective. Its aim not to replace strategic HRM perspective, but to bring HRM into the next stage of maturity	De Prins et al. (2020)
8.	SHRM- Attempt to Holistic Approach	Psychological perspective Sociological perspective Strategic perspective Green perspective	v. Engage in dialogue with employees, promote work–life balance, autonomy, self-development, employability, opportunities of flexible working conditions vi. Family-friendly personnel policies, health and safety policies vii. Employability, employee appraisal, recruitment, sustainable competitive advantage viii. Green employer branding, promotion of environmentally behaviour, sustainability awareness	HR managers can play an exemplary role from two perspectives—sociological and psychological, which could be achieved through diversity management and work–life balance programsAt last self-management is also crucial to control their behaviour and expectations regarding work–life balance	Mazur (2015)
9.	Dimensions of SHRM	Justice and equality Transparent HR practices Profitability Employee well-being	v. Obeying laws and regulations, diversity management, ethical laws, exemplary behaviour vi. Allocation of HR resources, open two-way communication, employee participation, individuality, competence development vii. Long-term thinking, proactiveness in actions, integration of organisational strategies viii. Preventing exploitation of employees, leadership style of employers, meeting physical and mental demands	Sustainable human resource management seems to bring the people and respect for humanity to the human resource management and widen the future HR perspective to include both stakeholders as well as more employees	Järlström (2016)
10.	SHRM model	Organisational effects Social effects Individual effects Ecological effects	v. Employment relationships, sustained competitive advantage, durable supply with HR and healthy workforce vi. Quality of life, good relations, social legitimacy, accountability vii. Performance, satisfaction, motivation, employability, lifelong learning viii. Location of work, reduce costs, green products and services	Sustainable human resource management is an emerging concept in the earlier years. Additional, integrated frameworks based on theories are required to reduce their ambiguity, complexities and outcomes	Kramar (2014)

Benefits of Implementing Sustainable Practices

In one of the later studies, one more researcher had also explored that human resources are the most invaluable resource in the organisation. So, there is a need to value human resources and bring back the respect for humanity back that became possible through SHRM practices (Cleveland et al., 2015). So, we explored that SHRM is more inclined towards the well-being of employees at the workplace. The model developed by the researcher in the current article will also lead to the enhanced image of the hospital sector by visualising all these earlier research work (Table 4).

Table 4.

Studies Highlights Benefits of Sustainable Practices.

S. No.	Title/Name of the Journal	Major Focus	Findings	Source
1.	Building sustainable organisations: The human factor/Academy of Management Perspective	Neglect of human factor in sustainability research	Just as concern for protecting natural resources, there should be similar concern for protecting human resources Green companies enjoy reputational benefits that help in brand building and product  differentiation Companies with better record of human sustainability enjoy benefits such as attracting and retaining employees	Pfeffer (2010)
2.	Advances in implementation of SHRM: Polish companies experience/Journal of Entrepreneurship and Sustainability Issues	Socially oriented sustainable practices	Encouraging employee to undertake socially and environmentally oriented practices and rewarding them for their efforts Encouraging the preference of candidates with ecological competencies during recruitment	Bombiak (2020)
3.	Impact of sustainable human resource management in organisational performance: A study on Bangladeshi HR professionals/Proceedings of 15th Asian business research conference	Impact of sustainable human resource management practices on the performance of the organisation	There are instruments on which SHRM depends such as human resource recruitment, personal deployment, human resource development, human resource marketing, retainment of staff, disemployment, management and leadership From above, four factors—sustainable recruitment, selection, marketing and dis-employment have a positive influence on the organisational performance	Arman (2017)
4.	The role of HRM in developing sustainable organisations: Contemporary challenges and contradictions/Human Resource Management Review	To examine the impact of sustainable practices in encouraging employees to engage in sustainable behaviour	When organisations signal their orientation and commitment towards sustainability, employees are also willing to engage both in in-role and extra-role sustainable behaviour Proper training and rewards also influence sustainable behaviour Supervisory support is a key to influence sustainable behaviour	Podgorodnichenko et al. (2020)
5.	The future of HR is RH: Respect for humanity at work/Human Resource Management Review	Respect for humanity at work	To bring the respect back for humanity at work. The organisation needs to fit and redesign jobs to the needs of people, which aid to creativity, maximise long-term development and health of employees To listen and address diverse needs of each other Train, educate and model conflict management collectively among all employees level	Cleveland et al. (2015)

Discussion

We confront specific research gaps from the extensive literature review, which we seek to, fill through the current research study. First, to the best of our knowledge, no prior research has been conducted in SHRM practices considering the hospital sector. Second, the earlier studies were diverted more towards the environmental aspect as the word ‘sustainable’ is generally linked. Nevertheless, the present study will cover all the dimensions—economic, social, ecological and psychological human resource management. Third, even though there has been tremendous research is done on this topic. However, there is a gap concerning that how well-being is secured through SHRM practices.

This research contributes to the current literature in several ways, such as the study seeks to close the gaps by proposing a conceptual framework—sustainable HRM layout. The current research is timely and advantageous. The research contributes to the earlier research studies considering the hospital sector. We formulated a SHRM model for the hospital sector only because this sector is the most affected during the pandemic. The inclusion of the psychological aspect in the human resource management would also contribute towards the well-being of the healthcare workers. Psychological human resource management means the art of managing ‘the employees’ of the organisation.

Proposed Model of Incorporating Sustainable Practices

Hospitals nowadays have changed perception for maintaining employees—‘healing touch for patients’ now being shifted to ‘healing touch for humanity’ which gradually enhances the importance of human resources in the organisation (Chakraborty et al., 2019). The primary front-line staff that is the patient-facing staff in the healthcare industry was nurses and doctors, respectively (Cooke & Bartram, 2015). Presently, the way healthcare industry has been going through a terrible phase. It necessitates meeting doctors’ expectations with that of the patients and employees (Tomar & Dhiman, 2013). It is a well-known fact that hospitals deal with a significant amount of hazardous and non-hazardous waste and generate polluting outputs (Filho & Frankenberger, 2020).

The primary reason to bring sustainability in the hospital sector is that nurses feel least satisfied because of improper recruitment policy, improper deployment, fewer career growth opportunities, and fewer training opportunities (Bansal & Malhotra, 2016). Similarly, the reasons like deterioration of job quality, reduced level of job satisfaction, morale, engagement, a rising level of stress and burnout also lead to work intensification and create nurses shortage, consequently resulting in the vicious circle (Cooke & Bartram, 2015). The underlying reason for this present study is that hospitals were often described as stressful places, with demands of high job quality, it contains challenges, commitment and interaction with patients (Nilsson, 2011). The healthcare sector is required to relook, design and formulate strategies that are beneficial not only for the customers but also the stakeholders (Goh & Marimuthu, 2016). There is a need to recognise these working conditions through sustainable practices. Eventually, by considering all the research done on the hospital sector, it is necessary to embrace sustainability, not only for its workforce but surely for the entire world and entire ecosystem.

Possible Initiatives for Incorporating Sustainable Human Resource Management in the Hospitals

With the shift in the paradigm from ‘growth only’ to ‘growth with sustainable human development’, the canvas for the development gets shifted towards sustainability. The real wealth of the nation is the ‘human resources, and the principal objective of sustainable human development is to build an environment for the people to enjoy long, healthy, and happier lives’ (Goyal & Singh, 2019) and build sustainable strategies to create a better environment (Cooke & Bartram, 2015; Iqbal & Piwowar-Sulej, 2022). A study undertaken by Maeda in Japan explored the introduction of a sustainable healthcare system concerning COVID-19—task sharing, task shifting and securing staff (Salyer et al., 2021).

The healthcare system needs to cope with limited available resources and provide specialised care to COVID-19 patients through a sustainable approach. Rodriguez et al. (2020) explored that sustainability is a social issue, and there is still a lack of clarity about implementing sustainability activities (McGain & Naylor, 2014). The framework of SHRM has majorly four perspectives through which one can incorporate sustainable HRM—psychological, sociological, strategic and environment (Mazur, 2015). We highlighted our framework to sustainability—SHRM layout in Figure 1 for the hospital sector. Hospitals should incorporate them in their management; it would automatically lead to a step towards SHRM or sustainability.

Psychological Approach (Employees)

Quality of work–life of the employees is considered as an essential dimension of the concept ‘sustainability’. Employees wish to remain in that organisation that is contributing something to the environment. Initially, justice and equality are the significant factors that affect the employees’ mentality and whether they wish to stay or leave the particular organisation. Diversity management in terms of gender, age, ethnicity, education and health should be mentioned in the recruitment decisions (Järlström, 2016). Fair and equal treatment meant here is that rules, regulations, rights were intended to be equal for everyone throughout the organisation. Employability of workers, promoting health and pleasure at work will improve self-knowledge and identity and develop their talent and potential (Pipoli, 2014). Sustainable employability of employees would be highly beneficial for the organisation, as it leads to higher productivity and lower sickness. So, it is required to encourage all the younger and elderly employees to the happy and healthy progress in the organisation (Ybema et al., 2017). In the last 20 years, transformational leadership has been chiefly used of all leadership theories and most often influences diverse behaviours, as leaders influence employees through a moral commitment to their followers (Robertson & Barling, 2012).

Strategic Perspective

Transparency in human resource management practices would develop an organisation to enjoy fruitful performances. Incorporating competence development, resource allocation and career planning were considered the central feature for sustainability for the long run. Profitability and long-term thinking were considered as the critical elements of sustainability. As employment relationships have changed nowadays, employees tend to change jobs, and their environment becomes critical. Nowadays, employees look for better work–life balance and expect employers to behave in a more socially responsible manner. Along with this, reasons like dissatisfaction, declining firms loyalty, increasing working hours, and stress levels call for the sustainability of human resources (Macke et al., 2019).

Environmental Aspect (Green)

With the rising graph on the number of studies on organisational environmental practices (Ones and Dilchert, 2012; Pinzone et al., 2019), it is appreciable if organisations support human resource management practices, such as staffing, training, performance evaluation, and rewards to implement greening practices and behaviour (Iqbal, 2020). Recruitment and selection of employees committed to the environment were essential for the organisations which implement green practices; environment training is also a relevant dimension under Green HRM (Jabbour et al., 2016). Green HRM includes recruiting and maintaining employees who endorse eco-friendly behaviour, providing them environmental awareness training, reflecting their eco-friendly contributions in performance appraisal (Shen et al., 2018; Amrutha & Geetha, 2020). Employees are also more likely to attach themselves to companies that are adopting environmental management practices (Pellegrini et al., 2018). Initiatives (Sharma & Gupta, 2015)—going paperless, recycle glass, paper, plastic, assembling waste materials, reducing business travel.

Social Sustainability

There is one more dynamic of sustainable HRM that is ‘social dimension’, which primarily involves the well-being and wellness of employees, not only in terms of their health but also in terms of their job security (Stahl et al., 2020).

Research Implications

Hospitals are service organisations based upon the ‘patient centricity’ hallmark, due to which the staff at the hospital felt neglected with the operations of their organisations. They are not satisfied with the working conditions at hospitals, insufficient learning opportunities, a lot of documentation work, and compensation packages (Tomar & Dhiman, 2013). On the other hand, as far as long-term sustainability is concerned, there is a need to have sustainable behaviour in day-to-day lives of every single individual. We have also presented a checklist in Table 5, which the healthcare professionals of hospitals will fill to measure the adoption to the range and volume of sustainability practices of their respective organisations.

Table 5.

Checklist of Sustainable Human Resource Management Practices.

Sustainable Human Resource Management Practices
S. No.	Strategic and Psychological HRM	(Yes/No)
Job design
1.	Is environmental training the part of your job description?
2.	Does your organisation set sustainability targets in the job description?
Recruitment and selection
3.	Did your organisation offer online exams and interviews to reduce travel?
4.	Did your organisation monitor and report the adoption of environment-friendly practices in the staffing process?
5.	Does your Induction program demonstrate the sustainability goals of the organisation?
Training and development
6.	Does your organisation provide training to all employees regardless of their gender, age and professional category?
7.	Did your organisation provide ecological training to all the employees?
8.	Did you participate in matters concerning environmental issues?
Performance appraisal
9.	Does your organisation’s compensation policies discriminate in terms of gender and type of contract?
10.	Are there any different rewards for achieving individual and collective performances?
11.	Are the remuneration policies transparent to the workforce and members?
12.	Does the senior management also provide you rewards based on environment-oriented tasks?
Work–life balance
13.	Did your organisation alter shifts according to your personal needs?
14.	Does your organisation transfer you to some other department or area because of your own reasons?
15.	Did you get leaves unpaid leaves in case of your family issues?
16.	Does your organisation organise workshops for implementing work–life balance practices?
Employability
17.	Does your firm continue to support the most experienced staff even once they retire?
18.	How far your hospital provide you with opportunities for your growth and development?
Sustainable leader
19.	What kind of attitude did a young leader show to elderly people in your organisation?
20.	Did your leader understand your needs and wants?
Long-term orientation
21.	Did your organisation set a target for growth and profits for the coming years?
22.	How far does your organisation deal with the quality of care treatment to patients?
Green human resource management			Environment-friendly practices
23.	Did your organisation make policies for the efficient use of water?
24.	Is there any mechanism for sorting and recycling garbage in your organisation?
25.	Are there segregated dustbins for different types of waste?
26.	Did your organisation, maintain greenery and encourage all to maintain greenery?
27.	Did your organisation create a draft report on environment practices?
28.	Has your organisation made provision for sustainable practices in the overall budget?
29.	Are there any ‘objectives for environment protection’ along with other objectives of your organisation?
Green behaviour
30.	Do you use stairs or elevators?
31.	Do you plant trees and maintain greenery at your workplace?
32.	Do you pay close attention to running water and leakages from pipes at your workplace?
33.	Are you passionate towards the environment?
34.	Do you encourage others to adopt environment-friendly behaviours?

Source: Carrion et al. (2020), Kantabutra et al. (2020) and Kim et al. (2019).

Implications for Managers

Sustainable Job Description

Job description describes the requirement of a specific job, tasks, roles and responsibilities of a unique position, which were generally matched with the candidate’s qualification to appoint the right person at the right place. While recruiting, the human resources organisation should also match a candidate’s willingness towards meeting the organisation’s environmental-oriented objectives. Hospitals would discourage the use of plastic bags in the hospitals, not only for medicines but also for employees not to bring plastic bags from their homes to reduce the usage of plastic bags even in their employees’ homes. Healthcare professionals themselves encourage the use of their mugs for tea so that the paper-made cups, polystyrene cups, would be discouraged from use.

Sustainable Recruitment, Staffing, Selection

Hospitals require trustworthy, highly qualified and dedicated staff for growing in this competitive and sustainability-oriented environment. Hospitals must ensure the advertisement of vacant posts through their official websites or social media, not through pamphlets and newspapers, which usually involve a lot of paper consumption. Hospitals must ensure the reduction in unnecessary expenditure in recruiting candidates by employing the workforce from nearby locations, ensuring interviews of the selected candidates through online mode to reduce the cost of travel and traffic on the roads. Nowadays, candidates also desire to get employment in an organisation that shows responsibility towards the environment, employees and society.

Work–Life Balance

There are three shifts in the hospitals—morning shift, evening shift, night shift which usually imbalance the staff’s routine. Gradually, employees get a very uncertain time for their families, and stress levels are enhanced. So, there is the requirement of good work–life balance policies for the benefit of employees. To balance the respective employees’ work life and home life, hospital managers should sanction holidays to the employees in time of need. They should also provide workshops on reducing stress and motivates employees to initiate meditation and spiritual activities to attain mental peace.

Employability

Employability refers to the attributes of an individual that make a person able to gain and maintain employment. The young workforce may also leave their jobs when they do not feel happy at their workplace and when there is an authoritative relationship between employer and employees. The importance of employability is aroused from the ageing workforce. Respect the ageing of the workforce, build and enhance the workforce’s capabilities to get employment at any point in time, in any organisation, and at any age is crucial.

Mental Health and Wellness

Employees usually spend more time at their workplace, feel more connected with their work, and felt more attachment with their colleagues. When there is a workload in the workplace, employees face the stress of work. During this COVID-19, the significant burden is upon the hospitals, as healthcare professionals are at the front line during this outbreak. There are notable changes in the shift work, the tenure of shift work also enhanced, healthcare professionals need to build and maximise their ability to manage the higher volume of patients. So, it is required to reduce the psychological burden—hospital management must initiate awareness of benefits of healthy living life, promotion of sports activities in the workplace. In a nutshell, hospital administration is majorly required to build trust among employees about their health and safety by assuring proper stock of personal protective equipment kits, by assuring safety of many resources and their treatment at priority, in case they and their families get exposed to this infection.

Sustainable Leader

The relationship between employer and employee is always of a boss and subordinate where the boss always burdens his/her subordinates with orders and authoritative behaviour. In the hospitals, the same system prevails, where staff feels burdened because of the authoritative role of a senior person. So, in the hospitals, a leader is required who leads the human resources. Sustainable leader naturally influences their followers to behave sustainably that is, if leaders promote social responsibilities, reduce the consumption of papers, promote carpool and encourage sustainable competencies, healthcare professionals also try to follow their leaders. So, this is of vital concern to bring sustainability in the hospitals to take a step forward in achieving sustainable development goals.

Implications Towards Environment

Build Green Branding

If hospitals adopt green behaviour, green practices will automatically build a unique image. Everybody gets attracted to those organisations which indulge in practices for the welfare of the environment. Nowadays, employees also wish to get jobs in that organisation that goes for sustainable development.

Going Paperless

Avoid over-usage of papers at the office, encourage online recording of routine activities, the record of patients must be kept online so that the usage of paper gets discouraged.

Reuse and Recycle

As hospitals produce large amounts of single-use plastic items are involved in wastage of water at massive levels. Hospitals must ensure the reuse and recycle of the products, which creates massive harm to the environment.

Encourage Green Initiatives

The workforce’s green behaviour must be rewarded and encouraged by their respective organisations. Other employees get motivation from the rewarded employee, and from next time, all the employees get themselves indulged in sustainability orientation.

Table 6 represents the activities on the part of the individuals and management to bring sustainable behaviour in all aspects.

Table 6.

Research Implications for Individuals and Managers.

S. No.	Individual Implications	Management Implications
1.	Do not bring plastic bags even from homes	Ensure sustainable suppliers
2.	Bring reusable plastic bottles	Ensure sustainable job design
3.	Reduce usage of papers	Ensure Sustainable recruitment and staffing
4	Bring reusable tea mugs	Ensure mental health and wellness of professionals
5.	Go for carpool	Ensure work–life balance policies
6.	Build sustainable competencies	Appoint a leader who promotes sustainability
7.	Take public transport or walk	Ensure employability of staff
8.	Divide their work voluntarily with colleagues to reduce the burden of work	Promote fair remuneration and equality
9.	Plant trees in hospitals and homes also	Reduce the use of plastic at the workplace
10.	Go for outdoor games and activities for physical health	Go for planting every year

Source: Carrion et al. (2020), Kantabutra et al. (2020) and Kim et al. (2019).

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

About the Authors

Manpreet Kailay is currently a doctoral fellow at the institute Lovely Professional University, Punjab, India. Her interest area is sustainable human resource management. Prior to this, she holds a Bachelor’s and Master’s Degree in Commerce. Manpreet has also qualified UGC-NET, 2020, in the field of commerce. She also presented papers in international conferences hosted by the institutes such as the Indian Institute of Management, Ranchi, 2020, and National Institute of Technology, Sri Nagar, 2021, National Institute of Technology, Warangal, 2021.

Kamalpreet Kaur Paposa is a professor (assistant) in Human Resource Management at Mittal School of Business, Lovely Professional University, Punjab, India. Her area of research is HRM Practices, Human Resource Development, Skill Gap, Mentoring, Contemporary Leadership and Sustainable HRM. Additionally, she has a deep-rooted interest in research works related to service marketing, TQM and Industry 4.0. She has published and presented research papers in various national and international journals like Management and Labor Studies (Sage), International Journal of Public Sector Performance Management (Inderscience) to name a few.

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