IMPORTANCE AND ROLE OF HUMAN RESOURCES AND THE MANAGEMENT IN HEALTH CARE

With the opening up of economy and participation of private players in healthcare sector, the technological and innovative procedures in healthcare, improvement of healthcare facility’s in line with that of developed nations, there is a see saw change in healthcare spectrum. Accordingly the role of Human Resources Management has changed the functioning because healthcare is related to health of human beings where care and upkeeping of the patient’s health is a primary of importance. Unlike other organizations healthcare organization is a peculiar sector in which the role of Human Resources is of utmost important. Human Resource Management in particular Personnel Management serve an important role in developing a team of professionals, to find new talent, train new employees, to support the healthcare functions. In addition attrition is an important aspect because any experienced qualified healthcare professional leaves the organization (specialists) will have greater impact in the facility; as such the human resources management should take all care to retain the talent and experienced and qualified healthcare professionals and Para medics by looking after their needs that is within the limits of the organization and at the same time to keep their morale high. This Article presents a significant contribution of Human Resources Management and the Personnel Management with respect to healthcare facilities and their functions, characteristics, role in satisfying the patient’s want needs and at the same time to reach the functional goals of the provider/facility. In a word healthcare professionals and


I. Introduction
When we trace back the history of healthcare facilities (hospitals), these facilities have existed from ancient times and even in 6 th century B.C. During the time of Buddha, there were number of hospitals to look after the handicapped and the poor. Some of the outstanding hospitals were built by King Ashok (273-232 B.C.). When, books return by Arabian and European travelers to India reveal the fact (around 8600) that Medicine in India was in its blossom, in that period even.
However, the situation has slackened, because the native Vaidyas are not given proper assistance in their investigations in healthcare and healthcare procedures. The chief sources of knowledge in the medicine is from the four Vedas namely Rig Veda, Sama Veda, Yajur Veda and Adharvana Veda. Mainly Adharvana Veda; indicates ways and means to protect people against many kinds of diseases and natural disasters. It is also mentioned in Yajur Veda (16/4) that the world should be free from disease and should have healthy mind. The development of Ayurveda in Ancient India (Ayush means life and Veda means knowledge) known for its meaning of science of life and how to prolong life etc., it is just and necessary to mention that the famous Charaka, a court physician of King Kanishka developed the medicine and subsequently Dhanvantari called the patron of God of Indian Medicines initiated many healing methods of healing and the knowledge was transferred to Sushrutha, who was the celebrated Surgeon in those times. Sushrutha the father of the surgery in those days made many inventions and of which many are the stepping stones in the present development of surgical technology and procedures.
However Indian Surgery/Surgical Procedures received a set back because of the principle of Ahimsa by Buddha. A recent Article by Katihunt and Hilary Whiteman on

"Stone Age humans had unexpectedly advanced medical knowledge, new discovery suggests",
A case of young man or woman around 31000 years back was discovered shows that signs of amputing left leg was discovered; this clearly shows that the knowledge about surgery and complex medicine was used in those days. When there is no technology as of now, those physicians carried out the task in,

"it is significant because it considerably pushes back our species knowledge about surgery and complex medicine. The foot and lower leg was deliberately removed with a clean, sloping cut. They had to have profound knowledge of human anatomy, how to stop the blood flow, anesthesia, antisepsis, all these are only became the norm very recently".
From that situation and today's technological advancement in healthcare is phenomenal and the knowledge has grown leaps and bounds with the introduction of surgery by robotics instead of human beings. The Present healthcare system though is entirely dependent on technological advancement in procedures (surgeries) still they have to be handled in proper perspective by human beings who are well versed not only with Anatomy and surgical information of the procedures but also should have the operational skills to use effectively those sophisticated equipment with benefit to the patient and to bring him/her back to the normal situation.
One of the components of modern healthcare facilities or the selection of Human Resources who can deliver and manage healthcare systems efficiently in healthcare facilities. Selection of such human resources who are well qualified, well trained having specific experience in line with that of the existing facilities who are in need of them is the order of the day.
This Article presents a view of human resources, selection, management in healthcare facilities because the requirement of each facility ranging from clinical establishment, super speciality hospitals, multispeciality hospitals will differ and specific from hospital to hospital. Human resources in health care unlike in other organizations and establishments is entirely different in nature, they role, objectives and criteria because healthcare facilities will deal with human beings.

II. What is human resources management?
Human Resources Management is, "Human Resources Management is the strategic approach to the effective and efficient management of people in a company or organization such that they help their business gain a competitive advantage. It is designed to maximize employee performance in service of an employer's strategic objectives" -(Wikipedia).

III. Objectives of human resources management:
Human resources will have some set normal objectives as defined below a. Achieving organizational goals.
The major function and objective of HRM is to fulfill the organizational goals. Utilization of human resources to its optimum level is the requirement and main goal for effective HRM. Normal organizational objectives include handling of workforce, updating staff requirement, efficient planning and execution. b. Introducing and implementing work culture.
The Human Resources Management should also maintain healthy and transparent relations among the team members and should see that the contribution of team members for 'a good work culture' by adopting right solutions of employee management software.

c. Integration of team members (work force)
One of the important roles and objectives of HRM is to make sure that the team coordinates effectively and efficiently. In Human Resources Management effective communication plays an important role and it is the need of the hour in any organization. Lack of communication, no communication, breakdown in communication, partial communication will affect the functions of an organization as such the HRM is a tool to assist in making integration of communication at all levels, else the management will fail in achieving their goals.

d. Training and development of human resources to motivate the employees
The prime objective in Human Resources Management is proper selection, training to specific needs and make the force to travel in the right path. While doing so the management should be careful enough to keep away the distractions and vibes. In addition the employee should be motivated by giving some powers for decision making, take the views of the employees and involve them in weekly meetings and decisions and respect their views and if they are fruitful encourage them monetarily or otherwise, Employees should be recognized on the appraisal reports and suitably rewarded.

e. Empowerment of workforce:
It is the duty of the HRM to encourage and recognize the services rendered by them to the organization and the motivational acts to the subordinates and at the same time they should be loyal to the organization. However, if the management does not recognize the skills and efficiency of the work force and encourage them with suitable benefits; 'Retention' will become difficult. While doing so the management should keep in mind the profits of the company and the health and welfare of the patients and they should evolve a comprehensive planning system keeping in mind all the goals of healthcare promoters, welfare of the employees but not at the cost of patient's pockets.

f. Data and compliance:
Functional and Organisational objectives include managing the organization, employees data and managing the compliances. In addition the HR mangers should also see that untoward incidences are not happen in the organization due to discomfort/displeasure among employees or patients or governmental agencies or in such other related matters where any pitfall will leads to heavy fines and the situation is grave with suspension of registrations, or both.
To eradicate or minimize these situations a automated software like HRMs systems if introduced can help to keep errors at the side and leave no window for owing any penalty from IRS. In addition the HRM should anticipate future human resources needs, managing such needs, talent hiring, and maintaining HR data. Sometimes online HR software will also help to certain extent. Finally to make HR Management fruitful they should have right strategies coupled with HRMS Software with integrated modules like recruitment management solutions, time sheet management, management software will make the department a successful one in any organization. Developing and working upon a HR Objectives of that particular organization/facility will always help a cutting edge of survival in that particular sector. However, with the changing environments especially in healthcare sector just like Covid-19 pandemic situation that has thrust upon the sector will change/effect human resources at large for which the management should be in a position to face the situation.

IV. Definition of human resources management in healthcare:
human resources for health (HRH) or health workforceis defined as "all people engaged in actions whose primary intent is to enhance positive health outcomes" according to World Health Organization's World Health Report 2006.

V. Human Resources Management in healthcare:
Human Resources Management in a healthcare sector is an important tool and has greater relevance because healthcare deals with human beings who are in need of, and some are in dire need of some kind of relief to their ailments/sufferings so that they can go back to their normal work and life. In short an healthcare facility is a miniature community in all aspects that operates like a small city, displaying same issues with a stronger view point of human relations factor.
Human resources in healthcare/healthcare facility plays an important and fundamental role in the facility to ensure optimum delivery of healthcare services and providing the best patient outcomes. Unlike other organizations in healthcare the human resources management department is mainly responsible for an assortment of Personnel wants that of employers, employees and the consumers namely the patients at large. Not only that the main important aspect of human resources management in healthcare sector/healthcare facility is to handle all aspects of operations that are Personally related. Any amount of disagreement/dissatisfaction leads to chaos, unpleasantness. Finally a word of mouth leads to business loss.

VI. Man power Planning in Healthcare
Unlike other organizations manpower selection and planning is the most crucial resource towards delivery of health care to the satisfaction of the receiver (Patient); as such one should take care of health manpower planning, according to that particular healthcare facility. Due to advancement of technology, medicine and procedures in healthcare and establishment of different healthcare facilities to cater to the needs of particular patients, particular ailments, the human resources planning plays an important role; especially in specialized field and only that particular manpower who has specialized in that particular field who can fit in to the environment of that particular facility can only be selected to fulfill the task. Hence, before manpower planning especially in the healthcare sector the management should think of what type Personnel are required in particular health departments leaving the administrative office and their general workforce should plan in detail the number of departments, number of personnel required and number of healthcare professional who are qualified trained and experienced to that particular department/section are to be selected; else the results will be disastrous; because healthcare sector is not a training platform nor any educative platform because the movement a person is selected in a particular field or department has to be on the task the movement he/she takes over the job. Hence, the Human Resources Management should keep in mind the following aspects, b. Regular maintenance staff including mechanical, electrical, electronics, software and civil.

VII. Manpower Planning comprises of two wings of healthcare facility namely,
a. Health care manpower planning b. Health care manpower management The most crucial aspect of delivery of health and health services depends upon man power, manpower planning and manpower management. Manpower Planning in healthcare sector is a technique of supply of manpower according to the demand of manpower to reduce the imbalance, so that the service delivery system in healthcare will not suffer; because the health service system is related to human beings is very crucial unless otherwise the service is met instantly on the spot on demand. This cannot be stored, preplanned, made to order but depends upon the requirement of each and every patient according to their discomfort/ailment and the procedure. Hence, the demand and supply are in the same place in healthcare service sector as such pre planning of required, qualified, skilled and experienced personnel are to be selected in advance, anticipating such requirements in future in that facility as per the goals of the facility aimed by the providers. Due to unplanned development of medical colleges and hospitals in majority of the states and till the private players in healthcare coming into the sector the main dependence of health service are, government hospitals, primary healthcare centres, anganwadi's, asha workers. However, with the private players entering into this arena the situation has changed the proportion of requirement of healthcare professionals vs patients. However, the ratio is far behind the advocated ratio of World Health Organization (WHO). This can be reduced/minimized with a uniform planning of healthcare in all the states and union territories as per the population ratio and the healthcare professionals as directed by World Health Organisation, then only the governments of all the states and union territories are in a position to give proper healthcare to the nation.
VIII. The role of human resources in healthcare and its impact and facilitating optimal healthcare services:

a. The role of human resources in healthcare
In healthcare facilities the department of human resources plays a critical role and depends upon the HR leader/manager. Compared to other organisation the role of human resource in healthcare is particularly critical because of the complexity faced by the healthcare sector, as already mentioned the demand and supply are at the same place and same point, the healthcare facility should have a strong Health care Professional team to help and navigate various challenges faced by any healthcare facility which are changing and are not static according to the situation.
The role of human resources in healthcare and their leaders thereon must recognize that the group of humans who fall within their stewardship extends beyond their pay check. Also it encompasses patients who are receiving the care from the healthcare professionals.

b. How to run successful healthcare practice and human resources:
The role of HR Leaders/Manager is not confined to one area but expands to various aspects of the practice and familiarity with both the human resources side of the job and with the healthcare industry. Following are the common roles and responsibilities of HR leaders/managers in healthcare facility.
a. Hiring, b. Training, c. Logistics Management, d. Relevant trends, e. Diversity, inclusion and equitable treatment, f. Patient satisfaction, g. Employee management, h. Dispute resolving and discipline in work force, i. Compliance of legal formalities.
All the above said programs are a continuous job in healthcare sector because the service requirement and demand of patients specific requirements are changing day in and day out due to various infectious diseases that are cropping up and change of environments, the role of HR Leaders/Managers is very crucial and they should be always in their shoes to meet the challenges (Covid-19, Monkeypox).
In healthcare sector the outcome of the healthcare services rendered by the facilities is related to and depends upon 'patient satisfaction' . Patient Satisfaction is the yardstick to evaluate the efficiency of the role of HR Leaders and Managers. The HR Leaders/Managers should adopt the system of feedback by preparing a questionnaire to elicit the feelings and suggestions from the patients and their accomplice before and at the time of discharge. It is always better to have weekly or monthly conference with all the heads of the departments and the HR Leaders to elicit the functioning of the facility and additional requirements of each and every department whether it is related to healthcare or not and sharing the feedback, so that suggestions can be invited from all the heads and can be implemented as per the order of preference.
In addition to avoid attrition, by addressing the problems of the healthcare professionals, their comforts, their needs and wants and finally Personnel obligations if any and create an atmosphere of "give and take", instead of applying rigid rules and regulations. The Health care Providers/Managers also responsible for the rules and regulations that are being enforced from time to time by the respective governments of State and Central, All India Medical Council, State Medical Council and the local healthcare laws such as safety requirements, infection control, safety in healthcare facility, legal repercussions. To conclude Human Resources Management in healthcare facility either government or private plays an essential role in motivating the employees, improving the interPersonnel skill, communicating skills, heeding, interacting. The Human Resource Management should act as a bridge between the management, employees, public assessment, reviews and addressing deficiencies, choosing criteria for employee appraisals/facilitations are some of the acts that will make the HR Management a successful unit in any healthcare facility. The said is very simple than deed. For a successful management they should design and develop simplified standards for effective management.

IX. Needs challenges and opportunities in recruiting and retaining healthcare professionals
The needs and challenges of healthcare system in healthcare sector has come out in the recent pandemic of Covid-19 and the subsequent variants and the present Monkeypox, that has shaken the Global Economy and the majority of the companies including the developed nations have fallen pray to the Pandemic Situation because everything in every country has come to a standstill except the healthcare delivery system and the dedicated healthcare professionals. Among all the countries we can say with authority that our country (India) played an important role in tackling the pandemic situation and in addition helped many countries by supplying vaccine which was produced first time against the Pandemic in India only. This clearly shows the role of human resources and the challenges faced by them in attending global needs by supplying the vaccine to contain the pandemic, which is a daunting task. In such a short time our healthcare professionals worked round the clock not even thinking about their own health to provide all possible assistance to patients effected with such new Pandemic Virus, which is hitherto unknown to healthcare. Among all other sectors healthcare when examined globally many human resources issues and questions arise. Some of the issues that may crop in universallycomposition and distribution of healthcare professionals including Para medical staff, related training issues, migration of healthcare professionals and Para medical staff, level of economic development in that particular country and in addition socio demographic, geographical and cultural factors. If we analyze the fact within the country it depends upon the variation in size, distribution and composition within the country's healthcare workforce is of great concern. Proper delivery and interventions in healthcare service in any country depends upon the number of healthcare professionals available and the ratio between healthcare professionals and patients. It is not sufficient to have number but the country should have proper facilities to train them. As the number of private healthcare facilities, some are with international affiliations and joint ventures are entering into the healthcare arena especially in India the requirements of each healthcare facility depends on their final goals in meeting the requirements of the patients, the input from the facilities have to be changed and developed accordingly.
Human Resources Management in any healthcare facility and the professionals/managers/leaders should understand the importance of developing a culture to suit to that particular healthcare facility to meet its challenges and needs. Another main important aspect especially in healthcare sector is communication;

X. Imbalances in the healthcare workforce
The task of addressing the imbalance/shortage of human resources in any healthcare facility starts with identifying the current availability and quality of healthcare professionals and Para medical staff and to give them proper and needy training to suit particular requirement and fill the gap. With the advent of private players in healthcare facilities due to government policies of opening up of economy and globalization of healthcare in addition major policy changes and reforms in healthcare, it is ideal time for comprehensive, targeted interventions to address the demand and supply mismatch that plagues the alied health systems in the country. The present healthcare professionals and Para medical staff in Indian healthcare compared to World Health Organization's recommended figures are different and there is a large gap. This was indicated by National Sample Survey Organization (NSSO) and Sensus of India in comparision with World Health Organization's figures.
This imbalance is not the availability of the healthcare professionals and Para medics because the improper establishment of medical colleges, nursing institutions, training centers for lab technicians and such other allied sectors including institutions are the major concern of healthcare workforce imbalance. Majority of the healthcare professionals not inclined to work in rural areas and refusing to go to inaccessible areas such as hilly areas, forests and areas without proper connectivity including roads. Majority of the healthcare professionals and Para medics wants to work in developed areas and star rated healthcare facilities only. Recently the government of India and the Indian Medical Association and the counter parts of the states sent recommendations to the Central Governments to pass a uniform legislation which can be applied in all the states including union territories that, all the healthcare professionals and Para medics after graduation should work for a minimum period in such under developed areas. If this is finalized, the imbalance can be minimized and healthcare services can be effectively introduced and implemented to that particular population where there are no minimum facilities, surprisingly for a ordinary fever the people have to walk kilometers and if they are sick they are carried by hands or bullock carts to the nearest primary healthcare center.
It is welcome gesture that the government of India has taken a decision to support human resources development and Para Medical Staff and such other allied healthcare workers with the establishment of National Institute of Allied Health Sciences (NIAHS) and National Institute of Para Medical Sciences (NIPMS). In addition the Government of India has taken a decision to establish Eight Regional Institutes of Allied Health Sciences (RIAHS). The functioning of the above institutes is to support the development of Human Resources in healthcare sector, standardization of educational institutions (healthcare) and the curricula and the training in the country. The decision of establishment of Eight Regional Institutes is to facilitate state-of-the-Art facilities, offering higher order/post graduate courses in various allied health streams. The role of NIAHS as a central body is, 1. To serve as the seat of learning for limited number of graduate and Post graduate programs at its location.
2. To perform a Central coordinating role for running ofsite/longdistance programs through long term sponsorships in different parts of the country.
3. NIAHS has opportunity to function as a test bed for developing a National strategy for best practices in allied health sciences.
4. The best practices lab's goal would be to enhance patient safety and quality of health care through the use of innovative, high impact training and research. 5. These best practices can be system wide involving many domains, or focus on innovations in an identified thrust area.
6. The role of NIAHS promote and accelerate research in allied health services is critical for the future of healthcare systems in India. This research should include a sustained effort in understanding the human resources land scape of allied health sciences that include the need of future projections. 7. NIAHS should take the responsibility of designing, formulating and updating course to the curricula on an ongoing basis. 8. NIAHS should develop the capacities of RIAHSS for skill training, system based practices and team training. 9. NIAHS should develop a culture of affiliation and collaboration with the private players in the healthcare sector and use their good offices for training by the qualified and experienced healthcare professionals as guest faculty on regular basis. These are only basic duties but there are many more which the NIAHS and RIAHSS can develop with regard to development of human resources that is the need of the hour in healthcare.

XI. Qualities of a critical care team in healthcare:
It is a welcome statement by Dr. Gourishankar Reddy, Head of Medical ICU and COVID ICU, BGS Gleneagles Global Hospital with regard to the healthcare professionals during Pandemic of Covid-19,

"Critical Care Medicine or Intensive Care Medicine is that field of medicine which deals with life and death situations. It can be compared to a battled field. Doctors, nursing staff and other healthcare workers working in Intensive Care Unit must possess the following qualities to contribute to better patient care and outcome".
That is the human resources requirement in healthcare compared to other sectors. Dr. Gourishankar Reddy also mentions the quality of human resources in serving the patients in an healthcare facility.

a. Compassion:
The important thing is to understand the pain and the emotional turmoil, the patient undergoing should be the quality of healthcare professional and Para medical staff. Unless one should understand the intensity of the patient suffering, it is difficult to care the patient by giving matching care to his/her suffering; In addition the holistic approach of health care, emotional support, psychological counseling will give positive outcome.

b. Continuous learning and attitude to upskills:
The heart of the healthcare is Critical Care Medicine and it is ever growing and is flodded with new knowledge; that is why the healthcare professionals and para medics need to keep with the pace. Learning never ends in the field of medicine and especially in critical care medicine. Intensive Care Units are always multidisciplinary interactions, helps for the healthcare professionals and para medics to learn more and upgrade their knowledge and skill for which they should have the attitude.

c. Critical Observation:
The professionals working in ICU's and CCU's should have the quality of critical observations on each and every aspect and function to update their knowledge and experience. It is necessary that the healthcare professionals and Para medics should identify the possible complications before they occur; so that the patients will have in time interventions and smoother recovery. Though the quality of critical observation develops over a period of experience, to have an eye on things and to find out misshapes, to its curiosity and patience backed up by profound knowledge. The saying is, "prevention is better than cure". d. Being a team: ICU's and CCU's comes under team work but not a single individual who is attending in shifts. But same is not the case in ICU's and CCU's because the care is not continued, the "chain of care" may break. Hence each member should be a team player and ready to take up the roles as per the need and situation. It takes much time to develop such team who can act as single unit in performing the task given to them, as if a single one is doing.

e. Servant leadership quality:
A peculiar situation arises in ICU's and CCU's on many occasions though the life's of the patients cannot be saved but the relatives of the patients thank the team for their efforts, though they lost their dear and near ones. This marks the highest trust and most transparent communication any healthcare professional and patient can have. This one quality can reduce major amount of aggression, mistrust and violence against healthcare professionals and para medics, unfortunately it happens sometimes. Always take the relatives and family members of the patient in to confidence in explaining the situation but never avoid talking to them.
f. Physical, Mental, Emotional strength: Inspite of the fact that the ICU and CCU healthcare professionals and para medics will have the situation always,

"odd working hours without proper sleep and meal is part and parcel of the ICU and CCU Professionals",
and makes them burn out. It is essential for those professionals working in ICU's an CCU's to have a healthy lifestyle to the extent possible; means good physical, mental and emotional strength building from a disciplined routine; thus, 'self care is must have quality' for ICU and CCU healthcare professionals and para medics. The saying is, "help self to help others".
g. Ability to multi task: In ICU and CCU multitasking is a mandatory virtue. Sometimes they will face with the situation of handling many critical patients in middle of the night which is not uncommon, as we have noticed during Covid-19 Pandemic. This Pandemic taught to healthcare professionals and para medics about the above quantity not in terms of physically managing the patients but also about ways and means to device a lot of techniques and instruments to help to manage multitude of tasks at one time. The saying is, "ever ready for anything" i. Ability to evaluate ever changing situations and quick decision making: In ICU's and CCU's a situation will arise that there will be a sudden deterioration in some patients health in such situations the healthcare professionals should be in their shoes to find out the cause for deterioration and instantly appropriate procedures to bring the patients to the normalcy should be taken. Especially when these professionals are dealing in situations of life and death the professionals will have few seconds at their disposal for decision taking and application of the same. It clearly shows their mental ability, efficiency in birth, thought provoking situations. The saying is, "swift and secure is the way to cure" . j. Tenacity: It is the ability of leadership in the ICU's and CCU's that counts when high drama is going around, the team leader should be able to manage himself/herself in addition manage the team in a coordinated effort to treat the patient and at the same time console the relatives and promote from such situations with success. The saying is, "courage is grace under pressure" .
k. Never give up attitude: In ICU and CCU's the situation is always is that the professionals will feel that they are a mission of impossible, because every patient is critical and the task to save and rehabilitate the patients seems a herculean task. However the professionals in ICU's and CCU's should always develop the concept of, "difficult roads lead to beautiful destinations holds good", here too.
The saying is,

XII. The importance and role of Human Resources in Emergency Rooms (ER):
Next to ICU and CCU another important division in healthcare is Emergency Room that are meant for seriously wounded or seriously sick patients. Developmental Technology and Advanced medication over the years, emergency medical care has taken gain and became speciality wing of healthcare sector. The Human Resources Management should be very careful in selecting the above mentioned Personnel for Emergency Rooms (ER) because they must have special skills and qualifications to attend to emergency care. These people require, "player strategies and approaches" in providing emergency care to the needy patient. Not only this, these Emergency Rooms (ER) will have the specially trained people (human resource) but also all medical equipment required are situated in one location. Especially for "International Patients" these ER are very necessary in any healthcare facility who have provision in attending of "International Patients". In such healthcare facilities in addition to Emergency Rooms (ER) they must include, emergency department, emergency ward, casuality department, casuality ward, accident and emergency wards etc., All these depends upon the size of the facility, availability of the Human Resource (professionals), geographical locations, and financial limitations.
To sum up, when the patient or their family or friend makes a call to the healthcare facility or the Central Ambulance Number, an ambulance is dispatched to the location and the professional inside the ambulance who are para medics, having certain amount of healthcare training but not qualified, comprising nurses, doctors and medical students. The movement the ambulance reach the patient they observe the symptoms of the patient and if condition necessitates provide emergency support while coordinating telephonically with the healthcare facility. This team in the ambulance do all the necessary to prevent the patient's condition from deteriorating before they reach the healthcare facility. Once the ambulance reaches the facility the team of experts will take care of the patient, and the team comprises of all the experts who can attend the critical care will examine the patient take immediate steps to normalize the situation. Hence these emergency rooms and the team members there on will, have greater responsibility and should be in their shoes to take care of things and effective measures and procedures so that without loss of time the patient can be brought back to stable from the critical condition. This is necessary in cases of accidents, heart attacks, brain strokes, blood clotting, respiratory problems etc. Of late all the Multi Speciality and Super Speciality healthcare facilities are very keen in establishing such provisions to the out patients who are in dire need of healthcare attendance. In this regard, the human resources management should be very careful in selecting the Personnel, inducing additional training if required and see that the personnel will keep up to their task. Not only the selection but also the attrition of such people is an important task because immediate replacement of such human resources is very difficult if not remote.

XIII. Personnel Management and its role in healthcare sector:
Definition: Personnel Management of human resources in healthcare is,

XIV. Role of Personnel Management in healthcare:
Though Personnel Management is part of human resources the functions are slightly different. The main role of personnel management of human resources through Personnel management is,

"imperative in the recruitment and maintenance of clinical and non clinical staff, promoting staff morale, providing opportunities for specialized development, and in the capability of a health organization to provide quality health care services and progress patient health outcomes".
Human Resources Management is an integral part of the overall healthcare facility administration.

XV. Significance of Personnel Management in healthcare:
Human Resources Management has a larger role in healthcare sector. HRM through Personnel management is responsible for much of the hiring and finding staff, as well as for their development and training. Doing this effectively ensures that the facility's patients will receive safe and quality care.

XVI. Patient Safety:
When it comes to patient's safety the Personnel management can impact Healthcare facility's bottom lines by securing and hiring employees who fit into the facility's culture, focusing on retention and contributing to learning initiatives that increase employee engagement.

XVII. Principles of Personnel Management:
Following are the principles of Personnel management in an healthcare facility,

XIX. Challenges of Personnel Management
Following are challenges faced by Personnel management in healthcare facility Collective bargaining agreements, operational personnel management, gaining access to relevant information, defining specific terms of engagement for temporary workforce, issuing purchase order with specific terms and conditions and finally basic planning of staff.

XX. Characteristics of Personnel Management:
Personnel Management is concerned with, The other laws that are to be acclimatized by the Human Resources Department are mentioned above. In addition to all these things the Human Resources Management in particular personnel management should be familiar with the general labour laws and also laws pertaining to employees such as 1. Enforcement of disciplinary actions against the workforce (labour laws) 2. Provident Fund Act 3. Bonus Act 4. ESI Act 5. Wages and Remuneration Act 6. And such other acts that are applicable to the employees other than healthcare sector. 7. Laws enacted by the legislature and amendments to the existing laws and GOs passed by the State and Central Government are to be familiar with Personnel Management.

XXIII. Conclusion:
Proper management of human resources is important in any healthcare facility in, recruitment and maintenance of clinical and non clinical staff, promoting the staff morale, providing opportunities for specialized development, and in the capability of a healthcare organization to provide quality healthcare services and progress of patient's health outcomes. Though Human Resources Management is an integral part of the overall healthcare facility administration but is an important subject. Any failure in human resources management brings chaos in healthcare facility as a whole. Hence, any healthcare facility will prosper and progress and meet the want needs of patients (consumers) with minimum of recourse of redressals is an important task for overall functioning of a healthcare facility.
There is a saying that,

"it is very easy to get thousand patients, but it is very difficult to have a one fully satisfied patient".
A word of mouth will make the difference and though the healthcare facility may not having latest equipment and comforts can prosper when they have best human resources in addressing the problems of the patients, healthcare professionals, Para medics etc., without any kind of adverse situations. Such healthcare facility can in no time become a fully developed equipped healthcare facility than a fully developed equipped healthcare facility with improper/imbalanced human resources. That is why the father of the nation (India) said,

"Health is wealth but not piece of Gold and Silver"
Truly golden words