Executive Summary
Today, human resource management (HRM) practices are commonly implemented in developed and developing countries. They include how people are hired, maintained, trained, and motivated. In this project, the healthcare sectors of Germany and Turkey will be compared on the examples of two local hospitals lines, Helios and Liv Hospital, respectfully. The work of healthcare providers and nurses depends on multiple factors, including culture, economics, demographics, and technology. These four forces will be analyzed to understand what HRM decisions Helios’s and Liv’s managers and employers need to make to help their employees succeed in their activities and fulfill their responsibilities. Gender equality, a work-life balance, flexibility, and communication are the main characteristics of HRM practices that can be effective for the German and Turkish hospitals today, under the impact of the COVID-19 post-pandemic era. Companies implement interviews, diverse advertising, and recent technological achievements to attract professionals and strengthen their skills in traditional settings and for remote work if necessary.
Introduction
Today, much attention is paid to the field of human resource management (HRM) and development (HRD) and the application of various factors to achieve improvements, promote changes, and deal with challenges. Companies and employers must address certain cultural, social, economic, and technological forces to organize their work properly. The primary goals of HRM practices include acquisition, motivation, and progress (Rasool et al., 2019). However, many other things depend on countries, their rules, regulations, and the needs of populations compared to global aspects. In this project, two private hospitals in Turkey and Germany will be analyzed through the prism of their HRM practices, employee engagement, and motives. The cultures of the chosen countries impress people with their uniqueness and diversity. Technological and economic situations differentiate, provoking the necessity to investigate multiple internal and external issues affecting professional development in organizations. Compared to balanced and definite German systems, the Turkish healthcare sector is full of surprises and contradictions. Therefore, the effects of such factors as culture, economics, innovative technologies, and demographics on German and Turkish private hospitals need to be identified and discussed to achieve success and profits in international affairs.
HRM Importance
HRM practices include various approaches to employee management in the context of which employees are defined as business assets. It means that employers should investigate and understand all affecting forces to find, select, hire, prepare, and encourage employees with minimized risks and increased benefits. European and Asian healthcare sectors have already undergone certain shifts in employment, facing some social, technological, and economic advances and shortages in health workers’ distribution (Blštáková & Palenčárová, 2021; Kulak & Tüzüner, 2020). Despite the existing problems, the implementation of HRM practices and policies turns out to be a significant step for employers and workers. Organizations find and hire the best and most appropriate people, train them with respect for current regulations and expectations, and motivate them to maintain engagement and job satisfaction. Today, the number of privatized hospitals in European countries continues to grow because of the necessity to increase cost-effectiveness and improve the quality of care that people should get (Back et al., 2022; Saygili et al., 2020). The chosen private organizations are Liv Hospital Group in Turkey and Helios Hospitals in Germany, the two largest multidisciplinary medical facilities, with more than 10,000 employees.
Private Healthcare Business in Germany
Germany is known for its possibility of keeping a work-life balance, planning each activity, and finding the most reliable resources for services. In this country, HRM practices are associated with clearly identified personnel administration tasks and contracts offered to each employee with a written summary of major terms and employment conditions (Schneider et al., 2019). It is not enough to identify the requirements that an employee and an employer should follow. German HR administration is complex in terms of its regulations and restrictions defined by local unions and medical councils (Schneider et al., 2019). Nurses and physicians get a chance to negotiate their wage agreements, and strategic management allows them to overcome the challenges of traditional management through long-term decisions and values. According to Blštáková and Palenčárová (2021), German hospitals may not be the most attractive workplace from the international perspective, but its personal development opportunities remain great for many employees. People are protected by several employment acts, underlining the importance of fair dismissal, notice periods, and working time regulations.
Many organizations demonstrate how the healthcare sector should work in the region. Helios is a well-known private hospital network in Germany, with more than 70,000 employees being hired throughout the country and more than 5.2 million patients being served (Helios, 2020). The COVID-19 pandemic has challenged medical facilities from different perspectives, and the properly trained and prepared staff could get the situation under control and apply the necessary organizational and care-taking steps. Sustainability issues and commitment are critical elements in this organization’s development because they help promote a healthy environment, address available natural resources, and benefit with values. More than 80 e-learning seminars and 800 advanced training courses are offered to employees to keep them aware of transparency, ethical behaviors, and environmental protection to establish future viability (Helios, 2020). Regarding the already made achievements and current working conditions, the chosen German private organization is characterized by improved education, career opportunities, and work-life balance as a part of HRM practices.
Private Healthcare Business in Turkey
Liv Hospitals introduce the line of facilities where physicians and nurses cooperate to promote a patient-focused approach. As part of the MLP Care team, more than ten thousand employees aim to deliver high-level comfort services and hospitality to all patients (MLP Care, 2020). However, despite creating equal working conditions, many Turkish hospitals cannot cope with the increased number of chronic diseases and aging changes. Liv Hospital is a relatively new organization, but its ratings and reports meet and even exceed expectations. The HR department aims at creating encouraging working conditions and transparent performance through measurable criteria (MLP Care, 2020). Sustainability and training are highly appreciated by promoting organizational and technical training. Much attention is paid to leadership and corporate culture programs (MLP Care, 2020). International orientation is enhanced to obtain valuable resources abroad and share local experiences with foreign partners.
In Turkey, HRM ups and downs are regular for local hospitals and international partnerships. Yildirim et al. (2020) report that it is expected to retain the brain-drain of native professionals by properly addressing global dynamics and the European Union membership. There are many favorable conditions for hospital employees, including public funding in education and technological implementations. At the same time, open migration and an insufficient health workforce are the challenges that make it hard to predict what could happen next and stick to one definite plan (Yildirim et al., 2020). A work-life balance has a small economic value in Turkish private organizations, and such facilities as Liv Hospital or other members of MLP Care should work hard, neglecting their personal needs, flexibility, and social obligations periodically (Kulak & TĂĽzĂĽner, 2020). One of the most evident achievements in the country was implementing the health transformation program to improve governance and satisfaction among citizens and care providers (Bener et al., 2019). Financial changes had a positive impact on the healthcare field, and such efficient networks as Liv Hospital and MLP Care could be created and contribute to the development of the country.
Factors in HRM Practices
HRM practices depend on many factors in the spheres of politics, economics, technology, and public relationships. Each private organization takes all possible steps to learn the most integral aspects that affect their work and implement policies to attract the population’s attention and encourage the choice of ordinary citizens. The connection between HRM and innovations is important because all parties are interested in promoting reliable information and achieving the best results. The ways of how people are hired, trained, supported, and motivated in the private healthcare sector in Germany and Turkey differ in terms of the local cultures, economic conditions, technologies, and demographic changes.
Culture
Differences in Turkish and German working conditions are highly predetermined by their cultural preferences and traditions. One of the most evident aspects is the style of life preferred by Germans and Turks. A work-life balance is a significant practice for many German private organizations, including the healthcare sector. Flexible working patterns have been widely used and discussed in the country since the enforcement of the Working Time Law (Kulak & TĂĽzĂĽner, 2020). In Turkey, a similar law was implemented in 2003, and it is known as Labor Law no. 4857 (Kulak & TĂĽzĂĽner, 2020). During the pandemic, most companies had to re-evaluate their flexibility to provide employees with safe and effective working conditions. However, before the 2019 crisis, the attitudes towards Turkish and German employees varied.
Communication and administrative programs are practices similar to the cultural beliefs of citizens. Most Turkish doctors and nurses could communicate after-work hours to discuss possible improvements and solve burning questions distantly. In Germany, people followed a clear division between work and after-work life. When German people are hired, a friendly environment and support are usually present to offer guarantees and underline obligations. In Turkey, few organizations prefer to use long-term contracts because changes cannot be avoided. Still, when Liv Hospital hires a person, a management contract, according to which duties and responsibilities are defined, is signed (MLP Care, 2020). There is a stable contract management system in the organization to ensure that all contracts are under control and all changes are properly managed as per the hospital’s needs. Compared to the Turkish system, more than 80% of Helios employees have permanent and fixed-term contracts, and temporary employment may be explained by unpredictable replacement situations (Helios, 2020). In fact, the issue of culture in Germany is not as evident as in Turkey, which explains the stability and order in German employment and unpredictability of Turkish HRM practices.
Germans are known for their calmness and prudence, while Turks prefer to talk a lot and interrupt communication. The collectivist cultural preferences in Turkey are evident, and people are able to choose between options during employment. HRM practices show unbalanced distributions of health employees because of the impossibility of finding skilled people and filling the employment gaps (Yildirim et al., 2020). At the same time, Liv Hospitals continue educating the staff and strengthening their communication and leadership qualities to create strong teams and resist the country’s overall disbalance (MLP Care, 2020). The pragmatic approach distributed among German hospitals allowed Helios to create several structured talent pools and deal with the shortage of workers in a short period (Helios, 2020). In both cases, the healthcare sectors try to select, hire, and train people with minimal losses to achieve cost-effectiveness and offer the best services for patients.
Economic Conditions
When a company decides to hire a new person or invest in staff education and improvement, the country’s economic situation and the facility’s financial status should be analyzed. It is necessary to prepare a hospital for expenses and identify if benefits could overcome losses. Employment is never permanent in the healthcare sphere because economic crises, human behaviors, and structural changes emerge from time to time (Kulak & Tüzüner, 2020). Germany’s economic situation is known as stable in Europe, and Helios’s employees demonstrate high responsibility and interest, supporting the facility’s financial success (Helios, 2020). Addressing the needs of citizens, the Turkish hospital under analysis is interested in creating economically diverse plans as a part of motivational programs (MLP Care, 2020). Despite the differences in the country’s economic positions, both organizations focus on the professionalism of their employees, appropriate education, and sufficient training. Helios might hire one person and invest in their education instead of searching for several people for the same position at different periods. Turkey is more unpredictable, and people are hired according to the current needs and available resources without considering future implications and benefits.
On the one hand, the economic status of Germany seems to be more favorable and stable than the Turkish situation, where changes and improvements challenge stability. The chosen populations are almost the same, about 83 million people (Germany economic outlook, 2022; Turkey economic outlook, 2022). However, the differences in Gross Domestic Product (GDP) per capita are evident: $9,078 in Turkey and € 41,47 in Germany (Germany economic outlook, 2022; Turkey economic outlook, 2022). GDP levels and unemployment rates go together because the decrease in one sector means negative changes in another sector and vice versa. In Helios’s and Liv Hospital’s cases, the economic situation affects the conditions under which people are hired and maintained. Low levels in Turkey explain the desire of citizens to live in the country and find higher salaries abroad. Thus, in Germany, people want to be hired locally, and employers fund educational programs for motivation because both parties are satisfied with their salaries and services. The pandemic has raised many employment questions, but the healthcare sector cannot stop working or delivering services distantly because people need real help from real experts.
Demographics
The demographics of Germany and Turkey in the healthcare sector are mostly females aged 25 and older. The selection of employees is based on their academic degrees (at least Bachelor’s). At the same time, male resources are needed to meet employment equality regulations. Today, men and women may be chosen for an open position if they successfully pass the application process and demonstrate their abilities and desire to work in hospitals. Both Liv Hospitals and Helias use advertising to attract the attention of young employees (Helios, 2020; MLP Care, 2020). Interviews with applications are organized face-to-face (if individuals are local) or via Skype or other programs (if individuals are from abroad) (Helios, 2020). Virtual personnel selection is highly approved during the post-pandemic area, and Helios’s leaders approve the choice of international specialists in nursing. Still, employers admit they do not recruit people from countries that struggle with a staff shortage (Helios, 2020). Liv Hospital’s recruiting abilities are supported by the possibility of participating in scientific activities and improving their skills through training and education (MLP Care, 2020). Thus, young people become the core applicants in HRM practices.
The gender factor plays a significant role in understanding what HRM practices should be applied to make the hospitals work effectively in Germany and Turkey. For example, in Turkey’s facility, more than 60% of managers and regular workers are females, and about 40% are males, while more than 60% of executives are males, and about 40% are females (MLP Care, 2020). In Germany, women hold about 31% of management positions, but the total number of recently hired women is 76% (Helios, 2020). These findings prove that HRM practices for training, improving, leading, and motivating should touch upon a work-life balance and employee security. Young women need guarantees for parental leave if necessary, and leaders should calculate what benefits and losses may be associated with these requirements. In Turkey, the hospital continues hiring women and replacing them with short-term employees, while in Germany, the hospital creates contracts to identify the responsibility and service terms for each employee individually.
Technologies and Innovation
HRM practices in German and Turkish hospitals may vary on the basis of cultural, demographic, or economic factors, but technology force is something the citizens of different countries are free to use regularly. In both countries, technological progress has already promoted significant shifts in the work of healthcare providers and nurses (Back et al., 2022). However, the ways how technologies affect HRM practices need special attention.
For example, in Germany, there is a strong healthcare system in terms of which patient care and employee training are conceivable. Helios continues developing its trainee programs to foster talents in hospital and nursing management, finance, and control (Helios, 2020). The staff gets a chance to learn about operational management distantly, and applications already reached the number of 769 in 2020 compared to 260 a year before (Helios, 2020). Another significant impact of technologies on the work of the HR department at the chosen hospital is the increase of video consultation hours. The COVID-19 pandemic has restricted the possibility of citizens visiting hospitals and maintaining their well-being. Helios physicians have improved their communication skills and observation practices to help and educate patients distantly (Helios, 2020). The implementation of innovative health technologies positively influences strategic decisions in urban and rural settings (Schneider et al., 2019). HR managers assess employees’ skills and knowledge of technologies and base new training programs on current needs.
The situation in Turkey is not as firm and beneficial as the one in Germany. Although new technologies emerge in the healthcare sector, people’s awareness of technical devices and role sharing is not enough to succeed in all activities (Yildirim et al., 2020). The hospital aims at introducing new education models for physicians and nurses as a critical element of their HRM practices, and individuals make their employment decisions regarding location preference. Compared to German employees, not many Turks feel comfortable with the offered technological devices, requiring more time and professionalism for education (Rassol et al., 2019). Communication technologies may allow employees to work not only within the hospital building, addressing evident advantages of telecommuting (Kulak & Tüzüner, 2020). Thus, information technologies are highly applied in medical treatments at Liv Hospitals, and the number of servers is more than 380 at this moment (MLP Care, 2020). Remote work in Turkish hospitals imposes new obligations on employees, and the task of the HR department is to distribute information equally and support the technological advancement of every team member.
Conclusion
This comparative analysis of the German and Turkish hospitals shows the impact of several forces on the work of the HR department and the changes in HRM practices. This research reveals certain similarities between the chosen facilities, Helios in Germany and Liv Hospital in Turkey. The demographic force is strong in both countries, explaining why some HRM practices address the needs for a work-life balance and gender equality. The economic situations in Germany and Turkey depend on many factors, including GDP levels and employment preferences. Thus, the German hospital faces fewer funding and education problems than the Turkish facility. Culture and technology remain the strongest aspects in defining HRM practices and how people are hired, motivated, maintained, and trained. Compared to calm and goal-oriented Germans who prefer to invest in one person and enhance this development, Turks like to make fast decisions and invite several people to apply for the same position. Resource substitution is frequent at Liv Hospitals, while Helios focuses on a sustainable environment. Despite the existing differences, the German and Turkish approaches to hiring, educating, and motivating employees deserve recognition, respect, and further analysis.
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