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Abstract
Background Paediatric professional scarcity and uneven distribution is acute in underdeveloped regions, exacerbated by COVID-19’s workload surge and burnout, highlighting the need for strengthened prevention and response measures.
Aim Propose an effective talent management model to address the challenge of paediatric medical personnel shortage and lack of management experience in Underdeveloped cities of developing countries.
Methods A crisis management plan has been implemented in a paediatric hospital in Henan, China, with a talent framework to ensure a skilled, stable workforce.
Results An advanced talent management system is vital to address paediatric talent scarcity. Leveraging the national Children’s Regional Medical Center, fostering international cooperation, sharing knowledge and harnessing regional policies are key to effective paediatric talent management through leveraging, promotion, and driving initiatives.
Conclusions Efficient talent management methods have a significant positive impact on addressing the paediatric talent crisis, enabling departments and institutions to effectively manage medical talent through scientific strategies, ultimately contributing to the alleviation of medical resource deficiencies.
- career development
- clinical leadership
- health policy
- incentive
- integration
Data availability statement
No data are available.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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WHAT IS ALREADY KNOWN ON THIS TOPIC
Pediatric professional shortages and uneven distribution are acute, worsened by COVID-19. Existing research underscores the need for strengthened prevention and response.
WHAT THIS STUDY ADDS
A customized talent management model specifically addressing pediatric staff shortages in underdeveloped cities, implemented successfully in Henan, China, demonstrates that by strategically leveraging local resources, fostering international collaboration, and harnessing policy incentives, a stable and skilled pediatric workforce can be developed and retained.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
Informs research on talent management, provides actionable insights for hospitals, and highlights the need for supportive policies to alleviate pediatric talent crises globally.
Introduction
The global shortage and uneven distribution of health professionals, exacerbated by the COVID-19 pandemic, poses a serious challenge to health systems, especially in low and middle-income countries.1–3 This issue has a significant impact on the effectiveness, accessibility and sustainability of health services and systems, especially in low and middle-income countries with relatively poor health resources.4
Simultaneously, the pandemic highlighted significant issues in talent management, including insufficient personnel planning, imbalances in personnel structure and varying levels of professional expertise among doctors.5 Enhancing talent management, including medical education, resource allocation and improving medical staff conditions, is crucial. However, limited resources in underdeveloped cities of developing nations hinder such implementations.
Specifically, China, as a country with about 279 million children under the age of 18, accounts for about 15% of the global child population.6 With the two-child and three-child policy, newborn numbers rise, expanding paediatric medical demand. However, prevailing issues such as the scarcity of paediatric medical resources, the uneven geographical distribution of hospitals and the acute shortage of talent in China continue to exacerbate the brain drain dilemma.7 8 High-quality paediatric resources are mainly concentrated in metropolitan areas, resulting in an influx of patients from other regions and an uneven distribution of medical service resources.
The National Health Commission initiated plans in 2016 to strengthen paediatric healthcare. Henan Children’s Hospital, a populous province’s hospital, became a pilot unit in 2019. Since then, it is gained experience in managing paediatric staff shortages. This paper shares these experiences to help policymakers strengthen health system strategies for pandemics or emergencies. Our goal is to ensure equitable access to quality healthcare for all, especially vulnerable groups like children.
Methods
In 2022, a researcher conducted 30 min interviews with each of the 10 long-serving human resources managers from paediatric hospitals in Henan, China. The interviews were thoroughly recorded, and pertinent evidence of management strategies was systematically collected to identify and highlight the crucial implementation points. The talks delved into talent management intricacies, challenges and solutions. The data covered talent processes and the National Children’s Regional Center’s establishment, aiming to reveal effective talent management principles.
The interview focused on three key strategies: (1) How can we optimally harness the formidable strengths of the National Children’s Medical Center to elevate our own comprehensive capabilities; (2) How can we establish strategies for advanced personnel development in hospitals to maintain a consistently skilled team; (3) How can we optimise and amplify its radiating influence in Henan Province, thereby elevating the comprehensive operational capabilities of regional paediatric talent.
Findings
They optimally leverage top-tier resources to empower talents with learning and growth opportunities, which they refer to as ‘Leveraging’. They cultivate talents through a series of initiatives, collectively referred to as ‘Promotion’. As the leader of the Henan Provincial Pediatric Medical Alliance, they gather paediatric resources, cultivate outstanding medical talents and establish a comprehensive child health service system, named ‘Driven’.
Leveraging
In 2019, the hospital partnered with Beijing Children’s Hospital (National Children’s Medical Center）to establish a mentor training system to cultivate renowned experts. Beijing Children’s Hospital actively dispatches expert teams to collaborate closely with the hospital. The hospital’s talent management department is responsible for coordinating cooperation matters, ensuring smooth alignment between experts and clinical departments, and experts rigorously screened to serve as dual directors, participating in surgical demonstrations, consultations, teaching and scientific research, in order to enhance medical service quality and talent cultivation. The hospital has evolved into the Affiliated Children’s Hospital of Zhengzhou University, fostering paediatric medical and health expertise with local universities. It offers a paediatric master’s degree programme and has 12 approved teaching and training platforms with 48 master’s instructors and 537 faculty members. The college has trained 47 graduates and 439 residents. Among our excellent trainees, some stay on after graduation, while others become stellar paediatricians in other hospitals, helping to address the talent shortage in paediatrics.
In parallel, they have erected a research platform with the primary objective of fostering exceptional talent, while concurrently attracting talent from diverse institutions for scholarly exchanges and collaborative research endeavours. This endeavour has successfully attained the objective of fostering a shared talent pool among academic and research communities. This strategy streamlines coordination among top talents, both internal and external and offers financial incentives through rigorous evaluations. Furthermore, the ‘agreement’ delegates accountability to a panel of renowned experts and academics, overseeing quarterly and annual task evaluations, with labour cost reimbursement determined accordingly based on these evaluations.
Promotion
Based on a comprehensive analysis of the hospital’s original resources and government support policies, they have proposed the ‘2628’ talent promotion project, aiming to introduce 20 renowned domestic and international academic teams on a part-time basis, select and cultivate 60 outstanding academic leaders and key talents, recruit 20 high-end talents and identify and develop 80 promising young talents. The objective is to cultivate high-level paediatric talents, establish a robust talent pool to fulfil the hospital’s needs and empower them to serve as academic leaders guiding other staff. Through the specific implementation of the ‘Talent Introduced, Leading Talent, Talent Cultivation’ programmes, collectively known as the ‘3T Talent’ programmes, a long-term talent cultivation mechanism has been established, provide robust support in scientific research, evaluation, platform development and training to foster skilled talents, as illustrated in figures 1 and 2.
The pyramid organisational structure of the ‘3T Talent’ programme.
Core elements and model framework of the ‘2628’ talent promotion project.
For talent programme success, hospital appoints dedicated manager, collaborating with HR. As of now, 20 renowned academic teams have been recruited, along with 46 full-time PhD candidates, including eight nationally recognised young scholars and winners of the Changjiang Scholar Award. Additionally, 42 experts have been awarded the title of national high-level talents, and 46 experts have been selected for the national regional health talent cultivation programme. Furthermore, 52 young talents and 13 PhD/postdoctoral fellows have been jointly cultivated through collaborations with universities. In total, the ‘3T Talent’ programme has cultivated 126 individuals.
Goal setting theory states that setting goals increases motivation and performance, guiding behaviour and prompting individuals to adjust effort based on difficulty, thereby influencing sustainability.9 Performance management, as a pivotal aspect of human resource management, leverages constructive feedback mechanisms to foster individual growth and professional competence enhancement.10 Empirical evidence indicates that human resource management strategies tightly integrated with performance can propel comprehensive optimisation and a leap in effectiveness within the performance management system.11 The ‘talent agreement’ and ‘annual department goals’ facilitate goal-driven management and dynamic oversight for departments and top talents, considering disciplinary development and scientific/technological characteristics. The goal is to balance disparities and foster collective talent progress. Contents focus on technical proficiency, talent development, research output and regular progress assessments. Exceptional departments/individuals are recognised and rewarded. The traditional quantitative evaluation is evolving into a personalised assessment system tailored to varying types, levels, development needs and job roles. Annual tasks are devised and assessed by the talent management department, with individual performance incentives subsequently disbursed by the Hospital Operations Management Department in accordance with the evaluation outcomes. As a future development, the hospital intends to establish a comprehensive evaluation system encompassing three levels: hospital, department and individual. The results of this evaluation will determine the reward coefficients for both departments and individuals.
Driven
Leading the Henan Provincial Pediatric Medical Alliance, which encompasses 236 units, they have created a regional medical hub utilising the ‘Five-Horse Carriage, Four-Wheel Drive’ management system, as depicted in figure 3. The alliance categorises its members into distinct groups based on geographical location, hierarchical structure and hospital-specific characteristics. Through collaboration, support, aid and cooperation, their aim is to elevate medical technology. The ‘four-wheel drive’ strategy encompasses policy formulation, organisational development, the provision of high-quality services and population coverage, contributing to the establishment of a comprehensive paediatric healthcare system.
Illustrative model of the ‘Five-Horse Carriage, Four-Wheel Drive’ management system implementation framework.
The hospital’s teaching management department has established a learning platform, inviting subject matter experts weekly to impart paediatric medical knowledge to advanced medical staff in a centralised manner. Additionally, the department oversees the comprehensive management of trainees and plans practical opportunities across various clinical departments within the hospital, fulfilling their urgent needs for deepening professional knowledge and receiving regular training. The hospital has implemented and expanded the ‘Thousand Healthcare Professionals’ programme by establishing partnerships, recruiting experienced mentors, utilising technology for remote access and conducting continuous assessments. This programme has nurtured 2040 paediatric technical talents for grassroots hospitals, encompassing key positions such as general practitioners, nurses, pharmacists and more. The expansion has been facilitated by strategic funding, the promotion of successful cases and the support of paediatric medical alliances, all of which have attracted more participants and resources to the programme. Furthermore, the hospital led the Science and Technology Benefit Plan, training 7655 healthcare professionals and identifying 177 key leaders. Clear goals, monthly progress tracking and cutting-edge technology were key. Collaborations with universities and experts, as well as remote learning technologies, expanded reach and improved training. The trained professionals have implemented new practices, enhancing patient care and strengthening the local healthcare system.
Experienced lesson
Health workers occupy a pivotal role in healthcare systems.12 The Global Strategy on Human Resources for Health: Workforce 2030 (GSHRH) outlines a global policy framework to secure an adequate healthcare workforce for achieving UHC and SDGs.13 The GSHRH highlights the growing prominence of the human resource shortage, projecting a global deficit of 18 million health workers by 2030. A robust talent management system is paramount in addressing the shortage of paediatric professionals, as it not only ensures the selection of highly skilled professionals with exceptional expertise through rigorous scientific recruitment processes and comprehensive training mechanisms but also uses competitive salaries and benefits, ample career advancement opportunities and a conducive working environment to attract and retain top talents. This approach significantly enhances paediatricians’ sense of belonging and loyalty to the hospital, effectively mitigating talent attrition. Furthermore, the hospital’s advanced talent management system collaborates with the national children’s regional medical centre platform to balance the distribution of paediatric medical talents, delivering high-quality medical services to paediatric patients. In line with the performance-based compensation theory,14 the hospital has introduced a regular performance evaluation system and implemented a reward and punishment mechanism, using monetary incentives to motivate employees and foster a reasonable and equitable system for talent attraction and retention. “Drawing on the authoritative platform of the National Children's Regional Medical Center, the hospital has meticulously established a specialized management department focused on optimizing workflows and efficiently integrating and allocating resources. Through close collaboration with multiple medical institutions, it has broadened its cooperation network, working together to address the challenge of shortages in pediatric professional talent. Importantly, the hospital accords top priority to the mental health and professional well-being of pediatric healthcare professionals, actively implementing measures to help them manage workplace stress caused by the pandemic and effectively alleviate job burnout. In turn, this approach fosters a resilient and motivated workforce, enhancing the abilities of medical staff in clinical practice, scientific research, and teaching, ultimately elevating medical standards and service quality.
By strengthening international cooperation and knowledge exchange, the hospital has gained more methods to address the issue of talent shortage. The hospital has actively organised 50 overseas cooperation projects, gaining approval from the Zhengzhou International Science and Technology Cooperation Center. The hospital has established long-term partnerships with 10 internationally renowned universities and hospitals, including medical institutions in Chicago, Kansas City, and Sweden. Cooperation focuses on multiple areas such as new technologies, disciplinary integration, telemedicine and more. The hospital has also established an online platform to share paediatric medical knowledge and provide the latest information. Forty clinical professionals have received overseas training to enhance their professional skills. Furthermore, the hospital has aligned its talent management strategy with the local government’s epidemic prevention and control measures, particularly during the peak of the pandemic, utilising online platforms to access a variety of educational resources.
Conclusion
In response to the challenge of medical staff shortage during the COVID-19 pandemic, Henan Children’s Hospital has embarked on a comprehensive paediatric talent management strategy, closely aligned with the establishment of the national Children’s Regional Medical Center. The hospital’s implementation efforts have demonstrated that a well-conceived talent reserve plan significantly expands the avenues for addressing the scarcity of paediatric professionals, fostering a more professional and academically rigorous approach to tackling this critical issue. While grounded in the hospital’s local context, the strategic planning framework outlined herein encapsulates universal principles that can be adapted and applied in various practice settings, aiming to advance paediatric talent management objectives.
Data availability statement
No data are available.
Ethics statements
Patient consent for publication
Ethics approval
The research was approved by the Ethics Committee of the Children’s Hospital Affiliated to Zhengzhou University with the ethical approval code 2023-K-112. Participants gave informed consent to participate in the study before taking part.
Footnotes
Contributors XY, JY and PZ contributed equally to this work. XY, JY and PZ contributed to preparing the original manuscript of the conceptualisation, formal analysis and writing. JZ contributed to the Image visualisation. YY and SL contributed to designing and editing the original manuscript. All authors read and approved the final manuscript. YY is responsible for the overall content as guarantor.
Funding This study was supported by the Fund of Soft Science Research Project of Henan Province (Grant Number 232400410255, 242400410235).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer-reviewed.