Case Study: The First Hospital The first hospital does not have a functional HR department. HRM functions in that hospital are delegated by the CEO and the finance manager to the middle managers in the organization, who do not have adequate knowledge and skills in HRM. Consequently, there have been inconsistencies in the HRM practices of the middle managers and supervisors. The hospital has also been facing numerous issues related to staff, including staff shortages, absenteeism and turnover, high level of grievances and industrial disputes. The ultimate problem the first hospital is facing is that the quality of care provided by the healthcare staff has been low, and the rate of accidents has been high. Such problems are common in organizations that do not have functional HR departments or effective HRM. Unfortunately, the CEO of the first hospital does not understand that the challenges being faced in the organization are caused by the lack of an effective HRM. Issue of Coordination Ineffective HRM practices have numerous negative impacts on organizations, as expressed in the first hospital. First, the lack of a functional HR department in the first hospital implies that there is lack of coordination between different managers as they carry out HRM roles (Nowak, Holmes \& Murrow, 2010). In such a case, every manager uses his or her own style of management. The problem becomes worse when the different managers do not follow the same management policies, rules and standards. In such a situation, for instance, different managers can respond differently to employees with low levels of performance. One manager can respond aggressively through admonishing employees due to low level of performance, whereas another manager can respond through adopting strategies meant to assist the employees to improve their levels of performance. When the employees that are treated harshly notice the difference, they are likely to lose morale, leading to a decline in the levels of job satisfaction and commitment. Lack of coordination can also occur between the managers and supervisors, as indicated in the case of the first hospital. Inconsistencies that might result in the delivery of involved (Kehoe \& Wright, 2010). Middle Managers' Lack of Expertise in HR Management Another major issue with the HRM management in the first hospital relates to the managers' lack of knowledge and skills in HR management. When the managers in charge of performing HR roles lack the required knowledge and skills, they are unlikely to be effective in their work. Such managers may not have adequate knowledge and skills on how to treat employees in a way that will enhance improvement in the levels of employees' job satisfaction, commitment and productivity (Atif et al., 2011). For instance, managers with limited knowledge and skills in HRM may be unable to understand how to respond to conflict situations involving two or more employees or supervisors and employees. Also, such managers may not be able to make effective decisions when dealing with important matters such fairness during the process of giving rewards in recognition of good performance. Most of the higher position are promoted for Male employee and Female employee has less chance to promote not upper than supervisors. Some of Female employee said that 'The pay here has been poor but we have worked hard because we thought the company cared about us. 'Some of us have been doing heal care services qualifications to progress our careers here'. Managers' Role overload The other notable issue about the first hospital is that the middle managers might have many other roles and responsibilities apart from the management of the employees. Even if those managers have knowledge and skills in HRM, focusing on the different responsibilities is likely to limit their ability to discharge the HR roles effectively. All the issues mentioned above related to the case of the first hospital lead to loss of morale and motivation and decline in job satisfaction and commitment (Harpaz \& Meshoulam, 2009). The reactions of the employees are evidenced by the challenges faced in the first hospital described earlier. The most important goal that healthcare organizations should focus on is to enhance quality of care provided to the parents (Holland, Sheehan \& De Cieri, 2007). As such, the ultimate reduction of quality of healthcare due to the negative reactions of the employees in the first hospital is a major issue of concern. You are appointed as newly HR Manager to setup proper HR functions and practices in The First Hospital. 5. a) How do you understand the level of psychological contract among managers and supervisors in the First hospital? b) Show how the psychological contract might be improved by management action, to support the moral and job satisfaction. Justify your recommendation