An Analysis of the Effects of Human Resources Management on Healthcare Innovation in Hospital: A Scoping Review

In many health care systems around the world, increasing attention is focused on Human Resource Management (HRM). HRM is currently manifested as a key element of successful innovation because the human element is involved in the entire innovation process. Innovation is important in terms of public services, for example service innovation using information technology so as to increase efficiency and effectiveness in providing services. This study aims to analyze the effect of HRM on health service innovation in hospitals. This research method is a scoping review. The results of the research are from the literature search that discusses the effect of HRM on innovation in health services in hospitals. The types of innovations supported by HRM are HRM Practices, Knowledge Management, Humble Leadership, Green HRM, Crisis Management Theory, Clinical Directorates Model, and E-Medical services, E-Nursing services, and E-Adminstrative Services.


Introduction
The existence of human resource management is very important for organizations in managing, organizing, managing, and using available human resources so that they can function effectively and efficiently. For organizations, human resources are valuable assets that require good management and maintenance. This is because human resources will affect other resources in the organization (Astuti, 2018).
In many health care systems around the world, increasing attention is focused on Human Resource Management (HRM) (Kabene et al., 2006). The hospital is a service business, and the product is intangible and originates with the service provider, in this instance the officer or human resources. Human resources play a critical role in both the production and delivery of services. Human resources becomes a point of distinction with the goal of adding value and establishing a competitive edge for service businesses (Falih, 2017).
HRM is the application of management concepts to the organization and management of people inside a company. Human resource management encompasses a variety of management responsibilities, including recruiting, training and development, wage/salary administration, promotion administration, and social security and labor welfare (Aswathappa, 2010;Negi, 2013). The notion of human resource management evolved as the efficient utilization of human resources to ensure an organization's success (Zhu et al., 2007).
Human resource management methods are critical for companies' ability to influence and mold human attitudes, behaviors, and abilities, which is critical for businesses' ability to create innovations that align with their aims (Chen & Huang, 2009). Through the employment of suitable recruiting and selection strategies, hospitals may foster a successful health care culture (Fried, Gates, & Masselink, 2011). As a result, it is clear that the recruiting and selection process has a direct effect on organizational success (Mohammad et al., 2020).
The establishment of human resource management policies that are aligned with the strategy is complemented by a strong commitment to promoting innovation in order to increase the organization's competitiveness. It is becoming more obvious that innovation does not just occur as a result of new ideas, but also as a result of their efficient organizational execution. Any program, strategy, or practice in human resource management that aims to alter employee attitudes and behaviors that members regard as novel (Kossek, 2006). According to Jiménez-Jiménez & Sanz-Valle (2008), the primary practices that drive innovation include attracting, acquiring, and keeping workers that exhibit innovative characteristics (Maier et al., 2014).
The influence of human resource management on organizational and individual performance has emerged as a central study theme in the discipline in recent decades, as awareness of the potential of human resources and the need for managerial direction have grown. As a result, a growing body of research demonstrates the favorable correlation between human resource management and performance (Guest, 1997). Seeing that the role of HRM includes having an important role in hospitals in managing human resources in practice, growing employee attitudes and behaviors needed to stimulate and support innovation. However, there are still things that need to be explained regarding the role of HRM in innovation so that more exploration is needed.
A number of studies have investigated the decline in outcomes of medical innovations and their consequences. This decline is again evident when innovation is questioned, whether as a result of repeating treatments in the same patient or being applied to other patients or other therapeutic indications. This low innovation is associated with unwanted impacts and possible problems that tend to reduce the patient's quality of life (Djellal & Gallouj, 2007)

Methods
This research was conducted with a review method. The design of this research is Scoping Review. This research will be conducted from December 2020 to January 2021, by searching for information sources through online databases (bibliographic searching), namely, including in international journals: Science Direct, Google Scholar, and PubMed. The keyword searches used were human resources management, human resources innovation, and HRM in hospital. The inclusion criteria in this review were 1) Population: hospital. 2) Concept: hospital innovation. 3) Context: human resources management. 4) Types of review include; with a quantitative, qualitative and review design, published over the last 5 years starting January 1, 2016, in English. 5) Literature will be excluded if the concepts discussed are not published in journals.
Initial searches were conducted from online databases relevant to the topic via Science Direct, Google Scholar, and PubMed. A search was conducted on this source and retrieved data published from January 1, 2016. Using keywords identified by searching in online databases. The keywords used are; 1) Population: hospital. 2) Concept: Hospital innovation. 3) Context: human resources management. Trace the reference list of identified literature that can be included as additional sources. In analyzing, the authors classify papers that explain the effect of HRM on health service innovation in hospitals.

Results and Discussion
Based on the selection results from several article sources based on keywords, Google Scholar is 2,490, Science Direct is 1,473, and Pubmed is 1,679. Then from the total initial search, filtered by year of publication starting from the last 5 years the number of articles obtained was 1,984. Then, the selection of published articles was based on the title and abstract, as well as duplication that did not match so that it became 86 articles. Of the 86 articles, they were excluded based on the inclusion criteria to 16 articles. The steps in data extraction can be seen in Figure      In Figure 5 describing the number of articles based on the type of research, most of the research methods of articles analyzed using quantative methods are 63%, Then qualitative methods as much as 31%, and review methods 6%. Then, the authors perform a mapping of article search results based on the innovation type in Table 2.   Based on the articles analyzed, 7 influences of Human Resources Management (HRM) on health care innovation in sa kit home,can be seen in Table 2. After conducting the author's search and mapping phase, 7 findings will be obtained which will then be explained about the influence of Human Resources Management (HRM) on health service innovation in hospitals.

Human Resources Management (HRM) Practices
Human Resources Management (HRM) has an impact via process innovation, namely via Human Resources Management (HRM) Practices. Human resource management strategies tend to foster work cultures and situations in which workers have a strong commitment to the company (a positive attitude) and work diligently to attain organizational objectives. Cherif, 2020;Faiza et al., 2019).
The technique of ability-enhancing human resource management, namely "training and development," has been shown to have a beneficial effect on Innovative Work Behavior (IWB) (Knol & Van Linge, 2009;Pratoom & Savatsomboon, 2012;Zhang and Begley, 2011). "Rewards" are a kind of human resource management approach that increases motivation. At IWB, it has been shown that rewarding workers increases employee engagement (Bysted and Jespersen, 2014;Sanders et al., 2010;Zhang and Begley, 2011).
Based on the explanation of the above results from eight journal articles on HRM Practices (Bos-Nehles et al., 2017;Athman & Paul, 2019;Ojha & Sinha, 2018;Mohammad et al., 2020;Abhinandan et al., 2018;Nallamothu & Battu, 2019;Ali et al., 2020;Buchelt et al., 2020), so I as a researcher conclude that HRM Practices are one of the things that become the innovation process in hospitals. Implementation of HRM Practices can create commitment among employees to achieve organizational goals and innovative work habits.

Knowledge Management
Human Resources Management (HRM) has an impact on process innovation, namely Knowledge Management. According to Scarborough et al. (1999), knowledge management is any method or practice of producing, collecting, collecting, sharing, and using information, regardless of its location, in order to improve learning and performance in companies (Armstrong, 2006 in a growing number of organizations and corporations, recognizing that competitiveness is contingent upon effective management of intellectual resources (Zubair et al., 2020).
Based on the explanation of the results above from two journal articles on Knowledge Management (Zubir et al., 2020;Sengottuvel & Aktarsha, 2016), I as a researcher conclude that Knowledge Management is one of the things that becomes an innovation process in hospitals. Knowledge management creates human resources with intellectuals who are part of the process of innovation.

Humble Leadership
Human Resources Management (HRM) exerts influence via process innovation, namely Humble Leadership. A manager's duty in the area of human resources management (HRM) at a hospital must be to foster an attitude of humility in order to foster creative behavior among nurses. With an objective assessment of their limits and vulnerabilities, humble leaders tend to consider innovation failures as natural (Hu, Erdoan, Jiang, Bauer, & Liu, 2018;Yuan et al., 2018), which may actually result in increased growth. Numerous novel activities among nurses (Yang et al., 2019).
Based on the explanation of the results above from two journal articles regarding Humble Leadership (Ramli, 2020;Yang et al., 2019), I as a researcher conclude that Humble Leadership is one of the things that becomes an innovation process in hospitals. Humble leadership fosters more innovative behavior among nurses.

Green Human Resources Management (GHRM)
Human Resources Management (HRM) exerts impact via process innovation, namely via Green Human Resources Management (GHRM). According to Matahapati (2013), GHRM adapts many human resource activities such as recruiting and selection, training and development, remuneration and incentives, and performance assessment by ensuring that workers understand and support green behavior (Rawashdeh, 2018).
Human resource management is critical in recruiting and maintaining outstanding green professionals with specialized skills and experience in green human resources. Individuals with green talents and expertise deserve recognition for their environmentally innovative activities or performance (Rawashdeh, 2018).
Based on the explanation of the results above from a journal article regarding Green Human Resources Management (GHRM) (Rawashdeh, 2018), I as a researcher conclude that Green HRM is one of the things that becomes an innovation process in hospitals. Green HRM is a very important strategic tool to achieve the goal of improving environmental performance and innovative human resources.

Crisis Management Theory (CMT)
The influence of Human Resources Management (HRM) in the form of process innovation, namely, Crisis Management Theory (CMT). HRM plays a role in improving the responsiveness, skills, and professional capacity of human resources in hospitals in dealing with crises effectively. According to Fink (1986), CMT is about managing crises effectively to ensure business continuity. Important factors to consider in effective crisis management are accurate identification of crisis indicators and timely response, before disaster risk increases. In operations there is a need for management to be proactive rather than reactive and to train frontline employees to assist management professionals in their efforts reduce crisis risk (Kendrick, et al., 2017).