At the peak of the COVID-19 pandemic, Gregorio Marañón University General Hospital, the largest hospital in Madrid, was completely transformed to tackle coronavirus. This involved managing hundreds of new A&E posts, over 1,000 more people on staff, starting up a hotel converted into a temporary medical facility, etc., along with coordinating kitchen staff, cleaning staff, porters, pharmacy personnel and so on. Its Human Resources Director, José Miguel Blanco, says that the hospital has shown throughout its history that when extra effort has been needed, its professionals have stepped up to the plate in an outstanding way. And this time round, more than ever.

-Which things made it possible for you to handle this exceptional situation?

Lots of things helped us to deal with it, but one stands out from the rest; the engagement of our professionals, both people working in direct patient care and also staff delivering support services. The whole hospital came together as a team, united in the fight against the pandemic.
In terms of organisation, one of the measures taken by the hospital’s management was to set up a Crisis Committee made up of the members of the management team in charge of care services and general services. The Committee met every day at 8 am and 3 pm to review the hospital’s situation, and this meant we could put in place measures to deal with any incidents that had taken place.

-How was the transformation managed by the Human Resources Department?

As a support unit and facilitator of people management processes, the Human Resources Department assigned all its resources to the areas where a rapid response was needed. It was obvious to us that “critical areas” had to be set up in the Department, such as everything to do with recruitment and hiring, starting with calls for candidates from job boards and other recruitment sources such as the Public State Employment Service, and continuing with prompt hiring of staff to deliver care to patients who were being placed in the hospital’s new facilities. There are lots of administrative procedures which are generally required for recruitment processes, and in the public sector they are even more stringent. Plus it was essential to do everything quickly because the situation was pressing. Over a very short period of time, over 1,800 people were hired and appointed.
Another “critical area” was employment status. As a matter of urgency we had to deal with and process cases of isolation and temporary disability leave of staff with COVID-19 to make it possible to replace professionals who were in this position, but with the added problem that the usual circuits for processing these different kinds of employment status weren’t working, so we had to devise and map out new ones.
There was also a significant impact on recording and handling payroll processes because of the implications for salaries of isolation and temporary disability leave, the large number of new hires and handling remuneration derived from staff overtime to meet healthcare needs. In April alone we issued 10,300 payslips.

-And what was the interdepartmental coordination like?

Coordination is always difficult in an organisation of this size, and even more so in a situation as critical as the one we were going through. However, our professionals’ enormous personal effort and their outstanding commitment have made it much easier than expected. The whole hospital has worked together as a team.

-So we might conclude from all this that transformation is possible if the whole team pulls in the same direction. What have you learned from this experience?

We have learned that the key to achieving objectives is the engagement of professionals from all the hospital’s departments, each one doing their job, with a view to responding quickly and effectively while also complying with the legal requirements which always have to be borne in mind. Communication is crucial for this, and professionals need to know what the objectives are and what input is expected from them.

-What would you have liked to have done differently? And what needs to be improved now?

Looking back at the processes we carried out, with the resources we had and the situation we were in, I think there is little that should be changed. It would be more a matter of the details. The question about what needs to be improved does not call for a great deal of analysis and it’s easy to answer; we need to speed up administrative procedures, thus ensuring that professionals spend as little time as possible on them. Significant efforts and investment are called for to improve online processes both in-house and in the relationship with external candidates, the hospital’s future professionals.
A tool should be put in place for remote signing of contracts and appointments with every guarantee and to ensure that the person signing is the person identified in the document. Because it is taken for granted that first you have to check the candidate meets all the legal requirements to work in the category they are being hired for and that there is no reason to prevent them from doing this job (qualifications, professional association membership, negative certificate from the central sex offenders’ registry, etc.). The hospital is doing a certification process which includes verification at the primary source.

-So what provisions have you made for other outbreaks of COVID-19 or similar situations?

In terms of human resources, the hospital has extended all COVID-19 contracts to 31 December 2020 with a total of 873 professionals in all categories. As for infrastructure, the hotel converted into a temporary medical facility, which is managed by Marañón, is still open. Meanwhile we are improving facilities and implementing maintenance measures for the additional intensive care beds which were set up in the hospital library to make 36 additional beds available in case they are needed. Although obviously we hope this will not be the case.
As for healthcare, patient pathways have been put in place in A&E to prevent infection and ensure safe care.
Protecting our professionals is also crucial for us. The hospital’s occupational health and safety service has laid down the protocols to be followed in each situation and has the protective equipment needed. These are just some of the precautions we have taken. The hospital has a very detailed contingency plan to deal with possible upsurges.

-In addition to the work and emotional stress, the infection rate among healthcare personnel has been high. What are the consequences for the team after the last few months?

The infection rate among hospital professionals was 15% across all units, albeit mainly in direct patient care. We have also had professionals in the Human Resources Department who have gone down with COVID-19.
The Human Resources team is fairly worn out at present, because in addition to deal with handling the new hires due to coronavirus, it has also had to renew contracts for staff hired for this purpose while also managing the summer plan including hiring replacement staff for people going off on holiday and work-family balance leave for staff, which a high percentage of healthcare personnel have asked for.
So now more than ever they need to enjoy their holidays and time off which they haven’t been able to take until now.

-How have you experienced this situation from a personal and professional point of view? Has it been the greatest challenge in your career?

From a personal point of view, it has had an enormous emotional impact. The information I heard every day in the hospital’s crisis cabinet meetings was very worrying in terms of the number of patients coming in and the overall evolution. In this sort of situation, there is little time to think about the risk that you might also get infected. The situation was unusual not only in the hospital but also around town; you noticed it when you left home for work every day and walked along deserted streets.
I have experienced some extraordinary situations in my professional life, but nothing like this one. You had to be ready every day to ensure that the professionals needed could start working immediately, which meant that no matter what day of the week it was, you had to take all the steps required so that by 8 am the next day everything would be ready for the new employees to start working. From 15 March to 10 April, approximately 1,400 people came to the Human Resources Department to make arrangements for joining the hospital. We also had to implement measures to protect our Human Resources staff, who worked non-stop outside their working hours, on Saturdays, Sundays and holidays, in order to meet our objectives.

-What are the special features of human resources in a hospital setting?

While in general human resources departments are facilitators for the processes of the other units in an organisation, they are even more so in the healthcare setting. Here, the Human Resources Department cannot set up selection processes, risk prevention plans, evaluation, performance or remuneration without having the people running the other units on board and always bound by the rules stipulated by our central units.
When recruiting staff, you have to make sure they meet all the legal requirements, not just to comply with regulations but also because of the kind of things done in a hospital setting and the potential consequences for healthcare. So we have to do things like checking qualifications at source, professional association membership for staff where it is compulsory, checking they have no sexual crimes record, and also telling them about the duty of confidentiality and what happens if they breach it.
Another special area is labour relations with representation by members drawn from workers’ committees. As there are two different legal systems (non-established and special-statute staff) in the hospital, there is a Works Committee and a Public Employee Board.
Personally, I think that the human resources divisions of hospitals do a crucial job for hospital organisation, a job which is not very noticeable when everything goes well and is only talked about when there is some kind of mistake. Human resource management should be more highly appreciated; in-house by the various hospital departments and also by central units with human resources responsibilities as it is the extension of them in the workplace.

-What do you remember about your time at Esade?

My time at Esade was thrilling from an academic standpoint and also because of the relationship I had with other professionals who work in a range of areas in public administration. I still keep in touch with some of them today and not only through social media. It has also allowed me to follow the events held in the various fields: I thought the webinarsand master classes conducted during the pandemic were extremely interesting. I rate it very highly.