“Talent management strategies of a public UAE hospital in the Industry 4.0 era: A qualitative analysis”

Talents play a critical role in achieving organizational strategic goals and a higher level of performance in the healthcare industry. Therefore, the UAE government, which strives to provide world-class healthcare services, encouraged the adoption of talent management strategies and creation of essential capabilities for talent recruitment, development, and retaining. This study explores the talent management strategies, policies, and practices in multiple departments of a public UAE hospital. Moreover, it investigates required skills, competencies, and programs for those departments in the context of Industry 4.0. The study adopted a case study approach and qualitatively sur-veyed a purposive sample of 13 departmental managers, section heads, and supervi- sors who are experienced in employee management. The study found that talent management at the studied hospital is undefined and unclear in terms of strategies, policies, and practices. Furthermore, the study highlighted the need for employee encourage-ment, motivation, and engagement, as well as confirmed the critical role of manage- ment and leadership in facilitating talent management in the hospital. Accordingly, a UAE hospital could benefit from this study to develop its talent management policy and strategies that will guide managers in the Industry 4.0 era. The study aimed to explore the talent management strategies and practices of multiple departments of a public UAE hospital and explores the skills, competencies, and programs required for talent management in the Industry 4.0 Era. The result of the study disclosed critical gaps in talent management at the hospital level. The study found no talent management policy in place, which created a state of confusion and fuzziness among departmental managers, head sections, and supervisors about talent and talent management. In consequence, the understanding of talent and talent management concepts varied, and the strategies for talent selection, development, and retaining were undefined and unstandardized. On the other side, the paper identified many organizational and individual factors that facilitate and inhibit talent management in the UAE hospital. The study confirmed the critical role of management and leadership in facilitating talent management and highlighted the need for employee encouragement, motivation, and engagement. Furthermore, the study marked the need for intensive teaching of the hospital employees about Industry 4.0 and providing them with the relevant skills and competencies, such as data analytics. build


INTRODUCTION
Talent crisis of skilled labor is globally unaddressed. Accordingly, the shortage could reach millions of workers and result in a huge loss of annual revenue. In the UAE context, talent management became a critical issue for business organizations. Blandford (2009) claimed that the UAE organizations learned a lesson from the global crisis of low cash liquidity, which happened in 2009-2015, and felt the need to establish long-term plans that focus on talent management, utilization, and development.
In recent years, the UAE's image as a workplace has changed and professionals are attracted to enter the country, the UAE government's efforts to build a knowledge-based economy by providing national human resources with the skills required for the labor market, increasing the number of research and development (R&D) personnel, promoting entrepreneurship, and attracting talents (The United Arab Emirates' Government portal, 2019). However, the literature identified many gaps related to talent management, including the lack of training, learning, and development within the HR and talent management areas (Al Suwaidi, 2014). Moreover, insufficient management support for a talent management strategy, inadequate and unproductive training programs, and ineffective staff appraisal systems (Al Mansoori, 2015), a shortage in the national talent (Abir, 2015), underutilization of women (Waxin & Bateman, 2016), and inadequate manager's contribution to the talent management process (Al Awadhi, 2018) has been observed. Besides, Dirani (2018) identified a critical challenge of talent management and development activities within UAE organizations, which is the influence of the two-tier system that includes one for Emirati nationals and another for expatriates. Additionally, the HR functions of UAE organizations, including performance and talent management as found by KMPG (2019), are undergoing disruption due to Industry 4.0 technologies, such as artificial intelligence and applied data analysis.
Hence, this paper aims to explore the talent management strategies and practices of multiple departments of a public UAE hospital and investigates the skills, competencies, and programs required for talent management in the Industry 4.0 era. The study uses a structured qualitative questionnaire on a purposeful sample of departmental managers, section heads, and supervisors. Moreover, the study comes up with recommendations for improving talent management strategies and practices that suit a UAE hospital in the Industry 4.0 context.

Talent and talent management definitions
The linguistic definition of a "Talent" by The Free Dictionary (n.d) is "a special, often creative natural ability or aptitude" and "a person with special ability in a particular field". In business sphere, van Dijk (2008) described "Talent" as the product of ability (competence, education, training, and experience), coupled with motivation (engagement, satisfaction, challenge, and wellness) and opportunity. Andersen (2013) another definition for a "Talent"-"a person who possesses special skills, which are difficult to copy or imitate, who is a top performer with competencies of strategic importance which cannot be readily developed". Also, The Chartered Institute of Personnel and Development -CIPD (2020) defined talent as "those individuals who can make a positive impact on organizational performance either through their immediate contribution or in the longer term by demonstrating the highest levels of potential".
In literature, the definitions of talent management vary. Collings and Mellahi (2009, pp. 26-27) defined strategic talent management as "activities and processes that involve the systematic identification of key positions which differentially contribute to the organizational sustainable competitive advantage, the development of a talent pool of high potential and high performing incumbents to fill these roles, and the development of a differentiated human resource architecture to facilitate filling these positions with competent incumbents and to ensure their continued commitment to the organization".
Serrat (2010, p. 3) defined talent management as "the additional processes and opportunities that an organization makes available strategically to a pool of people who have talent". The definition carries a few keywords that are additional, pool, and strategic. The Chartered Institute of Personnel and Development CIPD (2020) proposed another definition that is "the systematic attraction, identification, development, engagement, retention, and deployment of those individuals who are of particular value to an organization, either because of their high potential for the future or because they are fulfilling business/operation-critical roles". Furthermore, The Chartered Institute of Personnel and Development CIPD (n.d.) emphasized that it is about using data obtained from the workforce, succession, and contingency planning tools to identify existing talents and to decide what talents are needed to add value to the organization.

Theories, strategies, and models of talent management
The resource-based view (RBV) of the firm proposed by Barney (1991) suggests that the firm competitive advantage depends on the valuable, rare, and hard to copy resources that include human resources. Accordingly, human resources development (HRD) is a branch of human resources management based on the strategic view of a HRD theory. One new definition of the HRD as outlined by Wang et al. (2017Wang et al. ( , p. 1175) is "a mechanism in shaping individual and group values, beliefs and skilling through learning-related activities to support the desired performance of the host system". Furthermore, several theories and models were developed to improve talent performance (Rabbi et al., 2015). Another important theory that emerged from the theory of the firm is the talent-based theory. This theory proposes that talent is the only resource that may help in gaining and maintain a competitive advantage (Rabbi et al., 2015). On the other hand, the World Economic Forum (2019) highlighted critical skills for the Industry 4.0 workforce, including 1) developing new leadership capabilities, i.e. the ability to embrace ambiguity and explain the associated risks and uncertainties to the workforce, combine operational management, technology, integration, and people management skills, and use analytic, 2) managing the integration of technology in the workforce, 3) enhancing the employee experience, 4) building an agile and personalized learning culture, 5) establishing metrics for valuing human capital, and 6) embedding diversity and inclusion.
On the other hand, Shaw and Varghese (2018) concluded that emerging technologies such as the Internet-of-Things, big data, and artificial intelligence will automate most of the HR processes and the HR departments will play a more strategic role in the organization competitiveness. Hence, the managers need to adopt appropriate management and innovation skills to survive and grow within Industry 4.0.
Whysall et al. (2019) suggested transforming the talent management theory and practice towards a more dynamic, systems-thinking orientation, acknowledging the interrelated nature of different talent management activities.

AIM OF THE STUDY
The study has multiple aims. It explores the talent management strategies, policies, and practices in multiple departments of a public UAE hospital in the Industry 4.0 era. The objectives of the study are as follows: 1) Get to know how managers understand the definition of a talent, talent management, and their practices of the selection, development, and retaining of talents at their departments.
2) The talent management strategies, facilitators, and inhibitors at a UAE hospital.
3) The manager's perception of the effect of Industry 4.0 technologies on talent management.
4) The skills, competencies, and programs required to develop the hospital's talents within the Industry 4.0 contexts.
The study will come up with recommendations for improving talent management at the UAE hospital to adopt the best talent management strategies to grow in the UAE's highly competitive healthcare market, particularly within the Industry 4.0 era. Besides, other UAE hospitals could benefit from the study to expand the role of the healthcare sector in enhancing the country's innovation and competitiveness.

METHODOLOGY
The study used the case study approach to explore qualitatively the talent management strategies, processes, policies, activities, and programs as practiced and described by a purposive sample of department managers, section head, and supervisors in a UAE tertiary hospital within the Industry 4.0 contexts.
The sample included participants with a minimum of 1-year of working experience in their current position and having responsibilities in employee recruitment, development, appraisal, and promotion. The data was collected until reaching a point of data saturation and no new result and theme were generated.
The case study approach helps to conclude a specific phenomenon, organization, event, situation, individual, or group. Besides, the interpretation of the findings is shaped by the researcher's own experiences and background.
The study used a structured qualitative survey to collect the required data. The survey contains four parts: 1) six questions to collect the necessary demographic data about respondents ; 2)  The survey was sent to the selected participants by email, including an information sheet about the research and instructions. Then, a reminder email was sent after two weeks to all participants. Finally, the participants sent back a total of 13 responses after four weeks.
Regarding facilitators and inhibitors of talent management at the UAE hospital, the respondents mentioned 19 comments related to the facilitators of talent management that could be listed only under the "organizational factors" e.g. management and leadership (7,  Regarding the effect of Industry 4.0 on talent management, the respondents mentioned 27 comments, which could be classified into 2 main groups, including answers relevant to the industry 4.0 (19, 70.4%) and answers irrelevant to the industry 4.0 era (8, 29.6%). Furthermore, the respondents mentioned 37 skills and competencies required for talent management within the Industry 4.0 era that could be listed under 4 main themes, including specific skills and competencies (11,29.7%) related to industry 4.0, cognitive skills (9, 24.3%), managerial skills (9, 24.3%), and 4) other skills and competencies (8, 21.6%). For further details, please refer to Appendix 1.
Finally, all programs and activities, which implemented in the UAE hospital for talent development, were found irrelevant to the Industry 4.0 challenges. For further details, refer to Appendix A.

DISCUSSION
The thematic analysis of what the respondents added to the definition of talent pointed out that most of the respondents believe that talents should have extra positive personal, leadership, or cognitive qualities to be able to make a positive effect on the organizational perfor-mance. This result matches, to some extent, the recommendation of The Association for Talent Development ATD (2014a). The study also found no agreement among respondents about a specific and dominant quality that can be added to the definition of a talent.
One respondent said "I believe that searching for talented people within the organization is an important issue. However, having a higher degree doesn't make someone talented. So, allowing who deserve will make a great and positive impact on all". Although this quote is smart and presents a well understanding of the concept of talent management, it still reflects a subjective view of one respondent, and it cannot be generalized to the hospital level. However, talent development and training got around one-third of the responses, while the other elements of the talent management process got smaller percentages. In general, the study concluded that the talent management concept is immature, vague, and fuzzy among respondents.
Regarding the strategies used for selection, developing, and retaining talents, the study found that the respondents did not use one criterion for talent selection. More, they mentioned contradicting opinions regarding Emiratization, which aims to select the local talents or to recruit talents from abroad. Additionally, 43.5% of the responses underlined training and support as a crucial strategy for talent development and mentioned other numerous strategies only once or twice. In addition, 45% of the responses suggested incentives and promotions as strategies to retain talents within the hospital, while the rest of the responses were incoherent.
Regarding the hospital strategies and policies, the results of the analysis reflect a major gap in talent management strategies of the UAE hospital as no talent management policy was able to unify the definition of a talent, provide clear criteria for selection, and define strategies for developing and retaining of the existing talents. In addition, the responding informants of multiple departments provided contradicting answers about the presence of the talent pool and people analytics at the hospital.
The results also confirm that organizational factors have a determinant role in both facilitating and inhibiting talent management at the UAE hospital. In particular, management and leadership, IT support, HR department, and training were identified as the most common factors of facilitating talent management. The study confirmed the findings of Al Awadhi (2018) regarding the critical role of management and leadership in facilitating talent management.
On the other hand, the results underlined lack of resources, encouragement, motivation, and engagement, absence of policies, and routines, which are the common organizational factors that inhibit the hospital talent management.
The results also underlined a few individual factors that inhibit hospital talent management, including diversity, lack of employee interest, etc.
The majority of the responses reflect an understanding of the impact of Industry 4.0 on talent management among respondents, and around one-third of the responses reflect confusion about the nature of Industry 4.0 compared to IT technology. The responses highlighted some skills and competencies that are required to develop talents within the Industry 4.0 era, including specific skills and competencies related to Industry 4.0 technologies and general skills and competencies, such as cognitive skills, managerial skills, etc. Further, the responses related to the development programs and activities of talented people in multiple departments of the UAE hospital were traditional in nature, non-specific, and aim to serve the overall goal of employee training and development rather than the requirements of the Industry 4.0 era.
In summary, the results confirmed that talents are those who have extra positive personal, leadership, or cognitive qualities that make them able to influence organizational performance. Nevertheless, the majority of respondents failed to provide a definite definition of talent management and failed to agree about one criterion for selection, developing, and retaining talents. This was due to the absence of talent management strategy and policy at the hospital level. The results also confirmed the need for specific training and development programs regarding the Industry 4.0 era.

CONCLUSION
The study aimed to explore the talent management strategies and practices of multiple departments of a public UAE hospital and explores the skills, competencies, and programs required for talent management in the Industry 4.0 Era. The result of the study disclosed critical gaps in talent management at the hospital level. The study found no talent management policy in place, which created a state of confusion and fuzziness among departmental managers, head sections, and supervisors about talent and talent management. In consequence, the understanding of talent and talent management concepts varied, and the strategies for talent selection, development, and retaining were undefined and unstandardized.
On the other side, the paper identified many organizational and individual factors that facilitate and inhibit talent management in the UAE hospital. The study confirmed the critical role of management and leadership in facilitating talent management and highlighted the need for employee encouragement, motivation, and engagement. Furthermore, the study marked the need for intensive teaching of the hospital employees about Industry 4.0 and providing them with the relevant skills and competencies, such as data analytics.
Organizations should develop their talent management strategies and programs that fit with their culture, resources, and business. Accordingly, this study could be a preliminary work to build talent management policy and strategies for the UAE hospital. Implementing a new talent management strategy could fill the gaps, clears ambiguity and fuzziness about talent management, attract talents and provide human resources with special skills required for the hospital, and align the UAE hospital strategy with the country national employment strategy 2031.

FUTURE RESEARCH
However, the case study approach was used on a one UAE hospital, which makes generalization of the research findings and conclusions impossible. It is recommended to conduct more research in two ways: firstly, conduct more qualitative research to explore the particular skills and competencies required for certain departments and specialties and secondly, conduct quantitative studies on a bigger sample obtained from various organizations to generalize the findings to the sector or country levels.

ACKNOWLEDGMENT
The nursing administration, nursing research committee at Tawam hospital and managers who responded to the study survey are acknowledged for the extension of support for the study.   In your opinion, how industry 4.0 is affecting (or going to affect) talent management?