June 2nd, 2008 by cswenson
Coming from a health care HR background, my experience was that recruitment traditionally took a back seat to other organizational issues. Somehow, recruitment and human capital initiatives were not seen as mission critical. Retention seemed to have to reach a “crisis” before getting attention or fiscal support. The mantra was always, “Vacancy and turnover rates have been within ‘acceptable’ ranges. Human capital is ‘not a problem now, but will be in the future’.”
The future is here.
A competitive and complex business world impacts the health care workforce. Supply and demand for skilled talent and generational differences and retirements causing brain drain will continue to intensify. Factors such as a slower labor force growth, aging workforce, a decreasing supply of younger workers and a multigenerational workforce all impact health care human resources. Additionally, a projected growth in health occupations of almost 30% along with a projected need for >5,000,000 new and replacement health care workers by 2010 and severe vacancies in leadership positions are all issues.
Replacement costs for health care positions are approximately $92,000 - $142,000 per position (1-1.5 times their salary) for RNs. With a 10% annual turnover rate of 300 RNs – replacing 30 RNs could cost 2.7 million. Decreasing turnover by just 2% - saves 24 nurses; a difference of six RNs and a savings of minimally $357,900. Enough said!
The way to succeed in health care today with savvy consumers is clinical competence, patient and employee satisfaction. What is the road to get there? Recruitment and retention initiatives that provide constant attention at every touch point with human capital. If you create a culture of retention, the workforce will come – AND STAY!
HR teams need to prove competence and value to the organization’s leadership. These teams need efficient tools that provide analytical information to support, change or update initiatives to meet the demand and can communicate to internal and external customers. Measurement is about keeping one step ahead. Knowledge is power!
To help you analyze and measure your retention efforts and decrease costs/improve your ROI, we invite you to attend a complimentary Webinar.
QTrac for Health Care Best Practice Webinar
Learn how hospital systems, can positively impact their bottom line through the capture of comprehensive HR analytics. Hodes QTrac for Health Care is a tool that monitors employee satisfaction and engagement during an employee’s first critical year on the job. See how custom analytics teamed with benchmark comparisons can improve your processes, retention and recruitment efforts.
Please join us on Wednesday, June 18th, 2008 from 2 pm to 3 pm EST for a web-based overview of QTrac’s proven success in helping companies reduce their turnover and retention costs. Our expert panel includes:
• Mark Rowe, Director, Workforce Development at WellStar
• Christen Uber, Director, Hodes QTrac and Consulting Services
• Cathy Swenson, VP, Hodes Healthcare Division
Retention and the promise
Retention is a partnership. It is an organizational responsibility! It is the job of HR, the hiring manager, and the leadership. For years, the manual processes encouraged a disconnect in hiring. HR processed the new hire; the department took over. The first year is critical to retention. The new relationship candidate fit, orientation, employment branding are all determined during this time. The employee chooses to stay or go – and tells about 20 of his colleagues, friends and family about his experience, (any of whom could be customers at any given time).
The bottom line – the future is here. Retention is truly key to organizational success.
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May 1st, 2008 by kchristmas
In wrapping up our discussion on retention, do not forget the ‘wisdom worker’. Retaining the older worker requires specific initiatives. With fewer employees retiring at age 65, and the age group over 40 expanding rapidly, health care organizations need to consider what will help to retain these workers.
First, review your pension and retirement rules so that you do not penalize retirees who want to continue to work.
Next, in the labor-intensive world of health care, consider how the work environment is going to impact an older person. Working in patient care settings is physically, mentally and emotionally taxing. Employers must address ergonomic issues from lifting to lighting, computer font size and allowing shorter shifts or longer blocks of time off for various professionals. Consider creating new roles that allow these workers to mentor younger employees or to assist in knowledge transfer. Invest in technological innovations that make work less physically taxing and time consuming.
Bear in mind how many in the older demographic are ‘between’ generations and find themselves both paying tuition for children attending college while also caring for elderly relatives. Think about benefits and perks that would make life easier for this work group.
“Wisdom at Work” the excellent Robert Wood Johnson Foundation document and the AARP website have outstanding recommendations about how to retain (and recruit) the aging worker. AARP has a section on best employers for workers over age 50 with practical examples of how employers made their environments, benefits and perks more attractive to this demographic.
And finally, remember that retention can add depth to the care provided by your organization and is more cost effective than turnover and subsequent recruitment. Do your best to influence changes in your organization that eliminate recruiter Ground Hog Day
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April 25th, 2008 by kchristmas
In the last blog, how the Applicant Tracking System can make or break recruitment efforts and impact retention was discussed. Another issue that has a strong impact on retention is who stays at your organization. If superstars are working alongside poor performers, you may have a large problem. And this could be impacting who remains in your organization.
Keeping marginal performers for months – or years- sends a strong message to your best employees. The message is, ‘It does not matter how you perform on this unit. If you can fog a mirror, you can stay.’
Although it is a fact that not everyone has the potential to be a star performer, everyone should be making a valid contribution to the work of the department. There must be minimum standards of competence, attitude and aptitude that apply to ALL employees. If they are not met, there should be a systematic way to either help marginal performers improve or move them along in their employment journey.
Retaining poor performers does not help them. If a person is not suited to a role or is not performing, deal with it. Although it may be disagreeable to confront individuals who are under-performing, doing so shows your best performers that they are valued. For if it unpleasant for a manager to discipline an marginal worker, imagine how difficult it is to work a shift beside someone who is unengaged, uninvolved, unsuited for the position or unsafe?
And the fact is, if you do NOT deal with marginal performers, you will lose your best. When they become fed up with how certain individuals are allowed to slide while they are held to a higher standard, a typical response is to leave the department to seek a work setting where performance is valued and rewarded.
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April 15th, 2008 by kchristmas
If your ATS (Applicant Tracking System) does not allow you to screen out inappropriate responses, it is time to sit down and have a serious conversation with your vendor. Most systems have the capability to add ‘knock out’ questions on the front end. If your ATS does not, there are products out there that can be added to enable screening. Some even rate the ‘best’ candidates based on specific criteria.
This screening helps the recruiter to respond rapidly to the best, and bring them in to meet with hiring managers, thus cutting down time to fill and minimizing the possibility that you will lose great candidates.
Another question about your ATS – has it been purged lately? How often do you scour the database to check for good candidates who have ‘slipped through the cracks’ and to remove duplicates? This should be a regular event to keep the size of the database manageable and to enable quick searches.
Interview Process
Interviewing is an area where recruiters can make a huge impact, but fewer and fewer do formal interviewing. When recruiters simply screen applications and pass them on to hiring managers, they have lost much of their ability to add value to the process, and burdened the hiring manager with the brunt of the work.
Recruiters need a solid understanding of each of their areas of responsibility, and the ‘fit factors’ for each area. In addition, recruiters who are in touch with their hiring managers know those managers’ goals for their areas. If you have never done interviews, you will need to be trained. Many consider interviewing a ‘natural’ ability, but the best have had formal training.
This objective assessment provides a framework for candidate referral that encompasses the basics (such as the job requirements) as well at the ‘big picture’ (or ‘fit factors’) for the unit or department. Recruiters may be called upon to ‘sell’ the candidate to the hiring manager as well as selling the candidate on the opportunity. If you are out of the loop in this integral part of the process, ask for more responsibility.
Recruiter screenings and preliminary interviews ensure that hiring criteria for the system will be uniform and will bring continuity to the process.
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April 10th, 2008 by kchristmas
One of the major sticking points in hiring for retention is receiving and sorting through responses. In most organizations today, candidates are driven to the web to apply online. That is fine, but it can really make more work for recruiters. Here are a few things to keep in mind.
Let’s start with the:
Applicant Tracking System How does yours stack up? Does it allow candidates to easily maneuver through the application process with a minimum of hassle? Can it help you find the best candidates for the positions you post, or is your system a free-for-all that leaves the recruiter sorting through cyber stacks of unqualified submissions?
Does your system allow you to send comprehensive pre-screen or interview notes to the hiring manager along with candidate resumes? If not, much of your value as a recruiter is being lost. Recruiters screen to ensure a candidate meets qualifications and evaluate whether they appear to be a fit. It is as vital to have good interview notes as it is to keep applications on file for a certain period of time.
Just finding the answers to these few questions can help you to uncover whether your ATS helps or hinders in quickly responding to the best candidates.
Too many systems do not have the capability to limit response, so you can literally have people who do not meet even the barest minimum of qualifications getting through the application process. This creates vast amounts of work on the recruiter side, not to mention time lost sorting through garbage. It is a great way to lose candidates or to lose out on the best candidates to other companies that can respond more quickly.
If you are not responding to the best of your candidates within 72 hours, it is time to re-think your approach.
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March 25th, 2008 by kchristmas
The previous two blogs in this thread have discussed hiring for retention. This next blog has additional tips to help recruiters target every aspect of selection towards making hires that will last.
Fit. As a recruiter it is important to consider the big picture and the fine distinctions. Yes, it is important for the manager or director to approve of the hire, but do you also consider the new hire’s fit with multiple shift leaders and high interface departments?
(For example, staff in the ED will have high interfaces with Radiology, laboratory, and the OR team just to name a few.) These can be deal breakers, for if a new hire loves the manager, but works night shift with a lead person with whom they do not get along, they are not going to last.
The recruiter should have an idea where the glitches lie in the units and departments for which they recruit. These can be gleaned in discussions with the hiring managers, and may be available in new hire onboarding surveys or exit interviews.
Although a recruiter cannot change or influence these issues, it is in their best interest to be aware, so they can present a realistic job preview to candidates for the area. And, if issues are not resolved, the recruiter should take proper steps to shine a light on what is happening and bring it to the attention to stakeholders who CAN make changes.
Hiring for retention is one of the best ways to shape the workforce and to impact retention from the very first contact with candidates. Not to mention, avoiding Ground Hog Day!
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March 17th, 2008 by kchristmas
The previous blog discussed hiring for retention as a way to make better hires and to be most efficient as recruiters. The first step was to make sure that job postings are accurate, descriptive and robust. Here is another tip on communication with hiring managers.
2. Recruiter/manager communication.
Do you have regular discussions with your hiring managers, including their open positions? It is so important to know what is new or changing within a unit or department. Do you know how many hires have been made and what turnover has been recently? Is the department experiencing growth or contraction? Have they added new services or equipment? It is a challenge to recruit effectively if you do not know what is happening.
Are you aware of the manager’s plan or vision for the ideal ‘new hire’ when getting ready to post a position? If the ideal is nowhere in sight, is there a plan in place to bring on a less qualified person for training? Most managers want experienced candidates to consider, but in today’s shortages, this may not be feasible. This should be broached at the time the requisition is received so the recruiter avoids putting an inexperienced person into a department where they will not receive proper training, or a poor onboarding experience.
Next, does the manager have someone in mind for the opening? Asking this simple question can save the recruiter a lot of time and effort, and can lead to a good discussion about how the manager sees his department.
The recruiter should work with the manager to shape the talent within the department. Looking at metrics such as longevity within the department and average age of workers (by shift) is important when deciding if a unit will experience retirements, or needs more experienced mentors to round out a shift with many novices.
Only through an ongoing dialogue can recruiters understand the issues facing hiring managers, and help them by targeting postings and efforts to find the best hires. Although it takes more time on the front of the process, it should pay off in the end with better retention.
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March 10th, 2008 by kchristmas
In February we celebrated Ground Hog Day. Do you remember the movie of that name - “Ground Hog Day” - where Bill Murray keeps waking up and living through the same day? Health care recruiters experience this syndrome when we do not hire for retention.
Recruiters and hiring managers want to carefully consider candidates’ appropriateness for the unit, department and system culture when interviewing.
Otherwise, the ‘Ground Hog Day’ scenario, where the same positions get posted and filled again and again comes into play. Or worse, managers are stuck with poor performers - with attitudes and ideas that do not fit the culture or work of their departments.
Effort expended to eliminate bad hires is a black hole that sucks up a lot of time and resources. Managers should put more energy into recognizing and rewarding top performers than they spend counseling or eliminating poor hires.
Where to start?
1. Job postings.
Are yours really descriptive? Do they provide a glimpse of the true work environment of the unit or department and how it fits into the bigger picture of the organization? Will outsiders understand everything listed, or do you have ‘internal’ information listed such as “2 West” rather than the name/description of the department? Health care is a unique 24/7 environment with many nuances on night shifts, weekends etc. Do you capture subtle shift cultural differences in your postings? It is important to describe the position and work environment as accurately as possible.
I challenge you to take a few moments today to look at the job descriptions you currently have posted and to compare them against the criteria above. If yours meet all standards, congratulations. If not, you have a place to begin.
Our next blog in this series will discuss other important areas to consider when hiring for retention to avoid recruiter Ground Hog Day.
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February 29th, 2008 by kchristmas
To paraphrase a catchphrase James Carville used during the Bill Clinton campaign for President, retention is the key to keeping costs under control and maintaining a productive workforce.
We are currently on the cusp of a recession. An unstable economy is often good news for health care recruiters, because health care professionals have a history of seeking stable positions during economic downturns, and also tend to increase their hours to full or part time. The need for flexibility is replaced by the need for a reliable paycheck.
Those who are Magnet or Beacon employers or top employers of choice have this experience most every day, as they offer work environments that put patient care first, and by doing so, provide a more stable, friendly and welcoming workplace. In these settings, workers know exactly what is expected of them, have reasonable and safe workloads and have the training and the tools they need to perform their work.
Although the Magnet and Beacon designations are primarily granted to nursing, both have been shown to have a ‘halo effect’ that reaches other professionals when the largest group in the hospital workforce – nurses - have their work environment issues addressed in a comprehensive way.
Many recruiters are held accountable for vacancy rates, but have no ability to address chronic turnover in departments for which they recruit. Some organizations press recruiters about turnover, when in fact, departmental managers have a greater impact on whether new hires stay or go.
Still, with shortages looming ever larger, according to all projections, it is high time to look at what drives turnover. And to not wait for a recession!
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