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Better Hiring Practices Helped Save This Health System $3 Million

Analysis  |  By Philip Betbeze  
   March 09, 2017

The HR department at Health First creates value by coaching senior leaders on identifying candidates with high potential and by raising retention rates.

Paula Just sees her health system's HR department's role as less of a traditional personnel operation and more of an in-house consulting agency, one that helps executives make the right hires by pinpointing their needs and taking mundane hiring practices off their worry list.

Just came to Health First, a four-hospital integrated delivery system in Rockledge, on Florida's Space Coast, three years ago from SSM Health in St. Louis.

She believes the HR team shouldn't just put new hires in front of training videos and get them to fill out the right paperwork.

Instead, the department should fill a key role in executive satisfaction by helping leaders more easily select the right hires by better defining roles, improving interviewing skills, and providing more time for evaluation of candidates.

"When we hire the wrong person, it creates enormous waste," she says. "There are lots of resources dedicated to onboarding, training, and administrative work that goes with bringing a new hire into the organization, and if they're here with us a short time, we ultimately lose that huge investment."

Looking for Value Creation
In charge of talent acquisition for almost every position besides physicians, Just and her team manage the onboarding process for every hire from pharmacists to housekeeping staff.

But the HR department creates value not in onboarding, but by helping senior leaders focus on the important elements of the open roles on their teams.

To improve the candidate and hiring leader experience, Health First brought in Cielo Healthcare, a vendor that applies technology and research to talent acquisition, resources a system the size of Health First couldn't develop in-house, says Just.

"As an integrated delivery network with 8,000 employees, that's not a resource we would have on our own," she says.

The vendor's resources allow Just and her team, at a high level, to help executives develop experience-based interview questions.

Hiring managers are coached—they know the work best—to better ascertain the likelihood of a candidate's success in a role.

It sounds simple, and is what every job interview should be tailored to ascertain, but it's often not how job interviews play out, says Just. Executives need training on how to hire effectively too—they don't come into management with that skill, necessarily. And they don't need to spend time reviewing resumes and setting up job interviews, either.

These changes in process have paid off in new hire satisfaction, which has improved from a baseline of 93% to 96%, and at least as significantly in manager satisfaction, which has improved from 69% to 97%.

"Prior to the partnership, our leaders really shouldered much of the burden of reviewing resumes, setting up the interviews and conducting them, and then we managed the onboarding," she says.

Now, a recruiter screens all resumes and each recruiter tailors how he or she interacts with the hiring manager. The effect should be that the better part of managers' time should now be spent evaluating candidates.

Another key measure of the new approach is 90-day retention, says Just.

"When we began, 90-day retention was at 86% and we have improved to 95%," she says. "That alone provided about $3 million in savings for us."

Realistic Job Previews
After a candidate has been identified as a likely fit by both their potential future manager and their potential peers (peer interviewing is required in the hiring process) the HR team goes a step further and arranges "realistic job previews," says Just—another safeguard against making a bad hire.

"The job preview lasts an hour or two, and the candidate is expected to shadow someone doing that job," says Just.

This type of investment of time in the front end of hiring pays benefits in some unexpected areas, says Just, for instance, in lowering the need for contingent labor.

Just and the HR team strive to schedule most staff shifts to care for patients and customers using their own full-time and part-time staff, with minimal use of overtime or traveler workers, in the case of nurses, she says.

"We have a number of things we've done to try to make sure we're improving our ability to use our core staff," she says.

Nursing Matters
It's no mystery that a shortage of nurses exists, and that shortage is felt acutely at Health First, because of its location about an hour east of Orlando, two hours south of Jacksonville and two hours north of Miami, large cities where nursing opportunities abound.

Health First created a number of ways to open up the nursing pipeline, including paid nursing internship programs for nursing students subsequent to their last year of training. That program has allowed Health First to extend offers to well-known new practice nurses earlier.

Previously, they wouldn't make a job offer without a license, "but at the majority of schools where we hired nurses, the board pass rate was so high that there was minimal risk in making the hire, and even if they don't pass, there's now a contingency plan so they can stay on as a nurse tech," says Just.

It's also partnered with the Health First Foundation to create incentives for its nurses to improve their education.

"There is a huge body of literature that supports that quality of care is improved when organizations have a higher percentage of BSN nurses," says Just.

To help improve that percentage, more than 80 scholarships have been provided to Health First nurses.

INNOVATION, STRATEGIC PARTNERSHIPS, COMMUNITY HOSPITALS
Through clinical research, strategic partnerships, early adoption of innovations and highly-specialized clinical programs, one Silicon Valley hospital is changing its role. Check out this live HealthLeaders Media webcast,
Redefining What it Means to be a Community Hospital: Innovation at El Camino Hospital on March 17.

Philip Betbeze is the senior leadership editor at HealthLeaders.

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