113 articles

Being Brave Enough to Fix What’s Broken

Every week Starbucks sends out an army of secret shoppers to measure the service individuals receive when they step up and order that venti caffe latte. The shoppers are charged with capturing what it is like to be a customer. If the barista provides exceptional service they are rewarded, but if the service is lacking, employees are provided training and watched for improvement. Everything is measured, documented and rewarded (one way or the other). Various healthcare delivery systems have been doing the same thing for about ten years when it comes to recruitment. How does it really feel to be a candidate applying for a critical position? With competition this stiff, every Human Resource Department needs to function with superior listening skills and an urgency that makes the candidate feel special. Not only does a smooth running HR Department capture the best and the brightest in terms of recruitment but it also builds the foundation for retention. Vette Swint, Employment Manager at Tanner Health System in Northwest, Georgia wrote to ask about Secret Shopping and what we have learned. What we have learned is not to be surprised by anything. We all assume recruiters are anxiously awaiting the good candidate and when they present—either online, over the phone, as a walk-in or through an Employee Referral Program—they are greeted professionally and legally. That isn’t happening 20% of the time. Top candidates are dismissed, given completely wrong information, treated like a nuisance, sent out the door and more often than not—not acknowledged at all. Thousands of online resumes are never reviewed. Candidates are routinely asked illegal questions by both the HR professional and the hiring manager. Entry-level applicants are generally dismissed and the good ones go out the door and find a job not where they would like to work, but where they are looked in the eye and recruited in a timely manner. Here are some of the highlights we’ve found from Secret Shopping: • Most healthcare delivery systems drive candidates online to apply, but only 18.1% of those applying ever hear anything. Online systems were to be the answer to recruiters being overwhelmed, but we’ve found it is just one more barrier to getting in the door. • When applying online only 9.9% ever hear anything and a high percentage only hear when they call to inquire about the status of their application. When the applicant explains they have already applied online, the recruiter’s response is “let me see if I can find your application.” Once found, the candidate is then afforded a response. • The online application is oftentimes cumbersome and unfriendly. It seems many systems simply took their paper application and put it online. Much is redundant and because it is lengthy the system tends to crash and force the applicant to start over. Beyond frustrating. • Candidates who walk in almost never get an interview even if they are applying for critical-to-fill positions such as Physical Therapists and Pharmacists. Registered Nurses are treated a little better but only one in four actually get an interview when presenting unannounced. Recruiters seem to be incredibly busy and they are. On average, recruiters spend only 45% of their time actually recruiting. There are Safety Committee meetings and the United Way and a zillion other odds and ends that get pushed to HR’s door and into the already swamped laps of recruiters. If a recruiter is a generalist, employee relations is going to win over recruitment every time and while some issue is being settled, applicants are walking to the competition. • Entry-level applicants are routinely dehumanized even though they should be one of the hottest hires. The number two reason a professional such as an RN, PT or Respiratory Therapist decides to leave the organization is because of high vacancy among entry-level workers. If you don’t have enough Certified Nursing Assistants or Unit Secretaries, the professionals have to step in to fill their shoes and they quickly tire and begin to question their own commitment to the organization. • Hiring Managers make legal mistakes more often than HR professionals, but it is a rare shop when someone doesn’t step over the legal line. Applicants are asked everything from their amenability to a “one night stand” to asking about “religious wildcard days” and if they plan to have more children. These are lawsuits just waiting to happen. • The recruitment process in healthcare delivery systems bleeds time. While we are seeing some immediate responses from recruiters, they are few and far between. However, when we shop other industries such as IT or finance, the responses are usually immediate. The younger generations—the very ones we desperately need as employees—don’t wait two weeks to hear if a company is interested in beginning the process. • Communication with the applicant is almost void. When individuals are looking for a job, every minute they don’t hear anything adds to the roar in their head. “They don’t want me” and “why haven’t they called” becomes louder and louder until the candidate decides they didn’t want the job anyway. Two days is a long time for a candidate; two weeks is unthinkable. What we have also found is that most of the recruiters who want to make a good hire are exceptionally hard working and want to treat everyone special. But the way the healthcare system is set up, it is nearly impossible. Yes, there are thousands of great resumes that are being lost because they are un-reviewed. But along with those thousands of good ones are thousands and thousands of unqualified ones. If you don’t have time to interview a hot candidate who has walked in your door, you aren’t going to have the time to weed through all the non-qualified applications mixed with the qualified ones. Recruiters need help on several fronts, but one immediate answer would be hiring a part-time screener who does nothing but review and respond to the online applications. This individual could even work from home and on a contract/hourly basis. They don’t need to become a full time employee unless you have an open FTE. And, if you are thinking about how to pay for another person, think about the absurdity of spending money on recruitment advertising in an effort to push more candidates into the system, if you aren’t looking at the ones already screaming to be reviewed. The Screener could review all the applications; respond to everyone with either a prepared “No Thank You” or a personal response about how interested XYZ Healthcare System is in their application. The good applicants could then be turned over to the recruiter who hopefully has the time to make the qualified candidate feel special immediately. Secret Shopping has shown us that nationally the recruiting system in healthcare delivery is broken, but at least now we know what needs to be fixed. When the shopping is conducted for a specific system we also learn what needs to be fixed individually. The good news is that everyone wins because the recruiter gets the help they need, the processes are realigned and the individual hospital rises above the competition. The successful healthcare system makes people feel lucky to have been chosen and they start out fully engaged, retention improves, recruiters are better equipped to manage the challenge and managers get the hires they need. Secret Shopping is being brave enough to want to know what is really happening and being willing to fix what’s broken. If you have a question related to healthcare recruiting you’d like me to answer on a future blog, send me an email at

To Job Fair or Not to Job Fair?

Harold Achimon, Clinical Recruiter with Wilson N. Jones Medical Center in Sherman, TX wrote: “I attend a few job fairs each year if they are local, however, I feel I should be on the road more. What’s your take?” There are so many and such a variety of job fairs in healthcare, it is difficult to pick the ones you should attend and others you should pass up. But bottom line—attend the job fair if it results in cost-effective hires. Nothing should trump that question. Personally I don’t like any job fairs with the exception of ones held by an individual hospital or system—and generally those should be for entry-level employees only as opposed to professionals who can ostensibly get a job just about any where at any time. Let’s look at the good and bad of each types of job fair: 1) Local—these fairs are the best of the others if you are really sold on job fairs. These local fairs would be ones you would participate in along with other healthcare facilities. The people who attend are in your area so they are aware of your system and there is little or no relocation costs. Make sure the attendance results in hires and a dazzling list of e-mail addresses so you can follow up with some relationship marketing once the excitement of the moment passes. 2) National—of course it is always nice to “be out there”, but being out there on a national level should be reserved for those very large teaching and research facilities with a reasonably sized recruiting staff. These specialized and large facilities offer positions which may mean a promotion or a very specialized position. Since Harold hires for a 241-bed community-based facility serving North Texas and Southern Oklahoma, he probably couldn’t justify the cost of attending a national fair. 3) Trade Journal/Newspaper Sponsored—these fairs appear to be good but I have found that so many people turn out who are not even remotely qualified, that little real recruiting occurs. They are also generally expensive so be careful you are really getting valuable candidates or at least valuable information so you can follow up. 4) College/University—if the schools are compatible with your facility and you are open to making new graduate hires, then by all means attend. You should have a few local schools where you know the faculty and advisors and they should be the ones on your list. Most facilities have as many recent nursing grads they can take at one time so focus your attention on other graduating disciplines such as physical therapy, imaging and respiratory. 5) Virtual—more and more often we are seeing job fairs that are virtual. Second Life often holds job fairs on line and they have been very successful with hires for high-tech companies. Healthcare isn’t quite there, where candidates develop their own avatars and interview with other avatars, but soon you’ll never have to leave your office and let your avatars do the talking. Here are the questions I always ask when thinking about recommending or attending a job fair in healthcare: 1) Will attending the job fair result in hires? 2) Will the number of hires made justify the costs? National cost-per-hire for entry-level runs about $469 a hire so if you are attending a fair that costs $3,500 you should make at least 8 entry-level hires. If you hire only one RN for the $3,500 you are winning since the cost-per-hire for an RN is around $6,889. 3) What is the sponsoring group doing to drive in potential hires? There should be enough publicity to ensure a good turn out and there are formulas you can apply based on what candidate drivers the sponsor is using to support the event. 4) Can you justify the time out of the office? 5) Will I see quality prospects at the job fair or will they be the ones who can’t get a job? 6) Will I look desperate if I attend one more job fair? Holding a successful job fair on your own is not as easy as it seems and it is vital you cover your bases so you make the hires. Here are just a few things to consider: 1) Where to hold it? The facility or at a hotel? St. Louis Children’s Hospital once held a job fair that was so successful they couldn’t get the ambulances through the traffic and the cafeteria ran out of food to sell. Having the fair at the facility is always good if you can handle the volume, otherwise make it a real event at an off-site location. 2) What will be your candidate drivers? Remember to e-mail the people who have already applied to your facility and who were reasonably qualified. Remember direct mail. You can get lists for certain zip codes and household income. Newspaper should be included in the mix, but radio tends to deliver only about 2% of the attendees and radio is expensive. 3) When do you hold it? Unfortunately for recruiters Sunday afternoon is the best time. This is a family day so provide on-site child care while the applicants are being interviewed. 4) Who should be involved? Normally the recruitment staff can’t handle the volume so you’ll need to have the hiring managers on site to do immediate interviews and conditional hires based on license verification and reference checks. Also if testing or on-line applications are a must, then you must have the computers on hand. The only thing really to question is will I make enough hires to justify the costs and will they be good, quality hires? You wouldn’t place a $12,000 display ad in the New York Times for a single open Certified Nursing Assistant (CNA) position because you should be able to hire them for, or under, the national average of $469. Consequently figure your outcome in hires verses the cost of the event. If you have a question related to healthcare recruiting you’d like me to answer on a future blog, send me an email at

Two leading CHCOs affirm need for employer branding … even (especially) now.

On Tuesday, I heard two top Chief Human Capital Officers (CHCOs) confirm what we have been sharing with our clients as the way ahead in 2012: Even amidst budget issues, agencies and their workforce need to get the story out about their value. In fact, with government employees being slammed as under-worked and over-paid, the present is the best time to show taxpayers the ROI on their taxes and government leaders the ROI they receive from investing in employees. Employees can then genuinely believe their own management finds them worthy of enhancing skills through education and training.