Increasing access to care, and changing care delivery models, and payment methodologies, are forcing hospitals, clinics and health systems to re-think staffing models. We are seeing significant expansion of the use of advanced practice providers, re-working of the role of nursing managers, nurses and nursing assistants and even how physicians practice. I recently read an interesting article looking at the productivity and impact of various staffing models. Click here to read it.
What do these changes mean?
Physicians need to function as effective delegators.
Physician Assistants and Nurse Practitioners need to work more collaboratively, while sometimes functioning with even more autonomy (yes, these two seem contradictory).
Managers at all levels need to delegate, coach, teach, and pro-actively find ways to implement the organization’s mission and strategic plan. They need to shift from basic management tasks to skills that might, traditionally, be considered “leadership.” They also need to take an active role in building a team with the behavioral competencies necessary – that means an active role in selecting candidates and developing their teams.
What we’d traditionally consider “direct contributors” (nurses, therapists, etc.) need to get better at high level functions and delegation. Nurses need to work closely with nursing assistants who can handle many routine patient care tasks, leaving nurses to more complex patient management tasks.
What does this mean with regard to talent, competencies, selection and development?
1) The education of these people may not be keeping up with the change. It will take time for educational programs to adjust to these new staffing models and place an emphasis on the required skills.
2) Talent acquisition needs to re-think what we are looking for. For a few years, we’ve seen a shift from an almost exclusive focus on academic background and clinical and technical skills, to an emphasis on important behavioral skills. Great start but now we need to incorporate these new concepts into how we define individual roles and organizational behavioral competency models. Five years ago the behavioral competencies for nursing may not have emphasized delegation and coaching. Now, it’s imperative that nurses can delegate, coach and develop nursing assistants.
3) The selection process at all levels needs to target these behaviors. How are you evaluating emotional intelligence, collaboration, delegation, coaching, or initiative and the ability to safely function with a higher level of autonomy?
Give real thought to behavioral competencies. This can get complicated and become an exercise in futility, but it’s critical. How do you select for, and develop the right behaviors if you can’t define them?
Healthcare hiring managers are notoriously poor interviewers. Decades of emphasis on clinical and technical skills means many think they can pick the right candidate. They need to understand behavioral competencies and the value of an efficient, structured, behavioral interview.
Healthcare-specific, behavioral assessments, designed specifically for selection or development (as the case may be) can add real value - Either screening tools for high volume positions, more in-depth assessments for managers/leaders, and even physician-specific tools.
Finally – while development efforts will always need to place a heavy emphasis on important technical and clinical competencies, we need to spend more time working with staff and managers on these important new skills.
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