The evolution of “evidence-based" medicine changed the healthcare industry. Not that long ago, clinical judgment, anecdotal evidence, and personal experience ruled clinical decision-making. Then we discovered that using research to drive decision making, treatment guidelines, and policies vastly improved outcomes and saved lives.
Human Resources professionals in the healthcare industry are beginning to use this approach to build evidence-based hiring strategies for selecting and developing talent, defining the behavioral skills they are looking for and implementing a consistent process to evaluate and develop these skills.
Want to learn how to implement an evidence-based hiring approach in your organization? You’ve come to the right place!
Recently, we hosted a webinar with Becker's Hospital Review, which was an engaging discussion with many questions on how to bring more objectivity and consistency to their hiring process. Here are some of the interesting questions posed by the audience:
At what level of the organization can you apply evidence-based hiring concepts? Where should you start?
Obviously, if your goal is to positively impact the organization’s culture and broad performance measures, then you want to apply these principles at EVERY level of the organization. How you apply them, however, differs. For front line roles where you might have a robust candidate pool, the focus is on valid, quick tools to screen OUT those less likely to perform and then use more objective, high volume hiring strategies. As you get into harder-to-fill professional roles, you need to pay close attention to ensuring a positive candidate experience, but still gather enough information to make an informed, objective decision. Perhaps you use hiring tools with different scoring algorithms or use them later in the hiring funnel. Most organizations employ a longer, deeper leadership-specific behavioral assessment. Of course, just as you take a different approach to recruiting leaders, you still use an interview process that yields useful data.
If you can’t implement an organization-wide approach, then identify the right place to start. Some organizations focus on front line roles because they have the most direct impact on the patient experience. Others start at the top because “leadership drives everything.” Where’s your greatest pain point? Where is there buy-in for a more deliberate approach?
How do you decide which behavioral competencies to measure?
Many personality-based tests measure a set configuration of behavioral traits that you have to try to apply to the job you’re evaluating for. Some are configurable, meaning you can decide what competencies you want to measure. The first approach may be better than nothing, but it creates some problem-making hiring decisions against a generic list of personality traits. It's likely not predictive and the validity of the tool would be easy to challenge. The second approach requires a level of expertise regarding behavioral competencies and personality assessments.
Our recommendation is to work with a team of assessment experts who know healthcare. Do they have a large database of healthcare assessments to form a reasonable hypothesis regarding what you should be measuring? How often do they perform validation studies comparing test results to on-the-job performance? We recommend considering a continuum of approaches depending on your situation. Some call for a robust job analysis process to enhance predictability of the process, gain organizational buy-in and ensure legal defensibility. Other situations don’t require as involved a process.
Sometimes, it’s sufficient to rely on validation work from past projects on similar roles, but often you want to gather data through some combination of on-the-job performance, focus groups, or surveys.
Implementing hiring tools presents a change. How do you gain buy-in?
If you are working with an assessment vendor that really understands psychometrics, you should be able to configure an assessment that brings value. Particularly in healthcare, though, success or failure depends on the ability to implement the project in a manner that brings real value and gains the support of leadership and hiring managers. Start by defining what you are trying to accomplish and how it will help leaders and managers to achieve their goals. Give them input on what’s important to them and the most efficient process. We’ve had great success doing a series of educational sessions on the concept of a more objective, evidence-based strategy for new clients, especially for nursing.
Finally, agree on key performance metrics and pro-actively report these to hiring managers so they see the project is achieving its goals and helping them to achieve theirs!
How do you apply these strategies when you struggle to get enough candidates to fill some roles?
This is where flexibility comes into play. When you have a robust candidate pool, you are trying to sift through to find the best qualified and most likely to succeed. When you only get a handful of candidates, or just one, the concept is the same but the process differs. In this case, you are trying to avoid a really bad hire – the one where you would have preferred to wait, rather than deal with a problem employee. When you have limited candidates, making the right choice becomes even more important. If you pick the wrong person, how long will you wait to get another qualified candidate? Similarly, if the situation means you must hire someone less than ideal, it’s imperative to understand your new employee’s strengths and weaknesses. This is where it’s important to have flexibility in your hiring tools and how you use the results.
How do you measure the ROI of a hiring system and evidence-based hiring tools?
This may be the most important and often-asked question of people looking to improve their hiring process. We believe in a holistic approach. Start with broad organizational goals – improving quality of care and the patient experience. These are metrics discussed daily. While it’s hard to measure a direct relationship between hiring tools and these broad measures, leadership usually appreciates that hiring better people is important. Then you can look at metrics that are more directly related to the hiring process. This can include hiring manager surveys on whether the system works for them and system efficiency metrics like time to fill. Finally, the most direct measure is to compare results of hiring tools – usually the assessment or the interview with on-the-job performance. This is done via a formal validation study. You should be working with a vendor that is capable of doing this work if it’s necessary. It’s important to identify these metrics early and report on them regularly.
Want to learn more about Evidence-Based Hiring concepts? You can get started with our recent, popular white paper: