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A History of Healthcare Talent Strategies and How Far We’ve Come

February 28, 2018

healthcare-talent-strategies.jpgI came to Select International seven years ago with a background in hospital operations/strategy consulting, and before that, I was an employment and healthcare law attorney. After joining Select, I learned a great deal about the human capital management industry. I’d worked with plenty of employers, including healthcare employers, but as an attorney you deal with issues that arise, not human capital “strategy.”

Related: Confessions from an Attorney: Pre-employement Assessments

As a consultant to hospitals on service line operational issues, it had become apparent that no matter how much expertise, experience, and tools were brought to the table, the quality of the hospital team – the leaders, physicians, and managers – would determine whether a particular hospital succeeded in implementation of proven strategies. It was also obvious that the hospital’s culture played a big role. Were front line staff engaged enough and adaptable enough to make the changes that improve outcomes and the patient experience?

Related: 4 Ways Everyone Can Increase Patient Satisfaction

All of this brought me to Select International, a leader in human capital strategies and tools. Once I saw what firms like Select were doing for decades in other industries, I realized there was a substantial gap between a healthcare system’s needs and their talent strategies. This gap was far greater in healthcare than in almost any other industry. Concepts that seemed revolutionary in healthcare were standard in manufacturing, for instance.

A Look at the Past

Just seven years ago, I met with one of the largest health systems in the country about improving their approach to hiring talent. Looking back, it should have been stunning that a system this large and sophisticated did NOT have a separate, dedicated talent acquisition team. When we started talking about behavioral competencies to target during the hiring process and to improve during development (competencies like dependability, adaptability, emotional intelligence, etc.), they were confused. The only competencies they ever talked about were clinical/technical Joint Commission competencies. They interviewed candidates but there was no standard interviewing program, per se. They’d been fined by the OFCCP for inconsistent, unfair hiring practices – mostly because they had no defined process and terrible documentation. Then I found out that they were not alone.

Related: Do You Need to Worry About OFCCP Audits and Fines?

Healthcare systems were just beginning to look at talent and human resources as important strategic functions (rather than administrative). I’d worked in and with hospitals long enough to recall when “Personnel” was less of a department and more of just an office in the basement that handled everything, including hiring. Hiring consisted of processing requests to fill positions, advertising for candidates, and then sending the candidates to the hiring manager who, based on who knows what criteria, picked your next employee. If that employee failed, they went back and started over.

In 2014, we wrote that the transformation of healthcare would require a transformation of the healthcare workforce. We cited a forum hosted by the American Society of Healthcare Human Resources (ASHHRA). That forum concluded that:

  • Healthcare delivery is shifting from a dependence on individual expertise to a reliance on coordination and collaboration.

  • Organizational culture must change to place a greater emphasis on teamwork and coordinated care.

  • This begins with the ability to hire the right people.

Related: Reforming Healthcare Means Reforming the Healthcare Workforce

Where We are Today

We’ve made some progress. Fortunately, MOST organizations think about talent differently and some have made great progress. It’s heartening to join panels at conferences where the panelists are accomplished talent professionals – often CHROs who have come from other industries and now appreciate the special mission of healthcare. They are spreading the message that in an industry where people, to a large degree, ARE the product we sell, and that investing in talent is not only important, but paramount.

One sign of how far we’ve come: the growing interest in a more deliberate approach to hiring and developing physicians. Seven years ago, this was unheard of. We've also noticed:

  • Most hospitals have at least begun to incorporate behavioral competencies into their hiring system, with a better interviewing program, or predictive behavioral assessments.

  • Many now realize that one of the biggest gaps exists with front line managers. Historically, we promoted good individual contributors, but we are realizing that we need to identify and develop front line staff who have the potential to be effective managers.

  • Most organizations are committing resources to leadership development and succession planning.

  • Most systems have separated talent acquisition functions and identified key business metrics (time to fill, candidate engagement, turnover, predicting on-the-job performance, and hiring efficiency) to measure their effectiveness.

Questions for the Future

Looking back over the past four years, how far have we come? Is the pace of change sufficient? Are we making the right changes? How is the staffing shortage impacting our efforts? Are we too quick to abandon solid, long-term strategies under short-term pressure? Are we making efficient use of technology or just jumping at the next shiny object? Do hiring managers understand their role in building and developing their teams? Are we doing enough to develop front line managers who get the importance of this role?

A lot of questions, I know. I’d be interested to hear whether people think we are on the right track, and if we aren’t, what track, exactly, should we be on?

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Healthcare Culture

Bryan Warren Bryan Warren is the President of J3 Personica, a consulting, assessment, training, and coaching firm, and a guest blogger for PSI. Bryan is an expert in progressive talent strategies, with a particular focus on leader and physician selection and development.