In many industries, opening a new facility is relatively common. Manufacturing, distribution, and retail companies are familiar with the start-up process. Our team has a pretty well-oiled approach to building a high volume selection system for a new facility. It starts far in advance and we know exactly how it will work.
The exciting part of these projects is the opportunity to define and build a culture and a selection system to support it from the ground up. Trying to change a culture and implement new processes in the face of history, tradition, and the politics of an existing organization can be painful, but setting these standards and expectations before you open the doors is a bit easier.
However, the challenge is that healthcare start-ups are less common and more complex. Most hospital leaders and administrators will not be involved in opening a new hospital or campus in their careers. Perhaps they’ve opened new physician offices, surgery centers, or other outpatient clinics, but a completely new hospital from the ground up is far less common. So, it’s likely this will be your team’s first experience. A hospital is also a far more complex organization than other startups, like a manufacturing plant, for example. Reproducing manufacturing plant operations is relatively simplistic compared to establishing patient care operations, while the clinical and patient care issues can seem endless.
What’s often missing is expertise in efficiently and effectively staffing the new hospital and defining and building new cultural expectations into an ongoing selection system and other talent strategies. For instance, the number of job titles, job families, and important hiring considerations in a hospital are significantly higher than a manufacturing or distribution facility. Fortunately, we’ve been able to combine our startup expertise with our healthcare selection expertise to build selection systems for several new hospitals and the lessons we’ve learned can be applied to existing hospitals, too.
A few things you can learn from those who’ve been through this process:
1. Start with your senior team.
You need to be particularly careful and deliberate in building the leadership team. Building operations from nothing requires a different skill set than running an existing operation. You need leaders who are visionaries, who are flexible, innovative, and comfortable with ambiguity but also with an ability to execute. Before the hospital even exists, these leaders need to be able to sit in a room and create the vision and new processes – much different than stepping into an established organization. They also need to be adept at building the next level of leadership in one fell swoop. They won’t be picking one or two people to round out an existing team.
2. Start early!
This should go without saying, but most of the early attention in the planning process is focused on facilities and core patient care and operational issues. HR and the hiring process is a bit of an afterthought. The reality, though, is that your HR team has never been through this. Every one of the hospital startups we’ve worked on would have benefited from starting formal discussions about the selection system at least a few months earlier than they did.
3. Define what you are looking for.
Here’s where you have an advantage. Rather than trying to change a culture that already exists, you have the opportunity to define and build the culture from the ground up. This work requires some deliberate steps, though. When you define the culture you envision, you can't leave it at the theory stage. You need to define the specific behavioral competencies you’ll be looking for in staff at every level of the organization. These are the skills you'll target in the selection process, and that will form the foundation of your performance management and staff and leadership development efforts. That’s how you build and sustain a culture.
4. Pay sufficient attention to the selection system and hiring process.
The startup process is not just your normal selection process with a higher volume. You can’t expect your current HR team to handle this by just doing more of what they normally do. High volume hiring means they will need to develop a new process. They’ll need to sift through thousands of candidates quickly. They can’t use the same system they use to process their standard number of requisitions. Will your current ATS work? Will it need to be modified? Where will you get the resources to screen applicants, resumes, and do phone interviews? How will the process change for various job families?
5. Deploy evidence-based hiring practices.
You need to be as deliberate and objective as possible at every step of the hiring process – on a large scale. There is no room for non-standardized hiring decisions based on instinct or variable standards. Choose the right tools: applicant tracking systems, interview guides and training, behavioral screening tools, etc.
Related: Evidence-Based Hiring: Everything You Need to Know
6. Consider internal transfer policies.
If the new facility is part of an existing system, what’s the policy on how you’ll handle internal transfers? There are relationship and political considerations as well as cultural considerations. This is not a five minute discussion. We’ve been through these situations and can outline options and the pros and cons of each option.
7. Keep your standards in the face of challenges (but remain practical and flexible!).
There will be bumps in the road. At some point, there will be that old pressure to just find someone with a pulse and a certification. For the most part, you should resist that – you’ve invested too much and this is your opportunity to build the ideal facility and culture. But some of your estimations about the depth of your candidate pool and the relevant standards may have been off and you’ll need a deliberate approach to deciding when to make thoughtful changes to your system.
Do you want to learn more about staffing a new hospital? Click here to read the thoughts of Mark Sevco, President of UPMC East in Pittsburgh, who’s been through this process and can now boast of his health system's top patient satisfaction scores.