For decades, most of the healthcare market has faced a shortage of qualified candidates. The severity of the problem varies by market, but many organizations struggle to establish a robust candidate pool. This creates a particular problem in healthcare because the product or service being delivered is, primarily, based on human capital. Physicians, nurses, other support staff and care-givers ARE the product. Not much of providing care can be automated and we aren’t talking about selling a widget built from raw materials.
This means that healthcare organizations have always faced the talent acquisition dilemma - quality vs. quantity? It’s a balancing act. We were meeting with a CHRO and his team from an organization with over a thousand sites of service - both inpatient and outpatient clinics. They were adamant that these three areas were paramount to their organization:
But when a clinic is short a provider, it makes it impossible to care for patients or even to comply with certain regulatory requirements.
Changes to the industry make it imperative that organizations hire quality candidates. These are the candidates who will ensure a positive patient experience and high quality care. Of course, these have always been important goals, but now, payment is tied directly to patient satisfaction scores and quality/patient safety metrics. But organizations can’t take care of patients if they don’t have bodies to do it!
What did they decide? They carefully evaluated their candidate pool and selection ratio, turnover rate, and how to use their interview and pre-employment assessment results to map a plan whereby they become 5% more selective each year for the next 5 years – thereby slowly increasing the quality of their workforce, while still being able to fill critical spots.
They were only able to do this because a thorough validation study revealed, very specifically, what hiring data predicts on:
- Job Performance
- Counter-Productive Work Behaviors
- Patient Safety Incidents
This was powerful data that allows them to be quite deliberate in their workforce planning and understanding its impact on patient outcomes and organizational goals.
In industries where the candidate pool is, historically, more robust, it’s been relatively easy. Put tools and processes in place to screen out candidates you know are not likely to be good at the job. You can set the bar high because your “selection ratio” is positive. As the overall unemployment rate declines, though, other industries are starting to face the same dilemma – hold out for a high quality candidate or “settle” for someone who may not be a great employee?
If the question is, “Quality or quantity?” – the somewhat obvious answer is “both.” You need to do all you can to attract qualified candidates. This might mean a formal employee branding strategy and innovative recruiting approaches that attract more people. At the same time, though, you can’t lower your standards so far that it negatively impacts your culture, the patient experience and safety, or your reputation in the community.
We tell clients in these situations to be as deliberate and thoughtful as possible. Even though your selection ratio isn’t particularly good, you still want to have as much objective data on a candidate as possible. Indeed, if candidates are scarce, it becomes even MORE important to make informed decisions. Sometimes the data will lead you to continue waiting on the next candidate because the one in front of you has too many red flags to take a chance. Sometimes hiring managers struggle with this concept, but they can all recall several hires they wish they’d never made. The goal is to avoid those hires, but by design, not by chance.
Alternatively, if the situation warrants you taking the next person with the minimum qualifications, it’s imperative to understand that person’s strengths and weaknesses. With this information, there will be no surprises and you can prevent problems before they occur. But none of this happens if you don’t have the objective data to make an informed decision or to successfully manage a potentially problematic employee or staff member.
To learn more see our recent Becker’s Hospital Review paper on the concept of “Evidence-Based Hiring.”