The harsh reality in healthcare is that providers must meet higher expectations for quality of care and enhanced patient safety all within the framework of lower costs, our new holy grail.

higher expectationsThis points to a need to shift in the way we execute our talent acquisition programs.  We need to hold our recruiters accountable for finding the right people, not just filling slots.  This means realigning performance metrics.  From the Chief Executive Officers and members of the senior leadership team to nurses, techs, dietary workers and housekeepers, we must also screen for competencies that will be increasingly important.

For example, in the past the hospital CEO was seen as the master of the ship who exercised complete control even if they did not.  That command-and-control approach drove the questions that recruiters asked of candidates in interviews.  While there are still pockets of senior executives who cling to that approach as evidenced by the interesting belief that buying a physician’s practice equates to ownership of the physician, including their loyalty to do what they are told, the dynamic challenges in healthcare are driving a new leadership paradigm.  This paradigm requires some different competencies.  I touched on this in a previous blog post, Working In Healthcare, A Privilege Not A Right.

The fact that we will increasingly deliver care more in the community and less inside the brick and mortar box we call acute care hospitals, requires a leader who, much like the conductor of a symphony orchestra, must coordinate and collaborate with complex, disparate interests in varied settings to achieve this business model — better quality and safer care at lower costs in a way that patients like.

The quality of the employees — their skills and values — is more important than ever.  Yet not all healthcare CEOs have come to embrace the importance of their role in the talent acquisition.  Some of the great business chief executives understood that the employees were their most important corporate asset and they devoted a large amount of their time to both hiring and continuous education to ensure that this precious resource delivered maximum value.  We are not there in healthcare, not even close, but it is where we need to be.

Over the past three years, I have been revising our very successful, structured CEO behavior and values interview tool, to incorporate these increasingly important competencies.

  • How you hire
  • Quality of care and safety
  • Patient satisfaction
  • The ability and the courage to encourage entrepreneurial thinking

Today, I want to focus on the first competency — how you hire. This is where it all begins.

Just as CEOs today are held more accountable for the financial results over their quality or safety of care performance,  in-house recruiters are held more accountable for how quickly and cost effectively they fill vacant positions.  The vast majority are not held accountable at any level for the turnover rate of their candidates who are ultimately employed.

Moreover, while some hospitals are now using behavior and values interview techniques and some even deploy personality/behavior and values assessment tools, there is far too little emphasis placed on one critical values set:  caring – an internal passion for service and, this is very important, empathy and the day-in, day-out ability to do the work they are responsible for doing in a deeply personal way, as if they were caring for a beloved family member or best friend.  Not every employee, including nurses, have that combination of qualities.  The more troubling issue is that far too many hospitals never even think about those qualities for a specific candidate during the hiring process.

The focus on the poorly aligned talent acquisition metrics keeps recruiters from exploring that critical values set.  They are tasked for fulfillment — hire the people as quickly and as cost effectively as possible to fill the slots; reduce overtime and eliminate the high costs of traveling nurses and other temporary contract professionals.

Changing how we hire people takes time — to retool the process and for the approach to take effect, probably three to five years.  But if you want to improve quality of care, safety and patient/family satisfaction, this is what it will take for a sustainable change.