We hire people then we watch them leave. It is a cycle that continues repeatedly. Have you ever stopped and asked yourself “Why?” If you haven’t maybe you should pause and ask. And if you have asked, maybe you should take a different look.
In an environment of changing payment structures from fee-for-service to payments based on outcomes, having stable and well educated staff is paramount to clinical excellence and desired financial outcomes.
Developing a strong foundation is an essential step for any staff to grow upon. If the foundation is weak, attempts to build upon it will crumble and be unsuccessful, leading to frustration directed at, and felt by, managers and on the employee as well, not to mention the financial stresses.
A strong foundation is one that starts with hiring the right person for the right job. When you think about your hiring practices, what does that look like? Have they changed with the times or do you hire based on how you have “always done it?” Do you conduct numerous interviews? Are they chosen because they happened to be a person with the credentials you needed?
We know that financial health of the organization is at risk because of turnover, and hiring the wrong person is a very costly consequence. According to the NSI 2016 National Healthcare RN Retention report, the average cost of turnover for a bedside RN in an average hospital is $30,000 to $80,000 which can result in an average loss of $5.2-$8.1 million per year, depending on your turnover rate. Each percentage of RN turnover will cost or save an average hospital an additional $373,200. These are staggering numbers.
So, how do we start to decrease these costs? It starts with hiring the right person. Making sure that they are not only the right person for your organization but equally important, that they being placed in the right role.
Every hospital’s goal is to provide quality care and have excellent outcomes. During a typical interview process it is hard to determine if the candidate is indeed as clinically proficient as they say they are. It is equally important that the people you bring into your organization will fit in with the hospital’s expectation from a behavioral perspective.
One way to be sure that hospitals are hiring the top candidates in their function area is providing all candidates with pre-hire testing. Performing assessments that are focused on clinical reasoning along with clinical competence is a repeatable process that will help you benchmark candidates and their levels of clinical knowledge and competence against other candidates and even current staff. Determining if the new graduate that has applied for the ICU position has the skills to work there is not only an advantage for the hospital, but for the candidate. Studies have shown that if staff are working beyond their skill set, they become frustrated and will not be successful in their roles.
The other aspect that is equally important is doing a behavioral assessment. It will help you determine if the person has the right personality for your hospital as well as for the role for which they are applying. For instance, if the candidate testing shows they prefer to work in a predictable environment and they have applied for an ER position, that would be setting them up for failure. This knowledge would also help you have the conversation with them explaining that they would be most successful working in Med/Surg. The conversation can also include goal setting to work toward a position in the ER after building up their skills with their preceptor and other education guidance. Without this data, you would not know where their strong and weak areas were and where you should target their training.
This three-pronged approach of candidate pre-hire will provide you with the opportunity to not only look at all candidates the same way, but make determinations on which candidates are the best of the best for your hospital, and where they would be the most successful. You will also be aware of their weaknesses which can be strengthened and worked on during their onboarding and beyond.
By Debi Damas, RN, Group Product Manager, Acute and Pre-Acute Care, Relias Learning
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.
