8 min read
When I first took over talent acquisition of a large health system, I was shocked at how traditional the recruitment process was for nursing and other ancillary healthcare roles within the health system. I had come from another industry that was at the forefront of recruitment technology and recruitment marketing, and I felt like I had taken a time machine backward!
My systems were dated, my processes seem antiquated, and I was surrounded by hiring managers who felt like they were entitled to talent. As in, talent should be begging them for the job, not the other way around. Because of this perfect storm of awful recruiting practices, we were spending millions of dollars on agency nursing and Locums.
The first thing I did was call my CFO and scheduled a private meeting. I was prepared to ask for an enormous increase in our talent acquisition budget, more than double the previous year. I had all the data and charts and I walked in confidently. I sat down and before I could say anything, he said, “Tim! Thanks for coming, I was going to set this meeting up myself to go over your budget with you for next year! We need to find a way to cut 15%!”
I felt sick to my stomach!
It’s classic healthcare. There’s a mission to save lives. You don’t save lives by spending money on non-life-saving expenses. Or, this was how it was traditionally looked at across all non-revenue healthcare functions, and still is at many healthcare systems across the country. Thankfully, though, we are also seeing many examples of modern healthcare systems that understand the value of having an amazing talent attraction engine, and how being world-class at Talent Acquisition can actually save a healthcare system valuable dollars that can be spent on patient care.
I’ll be honest, the CFO and I became very good friends. I found in him a partner who understood if we are paying agencies millions of dollars to properly staff our health system, we are paying a super-premium to have that done. If we do this properly ourselves, we can save 30-40% of that cost which is simply agency profit. The problem we had was a leadership team that didn’t trust that Talent Acquisition could do that!
The first thing I had to do was fight to get properly funded if I wanted to change. Working harder is not a sustainable talent acquisition strategy for success! But, it’s the main strategy used by the majority of healthcare talent acquisition teams. The problem isn’t that you can’t work harder, it’s that it still only gets you so far, and eventually, you just burn out your best people and you end up worse off.
I found my “extra” money in the spaces where we were having to spend more money because we weren’t able to recruit well on our own, then my team and I had to prove that little by little we could make a dent into our agency spend, by having better processes, better technology, and utilizing modern recruiting strategies. Healthcare TA leaders will understand, though, that unit managers don’t want to give up their agency folks! It’s a crutch that they’ve come accustomed to relying on over time and those agency resources are hard to give up.
I had to use a bit of informal leverage and a little formal HR power to get a couple of nursing managers to play along with me. With my new CFO champion, I called a meeting with two nursing leaders to “propose” a test “we” were going to try with their units to eliminate agency spend altogether by properly staffing their units. Of course, they were skeptical because it had never happened before, but when the CFO and HR guy are sitting across from you, it’s hard to say “No!”
The key was that we weren’t eliminating agencies first and leaving them short-staffed. We were first going to “overstaff” them while they had agency and allow them to properly onboard and train, and then little by little ween them off of agency. We had to prove to them we could get them the “permanent” corporate staff first, allow them to transition, and show them the value of having full-time staff versus agency nurses.
In the first year, moving unit to unit, in “test” mode. We were able to eliminate half of our agency spend, while only increasing our TA budget by a few hundred thousand dollars. We saved well over a million, we spent about two hundred thousand. The CFO and CEO were super happy. Talent acquisition had the resources we needed, on an ongoing basis, and we continued to go after the rest of the agency spend. The goal was never zero agency spend, as there will always be some capacity, short-term needs for agency. The problem I see in every health system, is we are using agency for full-time staffing, not emergency staffing.
We had a culture where leaders in the health system just assumed that talent acquisition couldn’t help them, so they ran to agency to help them with their needs. Again, working with finance, we put a stop to the ability of leaders being able to request agency assistance. The only way an agency would get its invoices processed is if they were approved by talent acquisition. We had to know where the money was being spent and why! We had to know where we were failing in talent acquisition, no matter how hard it was to see.
This one simple process change, while not popular with leaders, immediately gave us great insight into where and how much was being spent on agency and where our biggest problems were. We also found out that roughly 10-20% of agency spend had nothing to do with talent acquisition failure, but because we had leaders who had fallen in love with their agency resources and didn’t want to give them up! We had candidates for those jobs, but leaders were telling us “No” simply because they didn’t want to lose their trained agency nurse.
I often speak to talent acquisition leaders in healthcare who will say, “Tim, I don’t have the capacity to take on agency!” and my reply is always, “yes you do!” It’s a giant bucket of money being spent and the majority of that spend is a direct correlation to talent acquisition failure! It can’t be ignored! Plus, every single dollar you can cut from that spend is a TA win!
First, I’m using “Nurses” as the main role, but let’s be honest, this is about all positions we hire for in healthcare. It’s just that nursing makes up such a large portion of the hiring we do, but all of the strategies and tools I talk about work across healthcare roles from salaried to hourly.
#1 – We used our Recruiting Super Power!
We immediately ramped up our “Alumni” and “Boomerang” hiring. Roughly 30% of new hires, across all jobs, leave within six months. It’s for all the reasons you can think of around fit, culture, etc. This is about the grass isn’t always greener on the other side, and we were going to welcome our past employees back with open arms. In fact, not just welcome them. We were going to pursue them with vigor! No one was going to love them as much as us. While we wouldn’t get them all back, we were going to some of them back!
We used a combination of mediums to message our former employees. We texted them updates about new stuff going on at the health system, promotions, projects, awards, etc. We all love hearing the “gossip” of our former employers, and we played into this desire to want information. We sent emails, send snail mail to their homes, we made periodic phone calls. We built an entire communication plan around keeping in contact with former, high-valued employees.
The greatest superpower a recruiter has is to make someone feel wanted. We made our former employees feel very wanted!
#2 – We started texting nurses!
When I first started at the health system none of my Nurse Recruiters would text a nurse. They only sent emails. When I asked them why don’t you text these nurse candidates, they chuckled and said, “Tim, you don’t understand, nurses don’t want to be texted!”
So, we went on a field trip!
That field trip over to one of our hospitals and visited one of our Med-Surg Units and spoke to actual nurses who worked for us and I asked a few questions:
Tim: “How much time do you get to sit down and check email throughout the day?”
Nurse: “OMG! Almost never. Maybe a few minutes and then it’s only my work email.”
Tim: “Yeah, I know you guys are running constantly! If I had to reach you, during your shift, what would be the best way to contact you?”
Nurse: “Oh, just text me! That’s really my only communication all day I get.”
End of the field trip.
Nurses are very busy people with full lives. They don’t check LinkedIn. They rarely check their email. If you want to reach them, you have to reach them in the way they communicate and that’s by text message.
#3 – We turned on the Programmatic Job Advertising engine.
Marketing works. We all get marketed to non-stop all day long. When we are online. When we are watching TV. When we are watching TV and online at the same time!/p>
It turns out, most of us in talent acquisition isn’t very good at marketing and job advertising. We tend to just post jobs in the same places we always have, regardless of how great they work or don’t work. We do this primarily because we don’t know there are other options. This is how you were trained, so we just keep doing it.
Traditional job advertising is fairly inefficient. You post a job on a job site, hoping a candidate you want will visit that job site and see your job and apply to that job. Only about 15% of people are actively looking for a job at any time, so 85% of people are not actively looking, meaning they probably aren’t going to job sites.
Programmatic job advertising is basically letting artificial intelligence put your job ad in front of candidates where they are on the internet versus where you think they might be if they were looking for a job. An example of this could be a Nurse is reading an article on a site about a new nursing technique and innovation and programmatic technology would serve up your job ad to this nurse on that site the moment they just happen to be reading that article! It’s amazing and scary technology all at the same time!
We see healthcare organizations that test programmatic job advertising spend less and get more applicants than what they were doing prior to using only traditional job posting methods.
#4 – We owned the Nursing programs in our area!
We made the conscious decision that no other health system was going to do as much as we would at our local nursing programs, pharmacy programs, doctoral programs, physical therapy programs, etc. We were going to donate resources, time, etc. We were going to be the flagship partner for these educational institutions so when students thought of where they wanted to go work, it was going to be us, every time.
We sponsored Nursing school awards programs with scholarships and funding for ceremonies, etc. Besides sponsoring we made sure our nursing executives showed up and mentored. We worked with school staff to help them get our nursing leaders as frequent speakers for their classes and programs.
We also instituted two programs to show our commitment to new grads. We would sign up nurses prior to graduation and pay for tuition, etc. And we also started a tuition repayment plan. Both plans were built on the same premise. Come work for us for a certain period of time, and we’ll pay for your school. Of course, the health system can only take so many entry levels, but we wanted to get in early and get our pick of the best and brightest.
#5 – We did some gorilla marketing!
Sometimes you still have to go old-school when it comes to marketing to candidates and we put up billboards around our competition with our employment branding messages and easy text to apply messages. I wanted to let every healthcare worker in our area know, constantly, they had another option after a long, hard, frustrating day. And we were that option!
We hired rolling billboards on Nursing Week to drive by their campus with messages of appreciation of their efforts and profession, with us highlighting our “Nurse of Year” professionals, etc. I wanted them to think, “why doesn’t my health system appreciate me like that?!” We worked with our young nurses to support after-hour networking and wine parties where they could invite former classmates who worked at other systems to stay connected. We offered up awesome speakers for continuing education where we of course invited our nurses but also sent invites out to “all” nurses in the area to learn and grow.
Recruiting nurses and healthcare workers, in general, is always hard, and it’s extremely hard now and what looks like will be hard well into the future. We can no longer just post our jobs and pray and hope someone will apply. We must actively pursue candidates and show them there are great options for them to prosper and succeed.
We do this through great messaging and marketing and having the tools that will allow us to reach healthcare workers in the way they want to be communicated with. There is no one silver bullet when it comes to being great at nurse recruiting, but when we use all the silver bullets we have together, we can be much more effective in attracting and hiring great talent.
Emissary is a candidate engagement platform built to empower recruiters with efficient, modern communication tools that work in harmony with other recruiting solutions.
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