NAHCR Directions Winter 2014

DIRECTIONS National Association for Health Care Recruitment

Volume 38 Number 4

Winter 2014

PR E SID E NTI A L PE RS PEC TIV E S Derek Cunningham, PHR, CHCR As I write this message, I am excited about this time of year. First, it’s a season of Thanksgiving. What sorts of things are you thankful for: family, friends, health, job, freedoms, faith, etc? It’s often a time to take a moment and reflect on what’s most important in our lives. Personally, I start with faith and family and move through the list from there. This also includes being thankful for NAHCR and the friends I’ve made through the years, great career advice, and leadership experience. Looking ahead, there are tell-tale signs of this most wonderful time of the year (some less obvious where I write this from in San Diego). The sights, sounds, and smells all indicate it’s time for the holidays and time to flip the calendar to a new year. While much of the focus will be on gift giving and thinking of others (rightfully so), it’s also a good time to reflect on our own careers. Through NAHCR, you can give yourself a gift as well; the gift of knowledge/education, career assistance, advice, networking with other professionals, and more. Some good New Year’s resolutions might include more involvement in the association, participating more in the webinars and other educational events, asking the right questions to help assist you in becoming a “go to” person in the profession, or perhaps joining one of our committees. The association is only as good as the strength of its members, and the NAHCR Board seeks to ensure our continued strength and longevity, and that the needs of our membership are being well served.

While there is plenty of excitement in how our profession will continue to advance this next year, there are plenty of challenges as well. The Affordable Care Act, changing staffing dynamics, an aging workforce, and other challenges will be presented, but NAHCR strives to provide you the tools to meet these challenges head-on. Our members should be seen as thought leaders in the profession, the ones the leadership of each of our organizations should turn to for advice and assistance as experts in the field. continued on page 3

Presidential Perspectives . . . . . . . . . . . . . . . . . 1 Presidential Perspectives . . . . . . . . . . . . . . . . . 1 Board of Directors. . . . . . . . . . . . . . . . . . . . . . .

Directors. . . . . . . . . . . . . . . . . . . . . 3 Board of NAHCR Transitions to a Alternative Recruitment Strategies: A Proven New Management Company. . . . . . . . . . . . . 4 Approach for Finding Better Candidates and NAHCR Board of Directors Update. . . . . . . . 5 Reducing Employee Turnover . . . . . . . . . . . . . 4 Letter from the Past President. . . . . . . . . . . . 5 HCAHPS Insanity: Why Doing the Same Bringing Science & Technology to Surveys Over and Over Limits Your Results. . . 6 Hospital HR. . . . . . . . . . . . . . . . . . . . . . . . . . 6 Research Brief: RNs at Risk . . . .Health . . . . . Care . . . . .Recruiters . . . . . . . . Favor . . . . 7 Traditional Nursing Congratulations to Degrees. . . . . . . . . . . . . . .

2011 CHCRs....................98 The 2011 Healthcare HR Initiatives Health Care Mobile Recruitment Trends and Survey...10 User Behavior. . . . . . . . . . . . . . . . . . . . . . . . . 11 Image 2011 Conference Recap..................12 Member Focus Spotlight. . . . . . . . . . . . . . . . .

A Graduate Student’s Perspective..............1312 Award Recipients.........................................14 Recruiters' Toolbox. . . . . . . . . . . . . . . . . . . . . 13 NAHCR Regional Updates.........................16 NAHCR Award Winner Publishes Book • Northeastern Regional Update...............16 “The Humpty Dumptys”. . . . . . . . . . . . . . . . . . 14 • Southern Regional Update.....................18 Legal Update. . . . . . . . . . . . . . . . . . . . . . . . . . 15 • Western Regional Update......................19 Corner. . . . . . . . . . . . . . . . . . . . . .

•Committee North Central Regional Update............20 16 NAHCR Sites.........................22 Save the Chapter Date for Web IMAGE 2015. . . . . . . . . . . . 17 NAHCR Institutional Members.....................23 2014 Career Fairs and Job Fairs. . . . . . . . . . . 17 2011 Career Fairs and Job Fairs..................24

Winter 2014

page 2

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

Reach New Potential Customers ADVERTISE IN THE NAHCR DIRECTIONS NEWSLETTER The NAHCR Directions Newsletter has a circulation that reaches more than 800 health care recruiters a year in electronic copy.

For advertising information, contact: Sheila O’Neal, NAHCR@goAMP.com 913.895.4627

2014-2015 NAHCR BOARD OF DIRECTORS

page 3

PR E S ID E NTI A L PE RS PEC TI V E S

continued from page 1

The first step in doing this is to renew your NAHCR membership. If you had this publication passed along from a friend, please consider becoming a member. If you are already a member, we look forward to your renewal this next year so you may continue to reap the benefits.

In order to continue to provide quality services to our members, the NAHCR Board of Directors unanimously voted to increase the annual dues for our active (recruiter) members. This decision involved a lot of thought and discussion and was not taken lightly by any means. It is worth noting that the association’s dues for active members have not been raised in over a decade. This increase will aid in covering the higher costs while maintaining services you have come to expect, as well as review future ones to match the changing dynamics of our industry. Please visit our website at www.nahcr.com for more benefits of membership.

Hopefully one of your resolutions will be to assist in building a better association, as we work to make it better for you. Let’s look forward to great things in 2015. Happy New Year! 

Officers PRESIDENT Derek Cunningham, PHR, CHCR PRESIDENT-ELECT Julie Hill, BSN, RN, CHCR, RACR FINANCE DIRECTOR Claudia Cotarelo EDUCATIONAL DIRECTOR Michele Snider, BSN, RN, CHCR REGIONAL DIRECTOR Lori Faber, MSN/MBA, RN COMMUNICATIONS DIRECTOR Theresa Mazzaro, RN, CHCR INSTITUTIONAL MEMBER AT LARGE Jennifer Henley, PHR

NAHCR Staff EXECUTIVE DIRECTOR Sheila O’Neal EDUCATION PROGRAM COORDINATOR Christie Ross, CAE MEETING PLANNER Debbie Jennings ADMINISTRATIVE ASSISTANT Candice Miller

Happy Holidays from NAHCR! The NAHCR Executive Office will be closed on Dec. 24-26 and Dec. 31 as well as Jan. 1-2, 2015.

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

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Alternative Recruitment Strategies: A Proven Approach for Finding Better Candidates and Reducing Employee Turnover Chris Holdcroft Senior Consultant for Talent Management, HealthcareSource Health care recruiting can be challenging across the board, but it’s especially true for entry level positions in departments with high turnover or for atypical positions.

Large pools of candidates are needed, there’s often not enough time to conduct thorough phone screens, and time is wasted interviewing “non-viable” applicants. When new hires are unaware of job expectations, it often leads to turnover.

Alternative recruitment strategies are a solution that has worked well for Bronson Healthcare Group. This regional, not-for-profit health system in southwest Michigan created three innovative programs to hire Environmental Services staff, temporary trainers, as well as certain types of nurses and patient care assistants.

Launching Alternative Recruitment with the Test Drive Program Bronson Healthcare Group began exploring alternative recruitment after learning about a program that the local Michigan Works! office was developing. This workforce development organization was collaborating with area industries to provide candidates with a realistic picture of what work was like in different sectors. Bronson Healthcare Group explored how to implement a similar program in-house. Bronson had a large number of positions and high turnover within Environmental Services (EVS) which made that department a good place to start. EVS needed to not only attract candidates, but also reduce the high turnover.

“Our first step was interviewing management and employees to generate buy-in and to understand the characteristics of successful new hires,” said Emily Miley, MPA, Employment Specialist at Bronson Healthcare Group. Common problems in the EVS department included attendance and punctuality, not meeting appearance standards, not understanding the responsibilities of working in a hospital environment, and failing to see how their position had direct impact on the success of the hospital.

In addition, the HR challenges were numerous: many candidates didn’t have a large amount of work experience, candidates often lacked an understanding of the requirements of the position, and phone interviews were difficult due to communication difficulties or scheduling issues. With so many open positions, many managers were often placed in a situation where they were interested in the same candidate and ultimately competed with each other.

In response, the HR team at Bronson Healthcare Group developed the Test Drive Program. EVS candidates were invited to a two to three hour on-site informational session.

Since candidates were required to RSVP, individuals who failed to RSVP self-excluded themselves. “The focus of the sessions is twofold. Candidates get more information about careers in healthcare and what EVS jobs are like, while managers and recruiters have the opportunity to observe and conduct pre-interviews,” said Miley. The Test Drive sessions provided EVS candidates with an overview of the Bronson system, as well as provide insight into job expectations, standards of conduct, attendance and appearance requirements, hours, pay and benefits.

Attendees also learned interviewing and resume tips. All attendees were asked to participate in an interactive team project. This let recruiters and hiring managers see how candidates collaborated with potential teammates. At the conclusion of the meeting, recruiters debriefed with hiring managers and identified candidates to invite back for more in-depth interviews. “The candidate reactions have been very positive and we’ve gotten higher quality candidates,” noted Miley. “Setting expectations upfront is very important because working in a hospital is very different from cleaning offices or hotels.”

The results have been impressive. EVS turnover, transfers, and candidate screening time have significantly decreased.

Turnover in 2007 was 24.5 percent and year to date in 2014, it’s 8.4 percent! The estimated cost savings in the first year of the program was $65,900. Bronson Healthcare Group has now expanded the Test Drive program to other departments including Food Service, Security, Material Management and Patient Transport, Patient Care Assistants, Patient Sitters, Medical Assistants, and Registered Nurses.

Expanding Alternative Recruitment to Atypical Hospital Positions and Nursing When Bronson Healthcare Group implemented its Epic system, it needed to hire 40 trainers for the go-live within a few weeks. These were unique positions for the HR team, since they were temporary, six-month assignments that required specific skills that health care recruiters don’t usually look for. The ideal applicants needed excellent presentation skills, open availability, and had to complete a six to eight week training course to be formally credentialed.

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014 In response, the recruiting team modified the Test Drive program.

“We invited about 20 candidates for each session and then split the attendees into two groups. Each participant had a five minute, one-on-one interview with three different people.

In addition, attendees were given an advance assignment – making a five minute presentation in front of the group,” said Miley. This approach gave candidates detailed and realistic expectations about the job and it also gave the Bronson team an insight into each candidate’s presentation skills.

Individuals who were not interested again self-selected out, allowing the organization to hire a large number of committed and invested new employees at the same time. There was very little turnover, since new hires knew exactly the positions expectations.

For nursing positions with high turnover, such as emergency room staff, recruiters at Bronson Healthcare Group realized that they needed a larger candidate pool. They implemented a small group interview process for novice nurses, nurses without acute care experience, graduate nurses, and patient care assistants (PCAs). Hiring managers met with up to four candidates and provided detailed information about their units.

“After implementing the program in 2013, turnover has decreased significantly for among both RNs and PCAs. In 2011, our turnover rate for RNs was 6% and year to date in 2014, it’s 3.4%. Similarly, the turnover rate for PCAs in 2011 was 9% and year to date, it’s 4%,” said Miley.

Lessons Learned and Recommendations According to Miley, better candidates and reducing turnover have been the biggest benefits associated with alternative recruitment strategies. Other advantages include the time saving for the HR team. It’s now possible to screen a large pool of applicants in two to three hours, rather than the 10 hours required to conduct individual phone screens with 20 applicants.

For organizations that are considering an alternative recruitment program, Emily Miley offered six recommendations: 1. Get manager buy-in. This is the most important component of a successful alternative recruitment program. Without manager participation, this type of initiative will fail.

page 5 2. Identify the positions best suited for alternative recruitment. Look at areas with large numbers of regular openings and positions where a large applicant pool is necessary.

3. Determine what information is important for candidates to have upfront. Engage managers and employees in the departments. Provide honest realistic aspects of the job that are important for applicants to know before they accept an offer.

4. Define the characteristics of the ideal applicant. Work with people in each department to determine what qualities to look for in applicants. Choose interview activities that will help assess those qualities.

5. Use recruiting technology to automate and manage the process. Bronson Healthcare Group uses its applicant tracking system to send out meeting invitations to candidates. The system is also a central place to store notes about candidates. It’s possible to quickly see if an applicant has attended sessions in the past.

6. Make the program your own. With alternative recruitment programs, it’s important to continually ask for feedback and to be flexible. Be willing to revise, update, and improve processes over time.

Bronson Healthcare Group’s experience has shown that alternative recruitment programs can be a win for all stakeholders in the hiring process. Recruiters save time through more efficient screening and reduced turnover.

Hiring managers get better quality candidates. Applicants have realistic expectations about the job before accepting an offer. At the end of the day, all these factors contribute to better patient care.

About Chris Holdcroft In his twelve years with HealthcareSource, Chris has managed Client Services and was the Product Manager for the Position Manager Applicant Tracking product for Versions 5 through 10. He is now a Senior Consultant for Talent Management, helping hundreds of health care organizations improve their talent management processes.

He can be reached at solutions@healthcaresource.com. 

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

page 6

HCAHPS Insanity: Why Doing the Same Surveys Over and Over Limits Your Results James H. Killian, Ph.D. Vice President | Assessments, Findly Talent, LLCe

The patient experience has become increasingly important in driving business outcomes within the health care setting.

Patient surveys are routinely administered to gauge patient satisfaction, and numerous vendors have designed simulated surveys to help hospitals shed light on areas of strength and concern. However, these descriptive measures mostly focus on opinions, attitudes or observations that have already occurred and do little to predict whether those providing direct care (or support) have the capacity to deliver outstanding patient experience. We will explore the importance of using both predictive and descriptive assessment jointly to pinpoint the importance of potential and performance to drive better patient outcomes.

Leveraging quality data for organizational initiatives and policy is long overdue – hence the “Big Data” movement, which advocates deep analysis of disparate data sources to drive more informed decision-making. Among health care systems, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has become the core data analytic focus of most providers driving change in patient-centered programs and policy. These patient satisfaction ratings are aggregated by each hospital and reported publicly1, meaning that hospitals’ treatment of patients is as exposed as restaurants are to Yelp reviews.

HCAHPS scores themselves have become an incredibly important metric driving everything from the creation of chief experience officer roles, to corporate branding and messaging, to employee training and onboarding and far more. But more directly these scores also affect Medicare and Medicaid reimbursement for each establishment.

Thus, there is a rather large indirect and direct relationship between patient satisfaction and the overall culture, operation and financial performance of health care providers. Yet, still unaccounted for among the cadre of data is the fact that HCAHPS scores themselves are an aggregate result of individual experiences of people interacting with other people – in this case, patient and provider. Recent research by Gallup has pointed out the fact that by the time patients fill out the surveys, they are no longer under the direct attention of the providers they are rating2 meaning the conversion of survey ratings into HCAHPS scores is based on lagging patient ratings (i.e., fuzzy recollection of events), rather than real-time or leading indicators of those who are likely to provide an outstanding patient experience. Raw score differences could be minimal, but appear more disparate once calculated and adjusted

– thus presenting the potential for a feedback loop wherein practically insignificant differences are magnified and acted upon, putting our health care systems in a reactive mode as opposed to a strategic and proactive one.

Despite there being some flaws in HCAHPS (as with any data), the program provides an excellent platform to universally focus U.S.-based health care providers to set a standard for patient-centric care. This critique comes more from the viewpoint of leveraging other sources of data that contribute to, or help account for the variance in, HCAHPS scores. It’s about not putting all our eggs in one basket so we enable our health care providers to be successful in staffing, resourcing and maintaining their corporate brands.

The above points out an obvious consideration: A successful patient engagement begins with the people providing the care. The theme that long-dominated hospital settings was one of medical and technical superiority, with far less emphasis on the “soft skills” of patient care – “we are a hospital, not a hotel.” Although this attitude has softened over the last 15 years or so, there also has been limited focus and progress determining among individual skilled health care providers (i.e., nurses, doctors, support staff) who can deliver the best care with the best experience.

Yet, most anyone in this space agrees that a quality patient-centric experience is a critical ingredient for HCAHPS ratings. That said, what is largely missing (in my experienced opinion) are predictive indicators of the likelihood that each individual contributor will have a positive engagement with each patient receiving care. Research by PricewaterhouseCoopers has indicated that the attitude of health care staff is a major factor in impacting consumers’ decisions about their providers3. Identifying those individuals up front who have “the right stuff” to provide quality medical care and patient experience complement an institution’s measurement of satisfaction via HCAHPS surveys.

Quality people lead to quality outcomes; hospitals that perform better on clinical metrics also fair better on patient experience surveys4. Many health care systems believe they are already addressing this issue of quality via their existing employee selection processes of interviews, reference checks and multi-rater-type instruments, but they are still missing a large piece of the puzzle. In reality, the talent acquisition industry has simply changed the format and delivery of methods we know are flawed and biased (e.g., interviews).

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014 New data-based tools are needed to guide the actions necessary to select and manage critical health care professionals who ultimately provide the real link between care and patient satisfaction. If we agree that a major approach to improving HCAHPS success resides in the direct care that providers are providing, then the need for analysis and utilization of differentiators between successful and less successful health care providers at the individual performer level is obvious. It only makes sense to have a renewed focus on more causal – or at least directional – indicators of individual success which ultimately results in better patient experience and better aggregate HCAHPS ratings. Leveraging data that is predictive in nature – to provide better odds of hiring the right people, with the right attitude, patient centricity, quality and service orientation, etc. means starting with a better stock of talent thereby setting up our health care systems for success. Otherwise we continue to perpetuate the same issues – treating symptoms without addressing the root cause. As examples:

page 7 talent and performance on the things that matter most. In short, there is a need to augment decision making at point of entry among provider talent. To accomplish this in a meaningful way, we must determine a select group of skills, which statistically differentiates top and bottom performers.

These facts can only be gathered through detailed data collection and benchmarking against the real drivers for individual patient-centric success as documented by research across large numbers of professionals performing patient care. HCAHPS provides a good framework to begin this rigor.

Conclusion

Health care has come from a long line of excellence that focused on hard skills, pedigree and work experience. Over the last five years, there has been an accelerated interest in the patient experience and how to best measure it. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) is a good universal standard.

Predictive and Actuarial Assessment Descriptive Assessment However, it is not without Measures …

Measures … its own challenges – and Current performance  Potential for patient centricity focuses on evidence “after What others observed you doing  Behaviors that support patient satisfaction the fact.” We believe there Opinions and attitudes  Beneficial skill sets an individual is most is more to the future of What has happened in the past? likely to default to using. measuring health care  Predispositions toward desired future-state outcomes based on richer data analytics across talent and results. Actuarial data Leveraging both predictive and descriptive data provide an leveraging thought out and quality data models can start us opportunity to (a) know what talent we have to work with, on the path to setting up success among our health care (b) better understand the results those individuals are providers for years to come.  providing and (c) calibrate data-driven solutions to improve

______________________ 1 http://www.hcahpsonline.org/home.aspx (2014).

2 http://businessjournal.gallup.com/content/163286/hospital-patients-feelings-facts.aspx (2013).

3 PricewaterhouseCoopers. Customer Experience Radar Research. (2011).

4 Luxford, K. (2012). What Does the Patient Know About Quality? International Journal for Quality in Healthcare: 439-440.

4 http://www.medscape.com/viewarticle/771140

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

page 8

Attitudes of Health Care Recruiters toward Online and For-Profit Nursing Degrees Registered Nurses Have Four Options for BSN Degree Completion Traditional College, Classroom Study Traditional College, Online Learning

?

For-Profit College, Classroom Study For-Profit College, Online Learning

Survey of Health Care Recruiters Responses from 116 health care recruiters in a national survey indicated that health care recruiters prefer RN to BSN degrees earned from traditional colleges and classroom study. Online RN to BSN degrees from traditional colleges were also favored over online RN to BSN from for-profit colleges.

Advantage in the Hiring Process If experience and other qualifications were equal, how much of an advantage in the hiring process would a registered nurse job applicant with the following degrees have in comparison to a job applicant with an associate degree in Nursing from a community college?

Percentage of Ratings for “Significant Advantage”

37.4% Traditional College + Classroom Instruction

21.7% Traditional College + Online Instruction

18.3% For-Profit College + Classroom Instruction

10.5% For-Profit College and Online Instruction

Credibility How would you rate the credibility of the following nursing degrees?

Percentage of Ratings for “High”

86% Traditional College + Classroom Instruction

37.5% Traditional College + Online Instruction

49.6% For-Profit College + Classroom Instruction

23.9% For-Profit College and Online Instruction

Likelihood to Hire How likely would you be to recommend hiring a registered nurse job applicant with the following degrees?

Research Brief: Health Care Recruiters Favor Traditional Nursing Degrees James Kineer, PhD Vice President of Human Resources and Organizational Development at Indiana Regional Medical Center in Indiana, Pennsylvania The United States is facing a critical shortage of registered nurses holding bachelor’s degrees. According to HRSA, only 50% of registered nurses hold a bachelor’s degree or higher (Health Resources and Services Administration, 2010). Higher educational attainment among registered nurses has been associated with improved patient safety and clinical outcomes (Aiken, Clarke, Cheung, Sloane, & Silber, 2003; Estabrooks, Midodzi, Cummings, Ricker, & Giovanetti, 2005; Friese, Lake, Aiken, Silber, & Sochalski, 2008). Many organizations have called for an increase in the number of baccalaureate degree prepared registered nurses. Among these organizations is the Institute of Medicine who has called to increase the number of registered nurses with bachelor’s degrees to 80% by 2020. The Institute of Medicine has also suggested that online education and for-profit colleges may play a role in closing this gap (Institute of Medicine, 2010).

This article outlines the findings of a research study I conducted that found significant differences in health care recruiters’ perception of nursing degrees based on the method of instruction (classroom or online) and the for-profit/ nonprofit status of the school. The findings are based on the responses of 116 active members of the NAHCR members to an online questionnaire. The survey tool asked respondents to rate four different RN-to-BSN options on four criteria: advantage in the hiring process, credibility, concerns about credentials and likelihood to hire. In all four criteria, a RN-to-BSN degree from a combination of classroom study at a traditional college was clearly perceived the most favorably.

Nursing degrees from a combination of online study at for-profit colleges were consistently rated the lowest. An analysis of comments provided by respondents provided further insight into these ratings. The accreditation status of a nursing degree program was the dominant concern. Participants in the study also expressed concern that online education cannot provide the same level of direct experience as classroom based education. While the recruiters in the study preferred job applicants with degrees from traditional colleges and classroom instruction, the participant comments indicated that a hiring decision is often a complex process and that the source of a nursing degree may be less important than other factors such as experience, performance in the interview and organizational fit.

Percentage of Ratings for “Very Likely”

73.9% Traditional College + Classroom Instruction

48.6% Traditional College + Online Instruction

45% For-Profit College + Classroom Instruction

38.9% For-Profit College and Online Instruction

Source: Kinneer, J. W. (2014). A comparison of health care recruiters' attitudes toward RN-to-BSN degrees based on instructional delivery method and college for-profit/nonprofit status (Doctoral dissertation, Indiana University of Pennsylvania).

Dr. James W. Kinneer is the Vice President of Human Resources and Organizational Development at Indiana Regional Medical Center in Indiana, Pennsylvania. He completed his doctoral studies in Communications Media and Instructional Technology at Indiana University of Pennsylvania. Correspondence concerning this article should be addressed to James Kinneer, 2680 Melloney Lane, Indiana, PA 15701.

Contact: jkinneer@outlook.com

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

page 9 Table 1

If experience and other qualifications were equal, how much of an advantage in the hiring process would a registered nurse job applicant with the following degrees have in comparison to a job applicant with an Associate Degree in Nursing from a community college?

No Advantage

Little Advantage

Some Advantage

Significant Advantage

Traditional College and Classroom Instruction

13.9%

7.8%

40.9%

37.4%

Traditional College and Online Instruction

17.9%

24.3%

36.6%

21.7%

For-Profit College and Classroom Instruction

18.3%

15.7%

47.8%

18.3%

For-Profit College and Online Instruction

21.9%

36.0%

31.6%

10.5%

Very Low

Low

Moderate

High

0%

0%

14%

86%

Table 2

How would you rate the credibility of the following nursing degrees?

Traditional College and Classroom Instruction Traditional College and Online Instruction

0%

0%

54.5%

37.5%

For-Profit College and Classroom Instruction

.9%

4.4%

45.1%

49.6%

For-Profit College and Online Instruction

8%

22.1%

46%

23.9%

Table 3

How much concern would you have about the credentials of a registered nurse job applicant with each of the following degrees?

No Concern

Little Concern

Moderate Concern

Significant Concern

Traditional College and Classroom Instruction

71.7%

25.6%

1.8%

0%

Traditional College and Online Instruction

38.4%

43.8%

15.2%

2.7%

For-Profit College and Classroom Instruction

44.2%

43.4%

11.5%

0.9%

For-Profit College and Online Instruction

25.4%

36.8%

22.8%

14.9%

Table 4

How likely would you be to recommend hiring a registered nurse job applicant with the following degrees?

Very Unlikely

Unlikely

Likely

Very Likely

Traditional College and Classroom Instruction

.9%

0%

25.2%

73.9%

Traditional College and Online Instruction

.9%

8.3%

42.2%

48.6%

For-Profit College and Classroom Instruction

.9%

4.6%

49.5%

45%

For-Profit College and Online Instruction

5.5%

23.6%

40%

30.9%

References Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290(12), 1617-1623. doi:10.1001/jama.290.12.1617 Estabrooks, C. A., Midodzi, W. K., Cummings, G. C., Ricker, K. L., & Giovanetti, P. (2005). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, 54(2), 72-84. doi:10.1097/00006199-200503000-00002 Friese, C. R., Lake, E. T., Aiken, L. H., Silber, J. H., & Sochalski, J. (2008). Hospital nurse practice environments and outcomes for surgical oncology patients. Health Services Research, 43(4), 1145-1163. doi:10.1111/j.1475-6773.2007.00825.x Health Resources and Services Administration. (2010). The registered nurse population: Findings from the 2008 national sample survey of registered nurses. Retrieved from http://bhpr.hrsa.gov/healthworkforce/rnsurvey/2008/nssrn2008.pdf Institute of Medicine. (2010). The future of nursing: Focus on education. Washington, DC: National Academies Press. Retrieved from http:// www.iom.edu/~/Media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Education%202010%20Brief.pdf 

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

page 10

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NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

Winter 2014

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Health Care Mobile Recruitment Trends and User Behavior Dave Tuttle, MS Executive Vice President and Chief Product Officer, AppVault

Over the past two years engaging candidates on mobile devices has become critically important. With over 40 percent of health care career site users arriving from mobile devices it’s safe to say that having a mobile optimized destination in 2014 is as important as having a traditional website was back in 2004. This article examines the reasons for this increase in mobile job search and explains how health care professionals are consuming mobile content when researching and applying for jobs. At AppVault, we’ve looked at the analytics and user behavior of dozens of our mobile clients in the health care space and have provided an analysis on the state of mobile health care recruitment.

Why are health care candidates turning to mobile devices for job searches? This increase in job seeker behavior amongst these professionals can be attributed to several key factors: Improvements in Technology – As mobile devices become faster and mobile Internet speeds improve, performing process based tasks such as researching or applying to a job have become just as convenient on mobile as they are on a laptop. Consumer user behavior has eliminated the mobile learning curve and job seekers have come to expect the same user experience when applying to a job as they do when they make a purchase on Amazon. Additionally, as more career sites and applicant tracking systems are formatted for mobile, health care job seekers are coming to expect that hospitals and employers will offer a mobile optimized experience.

Anonymity – Unlike many professionals, health care workers often use shared work spaces or terminals and have limited opportunity to anonymously search for jobs on desktop or laptop computers during working hours.

As a result, nurses, therapists and allied health workers rely on the privacy and anonymity provided by mobile devices to conveniently search for jobs during peak working hours. As a result, formatting your career site for mobile can provide your organization with access to these candidates and give you a significant advantage over your talent competitors.

Convenience and Personalization – Mobile devices are always with us and their use allows health care workers to research their career aspirations during the critical margins of their working day. Nurses and doctors are always on the go and the mobile Internet experience lends itself well to this lifestyle. Moreover, as health care workers have increasingly come to rely on mobile applications

for professional tasks, this preference for mobile convenience has carried over into their job search behavior and expectations.

What kind of employment related activities are being performed by health care professionals on mobile devices?

Job Search – The most important element to engaging health care professionals on mobile devices is ensuring that you provide them with an end to end mobile experience. This includes formatting all ATS requisitions for search and display on mobile devices. Similarly, you must provide multiple calls to actions, beyond the apply, that are formatted for mobile. This includes allowing candidates to share a job with their social network on Facebook and Twitter, email the job to themselves, or quickly opt in to a talent community. Simply taking the ATS experience and formatting it for mobile could cause you to miss out on a lot of passive and hard to find candidates.

Research – Beyond just searching and applying to jobs, health care professionals rely on mobile devices to tell them about some of the intangible aspects of working for a hospital or health care facility. These include information about a company’s culture and commitment to diversity.

Additionally, providing content related to charitable and green initiatives are attractive to mobile job seekers. As the employment outlook for health care has improved over the last several years candidates have become more discerning regarding vacations and benefits packages.

Having this information formatted and displayed on your mobile career site is equally as important as the mobile optimization of the job search.

Location Specific Information – It is important that your mobile optimized career site work with the strengths of mobile devices. One of the key strengths that the mobile job seeker experience provides is location specific information. If you are willing to relocate candidates, you need to not only state this in your mobile career site, but provide Google map integration so that candidates can measure their commute time or see local amenities that will help them evaluate if they are willing to move or extend a commute in order to work for you.

Other considerations for mobile strategy: Email – Often overlooked in discussions of mobile recruitment, opening email is one of the primary activities that is performed on a mobile device. Any mobile engagement and recruitment strategy must include mobile optimized email communications. Email messaging must be brief

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and to the point in order to accommodate the limited time that mobile job seekers can devote to reading email messaging.

Use of Audio and Video – Thanks to increases in bandwidth and processing speeds over the last several years, mobile video usage has increased significantly in both volume and duration. If you have compelling video content, it is important to make sure that it is displayed on your mobile destination so that your recruitment efforts can benefit from this increase in engagement. However, video assets can be expensive and time consuming to

Member Focus

SPOTLIGHT Jerry Davis did not start his career out in recruiting.

Like so many of us, he had a different path then his current role as Recruiter at Portland Adventist Medical Center. He received his bachelor’s degree in 1986 in communications. During his degree program, he had the opportunity to complete an internship in Media Production at Adventist in Portland. When he graduated, the internship turned into an on call position which then led to full time at Adventist.

Jerry enjoyed working full time for nine years. Like so many other businesses, Adventist went through a reduction in the Marketing department which included his position. After 18 months for Cisco in marketing, Jerry had the opportunity to be the Marketing Director for a value added reseller in computers. But something was missing.

He wasn’t making a difference in people’s lives. He knew he wanted to be back in health care, but he just wasn’t sure where. So, like many of us, he went back to school.

After getting his MBA, he went to work for Providence for four years in marketing and communications. Long commutes were not wearing well on his quality of life, and as Jerry is the ultimate networker (you can ask him about the stable where he boards his horse – the owner’s daughter who worked for this company … ), he soon found himself as the Director of Marketing for a language interpretative services company.

Through more networking (and his stellar reputation), when a position opened in recruitment at Adventist, the HR Assistant Director reached out and brought him on

produce. If you don’t have any recruitment related videos, you may want to consider recording audio descriptions or supplemental information related to individual jobs or departments.

As mobile becomes the primary venue for job search for health care professionals, it is important to understand their behavior and motivations. Mobile career sites are more than just jobs and applications. They need to be constructed as if they are your only source for providing information to job seekers because to many, this will be the only destination that they engage. 

Theresa Mazzaro, RN, BA, CHCR, Nurse Recruitment Supervisor, PeaceHealth board. He worked one-half time in recruitment and onehalf time in marketing. Doing both jobs made Jerry acutely aware of how close these two business segments are related. “My extensive background in marketing has been such a compliment to my recruitment role.”

As soon as he became a recruiter, he went to his first NAHCR conference (in Minneapolis). Jerry was hooked – “I loved meeting everyone, the education and networking was amazing!” He immediately joined the local health care recruitment association (OSWACHR) and has his sights on a board position in 2016. His company, seeing the great value in his participation in 2013, is planning on sending him to NAHCR in 2015.

Recruiting is a great combination of technology, data, and people. “I love hearing people’s stories – it’s my favorite part of my job. I thought I was an introvert, but I really get my energy from the interactions with my candidates and hiring managers.”

Jerry now feels like he makes a difference every day. He affects the care in his community and helps hire the very best for his organization. “I encourage new hires (that aren’t necessarily at the bedside) to go and sit in our lobby and observe the patients and families. It validates what we do.”

Thanks for sharing with us, Jerry – we’ll see you in New Orleans!! 

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

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Recruiters’ Toolbox: PACK THE HOUSE WITH TOP TALENT

Best Practices for Hosting a Successful Recruitment Open House Anthony Gentile Managing Partner of Katon Direct In today’s competitive environment for top talent, health care employers must constantly communicate with and engage their local talent pool. The main challenge for recruiters is that most of the experienced talent pool is extremely passive and most likely not proactively seeking career opportunities.

So what can your organization do to best position itself as an employer of choice and stay top-of-mind?

One of the best strategies for connecting with and meeting your local talent pool is to host an open house event. Open house events have proven to be extremely successful, primarily because it’s the only way for your organization to personally connect face-to-face with the local talent pool and directly present your stand-alone opportunity.

If executed properly, open house events can become an integral part of your recruitment strategy. Katon Direct has worked with hundreds of organizations over the past 12 years that have collectively hosted thousands of open house events. Below are some tips and best practices that Katon Direct has compiled to help you achieve maximum return:

Define Your Goals What are you trying to accomplish by hosting the event?

Are you just looking to make as many hires as possible?

Address the more difficult-to-fill positions? Build a talent pipeline? Foster employer branding? Knowing what your goals are is important because it will help dictate your strategy, determine an appropriate budget, and calibrate your expectations for success.

Check the Calendar Having your event take place on a date or time that is inconvenient can turn away potential candidates that otherwise would have attended. Be sure to select a date for your event that does not conflict with any national/religious holidays. It doesn’t matter if you are giving away great prizes or serving gourmet food – if you host an event on the Friday before Labor Day nobody will show up! Also, on the day of the event, try and accommodate candidates that work various shifts by having morning, afternoon, and evening availability.

Personalized Call to Action Create an event-specific landing page that allows candidates to RSVP and request additional information.

Take it a step further and personalize the page for the candidate by pre-populating their contact information. This not only makes it easier for the candidate to RSVP, but also creates a personal, one-to-one connection that they will notice. The more comfortable the candidate feels, the more likely they are to express interest in your event and career opportunities. Also, be mindful of the candidates that are interested in attending, but are unable to as a result of scheduling conflicts. Be sure to acknowledge them and provide instructions as to how they can obtain more information.

Relevant Messaging For the most part, candidates are interested in the information that matters to them. It’s extremely important to make sure that the message provides relevant information specific to each candidate. For example, if you are hosting an event for RNs, PTs, and OTs, you should segment that audience and only provide the specific details that would matter to the individual candidate (e.g. an invitation to an RN should say “We are hosting an Open House for RNs!” and not “We are hosting an Open House for RNs, PTs, and OTs!”

Mass Micro-Marketing Who is your target audience? If you’re only interested in registered nurses with 2+ years of experience that reside in a 30 mile radius of your facility … then you better only invite registered nurses with 2+ years of experience that reside in a 30 mile radius of your facility. Micro-marketing is the process of pre-identifying your target audience and communicating with them in a very personalized and relevant way. An “open invitation” may sound like a good way to drive attendance, but chances are you’ll end up wasting resources on candidates that do not fit your criteria. continued on page 15

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Recruiter's Toolbox continued from page 13

Offer Incentives

Follow-up

Always keep in mind that the overwhelming majority of the talent pool is employed, and somewhat satisfied with their current job. Why would a gainfully employed candidate give up an evening with their family or take a day off from work to attend your event? You need to offer an incentive beyond the promise of great career opportunities. Raffles, prizes, food, entertainment, etc. … are great ways to draw a crowd.

Not every candidate that walks through the door will result in an immediate interview/hire. Typically you will have to nurture the relationship and stay top-of-mind. Be sure to send a “thank you” note to all attendees and let the qualified candidates know that you are interested in scheduling an interview. If you have a CRM application, you can load up all of the candidates you want to stay in touch with and create personalized lead nurturing campaigns.

All Hands on Deck On the day of the event, have recruiters and hiring managers available for on-the-spot interviews to accommodate the active job-seekers. If a qualified candidate is interested in one of your opportunities, it’s best to start the interview/offer/ hiring process before they walk out of the door. Otherwise they can very easily walk across the street to your nearest competitor.

In the end, there is no substitute for meeting your local talent pool face-to-face, and an open house event is the only strategy that allows you to do that on a large scale.

When executed properly, open house events can be used strategically to make a lot of hires, build a talent pipeline, and put you in front of your local talent pool. If you plan in advance, define your goals, and get buy-in from your team you will pack the house with great talent. 

NAHCR Award Winner Publishes Book “The Humpty Dumptys” Louisville, Ky. (October 22, 2014)--The National Association for Health Care Recruitment (NAHCR) 2013 Lifetime Achievement award winner, Greta Sherman, has been busy even though she retired in 2012 as a Senior Vice President of a recruitment advertising agency and a long-time advocate for NAHCR. In September 2014, she had her first mainstream novel, “The Humpty Dumptys,” published by L’Oeuf Publishing.

The book is the first in a series and since it is close to autobiographical, there are a lot of references to what it is like to work in health care recruitment. “Names and places have been changed to protect the innocent,” said Sherman with a laugh, “but lots of healthcare recruiters will know exactly what is going on professionally for the main character, Hedy.”

The book is also the story of what happens when you hit a child. “The novel very effectively shows the results of abuse,” said an Amazon.com editor who reviewed the book. “Given the nature of the story, it would be easy to fall into heavy-handed, preachy treatment of the message. The novel avoids this quite nicely by keeping its focus on the present-day time frame,” the reviewer continued.

The book is available on Amazon.com in both print and Kindle versions. If you would like a personalized copy, contact Greta Sherman at www.gretasherman.com or on Facebook.

NAHCR • P.O. Box 14365 • Lenexa, KS 66285-4365 • Phone: 913.895.4627 • Fax: 913.895.4652 • Email: nahcr@goAMP.com

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Spike in Pregnancy Discrimination Charges Prompts New Guidelines from the EEOC Michael Padgett, Jackson Lewis, LLP

In 1978, Congress enacted the Pregnancy Discrimination Act (“PDA”) to clarify that discrimination based on pregnancy or related health issues was prohibited by Title VII of the Civil Rights Act of 1964. Recently, pregnancy discrimination claims filed with the Equal Employment Opportunity Commission (“EEOC”) have increased significantly. In response, the EEOC recently released Enforcement Guidance: Pregnancy Discrimination and Related Issues (“EEOC Guidance”). The EEOC Guidance attempts to clarify some distinctions between the PDA and the Americans with Disabilities Act (“ADA”). Additionally, it provides some useful examples and suggestions for current employees, as well as touching on the PDA in the context of the hiring process.

PDA: The Basics In a general sense, the PDA prohibits different treatment in hiring, firing, or other employment decisions based in whole, or in part, on pregnancy or pregnancy related conditions.

It can be tempting for interviewers to attempt to gage an applicant’s ability to continuously serve in the open position.

However, asking the wrong questions can easily lead to unfavorable evidence if the applicant sues down the road.

Unlike some forms of illegal discrimination, pregnancy discrimination need only be a motivating factor in the adverse decision. For example, an employer could choose not to hire a woman both because she is pregnant and for a separate legitimate reason and liability could ensue. Pregnancy need not be any more than one of other motivating factors to constitute pregnancy discrimination.

Pregnancy discrimination can be based on a current pregnancy, past pregnancy, or a potential or intended pregnancy. According to the EEOC Guidance, past pregnancy discrimination may include discrimination based on complications stemming from a pregnancy or current parental leave, for example. It can also include the simple fact that an applicant has children.

Discrimination based on the intent to become pregnant or the potential of becoming pregnant can occur when decisionmakers make employment decisions with a preference for what they anticipate will be uninterrupted employment.

With all three forms of pregnancy discrimination, one of the frequent issues is decision-maker knowledge. If a decision-maker is not aware an applicant is pregnant, has been pregnant, or intends to become pregnant at the time of the decision, the decision not to hire the applicant cannot be pregnancy discrimination. However, imputation of

knowledge is not limited to the applicant directly informing the decision-maker of the pregnancy. It can also include knowledge that the woman is pregnant through the decisionmaker’s observation of the applicant or some other indirect information.

Timing matters in this analysis as well. The closer in time the interviewer gains knowledge of the pregnancy related information to the adverse decision, the stronger the evidence of pregnancy discrimination.

New Enforcement Guidance The EEOC Guidance provides direction to decision-makers to avoid running afoul of the PDA. The EEOC Guidance emphasizes that during the hiring process, the employer’s focus should be on the applicant’s qualifications for the open position. Questions about the applicant’s pregnancy status, kids, or family plans can quickly and even inadvertently lead to murky water for the interviewer. It is important to note that discussion of such topics is not necessarily unlawful standing on its own. Rather, the fact that interview questions relate to pregnancy, even indirectly, can be cited as evidence by a claimant that the decision not to hire included pregnancyrelated conditions as a factor.

Before the interview process, the employer should develop specific job related qualifications for a given position that emphasize qualities and proficiencies needed for the job. Stick with these questions consistently to avoid the appearance of asking potentially gender-related questions.

No doubt, it can be natural during the interview process for applicants to share information beyond the questions asked.

It can be tempting to let the applicant open up and provide additional information; after all, that may provide additional information with which to analyze a candidate. However, it is prudent not to let the applicant stray too far down the road of personal information, especially information that might be cited as evidence of knowledge or a discriminatory motive.

The EEOC Guidance also advises to ensure the widespread and equal communication of job openings. When evaluating applicants’ work histories, focus on work experience and qualifications and give equal weight to cumulative (albeit interrupted) work experience that would be given to uninterrupted experience. Perhaps most importantly, make sure employment decisions are well documented. Notes indicating the lawfully permissible positive and negative attributes of individual applicants can be invaluable in the event of a charge or lawsuit down the road. Explaining the

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Legal Update continued from page 15 decision to hire or not to hire, when possible, can also be helpful.

Ultimately, the best practice to avoid pregnancy discrimination claims during the hiring process is to conduct a consistent set of interviews. Consistency in

topics, questions, and overall format undercuts a claim of differential treatment. Certainly there is no surefire way to avoid pregnancy discrimination claims, but the following the EEOC Guidance coupled with good interviewing tactics can minimize the risk. 

Committee Corner

Membership Recruitment and Retention

The Membership Recruitment and Retention Committee has been working on a number of new initiatives over the past year. The committee had the privilege of welcoming close to 200 new members this year! While we are welcoming new members, we still have work to do in order to retain our current members. The Board is hard at work looking at all aspects of the association’s programs and services in order to determine if they are valuable to you, our members. Watch for more details about this work in future correspondence.

Do you know that the Membership Committee launched a Member Referral program? Association data shows that the most effective way to increase membership is using referral programs. There is no better advertisement than recommending membership to your peers. We challenge you to invite at least one person to become a member.

Membership Value Proposition Working with CKR Interactive, the Membership Committee developed a Membership Value Proposition (MVP). This process helped NAHCR to refine the key motivational components of membership and develop a branding strategy around this MVP. You should have seen and are becoming familiar with the branded images and slogans of the “For me” campaign.

The MVP is: “Top health care recruitment professionals nationwide turn to NAHCR to enhance their career success and advancement. From CHCR credentialing, best practices and free webinars to articles by leading

experts and the annual IMAGE conference, NAHCR delivers the specialized and unique content members seek to address the changing face of health care and be a leader in their field. Join NAHCR today to further your career and begin connecting with talented peers – it’s your premier resource for building a strong network of respected colleagues and cherished friends across the country.”

The Membership Committee is working in conjunction with the Communications Committee to promote the personal side of NAHCR members through Facebook postings as well as LinkedIn articles and resources. Thematic messages have been developed with regards to membership and the MVP/For Me campaign to run in NAHCR News, Directions, direct e-blasts, and through social media. Please take a moment to “like” us on Facebook, join our LinkedIn group and company page and follow us on Twitter!

Also, please take just one minute to think about one of your colleagues and peers to whom you can recommend membership in NAHCR. There are sample emails and letters for these introductions in the Membership Referral program brochure. NAHCR is only as strong as its members and a more diverse and robust membership makes networking with your fellow members even more beneficial to everyone!

Membership renewal invoices for the 2015 year have been distributed already and you should have received your initial invoice in hard copy via USPS. If you have not received this information, please contact the Executive Office and let us know so that we may correct your address and/or resend your invoice. We are all very excited about the changes that are happening at NAHCR, and we hope you will join us for another year! 

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2014 NURSE.COM/NURSE WEEK/ NURSING SPECTRUM CAREER FAIRS NOVEMBER Tuesday, November 18, Pasadena, Calif.

2014 ADVANCE JOB FAIRS REGIONAL VIRTUAL JOB FAIRS January 21, 2015 YAI Network Online Open House 11:00 a.m. - 3:00 p.m. Eastern Time

IN-PERSON JOB FAIRS No events scheduled at this time.

NAHCR Mission NAHCR provides health care recruitment professionals education, networking and resources to become strategic business partners within a dynamic health care environment.

NAHCR Vision NAHCR will be the preeminent organization for health care recruitment professionals.

Follow NAHCR on:

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