Between now and
the end of 2014, the US Department of Labor is predicting a thirty percent
increase in the number of health care jobs. This will amount to approximately five
million new employees in the field of health care and one out of every five of
these jobs will be in the field of health services. The challenges facing
health care organizations will be immense as they try to develop and implement
strategic plans to recruit and train a quality workforce. Retention of these
employees will be a key factor in minimizing operating budgets due to the high
cost of employee turnover, which in a study conducted by the American Association of Retired Persons (AARP), can amount
to up to fifty percent of payroll dollars. The role of the human resource
department will be critical to the success of these health care organizations
in their ability to hire, reward, and retain the employees they need to operate
and thrive in a constantly changing industry.
In this article we
will discuss the human resource processes of recruitment and retention; selection
and onboarding; training and development; and performance appraisal and
compensation as they relate to four different types of corporate strategies: a
low cost strategy, a quality differentiation strategy, a growth through
acquisition strategy, and a focus differentiation strategy.
The difficulties facing the human resources department of a health care organization with a low cost corporate strategy, such as a community health center, will more than likely be financially related. These facilities often have a high employee turnover rate due to low pay, and must operate and succeed on a limited budget. Therefore, recruitment of employees will have to be done through services who do not require remuneration, such as Craigslist; industry journals; and internet job sites such as, Career Builder. Selection of candidates will normally consist of just a single interview where their
skills can be demonstrated. Once hired, training for the workers such as medical
assistants and administrative staff will be done on the job with other
employees assisting to develop the new “hires” to perform their duties
efficiently and at a minimal cost. Doctors and nurses working or volunteering
at the community center should already possess the skills necessary and as
determined through the credentialing process, need very little training.
However, they too will have to learn how to operate on a limited budget while
still providing the highest possible quality of care to their patients.
Performance appraisals will normally be done once a year but annual pay raises
will be small. Most employees of a health care facility operating on a low cost
strategy will be paid an hourly rate that is on the lower end of the pay scale
for the health care industry and benefits will be minimal, if they are even
offered at all.
Another source of potential
employees for a low cost-strategic approach is to allow and incorporate the use
of interns from various medical training programs in the medical office while
they work toward meeting their course requirements. This would be a free source
of labor and can help keep costs down. These students could be trained on the
job and would be a continuous source of free labor since most of the educational
institutions pay for their insurance while they work at their intern sites.
Training hospitals affiliated with U.S. medical colleges have been utilizing
this technique for nearly one hundred years, as they place upper class-men in
these institutions for clinical experience.
corporate strategy approach, such as adding a birthing center to a family
practice clinic, would allow the HR department more resources in their search
for skilled employees. Recruitment would still be done via online sites as well
as local newspapers and local workforce centers but it can also be done from
within. Employees already working for the facility may wish to transfer to the
new clinic, which would help minimize the training and onboarding processes
since these individuals will already be employees of the company and in their
system. This type of health care organization would want to focus a little more
on quality employees who would provide outstanding care
since competition for patients would be more of a factor. Performance
appraisals could still be conducted annually and good employees should be
compensated for successful execution of their job duties. Compensation would be
based on a scale for similar jobs in the area and basic benefits should be
A situation in
which the human resources department would have unique challenges would be a
growth-through-acquisition strategy, such as two hospitals merging. In a
setting such as this, most employees already working for the facilities would
probably be retained and some may even need to be laid off initially until the
merger is complete and new growth in the businesses is achieved. The first step
would be to offer severance packages to any employees who are interested. The
HR department would then begin to assess the performance reviews of other
employees and attempt to determine which ones are the best to keep on staff.
Once the merger is complete and the facilities can begin to expand their
operations, new hiring can be achieved in much the same way as other corporate
strategies. Advertising for available positions could be done via job search
sites, local media and job force centers and even national sites and agencies
if the organization is trying to attract highly skilled professionals from a
vast pool of individuals. Interested applicants would be pre-screened to
determine qualifications and go through an initial interview process. The
qualified candidates would then be chosen and offered employment. Quality
employees would be a top priority in order to maintain a high standard of
patient care and satisfaction. Medical and dental benefits should be offered to
employees as well as at least one week per year of paid vacation for senior
employees. Performance appraisals would be conducted at least once per year and
pay raises offered to deserving individuals. For employees who are salaried,
annual pay raises should be offered.
The most challenging scenario for human
resources would be a focus-differentiation strategy, such as a surgical burn
center. According to a study done by the Department of Health and Human
Services, the demand for physician services will increase by 22% between 2005
and 2020 and the supply of physicians to fill that demand will not be
sufficient. Therefore, competition to hire the type of highly
skilled and desirable health care workers will be tough and HR departments may
even recruit from overseas to meet their staffing needs. “Headhunting” firms
may be utilized to help find potential employees and due to the large fee
awarded to these agencies, retention of the hired individuals will be key.
Candidates from across the country would be prescreened to determine
qualifications and applicants would then be flown at company expense for an
interview with senior administration of the specialized facility where they
will work. Once hired, the new employees would be paid a moving stipend and offered
the assistance of a relocation specialist to make their move a hassle free one.
Upon starting their new job, they would be provided with a sponsor or mentor
within the organization who will help them learn the ropes of the institution and
assist with onboarding until they are comfortable in their new role.
Since the health care industry is
constantly changing, continued training and skills enhancing workshops would be
offered to employees as needed in order to keep them up to date with current
trends and technology. If these training seminars are in other locations, the
trips will be paid at the expense of the employer. Performance appraisals will
be conducted by senior staff and peers at least twice a year and bonuses
awarded based on satisfactory results and achievements. Compensation would
usually be salaried pay and would need to be at the high-end of the pay scale
for similar jobs in the field with a severance and retirement package to be
determined prior to employment.
Due to the high
costs involved in hiring of employees of this caliber, retention becomes a
critical issue. A comprehensive options and benefits package would have to be
offered to include such things as paid time off, income protection, regular
salary increases, performance bonuses, 401K and retirement packages, assistance
with paying malpractice insurance, and “work and life balance” programs.
The demands on the
healthcare industry are increasing at a time when the cost of providing
healthcare is also increasing and a quality workforce will be the key to
success for companies wishing to operate and survive in the business of health
care. The need to implement successful human resource policies for employee
recruitment, selection, training, development, compensation, and benefits, in
addition to performance management, will be an important part of an employer's
ABOUT THE AUTHOR:
Stacie Fisher is a senior business student of Dr. Counce, and is in the Health Information Management degree program at Intellitec Medical Institute in Colorado Springs, Colorado. A Magna Cum Laude student, Ms. Fisher is finishing her internship this Spring and will graduate this Summer with The Class of 2013. All professors and instructors at IMI are convinced that Stacie will eventually move into the ranks of instructor and beyond.