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Strategic Recruitment and Retention

The purpose of this paper is to respectfully challenge you into thinking strategically about why and how you recruit and retain employees.  Do you consider it a low level HR function, or is it a strategic imperative?  The answer to this question will largely determine your success in everything you do.  In fact if you have not had the success you had hoped in other strategic initiatives, it is likely because this imperative is foundational to any other success you seek.

In most health care organizations salary and benefits are between 50% and 80% of  total costs – the largest expense by a huge margin.  It is also the single largest variable in your organization’s overall success or failure.  Take a moment to think back on the best employee you ever had.  Now the worst.  Compare and contrast their impact on satisfaction, efficiency, workplace harmony, revenues, innovation, cost savings.  What is the value of having an entire staff of those “great” employees?  Whenever I use the term, employee, included in that group are board members, physicians, and employees.

Recruit – “”to engage in finding and attracting employees… to recover health… to gain new supplies of anything lost or wasted.”  Aren’t dictionaries great!  How many employees have you “wasted” or “lost” lately?  Can any of us afford that, really?  So the process of recruitment is more than just attracting, but of not losing or wasting invaluable human resources as well.  Tom Peters says “Talent is a B-I-G word.  And a word that’s very different from “worker” or “employee.”  It has been said that our most valuable resource is not our people – but the right people!

Strategy – “a plan, method, or series of maneuvers or stratagems for obtaining a specific goal or result”.  The dictionary goes on to clarify that strategy is “large-scale, long-range planning and development to ensure security or victory”.  I like Michael Porters thought that “Competitive strategy is about being different.”  He further clarifies “Differences in needs will not translate into meaningful positions unless the best set of activities to satisfy them also differs.”  I think Paul of the New Testament said it well “Faith without works is dead”.  Strategy without activity (implementation) is ineffective.

So, strategic recruitment is the long term process of both positioning and acting differently in order to attract and retain talented employees.  By talented we mean those who have both the technical and human skills to excel and move us forward in accomplishing our goals.  The more ways we can position and act differently, the more strategic it is.

Kotler & Bloom define competitive positioning as “to identify the major attributes used by the target market to evaluate and choose among competitive organizations.”  So in order to attract and retain we need to understand what would be attractive to our customer – in this case our employees and potential employees.

It is helpful at this point to identify what we are looking for as an employer as well.  Unless we know what we want, it doesn’t make any difference how well we know what employees are looking for.  Typical attributes employers look for include:

  1. Adult learning skills

  2. Specific credentials

  3. Goal setting skills

  4. Technical competency

  5. Emotional intelligence (plays well with others)

  6. Critical thinking

  7. internal locus of control

  8. Judgment.

This is a representative list only, and different employers will add or delete certain items, and will certainly emphasize some attributes above others.  As each organization develops their own list it is important to look at both technical skills (what we do), and human (who we are).  If you have not clearly defined what you are looking for in every employee, and for specific positions you are not looking at recruitment strategically.  You will fail to differentiate yourself to employees, and will fail to thrive in a competitive environment.

A national survey of nurses by Harris International outlined, in this order, what attributes nurses valued the most when looking at an employer (I include potential employer as well):

  1. Compensation (including benefits)

  2. Flexible schedule (includes adequate staffing levels, reasonable hours)

  3. Rewarding work

  4. Positive Peer and leadership relationships (includes respect and work environment)

There are other studies in other disciplines, but the themes seem fairly consistent.  If you have not identified what employees are looking for you are not looking at recruitment and retention strategically.  You will fail to differentiate yourself in the market and will make achieving your goals much harder, if not impossible.

Knowing this, what are you doing about it!

Its important to remember that strategies with one or two differentiating factors are going to be simple to replicate, and will not provide long term value.  We need to look at each phase of the recruitment and retention cycle, and try to differentiate at each critical phase.  The combination of tactics woven together will create your strategic advantage.  With senior management coordination, matched by involvement at all levels, your organization will achieve the necessary balance between depth of involvement and organization wide alignment.  Lets look at this a bit more closely.

Depth of involvement:

Any strategic initiative that does not become “how we do things around here” will not have lasting value.  If the program dies when the CEO leaves, it will have short term value.  Buy in at all levels is required to create day to day behavior.  We need to examine the impact on senior, middle, and direct supervisors as well as line staff.  We are talking about a change in culture, a challenge worthy of our best leaders.  If each level cannot see how they win, institutionalizing the change will be impossible.  So look at all of your employees differing needs and get them involved.  This does not guarantee that everyone will be thrilled, but you will at least have the opportunity to be more proactive.

Organizational alignment:

As a senior leader your key value will not be in coming up with the ideas, but in creating consistency and alignment between them.  Top management internalization of the new culture is an absolute must for the initiative to have any lasting impact.  So senior leadership (emphasis on leadership) is critical to create harmony between the different needs and solutions throughout the organization.

Are you convinced yet that looking at human resources strategically is your most important imperative?  What are the alternatives?  Take a critical function like patient accounts for example.  How many organizations have gone through some type of strategic initiative in patient accounts in the last 5 years?  How many achieved the results they sought, and if so for how long?  What if you had instead worked on recruiting and retaining the best and brightest – and let them do the work you hired them for?  Isn’t that the best method to accomplish your goal in a more effective and enduring way?  In his seminal work published in “Good to Great” Jim Collins says “The executives who ignited the transformation from good to great…first got the right people on the bus (and the wrong people off the bus) and then figured out where to drive it.”

You will notice this article does not contain a “to do” list, but a serious call to action.  So during your next strategic planning cycle as you start talking about facilities, revenue cycles, staff shortages, physician relations, or any other critical topics think about where our core value is added.  I hope you will agree it is in recruiting and retaining the best and brightest employees.  That is the best way to add long term value and lays the foundation for accomplishing all other strategic goals.

Tom Peters, “The Circle of Innovation” Alfred Knopf, Inc.  pg 65.

Michael E. Porter, “On Competition” The Harvard Business Review Books, pg 45-51.

Philip Kotler & Paul N. Bloom, “Marketing Professional Services” Prentice Hall, Inc., pg 60.

Harris Interactive. “Nurse Week/AONE Survey” Nurse Week, 2002

Jim Collins, “Good To Great” Harper Business, pg. 41

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