Staff Recruitment and Retention

When the discussion turns to hiring, recruiting new staff, whether it is for a professional or administrative position, there has to be a process.  You need to do all you can do to effectively prepare for the hire and ensure legal compliance.  Whether you are hiring to fill a vacancy or increasing staff due to growth, this is the best time to stop and look at what your current staff is doing as well as the practices real needs.

While you should consider how an additional employee will affect your payroll, you also need consider ways to reorganize in an effort to improve efficiencies at all levels.  For example:  maybe an upgrade of software will save enough time to eliminate the need to hire or replace staff; an assessment of the strengths and weaknesses of each staff member could help in deploying staff differently – putting employees where their strengths will allow them to excel and give you higher productivity.  You need to understand who and what it is that will help in moving your practice forward.

In planning for a new hire these are some of the things to consider first:

·         Is this hire for a short or long term – is this just because you have been busier than usual for a month or for a long period of time?

·         Would a consultant or other professional be able to help assess your business, reorganize your staff or maybe complete a project and eliminate the need for a full or part-time staff member?

·         Consider the cost of hiring a full-time employee versus using other alternatives – temps, per diems etc.

·         What needs to be done?  Can current staff absorb the job responsibilities?

·         Can you change current staff schedules to meet the needs of the practice – put staff in at times when it is most beneficial to treating patients, billing, collecting, etc.

·         Do you have the right “tools” for your staff to be as efficient as possible?

·         Do you need someone full or part-time?

·         What will the responsibilities be?

·         What skills and/or education will be required?

·         What costs will be associated with this hire?

·         Who is best suited to write and place the ad?

·         Where should we advertise – paper, internet, local schools.

·         Who will review resumes?

·         Who is best suited to do the phone, first and second interviews?

·         Who will check references?

·         Who will be involved in the final decision of who to hire?

·         Who is best suited to orient and train the employee?

 

 Let’s look at calculating the cost of a full-time employee.

Time:

                Number of hours worked by a full-time employee for a year = 2,080

                2,080 minus total hours of holiday time (6 holidays X 8 hours) = 48

                2,080 minus total hours of vacation time (10 days X 8 hours) = 80

                2,080 minus total hours of sick time taken (2 days/year X 8 hours) = 16

                2,080 minus other non-productive time (15% X 2080) = 312

                2,080 hrs minus (Holiday, vacation, sick, non-productive time) 456 hrs = 1,624 hours worked

  Costs:

                Costs of a full-time employee (first year)

                Annual Salary of $50,000

                Add legally required deductions (FICA & other employment taxes)

                Add hiring and training costs

                Add benefits

                Add pension/profit sharing

                Add miscellaneous costs

Equals total yearly costs

               

Example:               Annual Salary                                                      $50,000  ($24/hr)

                              Ad Benefits & legal required costs 30%              $15,000

                              Add other expenses of 20%                                $10,000

                                  Total annual cost of first year employee     $75,000

 

If you take the total cost of a first year employee and divide it by the total hours worked in a year – 2,080 you will get the hourly cost of the first year employee.  In the example above, the hourly rate is $36/hr.

Learning to calculate the cost of a full time employee will make it easier for you to truly evaluate the need for the new hire and whether or not your revenue will be able to support it.  This is the reason for looking at what needs to be done and determining if it would be better to reorganize, outsource or find temporary help to get through a tough period. 

It can be beneficial to align yourself with one or more temporary agencies or professionals who would like to work on an as needed basis.  Give them your job descriptions and use them when you have someone out on a leave – pregnancy, vacations etc.  This will help keep your business running at peak performance – no down time.  Be prepared and plan ahead.  You can also use temporary employees to work while you are hiring a full-time employee – sometimes your temp works out so well that they may want to apply for the position and since you have had the opportunity to really work with this person you will know if it will be a good fit.

Job descriptions are a valuable tool in the hiring process.  A good job description will identify the skills, educational requirements and other qualifications necessary to do the job.  They should validate and help establish performance standards.   Performance standards are essential in evaluating an employee’s job performance.  Each job description provides information needed to establish wages appropriate for the job. 

When writing a job description a good place to start is by asking current employees what needs to be done.  You can add to or delete from job descriptions as necessary to insure that the end result really identifies what the job involves.  Once you have clearly identified the job, summarize what the job is and then list the fundamental functions, other responsibilities and education, experience and/or skills required.

Job descriptions do not need to be all-inclusive.  They should be clear and concise.  While it’s not necessary to include responsibilities that are seldom performed, they should include a statement that allows a supervisor to “assign other duties as necessary”.  

When advertising for a job you must be sure to identify the most important job responsibilities.  Highlight what is most unique and distinctive about the job.  Why would someone want to work for you versus someone else?  What sets you apart from all the other practices advertising for the same job?  Is there room for growth?  Is this the best place to pursue a career?

Don’t make promises you can’t keep.  Be specific about the responsibilities of the job and the qualifications.  Identify the type of personality you are looking for – energetic, athletic, organized, multitasker and education required, license required, etc.  List the benefits including growth opportunities.

Be CREATIVE in where to place your ad – where will you get the best audience?  Some suggestions for placing your ad include:

·         In-house/employees

·         Newspapers

·         Professional magazines/newsletters

·         Internet

·         Friends, colleagues

·         Consultants

·         Recruiters

Since a resume can only give you limited information on a candidate, look for ones that best relate to the position you are hiring for, the job specifications and/or those that appear to have potential for learning.  Some of the things to note are: education requirements, job history - how long at each job, experience, and most important the presentation and grammar of the cover letter.

A phone interview is a great way to do a preliminary interview, save time and help you choose which candidates are worth bringing in for a personal interview.  Call to schedule the candidate – let them know what the interview is for and how long it will take.  Make sure you schedule phone interviews at a time that is convenient for the candidate and when they can talk privately and uninterrupted.   When you call to interview discuss the basics of the job, potential for advancement, hours of work, and their salary requirements and then clarify anything on the resume you may have questions about.

For those candidates that pass the phone interview call and schedule a personal interview.  When they come in, give them an application to complete.  Note the time it takes for them to complete the application.  While you review the application and resume again, give them the job description to look over.  When you finally get them in for the interview ask if they have any questions regarding the job description.  Give them some history about the company and the benefits of working with the organization.  Ask questions that will reveal their past experiences.  Give them some scenarios that you know they will experience if they get the job and ask how they would handle such situations.  Listen to the answers.  An interview is to find out more about the candidate not to reveal more about you.  You can also ask questions about people they like to work with and don’t, what their short and long term goals are and why they think they should be considered for the job.  Go over salary, benefits, start date, hours, the orientation process and if necessary, review any confidentiality and/or non-compete issues.

Be sure to ask for references – name, addresses, and phone numbers - and check them before offering a position to an applicant.  Ask for former managers (they may not be able to give you current one) and co-workers.  Have them sign a statement giving permission for the references they have provided to give an oral reference.  When you call references give them a brief description of the job the candidate has applied for.  Keep the discussion focused on what the candidate told you about the job with that reference.  Ask if expectations were met and based on the job they are applying for what would be best for you to focus on regarding training.

You can always ask a candidate back for a second interview to discuss the job position in more depth and go over the orientation and training they will receive.  Once you have made your decision to hire a candidate call and make them an offer – go over what you have previously discussed and confirm the salary, benefits, start date, hours to be worked, orientation process and, if necessary, the confidentiality and/or non-compete issues.  Follow-up with a letter confirming the above and ask them to acknowledge their acceptance by signing and returning the acceptance letter.

Now that you have your new employee, let’s discuss how to retain them.   You have already invested a good amount of time and money recruiting the right person so the orientation process including training and development is crucial to their and your success.  Make sure plenty of time is spent with the new hire.  You should have a well developed, outcome driven orientation program which includes training and development.  Your plan should include who will be doing the training, what the training will involve and the time frame in which each function should be accomplished.  A positive orientation will reinforce to the new employee that they made the right choice.  Introduce them to all staff, take them through the entire facility and show them where everything is including lunchroom, restrooms, first aid kit, etc.  Have them complete all new employment documents including an I-9 and W-4 form and benefit applications.

Typically, orientation periods are 3 months/90 days.  This allows the employer and employee the time to get to know one another and to determine if this is the right fit for both.  Discuss the orientation period and what will take place over that time.  Establish the employer’s and employee’s expectations.  Review the job requirements and performance standards and the time in which you expect each function to be accomplished.  Stick to your orientation plan.  Again, this will establish a positive experience for the employee and help insure their commitment to your organization. 

Be sure to do performance reviews periodically during the orientation period, at six months and then yearly.  Hold staff accountable by using the performance review process to identify areas that are strong and those that need more attention.  Set goals for the coming year and give them the tools to help them reach those goals.  Give each staff member the opportunity to do a self review before you do their annual review.  This will allow you to better understand what the employee believes they have worked on over the past year.  Performance reviews also show that you care about what your employees have accomplished over the past year.  

Once new employees have completed their orientation period it is an owner’s responsibility to keep them motivated.  Introduce new staff to your referral sources and the community.  Get staff involved at all levels.  Ask for help in establishing new programs and services.  Make sure you recognize anyone who makes an extra effort to improve communications and deliver quality care and service. 

Creating a positive environment takes a powerful leader.  Share your vision and mission.  Show you are a true TEAM leader.  Be open to new ideas and new ways of doing things.  Plan staff meetings to keep everyone up to date on what is going on in the practice.  Listen and learn.  Change can be difficult for many employees but a strong leader can ease the stress of change and, in fact, make it desirable. 

Your leadership, encouragement and strong employee relationships are essential to protecting the investment you have made in your staff.  Set the bar high – continually encourage participation to reach your goals.  As success finds you, you will be able to give back to those who helped get you there.  

 

 

Diane McCutcheon,
Business Management Consulting Services, Inc.
Account Matters - Billing & Collection Services
4 Charlesview Road, Suite 4
Hopedale, MA 01747
508-422-0231

diane@dmbmcsi.com