A few weeks ago, I had the opportunity to speak with two of our 2013 Talent Outcomes User Conference presenters, Frederick Morgeson, Ph.D. Professor of Management, Michigan State University, and David Szary, founder of LEAN Human Capital and the Recruiter Academy. In the presentation “Will They Stay or Will They Go Now? Understanding Turnover in Organizations,” Dr. Morgeson will be presenting on the science behind “hiring for fit” and how this leads to higher retention. David’s presentation, “Turning Hiring Managers into Raving Fans of Your Recruitment Organizaitons” will focus on how to quantify HR’s ROI in order to improve HCAHPS scores.

I decided to get them together to facilitate a conversation about their thoughts related to best practices to reduce turnover in healthcare organizations. Here’s what they had to say:twitter

What should healthcare organizations do to attract the right candidate?

Dr. Morgeson: One of the things that I know healthcare organizations have done is to look at their organization as a brand. Much like consumer brands, healthcare organizations need to do things to make their brand appealing. I think organizations should try to create a brand that will appeal to job applicants.

That brand should be driven by the mission and values of the organization. HR needs to figure out ways to communicate their brand to candidates through job postings and the career website. A lot of organizations will have textual information on their websites, but they should also have videos that include interviews with frontline employees and senior leadership. This gives applicants a realistic insight into the organization’s workplace environment and culture

David Szary: I agree with what Dr. Morgeson said. But I look at it from a the perspective of, “How do you become more of a sharpshooter with your sourcing strategy versus a shotgun approach?” Healthcare organizations need to identify who their top performers are and the characteristics that set the standard for new hires. 

I don’t think it’s inclusion, but it’s just being smart about your sourcing strategy. I think a lot of sourcing strategies are more of a shotgun approach– “let’s go get the message out,” but then you have to use assessment techniques to filter in high quality candidates. So a sharpshooter approach is another way to go find top candidates.

How do you think talent management technology for recruitment, such as applicant tracking software or assessments, can help to reduce turnover?

Dr. Morgeson: I think one of the things that can really help reduce turnover is to develop an assessment that is predictive of what leads to turnover or, alternatively, to retention. We know there are certain recruiting sources that result in higher retention rates. We know that certain kinds of people are much, for lack of a better word, stickier in organizations. In other words, they’re much more likely to stay than to leave. It’s a personality characteristic that one could look at.

There’s also background or biographical information about applicants that one could try to measure and tap into. Previous employment history would be an example. Existence of friends and family at the organization would also be predictive of lower levels of turnover.

David Szary: I think one of the things that I’ve been a big evangelist and advocate of around turnover is this idea of good turnover and bad turnover. We’re trying to reduce turnover, but if we made a bad hiring decision, and we don’t have a person that is performing well, for whatever reason, having that person is probably not best for the organization or for the individual. At some point, it’s going to cause stress on them and stress on the organization. I think sometimes we just look at turnover rates and low turnover does not always predict a high performing organization. You have to look at the regrettable hires that led to good turnover.

Whenever we talk turnover, I think we need to really look at it through that lens, because folks that aren’t working out for whatever reason, whether it’s a cultural mismatch, performance — a competency or skill mismatch — it’s healthy for them to go and for the organization to find someone that’s going to be a better match. 

Dr. Morgeson: I think that’s a great point, and one of the distinctions that we often make is, I’ll call it dysfunctional versus functional turnover, and so who is it that’s turning over? Healthcare organizations must have a sense of what kind of turnover they’re experiencing and what kind of turnover they’re trying to drive down through behavioral assessments or any kind of technology oriented initiatives. It’s very important, so you want to make decisions that will drive down dysfunctional turnover — in other words, turnover of good performers. Your main goal as an organization is to try to hire the best people and to keep the best performers. If, for whatever reason, you end up hiring lower performers, their departure is not necessarily a bad thing.

How do you think interviews should be structured to thoroughly assess candidates’ behavioral and technical competencies? Is there any certain format you think works best?

David Szary: My expertise isn’t in validated assessments, but how do you create a mood conducive to transparency in the discussion if it’s not a validated statistical tool? There’s a million and one books written on how to ace the interview on the candidate’s side, and there’s a million and one books written on how to give a good interview.

I think oftentimes we go into what I’ll call an “interview format” versus a “professional discussion.” I think the best thing I had going for me early on as a recruiter is, I had no classic education or training whatsoever on interviewing, and my style was very laid back. I think my approach was — and still is, “I just want to get to know you.” This isn’t about right or wrong or good or bad. It’s about a position and the skills and competencies that that person must possess to be successful within an organization and a given job.

I think whenever you can get into a professional discussion, as opposed to an interview– it can allow for more transparency and open dialogue between a candidate and an employer. Unfortunately, I think sometimes we get too rigid around the interview process. “We have our interview guide and we have our ratings system,” and I see candidates tense up, — you’re not getting honesty in the dialogue. 

Dr. Morgeson: I’ve done a lot of work in the structured interview domain. My take on this is that there are a lot of different ways in which one can structure the interview. I don’t know that there is any one best way, at least the research evidence doesn’t suggest as such, but what the evidence is really clear on is that you need to structure the interview in some way. I’ve really looked at the different components of structure and the different ways in which you can structure an interview.

I’ll talk to just a couple of these. One is to use questions that tap into job related aspects or whatever it is you’re trying to predict. If you’re trying to predict who’s going be a good performer, or who’s gonna stay in a job, or even who’s going to deliver good customer service or deliver a positive patient experience, you have to make sure that your questions are tapping into the underlying competencies that lead to these desired outcomes.

Typically, I suggest two types of questions: Past behavior questions, such as, “What have you done in the past?” That really relies on the idea that your past behavior predicts your future behavior. Healthcare organizations can also use situational or hypothetical questions which is asking candidates to say what they would do in a given situation in the future. Using questions that predict important organizational outcomes is a piece of structure that’s important. 

I think another really big piece is to have a highly standardized process where candidates are treated similarly. Their answers are evaluated similarly across interviewers and you use multiple interviewers. These are all key elements of structure or standardization. I liken it, in the medical context, to standardization in medical procedures. Yes, there’s variability in patients. If you’re going to do surgery, or if you’re going to treat a patient, every patient is unique as is every job candidate. You would want a set of standardized processes and procedures governing a given surgical procedure but you have to adapt to each patient. Much in the way that we would sort of strive toward standardization in health care settings, we would want to do the same in hiring settings. 

How do you think a consistent interview process helps recruiters and hiring managers identify the most qualified candidate?

Dr. Morgeson: Absolutely. The evidence is crystal clear. When you have a well developed, structured interview, it is amongst the best predictors of employee job performance. Literally hundreds of studies have been done that show that that’s the case. The interview is an interesting phenomenon, because it’s probably the one thing that every employer uses. It’s so widely used and not often done well. Structuring it is one of the keys to finding out who’s going to be a top performer.

Are there any other recruitment best practices that you think will help in reducing turnover or any other techniques that you’ve seen used in organizations, whether they be healthcare or not?

Dr. Morgeson: Using behavioral assessment techniques can be used to figure out who’s going to be a good performer and who’s likely to stay. Healthcare HR teams must then figure out ways to manage their entry into the organization. This is especially important during the critical first two or three months of their time in the organization. HR and hiring managers need to make sure new hires are on board and socialized into the organization in an effective way. 

David Szary: I would agree. Recruiting is a simple concept,  that’s not very easy to do. HR teams must ensure that they have transparency with candidates, make sure they understand the organization’s culture and what is expected of them to be considered successful.


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The Editorial Staff is a team of writers with a passion for helping healthcare organizations manage their biggest and most important investment: their employees.