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Everyone Needs To Be Accountable

February 15

The mid-term elections reminded us that everyone is accountable—even the President of the United States. We answer to shareholders, or to sales goals, project quotas and productivity measurements. But there has always been a great deal of pushback when we talk about needing to measure the productivity of healthcare recruiters.

There are several reasons for this, including the fact that healthcare delivery, in large part, has not been held accountable. It is hard to draw a line of accountability when healthcare is often times faith based and intertwined with charity, when healthcare provides service to basically anyone with or without the ability to pay, and when we consider that the service being provided can be the difference between life and death.

And then there is the knowledge that healthcare recruiters have, at least in the past, a very difficult job. Supervisors were almost embarrassed to question recruiters when they were overwhelmed with requisitions, dealing with demanding and difficult hiring managers along with a shortage of skilled workers. Recruiters were perceived as working harder than most and caught in a world with so many variables it would be almost criminal to thrust quotas into the mix. Is it harder to hire a physical therapist than a staff RN? What about a charge nurse or a critical care RN on the night shift? There were salary bands to consider, and a mix of benefits along with the location of a facility. Should we consider the type of hire or the quality of hire? And how can you measure people anyway? They move, spouses are transferred and children are born.

Healthcare Reform, along with eventually 38 million more insured customers, demands that everyone and everything within healthcare delivery be measured - including recruiters. High unemployment numbers continue to plague the slowly improving economy, so vacancy rates within this country's healthcare providers continue to be at the lowest point in decades. Now is a perfect time to consider recruiter measurements, not because the bulk of the recruiters are not working hard, but because they are. And because you owe it to those who are working hard not to have to carry the load of someone else.

There are variables in most things which are measured. A charge nurse is the most difficult hire in today's environment, and physical therapists will be the most in demand. But hardcore sales people will tell you some sales are easier than others and it all balances out eventually. People move, but once a sale is made, budgets are cut and sales canceled. Life is full of variables. Human Resource executives need to build the fairest possible set of measurements, considering the variables and unique challenges of the individual facilities and then celebrate those who excel and deal with those who do not.

Like it or not, healthcare recruiters are sales people and as the economy recovers they will need to be more skilled than ever. Since 63% of every dollar that passes through a healthcare delivery system is attached to salary, wage and benefits, there is no line item more important than the "people" line item.

Every day a RN position remains open, it costs a healthcare delivery system approximately $279.68. Multiply that by 20 openings and you have $5,593.60 per day, and multiply that times 15 more days and it's $83,904. Reduce your days-to-fill on just 20 RNs and you can save enough to hire another recruiter. Measurement cuts both ways—it paints the picture of who is producing and who is not, but is also can build the case for easing impossible work conditions. Measurement can demonstrate how some recruiters are set up for failure because they work in impossible situations.

Generally, RNs should be at a 3:1 ratio to qualified applications to hire. Allied Health positions and semi skilled should be hired at a 5:1 ratio and entry-level (because of the necessity to read and write and pass a drug screen) is 10:1. Fourteen RN hires a month is the national average. That average is much less for pharmacists, rehab professionals and job categories with fewer openings. A recruiter with professional openings shouldn't have more than 30-35 open positions, and a recruiter with entry-level openings shouldn't have more than 60-65 openings. You should have, on national average, 1.2 FTEs of recruiters to every 1,000 employees along with .6 FTEs of administrative support.

There is no question that for-profit facilities almost always measure their recruiters and they tend to be much more productive. The not-for-profits look at the concept as nearly impossible. Days-to-fill, number of hires, types of hire and how long those hires stay should all be part of the mix. Healthcare recruiters can and should be measured. Those who are cranking it out, making the calls, fostering the relationships with the hiring managers, getting back to the applicants quickly are the ones who should be rewarded. Otherwise it is too easy to fall into the pattern of "I'm doing the best I can and that call can wait until tomorrow" and tomorrow and until the candidate is gone.

Put up a bell to be rung when a sale is made, post goals made and missed, provide incentives, do whatever it takes. Managing the people factor within healthcare delivery will mean the difference between keeping the lights on or closing the doors. Accountability is a good thing.

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