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Recruitment and retention strategies to cut turnover.

This first article in a four-part series on finding and keeping top-notch workers offers ways to identify candidates with staying power right from the start.

High turnover rates and the dwindling supply of professional and technical workers are prompting health care institutions and their laboratories to reevaluate retention programs. There are many good reasons for this.

*Replacement is expensive. Replacing a nurse, for example, costs from $2,000 to $50,000. A typical annual tumover rate for hospital nurses is 30 per cent-more than twice the average among 300 companies polled in a recent survey. Assuming an estimated cost of $10,000 for each nursing replacement, a 1,000-employee hospital with "only" a 20 per cent annual tumover rate would pay out $2 million each year. * Patient care can suffer. The impact extends beyond financial hardship to serious consequences for patient care. One critical-care unit had to be closed when its tumover rate rose from 30 per cent in 1982 to 77 per cent in 1986.

* Retention is better. The initial response to personnel shortages was to step up recruiting efforts, but administrators found that recruitment alone was only a quick fix. Once they realized that it is less expensive and less disruptive to retain than to replace, they changed their strategy. Many hospitals have now formed recruitment-retention committees. They hire coordinators to address thorough indoctrination, effective coaching, team building, and career development as well as devising proactive strategies for aborting resignations.

A retention program is most effective if you recruit employees who are likely to stay in the first place. Starting with a good team is essential to minimizing turnover.

Begin by asking yourself, "Why do our employees go elsewhere?" The answer may well be that their jobs are undesirable-although many managers prefer to believe that other companies areenticing their staffs away. This rationalization absolves managers from being accountable for departures. As proof, these managers may cite blameless letters of resignation or perfunctory exit interviews, at which the departing employee rarely speaks freely, concemed about jeopardizing good references or the opportunity to return.

An exit interview study by Zarandona and Camuso found that 38 per cent of employees listed unsatisfactory salary and benefits as primary reasons for leaving. In follow-up telephone interviews a year and a half later, only 12 per cent of the same employees cited those reasons as prime incentives for having left. In 24 per cent of cases, they retrospectively pointed to supervisory problems as the trouble-a dramatic increase over the 4 per cent who had cited this problem at exit interviews .

Supervisors blame top management for resignations. They identify non-competitive salaries, understaffing, objectionable work schedules, and other factors they conveniently consider beyond their control. Many supervisors don't realize they themselves are one cause of staff dissatisfaction. The main reason is that few employees have the courage to confront their immediate supervisors. Instead, they direct their ire at factors controlled by top management.

When employees say they are not appreciated by management, they are often talking about their immediate boss, not the CEO. According to Jenkins, the most common causes for dissatisfaction and quitting are an organization's lack of 1) talent development, 2) guidance, 3) trust, 4) involvement, and 5) objectivity and fairness. Supervisors tend to bear the major responsibility for these deficiencies.

Employees will tolerate tremendous adversity if they feel respected, can have their ideas implemented at least some of the time, and have a sense of belonging to their units. It's common for people who change jobs to tell themselves, "There must be a good place to work, where I'll be appreciated. "'

*Eight helpful steps. Address turnover problems as follows:

1. Ask yourself these key questions: Is there really a problem? When did it start? Which shifts or job categories are affected? How bad is it? Is it getting better or worse? Do signs suggest a morale problem? What are the underlying causes? How have we responded?

2. Determine the turnover rate for your organization, your department, and each shift and job classification. Normally, rates are higher for night shifts and non-exempt workers, such as phlebotomists and clerks.

Monthly turnover rates can be calculated with this formula:

Total resignations per month Average employee total

A few words of caution: If your turnover rate is low, that does not necessarily mean you have no morale problems. It may simply reflect a dearth of employment opportunities nearby. When many such opportunities exist, employees are usually less willing to tolerate dissatisfaction.

3. Consider the possible causes of a high tumover rate. Pay and benefits, work environment, location, parking, and other extemal factors contribute to employee dissatisfaction. Additional causes are a weak recruiting and selection process, inadequate orientation and training, and lack of supervisory support.

4. Information from new hires or job candidates can be an effective tool to help you analyze tumover problems. Ask what attracted them to the job. For new hires, ask what they have liked or disliked about the job and the workplace since they began to work there. Other useful sources of information are exit interviews, talks with employees who request transfers, and recruiters or recruitment-retention committees.

5. Compare the financial incentives and fringe benefits offered by your organization and its competitors.

6. Reflect on the ways in which you usually promote jobs to candidates during pre-employment interviews.

7. Study your indoctrination process and determine how it affects new hires.

8. Take stock of your coaching ability and team-building skills.

* Your role. A good recruiting program can reduce motivational problems, turnover, and payroll costs. Supervisors can play an important role in the selection process by insuring that the recruiter or human resources department has an accurate profile of the exemplary candidate. Make sure attractive features of the job are highlighted.

The more specific the advertising information, the better the chances of a good job fit. Overand underqualified applicants are high risks. This danger is minimized when recruiters have a realistic understanding of the necessary qualifications.

Supervisors can help by recommending special advertising channels, such as specific professional journals. They can assist in screen ing candidates by telephone, especially for highly technical jobs, and even help find employment opportunities for candidates' spouses.

Supervisors can use their networks to publicize job openings; ask their staffs, fellow supervisors, and sales representatives to help in the talent search; and recruit at professional meetings. Also effective are participating in career days, talking to medical technology students, and hiring summer interns. Incidentally, candidates recruited by current employees are less susceptible to turnover than those obtained through other channels.

When screening resumes, look for similarities between the duties of the job and those the applicant has performed elsewhere. Focus on relevant experience, work and salary history, education, training, and accomplishments. Check for gaps in time, shot-term employment, and lack of progress. Past performance is the best predictor of future performance.

Industrial psychologists claim their tests can pick out the stayers, but others say such testing is overrated.

One practical screening test is to ask candidates to perform a task listed in the job description. Candidates for a position that involves teaching, for example, can be told beforehand that they will be asked to give a short lecture to a small group as part of the interview.

Since most health care jobs require team effort, Lone Ranger types who find it difficult to work in a group may be early dropouts.

* Early signs. Indications of tumover susceptibility are often evident in the pre-employment interview. Some job-hoppers are less mature and have lower self-esteem than those with more staying power. Others have a degree of ambition not congruent with anything you can offer.

Stop, look, and listen when discussing why the person wants to change jobs. Watch facial expressions and language. Be suspicious of job moves for minimal salary change. Observe such signs of immaturity as chronic dissatisfaction, inability to cope with stressful situations, and rationalization of failures. Signs of tumover susceptibility are listed in Figure 1. Figure 11 provides examples of questions that help exclude potential quitters.

* The whole truth. In selling the

job, give candidates a clear picture of what it will entail. The more accurate a person's expectations, the more likely that person will be satisfied after gaining firsthand experience.'

When there's a shortage of qualified candidates, the people you want can choose among several employers. Sales ability often determines who gets the stars. A list of external incentives is presented in Figure III.

On the other hand, if you oversell the job by concealing its disadvantages, making promises that won't be kept, or distorting the truth, the ultimate result will be a high turnover rate. To make matters worse, the disappointed employees who leave will spread the word. Your recruiting program will eventually suffer.

Be enthusiastic and persuasive, yet honest and sincere. Mercer makes a good point when he recommends that candidates be told not only what duties and responsibilities are involved, but also the kinds of behavior that will be expected.' Behavioral norms may include long hours, weekend assignments, callbacks, or travel.

Give candidates a tour of the department. Point out the positive features, including arrangement of workstations and equipment, library, and lounge. Indicate access to storerooms and key departments such as the emergency and operating rooms.

If your personnel smile a lot and seem relaxed, point this out. Introduce candidates to one or two key people. Would-be employees are usually impressed if they get to shake hands with the department honcho or a member of the executive staff. Let them talk to an enthusiastic employee-alone.

Return together to your office for a summation and ask the candidate how he or she feels about the job. If you sense genuine interest, continue with your promotional pitch. Using the position description as a guide, point out the desirable features of the job. If the person indicates a special interest, such as research or teaching, discuss what you have to offer in that area.

Try to include the potential employee's spouse in at least a part of the interview or at a subsequent meeting. A common cause of resignations is spouse dissatisfaction. Sixty-five per cent of American families now have dual careers; spouses' concerns about their own need to change jobs if the family moves should be addressed. State that you would enlist the help of your human resources department to find a suitable position for that person. You may already be aware of openings.

Discussions of housing, schools, and other community matters may be appropriate, although it's usually better to take these up later, after you have narrowed the group to one or two candidates. There is also usually more time at a second session.

If you can't answer certain questions about benefits and organizational policies, escort the candidate to the human resources department or to other staff members who are knowledgeable about such matters. Some "sales tips" are shown in Figure IV.

If it's appropriate, hold additional meetings. A good practice is to hold one interview before and one after obtaining an applicant's references.

Prepare a worksheet to evaluate and compare applicants. The form should include a numerical weighting system. An example of a practical form is shown in Figure V.

* Obtaining references. Telephone contacts are faster and better than letters for obtaining references because people are much more likely to verbalize negative comments than to commit them to writing. To avoid litigation, many human resources departments will only confirm what former employees have asserted in job applications. Employees other than members of the human resources department may not be permitted to respond at all.

Here are two tricks for getting around these restrictions. If the person you call says he or she is not permitted to give references, say, "That's too bad, because without them the candidate will probably not receive further consideration."

Another ploy is to say that all you want is verification of what the applicant has already stated. Then give the employee's answers from the interview and ask for confirmation.

Use open-ended questions. Instead of asking, "Is he a good team player?, " say, "Please give me an example of how he was a good team player."

* Worth the effort. Personnel retention efforts can be very cost-effective and often serve to prevent the disruptive consequences of employee turnover. A good retention program starts with a structured analysis of the problem to determine the major cause or causes of the situation.

Minimize a tendency toward high turnover by improving your recruitment and selection process. The next article in this series will address better indoctrination and coaching as retention strategies.
COPYRIGHT 1989 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1989 Gale, Cengage Learning. All rights reserved.

Article Details
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Title Annotation:part 1
Author:Umiker, William O.
Publication:Medical Laboratory Observer
Date:Sep 1, 1989
Previous Article:Effectiveness of medical treatment under scrutiny.
Next Article:Finance skills for the non-financial manager.

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