Avoid Dire Hires: ASC Administrators Reveal Innovative Hiring Strategies
Question: What are the qualities you look for in a candidate for a staff member position at your ASC?
John D. Brock, NorthStar Surgical Center (Lubbock, Texas): One of the big things we look for is the ability of the individual to work independently. In ASCs, you don't have the means to supervise staff the way you do at a hospital and so we need people who are skilled and can work independently.
Also we look for a person with a good personality. We want everyone, physicians, employees and patients, to have a good experience, and the experience is the staff. They are what give us the competitive edge and so their personality and demeanor must be pleasant.
Cindy Young BSN, RN, CASC, Surgery Center of Farmington (Mo.): When hiring nurses, I look for previous surgical experience, intensive care unit experience or postoperative recovery room experience. I do not hire graduate registered nurses or an RN with less than one year experience in a clinical setting.
When it comes to surgical technologists, I only hire people who have previous experience in a hospital or surgical center setting or those who graduated from a surgical tech school. The surgery center environment is very fast and we have found it difficult for people with no experience to learn even the basic duties.
For business office personal hires, I look for someone who has excellent communication skills and who has previous office experience. If we cannot find a candidate with previous experience we look for candidates we feel are trainable. This is not something you find in an application; it is something you find during the personal interview.
Martha Colen, RN, MBA, CASC, Virginia Beach (Va.) Ambulatory Surgery Center: When hiring any staff, whether clinical or administrative, one of the most important qualities we look for is flexibility. Not only must your new hire have the requisite work experience, education, training and credentials, but they need to be able to adapt to the many variables we deal with in the ambulatory surgery setting on a daily basis, ranging from variable work schedules to fast tracking.
The second most important quality we seek in applicants is emotional intelligence. These are individuals who demonstrate self-awareness, empathy and are able to realistically identify their strengths and weaknesses. The third quality we place importance on is work ethic and an inherent desire to "do a good job." Put these together and you get a high performing, adaptable, great team member and care provider, whether in the OR, PACU or at the registration desk.
Q: What are some challenges you have faced when hiring ASC staff?
Angie Blankinship, BSN, BAA, CASC, Longmont (Colo.) Surgery Center: The biggest problem is that often you don't find the people who have the skills and education you need. It seems as though so many people are out of work. In fact, we have had engineers apply for scheduling or front-desk positions. Just finding the right person and lining them up for the right job is a challenge.
Longmont is a small town, though. My best source of finding new hires is the newspaper.
Ms. Young: Even though the person has excellent references, perfect qualifications and has an amazing interview if they do not fit, personality-wise, with your other staff and physicians they don't work out.
We overcome this by attempting to match applicants we feel would be good candidates with current staff members. This does not always work and you don't always get enough applicants to consider this technique.
Q: Have you hired from the inpatient setting? If so, what are the challenges you faced?
Ms. Colen: We look for individuals who have had prior experience and subsequently we often interview nurses who come to us from the inpatient setting. Salary ranges for RNs in ambulatory surgery appear low in comparison to inpatient pay scales for nurses, who are able to earn differential pay for evenings, nights and weekends and time-and-a-half for holidays. The challenge is that individuals coming from the hospital setting may perceive that they will be getting a pay cut if they go to ambulatory surgery.
We address this up front and discuss the overall benefit package in financial terms to help the applicant see the true value of taking the position. We offer annual bonuses for financial and quality performance and address the potential bonus earnings upfront when we extend the offer. We also have a healthy benefit package that we put a financial value on for the individual. Add that to the quality of life and great work environment in our ASC and we are usually successful.
Ms. Blankinship: The environment in an ASC is very fast-paced and we flex our staff according to the schedule. It may not be as consistent as it is in a hospital. So I have a conversation with potential hires about that because I want them to know beforehand. I want to see if they can handle the pace and scheduling.
Q: What are some of innovative hiring and retention strategies you use?
Ms. Blankinship: In our ASC, the staff has been there for years and years. Sometimes it's difficult for a new person to fit into the team. Sometimes I hire them per diem and not permanently. It gives me time to see how they fit in with the team and then decide whether to keep them on permanently.
Also, while I interview all potential hires, we have a committee of staff members who interview the candidate. They have been here for so long and have their own questions.
Ms. Colen: We have employed several creative ways to staff our center to get the job done, to retain great staff and to keep compensation costs under control. Because our case volumes vary from day to day and week to week, one day we may need the full staff on the schedule, and the next may be so light that we only need a few.
One of the things we have done is ensure that all clinical staff positions are variable. As long as the staff works the minimum number of hours required, they will earn all their benefits. Full time minimum work/pay requirement is 72 hours per pay period and part time requirement is 32 hours per pay period. This way we build flexible scheduling into the hiring process.
Also, whenever possible we hire "per diem" nursing staff. Per diems must work a minimum of 16 hours a month. Many per diem staff are hired with the expectation that they may work short or partial shifts to provide the necessary coverage at peak hours. This is ideal for nurses who do not need full-time work — who may be raising a family or who do not want the demand of a full eight hour shift.
Q: Is there a question that you always ask during hiring interviews?
Mr. Brock: One question I ask is: "How would hiring you benefit our organization?"
Often many candidates come in focusing on what they are going to get out of a job here rather than what they can bring to the organization, which is what they should be focusing on.
Ms. Blankinship: I always ask them if they enjoy doing what they are doing. You can find a lot about a person from that.
Ms. Young: One question I always ask is: "Have you ever had a problem with a co-worker or a boss? If so, how did you know there was a problem and how was it resolved?" Many times people will open up and spill the beans. One applicant told me, "I really don't get along with people so I keep to myself and really focus on my job." This told me she was not a fit for our facility if she couldn't get along with people.
Other questions I ask are: "Why should I hire you?" and "What experience do you have that will make you a great candidate for this position?" Many times people apply to every job available not knowing what they are even applying for.
Q: What are some common mistakes to avoid during the hiring process?
Mr. Brock: Not doing your homework on a candidate by calling past employers and doing background checks. Also be thorough in the time you spend with the candidates and get all the information you need.
At times you should have certain physicians sit in on the interviews depending on what position you are hiring for.
Ms. Young: Never ask a person if they are married, how old they are or if they have children. If you do not hire them you could face possible charges for equal opportunity discrimination.
Ms. Colen: First and foremost, do not rush to hire just to fill the position. Too often the urgency to fill the position obscures our better judgment. Hiring the wrong person for the job results in a lot of wasted time and energy on your and everyone's part. Finding the right person is much more important in the long run.
Another mistake to avoid is not checking references and verifying how they know the applicant. Always get the applicant's permission to check references and speak to them directly.
Finally, not evaluating the applicant's skills and abilities to do the job is a mistake. Depending on the responsibilities of the position, this may require having them demonstrate to you how they perform. If you are hiring a coder, give the person several operative reports to code. If you are hiring a sterile processing department person you may want them to come in to speak with the SPD staff about technique.
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