July 2003
In the late 1990s, the high turnover rate in Anne Arundel
Medical Center’s radiology department was a significant human
resource (HR) challenge. Today, the department has a low turnover rate of 6.5
percent, and a comfortably large applicant pool. According to Human Resources
Vice President Joyce Phillip, the explanation for the turnaround is a focused,
proactive, and personalized recruitment effort—much of it on the part of
HR generalist Priya Jagannathan.
Over the past four years, Jagannathan has partnered with
radiology department leadership to recruit and retain high-performing
technologists. “Because we like to promote from within, we look for
candidates with qualities that go beyond just a degree and a license,” she
says. The policy pays off: “One of our first new-grad radiologist hires is
now a senior CT technologist,” she notes.
Jagannathan has wooed potential radiology technicians and
other imaging specialists with a savvy combination of “soft” and
“hard” recruitment approaches—to use HR terms. That is, with
careful attention to the nuances of relationship-building, as well as to such
concrete facts as supply-and-demand-driven competitive salaries for the field.
Jagannathan often employs both soft and hard tactics in a
single outreach effort. An example is the first step she took in putting Anne
Arundel’s radiology department recruitment back on track: Making phone
calls to previous employees to see if they were interested in returning to the
department. After she described the changes the department had made, from
flexible scheduling to a closer match with marketplace salary levels, a
surprising number said “yes”—the grass in their new environment
had not been so green after all.
Jagannathan’s lack of health care experience made
recruiting difficult at first. Backed by a Master’s degree in Human
Resources, she had worked for an American manufacturing firm in India before
coming to the U.S. However, a productive collaborative recruitment effort
evolved, built on strong support from mentors—both within the radiology
department and in the hospital more broadly—and knowledge gleaned from
helpful radiology experts. In fact, Jagannathan is now “passionate”
about her work, says Phillip. Under Phillip’s supervision, Jagannathan has
launched or enhanced an array of successful recruiting and retention approaches
(which helps explain why the Medical Center’s vacancy rate is nearly 10
percentage points lower than Maryland’s average of 16.1 percent). These
approaches include:
- Sign on bonuses ($1,500), combined with competitive
salary levels and two semesters of tuition reimbursement, both for new grads
and current employees who want to enhance their skills.
- Flexible scheduling, which Jagannathn cites as the
department’s most popular benefit.
- Careful attention to the niceties of a potential
hire’s first visit that make the experience a personal one. This ranges
from accompanying the candidate to the interview location to supplying
information on local housing and how to apply for a Maryland license in the
applicant’s specialty.
- An open-door management approach, which encourages new
hires to talk with their directors about any problems in their work and to
speak with staff more generally about ways to improve patient and physician
customer service.
Jagannathan sums up why she has been successful in
recruiting scarce imaging technicians by noting that she is guided by the
long-term vision of the radiology department. This helps her be proactive in
her work. If the department’s services are expanding with the addition of
a PET scanner, she starts looking for the technicians needed to operate it.
And, it makes for a more productive relationship with recruiters. “Keeping
the department’s long-term goals in mind helps recruiters understand what
we’re looking for in applicants,” she notes.
This combination of a business-like approach and thoughtful
people skills no doubt helps explain why all of the new graduates hired since
Phillip and Jagannathan began their focused and proactive recruitment effort
are still with the Anne Arundel Medical Center.
Contact:
Priya Jagannathan
HR Generalist
Anne Arundel Medical Center
2001 Medical Parkway
Annapolis, MD
21401
Phone: 443-481-1959
e-mail:
pjagannathan@aahs.org
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As King Arthur discovered in his Camelot, a roundtable is a
good tool for giving meeting participants an equal say in planning how to reach
a common goal. He would no doubt be pleased that the roundtable concept is
alive and well in Charles County.
The common purpose at this roundtable, however, is not
chivalry, but speaking with one voice about the many benefits of a health care
career—and the many settings for that career. These settings are
represented by Healthcare Roundtable participants, from school health to
assisted living; home health to acute care. This broad base is the reason the
roundtable is working well, says Christine Stefanides, CEO of the county’s
sole provider hospital, Civista Medical Center and roundtable participant.
“The roundtable is successful,” she says,
“because a continuum of health care providers is involved. It is more
typical for health care providers to meet only among themselves, whether health
departments, health educators, or home health agencies.”
Founded two years ago by the Charles County Economic
Development Commission, the roundtable’s consistent message, combined with
state efforts, is already having an impact. Stefanides reports there were 55
graduates at last month’s nurse pinning ceremony at the local College of
Southern Maryland—the highest number in five years.
In addition, Stefanides sees an increasing number of junior
and senior high school students interested in health care careers. She
attributes at least part of the rise to the Nursing Unlimited clubs that the
roundtable helped launch in county middle schools and high schools.
When high school club members came to Civista to get a
first-hand look at nursing, Stefanides was impressed by how well they grasped
the concepts behind nursing. “They picked up on the level of caring and
compassion that nurses bring to their relationship with patients,” she
says. “One young woman who had been thinking of becoming a physician said
she now thought that nursing may be the place for her.”
The Healthcare Roundtable is the result of Economic
Development Commission efforts to create more jobs in the county. Currently,
about 60 percent of employed residents work outside the county, which is among
the fastest growing in the state. Among other industries, the commission is
targeting health care as a source of new jobs for county residents.
The roundtable’s focus extends beyond students; recent
retirees are a second target audience. “The county has designated October
as ‘health career month,’” says Stefanides. “We’re
planning activities for this fall that reach out to retirees who may be
thinking about starting a new career. We’ll point out that health care
makes a good second or third career.”
When asked what she sees in the roundtable’s future,
Stefanides describes a broad-based competition that will culminate in an awards
dinner next spring. Planning is already underway; the kickoff for nominating
outstanding health providers in eight categories will take place during this
fall’s health career month. In addition, an overall “health care
hero” will be selected—the kind of person who no doubt would have
felt right at home among the dedicated knights of Camelot.
Contact:
Donna Gray
Executive
Assistant
Civista Health
P.O. Box 1070
La Plata, MD 20646
Phone:
(301) 609-4265
E-mail: donna.gray@civista.com (Back to the top)
When it comes to increasing nurse managers’ visibility
to their staff, small hospitals definitely have an advantage. That is the firm
opinion of Denise Liston, vice president of Clinical Services at Garrett County
Memorial Hospital, where hospital and subacute care census numbers typically
range from the 30s to the 40s.
“At large hospitals, nurse managers have a heavier
administrative load, which can keep them from working with their nurses in
direct patient care,” she says. “At our hospital, nurse managers make
a point of providing some aspect of direct patient care almost every
day—whether it’s working ED triage, circulating in the OR, or
supporting a mother in labor. They provide models of excellence for their
staff.”
Liston says that while Garrett County’s size dictates
that nurse managers maintain excellent clinical skills, over the past year the
hospital has highlighted their role in demonstrating clinical excellence and
dedication to going the extra mile for patients.
“Nurses know their manager is there to back them
up,” says Liston. She cites as an example the particular skill of the ER
and acute care managers in inserting PICC lines and mid lines. “In
difficult cases, they may come in from home to help.”
Spotlighting nurse managers’ supportive roles
complements other efforts Garrett County is making to enhance nurse recruitment
and retention. For example, the hospital has used funds from a state Nurse
Support Program (NSP) grant to upgrade the orientation program for nurses.
“In the past, we didn’t mesh the schedule of a
newly hired nurse with a single staff nurse who could serve as a consistent
model and contact during orientation,” says Liston. “One day the new
hire might be with nurse A and the next with nurse B. The problem was that the
two nurses often had different approaches, and we ended up confusing the new
hire.”
Now, explains Liston, a new nurse spends at least one week
with the education coordinator, who is responsible for education programs
hospital-wide. The new hire still sees different hospital departments, but
under consistent guidance. “And,” adds Liston, “we get a better
sense of the new nurse’s skills.”
The Nurse Support Program grant also allowed Garrett County
to hire a nurse on a part-time basis to travel to local high schools and middle
schools to speak with students about a nursing career. The hospital created a
one-day Shadow-a-Nurse program that allows interested students to see firsthand
what nurses do. In addition, the hospital has started a nurse extern program
for nursing students who have completed at least one year of nursing school.
And Garrett County has become a clinical rotation site for local residents who
study nursing at Allegany College in Cumberland, which saves 50 miles of
driving time. Liston estimates that the hospital’s capture rate from these
nursing-student programs is roughly 75 percent.
But it is the nurse manager’s supportive role in direct
patient care that Liston believes is most important to nurse retention.
“Our staff see that the manager truly understands what it means to be a
nurse in our hospital,” she says.
Liston adds that even large hospitals can learn from Garrett
County’s example: “Management by walking around—showing that you
are willing to work shoulder-to-shoulder with staff—is the best motivator
any manager can use. It generates tremendous team spirit.”
Over the past year, Garrett County’s positive results
include a drop in turnover rate for its staff of nearly 90 RNs from nearly 17
percent, down to just over 7 percent. Liston cites the most recent Human
Resources staff survey as additional evidence of an improved environment for
nurses: “In the past, our nurses have voiced the greatest number of
complaints. This year, there were no nursing complaints.”
Contact:
Denise Liston
Vice President of
Clinical Services
Garrett County Memorial Hospital
251 North
4th Street
Oakland, MD 21550
Phone: (301) 533-4000
E-mail: dliston@gcmhmail.com
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Because Elaine Holman, director of the Hospital Learning
Department at North Arundel Hospital, is certified in both staff development
and continuing education, she is well aware that the current literature
describes the ideal role of a nurse manager as “chief retention
officer.”
But because Holman also has 35 years of nursing experience,
19 of them as a hospital department director, she knows that nurse managers are
so burdened with paperwork that their time to counsel nurses who are close to
burn-out—and thus close to resignation—is severely limited.
That’s why Holman included funding for six nursing unit
“administrative coordinator” positions in the hospital’s
proposal for a state Nurse Support Program (NSP) grant, which was awarded in
January 2002. “We recognized that if nurse managers are to serve as chief
retention officers, we needed a support mechanism to help them with clerical
functions,” she says.
Two of the administrative coordinator positions were filled
in July 2002 (in the ICU/CCU and the ED), and results are already evident:
goals to sharply reduce the percentage of the nurse manger’s time spent on
clerical tasks have been met (from 42 percent to 5 percent), as have goals to
increase time devoted to coaching, mentoring, and retaining staff (from 10
percent to 57 percent). Holman attributes much of this success to the excellent
work of the two people filling the administrative coordinator positions.
Just how capable the coordinators have become was
illustrated recently when one of the two nurse managers they support was called
away for several days because of a family emergency. While the manager was
gone, the assistant continued to promptly distribute staff notices and process
mail and phone messages, which meant the nurse manager had a less stressful
re-entry.
More tangible evidence for the benefits of giving nurse
managers time to counsel and coach their nurses is a drop in nursing staff
vacancy rates for both the ICU/CCU and the ED. When the grant was awarded, the
ICU had a 4.2 percent vacancy rate; it is now zero. The ED vacancy rate had
been 12.6 percent; it is now 2 percent.
Holman notes that the hospital already had successful nurse
recruitment initiatives in place before the grant, including an internship
program and scholarships for nursing students. What hadn’t worked as well,
she notes, was retention: “In 2000, we hired 23 new graduates, and lost 10
in the first 12 months. In 2001, we hired 51 and lost 8. But in 2002, we also
hired 51, and we’ve lost just one.” In addition, she notes, North
Arundel has since kept all the remaining nurses from the 2000 and 2001 classes.
Contact:
Elaine Holman
Director, Hospital
Learning
North Arundel Hospital
Phone: 410-787-4576
E-mail:
elahol@NORTHARUNDEL.ORG
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