The HealthcareSource User ConferenceNovember 6-9, 2016JW MARRIOTT • WASHINGTON, DC

THREE REASONS YOUR TIME-TO-FILL IS NOT YOUR RECRUITER’S FAULTDeb VargovickSenior Consultant – Lean Human CapitalHealthcareSource

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ABOUT DEB VARGOVICK• A Lean, Sig Sigma certified Green Belt, Recruitment

professional.

• Began working with Lean methodology in 1994, streamlining processes for The Disney Store division and Walt Disney World Resorts merchandise division.

• Most of her career, led large, operational teams for Fortune 500 organizations such as The Walt Disney Company, The Gap, Borders Group Inc. and Best Buy.

• Most recently, led the Henry Ford Health System’s Talent Acquisition team through a centralization restructure and the introduction of a new sourcing model.

• Helped define the new organizational structure, trained 30 recruiters on new processes, and implemented a Lean program to continuously assess and eliminate waste in the recruitment process.

HEALTHCARE RECRUITMENT - 2016

AGENDA

• Investing in Outbound Sourcing •Pragmatic solutions to ensure your hiring managers are part of solution

•Position Value Proposition

FOUNDATION OF OUR RESEARCH / INTELLIGENCE

Lean Human Capital Healthcare Community |

Recruitment Metrics Benchmark Study

650+ hospitals have participated in our Recruitment Metrics Benchmark Study over the last 7 years.

COMMUNITY | BENCHMARK STUDY PARTICIPANTS 2010 - 2016

FOUNDATION OF OUR BENCHMARK STUDY VOICE OF THE CUSTOMER

What do Hiring Manager and key stakeholders expect from

you?

FOUNDATION OF OUR BENCHMARK STUDY VOICE OF THE CUSTOMER

What do Hiring Manager and key stakeholders expect from

you?

CRITICAL VOC PERFORMANCE DIMENSIONS CAN’T MANAGE WHAT YOU DON’T MEASURE

VOC—“I want a cost effective recruitment solution that provides high quality candidates as quickly and efficiently as possible.”

Cost

Quality of Service Quality of Hire

Efficiency andProductivity

Responsivenessand Speed

TODAY’S LABOR MARKETHEALTHCARE RECRUITMENT LANDSCAPE

MARKET DRIVERS IMPACTING RECRUITING

Year Over Year Change (in millions)

808 1,023 Open Jobs; +26.6% growth521 508 Hires; -2.5% decline469 470 Separations; 0.0% change

THE INCREASING DEMAND FOR WORKERS

• By 2020:- 1 million new jobs in home health and

personal care aids

- 40% increase in physical therapy assistants and aids

- 400,000 LPNs and 500,000 new medical secretaries

• By 2022:- Over 1 million openings for nurses by

2022 (19% are RNs)

• Supply• AACN reported only a 2.6%

enrollment increase in entry level nursing programs

• Nursing/medical school enrollment isn’t growing fast enough to meet demand

• Almost 700,000 nurses are projected to retire by 2024

• Physician shortage is projected to reach 90,000 by 2025

TODAY’S LABOR MARKET 17+ MILLION HEALTHCARE EMPLOYEES IN THE US 1

• 14% are seriously/actively seeking a new position.

• 20% are casually looking (a few hours now and then).

• 32% are passively looking (if something comes along, I’ll take a look at it). We call them Listeners!

• 34% are not looking.

• Source—Staffing.org, Bureau of Labor

There is no Inventory!

• Virtually zero unemployment rate.

• If they are unemployed, they will quickly find employment.

• Everyone wants them - They need to be ‘recruited’

Ready to Move:

• 64% of healthcare professionals plan to look for a new job in the next year. 2

• 42% plan to look for a new job in the next three months. 2

34%NOT LOOKING!

32 % “Listeners”/Passively looking

14% Seriously/Actively looking

20% Casually Looking

INVEST IN OUTBOUND SOURCING

Business as UsualNon-Core Job Families

Hig

hLo

w

Low High

Tale

nt A

vaila

bilit

y

Hiring Volume/Priority of Role

Business as UsualCore Job Families

Critical, Difficult, VisibleNon-Core Job Families

Critical, Difficult, VisibleCore Job Families

• Facilities• Security• Clerical• Wellness

• Nutritional & Environment Services• Medical Assistants• Housekeeping• Clinical Support• Nursing Assistants

• RNs • Therapy• RN Leaders• Medical Coders

• IT/IS• Research• Corporate • Executive• Diagnostic Imaging• Pharmacy

Must invest in outbound

Sourcing

30-40%of hires

30-40%of hires

Designing your recruitment structure and strategies based on Talent Availability and Volume

Ave TTF

47 (45) days

72% (75%) < 60 Days

116 (112) days23 (24) days

28% (25%) > 60 Days

7+ hours sourcing perCandidate route to HM for

consideration

Organizations underestimate time required to outbound source and

pipeline candidates for difficult to fill positions.

3 of every 10 positions take on average 116 (Top 25% is 2 of every 10 positions take on average 113 (107)

days to fill). These positions have a significant negative impact on Cost of Vacancy, patient safety/experience, clinical outcomes and

employee engagement.

STRUCTURAL FLAW IN ORGANIZATIONAL MODELOVERALL BENCHMARK – 2016 (2015)

Zero time sourcing per candidate routed to HM for

consideration for a Business as Usual Position

© 1997 – 2016, Lean Human Capital, LLC

AGENDA

Req. Load: 2-5 Hours Sourcing/week: 25-30 # of candidates routed (per

week) to HMs – Difficult to Fill Positions: 2-6

# of candidates routed to fill a position: 3-5

Req. Load: 42-74 (Benchmark)

Hours Sourcing/week: 1-5 # of candidates routed (per

week) to HMs – Difficult to Fill positions: ???

# of candidates routed to fill a position: 3-5

Must INVEST in outsourcing like Search Firms if you want the same results!

Healthcare Recruiter Search Firm Recruitervs

COST OF VACANCY IMPACTRETURN ON INVESTMENT BY REDUCING TTF – CASE STUDY

Total Costs - CY2015GROSS COSTS

Direct Care RNs

NET COSTS Direct Care RNs (50% Premium for OT; 107% Premium

for Agency)

Overtime $26,983,445 $17,326,483 Agency $20,132,865 $10,384,922 Totals $27,711,405

INVEST in sourcing to reduce Cost of Vacancy

ALLOCATING THE RIGHT # OF RESOURCES FOR SOURCING – STAFFING OPTIMIZATION METHODOLOGY

Recruitment Process Time Study BAU CDV# of Hours for Each Category

# of Hours Needed per

Hire

# of Hours for Each Category

# of Hours Needed per

HireTime spent sourcing, pre-qualifying and routing a single candidate to the

hiring manager 1.00 5.00 8.00 40.00Time spent managing the hiring manager interview process (setting up

interview, getting feedback, etc.) for each interviewee 0.25 0.75 0.25 0.75Time spent developing/delivering offer, receiving feedback, etc. for each

offeree 0.50 0.56 1.00 1.11Time spent pre-boarding candidate (paperwork, credentialing, keeping

candidate warm, etc.) for each hire 0.25 0.25 0.25 0.25Total Recruitment Process Hours to Hire 1 Candidate 6.56 42.11

Administrative Process Time Study BAU CDV# of Hours for Each Category

# of Hours Needed per

Hire

# of Hours for Each Category

# of Hours Needed per

HireTime spent managing the hiring manager interview process (setting up

interview, getting feedback, etc.) for each interviewee 0.50 1.50 0.50 1.50Time spent pre-boarding candidate (paperwork, credentialing, keeping

candidate warm, etc.) for each hire 2.50 2.50 2.50 2.50Total Administrative Time to Hire 1 Candidate 4.00 4.00

Recruitment Resource Planning/Allocation SLA Days 365 SLA Days 365BAU CDV

# of Hires 100 100# of Sourcing/Pre Qual/Routing Hours Required 500 4,000 2.6

# of Interview/Offer/Hire Process Hours Required 156 211Total Recruitment Process Hours 656 4,211

# of FTE Recruiters Required to Meet Hiring Objectives 0.4 2.7# of Interview/Hire Process Hours Required by Admin 400 400

# of FTE Admins Personnel Required to Meet Hiring Objectives 0.3 0.3

ENSURING YOUR MANAGERS ARE PART OF THE SOLUTION

Intake Session & SLA

Compelling Value Proposition

Lean Interviewing Best Practices

BEING FISCALLY RESPONSIBLE

INVESTMENT COMPARISON BY INDUSTRY

$4,323 $4,300 $4,325$3,033

$1,065 $627

$0$1,000$2,000$3,000$4,000$5,000$6,000$7,000$8,000$9,000

$10,000

Cost Per Hire Analysis

25%

7.50%8.0% 6.7% 5.7% 6.2% 4.7%2.7% 1.5%

0%

5%

10%

15%

20%

25%

30%

Recruitment Cost Ratio

Interesting Observations: While we have not captured BWH’s Cost per Hire or Recruitment Cost Ratio, we estimate it to be Median to Low compared to

Benchmark. Compared to other industries, healthcare organization investment in recruitment is very low. Top performing organizations are investment more money in Recruitment*. When you compare internal RCR (1.9%) to cost of an RPO (5-10%) or search firm (20-30%), we believe internal recruitment teams

perform well considering the lack of capital investment.

INVESTMENT/ROI ANALYSISCost

17%

10%

55

44

0

10

20

30

40

50

60

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Bersin Level 1 -Reactive Tactical

Recruiting

Bersin Level 4 -Optimized Talent

Acquisition

Tim

e to

Fill

(in D

ays)

New

-Hire

Tur

nove

r

Cost Per Hire

$3,258

Cost Per Hire

$6,465

14%

12%

50

44

0

10

20

30

40

50

60

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

LHC - Less than 1year Transformation

Journey

LHC - 1 + YearTransformation

Journey *

Tim

e to

Fill

(in D

ays)

New

-Hire

Tur

nove

r

Cost Per Hire$606

Cost Per Hire$903

* Source: Bersin by Deloitte & Lean Human Capital

RECRUITING TOP TALENT – SIMPLE CONCEPTTALENT – SIMPLE CONCEPT Ensure Top Talent find you (or

you go find them)!

When they find you, is your message visually appealing & compelling?

When they engage, do they have a great experience and apply.

WHAT IS YOUR COMPELLING VALUE PROPOSITION?

To effectively build your compelling Value Position, you need to answer two questions:

WHAT IS YOUR COMPELLING VALUE PROPOSITION? TALENT – SIMPLE CONCEPT

Strategic Value Proposition:What makes your organization so special?

Tactical Value Proposition:Why would I want this job?

WHAT IS YOUR STRATEGIC VALUE PROPOSITION?

What makes AVERA special?

WHAT SET AVERA APART WAS OUR MISSION !WHAT MAKES AVERA SPECIAL ?

• Our mission!

• Our employees love their jobs!

• Avera is a nationally-recognized health care leader.

• Avera is home to state-of-the-art technology.

• Avera is committed to excellent patient care and service.

• Avera is committed to our communities.

• Avera is financially sound and stable.

• Avera offers cutting-edge opportunities.

• Avera offers great employee benefits.

• Avera employees appreciate our work culture.

• Avera employees can be part of something greater than themselves.

JOB POSTING (BEFORE)Nurse Practitioner -Req Num: 1407104Facility: Avera Medical Group MillerDepartment: Hand County

Schedule: Full TimeShift: Day ShiftHours: Monday-Friday, 8am-5pm; 80hrs/2weeksJob Details: JOB SUMMARY: Assumes responsibility and accountability for the provision of primary health care,

medical management and education of patients at the clinic in collaboration with a physician. Nurse Practitioners practice under the rules and regulations of the Nurse Practice Act of the state in which they work.

EDUCATION and/or EXPERIENCE:• Graduate of an NLN accredited school of nursing or equivalent; graduate of an accredited Nurse

Practitioner program required. • Master’s degree required.

CERTIFICATION, LICENSURE, and/or REGISTRATIONS:• An active CNP license is required. • Licensed as a Registered Nurse in the State of South Dakota and/or meeting the requirements of

Multi-state licensure required. • Federal and State DEA certification is required for South Dakota and Iowa employees. • Federal DEA certification only is required for Minnesota and Nebraska employees.

JOB POSTING (AFTER)Nurse Practitioner -Req Num: 1407104 Avera Medical Group MillerHand CountyFull TimeDay ShiftMonday-Friday, 8:00am-5:00pm; 80hrs/2wksIf you are a NEW Grad or experienced Nurse Practitioner interested in:

• Living in small town community.• Hunting/fishing/farming/ranching.• Serving a hard-working, down to earth community where everyone knows your name. • 24 hour access (via eCARE Services) to Avera’s visionary model specialty care “Virtual Hospital” to support the rural healthcare workforce.

This is the job for you!

Position Highlights/Responsibilities:

Avera Medical Group Miller in Miller, South Dakota goal is to help maintain the health of you and your family.

• We are seeking a full time Nurse Practitioner to join our family practice clinic and provide exceptional care for our patients. • Assumes responsibility and accountability for the provision of primary health care, medical management and education of patients in collaboration with a physician.• Communicate with patients, families, and physicians and demonstrate excellent interpersonal skills.

Requirements

• Graduate of an NLN accredited school of nursing or equivalent; graduate of an accredited Nurse Practitioners program required.• Master’s degree required.• An active CNP is required, Licensed as a Registered Nurse in the State of South Dakota and/or meeting the requirements of Multi-state licensure required.• Federal and State DEA certification is required for South Dakota.

Avera Medical Group Miller/Avera McKennan offers competitive compensation, benefits and professional growth in a caring work environment. If you have a passion and desire to enrich the lives and touch the hearts of your patients, consider joining our team in providing compassionate, high quality care and services within a caring Christian culture.

What makes Avera Special?

Questions?Presenter Contact Information for Additional Questions:

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THANK YOU!

Deb VargovickSenior Consultant – Lean Human Capital

HealthcareSource(248)918-8799

deb.vargovick@healthcaresource.com